Between bubbles and enclaves discussing a new working term to interculturalism and meaning via a case study of Israeli women in Brussels

Changing one’s place of residency creates new challenges, such as how to preserve social, cultural, ethnic or national identities and how to create a comfortable living environment in the new country; creating a new ‘home.’ In this article I explore ways in which migrant women transform a new place into a space, into a new home. More specifically, this article answers the question of the mechanisms used by Israeli women who immigrated to Belgium in order to create a setting wherein they feel a sense of comfort and belonging. I call this mechanism ‘social bubbles’, a term taken from Cohen (1992) in his work about types of tourists. Cohen named it ‘environmental bubbles’. My aim is to develop the use of the term for general migration. Looking at a religious group is often discussed in terms of ‘enclaves’ (Sivan, 1991; Valins, 2003). Enclaves are social forms where people live completely within the boundaries of the group. Individuals are not obliged to remain in the community (in the enclaves) but there is social pressure to do so. I compare the term ‘enclave’ with ‘social bubble’ and explain that the use of the term is more flexible, dynamic and leads to a new perspective on the whole phenomenon of integration of social groups: religious, ethnic, national and for different migration purposes; asylum seekers, expatriates, refugees and others. Although the concept of bubbles could describe social groups, such as Jewish people in Brussels, Belgium, this article focuses mainly on Israelis who immigrated to Brussels.peer-reviewe

Cardiopulmonary resuscitation in adults over 80 : outcome and the perception of appropriateness by clinicians

OBJECTIVES: To determine the prevalence of clinician perception of inappropriate cardiopulmonary resuscitation (CPR) regarding the last out‐of‐hospital cardiac arrest (OHCA) encountered in an adult 80 years or older and its relationship to patient outcome. DESIGN: Subanalysis of an international multicenter cross‐sectional survey (REAPPROPRIATE). SETTING: Out‐of‐hospital CPR attempts registered in Europe, Israel, Japan, and the United States in adults 80 years or older. PARTICIPANTS: A total of 611 clinicians of whom 176 (28.8%) were doctors, 123 (20.1%) were nurses, and 312 (51.1%) were emergency medical technicians/paramedics. RESULTS AND MEASUREMENTS: The last CPR attempt among patients 80 years or older was perceived as appropriate by 320 (52.4%) of the clinicians; 178 (29.1%) were uncertain about the appropriateness, and 113 (18.5%) perceived the CPR attempt as inappropriate. The survival to hospital discharge for the “appropriate” subgroup was 8 of 265 (3.0%), 1 of 164 (.6%) in the “uncertain” subgroup, and 2 of 107 (1.9%) in the “inappropriate” subgroup (P = .23); 503 of 564 (89.2%) CPR attempts involved non‐shockable rhythms. CPR attempts in nursing homes accounted for 124 of 590 (21.0%) of the patients and were perceived as appropriate by 44 (35.5%) of the clinicians; 45 (36.3%) were uncertain about the appropriateness; and 35 (28.2%) perceived the CPR attempt as inappropriate. The survival to hospital discharge for the nursing home patients was 0 of 107 (0%); 104 of 111 (93.7%) CPR attempts involved non‐shockable rhythms. Overall, 36 of 543 (6.6%) CPR attempts were undertaken despite a known written do not attempt resuscitation decision; 14 of 36 (38.9%) clinicians considered this appropriate, 9 of 36 (25.0%) were uncertain about its appropriateness, and 13 of 36 (36.1%) considered this inappropriate. CONCLUSION: Our findings show that despite generally poor outcomes for older patients undergoing CPR, many emergency clinicians do not consider these attempts at resuscitation to be inappropriate. A professional and societal debate is urgently needed to ensure that first we do not harm older patients by futile CPR attempts. J Am Geriatr Soc 68:39–45, 201