Life after care: psychological adjustment to bereavement in family carers of people with dementia

BACKGROUND: Despite well-documented evidence of the psychological effects of caring for a relative with dementia, little is known about the bereavement experiences of family carers. The aim of this study was to explore the key psychological changes associated with carers' adjustment to bereavement and "life after care." METHODS: All carers taking part were recruited from a day care center, providing specialist services to people with dementia. We asked carers to describe the key changes associated with psychological adjustment to bereavement through semi-structured qualitative in-depth interviews. Strategies carers used to cope with and adapt to their new role were also explored. All data were thematically analysed. RESULTS: Thirty-one carers were interviewed. The most frequent emotional reactions to bereavement were feelings of loneliness, loss, void, sadness, anger, and relief. Most carers were able to adapt to their new role, and engaging in pleasant activities was the most frequent strategy used to cope with loss and "life after care." CONCLUSIONS: Feelings of loneliness and loss are amongst the key emotional reactions shaping carers' adjustment to bereavement. Most carers are able to adapt to loss; however, a minority experience increased psychological distress after the death of their loved one. A small percentage of carers continues caring for other dependants. Further research is required to identify how carers of people with dementia adapt to bereavement and how this increasing number of individuals can be best supported

A QUASI-EXPERIMENTAL PILOT STUDY OF THE EFFECTS OF A STRESS MANAGEMENT & HEALTH PROMOTION PROGRAM IN CHILDREN WITH ADHD

Objective: The purpose of the present study was to investigate the effects of a stress management and health promotion program on the primary and secondary symptoms of Attention Deficit/Hyperactivity Disorder (ADHD) as well as on other variables concerning the daily routine and lifestyle of children with ADHD. Furthermore, the effects on the levels of perceived stress and the quality of life of parents of children with ADHD were investigated.Method: The research type was quasi-experimental. Two groups were created (intervention and control group) with a total of 50 participants. Each participant in the intervention group engaged in 8 meetings over a period of two months. The intervention program included information relevant to stress and lifestyle (daily and eating habits, routine, exercise, sleep) as well as the application of cognitive behavioral therapy and stress management techniques.Results: The results are summarized as follows: significant decrease in anxiety and symptoms of ADHD, and improvement in sleep conditions, eating habits and frequency of physical exercise of the children were noted. Furthermore, a positive effect on perceived stress and quality of life of the parents of children with ADHD was observed.Conclusions: The results of the present study show that the stress management and health promotion program significantly improves both the symptoms of the disorder and the emotional state of children with ADHD, as well as their general lifestyle.  Article visualizations

Meeting of the Ecosystem Approach Correspondence Group on on Pollution Monitoring (CorMon Pollution)

In accordance with the UNEP/MAP Programme of Work adopted by COP 21 for the biennium 2020-2021, the United Nations Environment Programme/Mediterranean Action Plan-Barcelona Convention Secretariat (UNEP/MAP) and its Programme for the Assessment and Control of Marine Pollution in the Mediterranean (MED POL) organized the Meeting of the Ecosystem Approach Correspondence Group on Pollution Monitoring (CorMon on Pollution Monitoring). The Meeting was held via videoconference on 26-27 April 2021. 2. The main objectives of the Meeting were to: a) Review the Monitoring Guidelines/Protocols for IMAP Common Indicator 18, as well as the Monitoring Guidelines/Protocols for Analytical Quality Assurance and Reporting of Monitoring Data for IMAP Common Indicators 13, 14, 17, 18 and 20; b) Take stock of the state of play of inter-laboratory testing and good laboratory practice related to IMAP Ecological Objectives 5 and 9; c) Analyze the proposal for the integration and aggregation rules for IMAP Ecological Objectives 5, 9 and 10 and assessment criteria for contaminants and nutrients; d) Recommend the ways and means to strengthen implementation of IMAP Pollution Cluster towards preparation of the 2023 MED Quality Status Report

