Ranked motives of long-term care providing family caregivers

Contains fulltext : 73019.pdf (publisher's version ) (Closed access)Family caregivers provide long-term care to their chronically ill loved ones and as a consequence they experience physical, relational and financial problems. This study investigates how long-term family caregivers rank 12 motives for caregiving. Motives are derived from the views of four philosophical anthropologists and are related to self-reported stress and joy and to several different background characteristics of respondents. Motives that focus on feelings concerning the relationship between caregiver and care recipient are more popular as a first choice than motives stemming from feelings of obligation or a general feeling of happiness and are also more popular than more self-directed motives. An analysis of full ranking data shows that two groups can be distinguished, one group of family caregivers with mixed motives and one group of family caregivers with motives that focus on reciprocal mutually equal relationships. The latter are mainly women taking care for a partner or a child, the former report high levels of stress. Implications for intervention programmes and health policy are being discussed

Management of hyperglycaemia of type 2 diabetes. Paradigm change according to the ADA-EASD consensus report 2018

peer reviewedThe strategy for the management of hyperglycaemia in type 2 diabetes was updated in October 2018 by a group of experts of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). They are triggered by the results of cardiovascular outcome trials published since 2015, which demonstrated a cardiovascular (and renal) protection with two classes of medications, SGLT2 inhibitors (gliflozins) and some GLP-1 receptor agonists (mainly liraglutide) in patients with established cardiovascular disease. Thus, after failure of lifestyle and metformin, the addition of one of these agents is recommended in presence of atherosclerotic cardiovascular disease. In case of heart failure or renal disease, the preference is given to a SGLT2 inhibitor, provided that estimated glomerular filtration rate is adequate (superior to 45-60 ml/min/1.73 m(2)). In all other patients, the choice is guided by the main objective, in concertation with the patient : to reduce the risk of hypoglycaemia (gliptin, gliflozin, pioglitazone or GLP1 receptor agonist), body weight excess (SGLT2 inhibitor or GLP-1 receptor) or medication cost (sulphonylurea, pioglitazone). If oral treatment is insufficient, the preference is now given to a GLP-1 receptor agonist rather than basal insulin. Thus, instead of a glucocentric and metabolic viewpoint predominant in the previous position statement, a paradigm change is proposed, focusing on cardiovascular and renal protection, within a patient-centred approach

Exposition d'étains suisses de types anciens: mai-juin 1919 : Musée des arts décoratifs de Genève

The phytoplankton genus Phaeocystis has well-documented, spatially and temporally extensive blooms of gelatinous colonies; these are associated with release of copious amounts of dimethyl sulphide (an important climate-cooling aerosol) and alterations of material flows among trophic levels and export from the upper ocean. A potentially salient property of the importance of Phaeocystis in the marine ecosystem is its physiological capability to transform between solitary cell and gelatinous colonial life cycle stages, a process that changes organism biovolume by 6-9 orders of magnitude, and which appears to be activated or stimulated under certain circumstances by chemical communication. Both life-cycle stages can exhibit rapid, phased ultradian growth. The colony skin apparently confers protection against, or at least reduces losses to, smaller zooplankton grazers and perhaps viruses. There are indications that Phaeocystis utilizes chemistry and/or changes in size as defenses against predation, and its ability to create refuges from biological attack is known to stabilize predator-prey dynamics in model systems. Thus the life cycle form in which it occurs, and particularly associated interactions with viruses, determines whether Phaeocystis production flows through the traditional great fisheries food chain, the more regenerative microbial food web, or is exported from the mixed layer of the ocean. Despite this plethora of information regarding the physiological ecology of Phaeocystis, fundamental interactions between life history traits and system ecology are poorly understood. Research summarized here, and described in the various papers in this special issue, derives from a central question: how do physical (light, temperature, particle distributions, hydrodynamics), chemical (nutrient resources, infochemistry, allelopathy), biological (grazers, viruses, bacteria, other phytoplankton), and self-organizational mechanisms (stability, indirect effects) interact with life-cycle transformations of Phaeocystis to mediate ecosystem patterns of trophic structure, biodiversity, and biogeochemical fluxes? Ultimately the goal is to understand and thus predict why Phaeocystis occurs when and where it does, and the bio-feedbacks between this keystone species and the multitrophic level ecosystem. © 2007 Springer Science+Business Media B.V.SCOPUS: ch.binfo:eu-repo/semantics/publishe