Fluctuations of prolonged grief disorder reactions in the daily life of bereaved people:An experience sampling study

IntroductionLoss-adaptation has been described as being characterized by ‘waves of grief’, whichmay result in a Prolonged Grief Disorder (PGD). Although this assumption about thefluctuating nature of grief is supported by theoretical work, it is not (yet) supported byempirical work. We are the first to explore to what extent PGD reactions fluctuate ineveryday life and whether fluctuations in PGD reactions are related to overall PGDlevels using experience sampling methodology (ESM).MethodsData from 38 bereaved individuals (74% women, on average 6 years post-loss, 47%lost a parent) were analyzed. For two weeks, five times per day, participants reportedon the severity of 11 PGD reactions in the past three hours (ESM-PGD). At baseline,overall PGD severity (B-PGD) in the past two weeks was assessed with telephone interviews using the Traumatic Grief Inventory–Clinician Administered. Root MeanSquare of Successive Differences (RMSSD) were calculated to reflect fluctuations inESM-PGD. Spearman correlations between RMSSD values of the 11 ESM-PGDreactions and B-PGD scores were computed.ResultsMean B-PGD scores were below the clinical cut-off. Some fluctuations in ESM-PGDreactions were found, as indicated by varying RMSSD values, but also floor effectswere detected. B-PGD levels were related to RMSSD values for ESM-PGD (ρ between.37 and .68, all p < .05; and between .36 and .63 after removal of floor effects).DiscussionWe found that (some) ESM-PGD reactions fluctuated in everyday life. This may offernew theoretical insights into loss-adaptation, which may result in optimizing PGDtreatment

To what extent does the securitisation of asylum seekers contribute to Australia’s failure to meet its relevant international human rights obligations?

BACKGROUND: Although it is well established that late-life depression is associated with both systemic low-graded inflammation and cognitive impairment, the relation between inflammation and cognition in depressed older persons is still equivocal. The objective of this study is to examine the association between plasma Neutrophil Gelatinase-Associated Lipocalin (NGAL) concentrations and cognitive functioning in late-life depression, including the potentially moderating role of sex. METHODS: A total of 369 depressed older persons (>/=60 years) from The Netherlands study of Depression in Older persons (NESDO) were included. Four cognitive domains, i.e. verbal memory, processing speed, interference control and attention were assessed with three cognitive tests (Stroop test, Wais Digit span test, and Rey's verbal learning test). Multiple linear regression analyses were applied with the four cognitive domains as dependent variables adjusted for confounders. RESULTS: The association between NGAL levels and specific cognitive domains were sex-specific. In women, higher NGAL levels were associated with impaired verbal memory and lower processing speed. In men, higher NGAL levels were associated with worse interference control. Higher NGAL levels were not associated with attention. No sex-specific associations of either high sensitivity C-reactive protein (hsCRP) or interleukin-6 (IL-6) with cognitive functioning were found. CONCLUSION: This study shows sex-specific association of NGAL with cognitive functioning in late-life depression

Individual differences in the temporal relationship between sleep and agitation:a single-subject study in nursing home residents with dementia experiencing sleep disturbance and agitation

OBJECTIVES: Previous studies on the interrelationship between sleep and agitation relied on group-aggregates and so results may not be applicable to individuals. This proof-of-concept study presents the single-subject study design with time series analysis as a method to evaluate the association between sleep and agitation in individual nursing home residents using actigraphy. METHOD: To record activity, three women and two men (aged 78-89 years) wore the MotionWatch 8© (MW8) for 9 consecutive weeks. Total sleep time and agitation were derived from the MW8 data. We performed time series analysis for each individual separately. To gain insight into the experiences with the actigraphy measurements, care staff filled out an investigator-developed questionnaire on their and participants' MW8 experiences. RESULTS: A statistically significant temporal association between sleep and agitation was present in three out of five participants. More agitation was followed by more sleep for participant 1, and by less sleep for participant 4. As for participants 3 and 4, more sleep was followed by more agitation. Two-thirds of the care staff members (16/24) were positive about the use of the MW8. Acceptability of the MW8 was mixed: two residents refused to wear the MW8 thus did not participate, one participant initially experienced the MW8 as somewhat unpleasant, while four participants seemed to experience no substantial problems. CONCLUSION: A single-subject approach with time series analysis can be a valuable tool to gain insight into the temporal relationship between sleep and agitation in individual nursing home residents with dementia experiencing sleep disturbance and agitation

Molybdate toxicity in Chinese cabbage is not the direct consequence of changes in sulphur metabolism

In polluted areas, plants may be exposed to supra-optimal levels of the micronutrient molybdenum. The physiological basis of molybdenum phytotoxicity is poorly understood. Plants take up molybdenum as molybdate, which is a structural analogue of sulphate. Therefore, it is presumed that elevated molybdate concentrations may hamper the uptake and subsequent metabolism of sulphate, which may induce sulphur deficiency. In the current research, Chinese cabbage (Brassica pekinensis) seedlings were exposed to 50, 100, 150 and 200 lM Na2MoO4 for 9 days. Leaf chlorosis and a decreased plant growth occurred at concentrations ≥100 lM. Root growth was more affected than shoot growth. At ≥100 lM Na2MoO4, the sulphate uptake rate and capacity were increased, although only when expressed on a root fresh weight basis. When expressed on a whole plant fresh weight basis, which corrects for the impact of molybdate on the shoot-to-root ratio, the sulphate uptake rate and capacity remained unaffected. Molybdate concentrations ≥100 lM altered the mineral nutrient composition of plant tissues, although the levels of sulphur metabolites (sulphate, water-soluble non-protein thiols and total sulphur) were not altered. Moreover, the levels of nitrogen metabolites (nitrate, amino acids, proteins and total nitrogen), which are generally strongly affected by sulphate deprivation, were not affected. The root water-soluble non-protein thiol content was increased, and the tissue nitrate levels decreased, only at 200 lM Na2MoO4. Evidently, molybdenum toxicity in Chinese cabbage was not due to the direct interference of molybdate with the uptake and subsequent metabolism of sulphate

Prognostic association of cardiac anxiety with new cardiac events and mortality following myocardial infarction

BACKGROUND: General anxiety and depressive symptoms following a myocardial infarction are associated with a worse cardiac prognosis. However, the contribution of specific aspects of anxiety within this context remains unclear. AIMS: To evaluate the independent prognostic association of cardiac anxiety with cardiac outcome after myocardial infarction. METHOD: We administered the Cardiac Anxiety Questionnaire (CAQ) during hospital admission (baseline, n = 193) and 4 months (n = 147/193) after discharge. CAQ subscale scores reflect fear, attention, avoidance and safety-seeking behaviour. Study end-point was a major adverse cardiac event (MACE): readmission for ischemic cardiac disease or all-cause mortality. In Cox regression analysis, we adjusted for age, cardiac disease severity and depressive symptoms. RESULTS: The CAQ sum score at baseline and at 4 months significantly predicted a MACE (HRbaseline = 1.59, 95% CI 1.04-2.43; HR4-months = 1.77, 95% CI 1.04-3.02) with a mean follow-up of 4.2 (s.d. = 2.0) years and 4.3 (s.d. = 1.7) years respectively. Analyses of subscale scores revealed that this effect was particularly driven by avoidance (HRbaseline = 1.23, 95% CI 0.99-1.53; HR4-months = 1.77, 95% CI 1.04-1.83). CONCLUSIONS: Cardiac anxiety, particularly anxiety-related avoidance of exercise, is an important prognostic factor for a MACE in patients after myocardial infarction, independent of cardiac disease severity and depressive symptoms