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

»Marble Artefacts of Obscure Function« and the Problem of Their Identification

Die zehn rechteckigen Marmorplatten, die aus Athen und Eleusis stammen, bilden eine eigene geschlossene Denkmälergruppe und konnten bis heute nicht gedeutet werden. Anhand einer systematischen Untersuchung auf der Basis einer detaillierten Katalogisierung legt diese Studie eine Deutung und Datierung der Marmorplatten vor. Indizien wie die Reliefdarstellungen, vor allem von Ölpressen, und Abarbeitungen weisen darauf hin, dass es sich um Abdeckplatten von θησαυροί handelt, in denen Geldbeträge verwahrt wurden, die zweifellos mit der Produktion und dem Vertrieb von Olivenöl verbunden waren. Die Platten können in den Späthellenismus und die frühe Kaiserzeit datiert werden; sie standen offenbar mit der breiten Übernahme von Elementen der römischen Wirtschaftsverwaltung in Zusammenhang, die in dieser Zeit in verschiedenen Bereichen erkennbar wird.The ten rectangular marble slabs originating from Athens and Eleusis form a distinct and self-contained group of monuments which it has not been possible to identify thus far. This study undertakes a systematic investigation based on a detailed cataloguing, and proposes an interpretation and dating of the marble slabs. The relief depictions, particularly of oil presses, and the chiselling of a margin indicate that the slabs served as covers for θησαυροί in which sums of money were kept that were undoubtedly connected with the production and sale of olive oil. The slabs can be dated to Late Hellenism and the early Imperial era; they were evidently linked to the wide-scale adoption of elements of Roman economic management which may be observed in various spheres at this time

Polyphenolic profile and antioxidant activity of five apple cultivars grown under organic and conventional agricultural practices

The polyphenols and total antioxidant activities of five apple cultivars, grown by organic and conventional agricultural methods in neighbouring farms, were determined and compared. Total polyphenols in the whole fruit and in the peel were determined by the Folin-Ciocalteu method, and the total antioxidant activity was determined by three established methods, diphenyl picrylhydrazyl (DPPH), azinobis (3-ethylbenzthiazoline-6-sulfonic acid) (ABTS) and ferric reducing/antioxidant power (FRAP). Polyphenolic content for the whole fruit was in the range of 80-196 and for the peel 165-400 (mg Gallic Acid Equivalent (GAE)/100 g fresh weight) for both types of agricultural practices. Antioxidant activities of fruit extracts were also relatively similar and well correlated to their polyphenolic content. High-performance liquid chromatography (HPLC) analysis of the most important polyphenolics (chlorogenic acid, catechin, epicatechin, procyanidin B1 and B2, cyaniding 3-galactoside, phloridzin, quercetin 3-galactoside and quercetin 3-arabinoside) also showed that concentrations do not differentiate significantly between the organic and conventional apples. Statistical significance of differences in antioxidant activities among the same cultivars was relatively small (flesh + peel or peel only) for both types of apples. These results indicate that organic apples do not present higher antioxidant or nutritional value compared with conventionally grown ones, as far as polyphenolic content and total antioxidant activities are concerned. © 2009 Institute of Food Science and Technology

Obstructive sleep apnoea syndrome promotes reversal albuminuria during sleep

Sleep apnoea syndrome (OSAS) may induce albuminuria during sleep which could reflect one of the possible pathogenetic mechanisms regarding cardiovascular risk. We studied 224 patients with newly diagnosed OSAS, free of any chronic disease, and any regular drug therapy. The levels of urine albumin/creatinine ratio (ACR) before (ACR-bsleep) and immediately after (ACR-asleep) a sleep study were determined. The same procedure was repeated during the first night on CPAP treatment (n = 121) and in 46 reevaluated patients, after 3 months, on CPAP therapy. Ambulatory blood pressure was monitored in 133 of the patients. ACR-asleep was significantly higher in patients (17.82 +/- 31.10 mg/g) compared with controls (6.54 +/- 6.53 mg/g, p < 0.001). The mean percent change in ACR levels between after and before sleep (%dACR) was increased by 8.82% +/- 61.06 in OSAS patients and reduced by 26.87% +/- 18.95 in controls (p < 0.001). During the first sleep study on CPAP, the %dACR was reduced by 21.40% +/- 24.59, in contrast to the increase observed during the initial study (10.73% +/- 69.93, p < 0.001). This beneficial effect of CPAP treatment was preserved in the reevaluated patients. The %dACR was +29.33% +/- 57.67 in nondippers (44% of the patients) and -5.57% +/- 40.81 in dippers (p < 0.001). It was negatively correlated to the percent change of systolic (rho = -0.284, p = 0.003) and diastolic (rho = -0.341, p < 0.001) blood pressure between wakefulness and sleep. Contrary to normal people, ACR is increased in OSAS patients during sleep, at least partially, related to the nondipping phenomenon observed in these patients. Following CPAP treatment, urinary albumin excretion is reduced