Pastoral Regression in Hemingway and Faulkner

Close reading of the landscape imagery of “Big Two-Hearted River,” asserting that Nick Adams’s interactions with rural Michigan reveal Hemingway’s attempt to reconcile the world of autonomous women with a docile feminine landscape. Goes on to argue that Hemingway’s male characters’ efforts to control and dominate nature reflect a deep-seated preference for traditional masculine values, which is ultimately detrimental to both characters and the author himself

Cardiac Implantable Electronic Device Infections; Long-Term Outcome after Extraction and Antibiotic Treatment

Background: The aim of the study was to examine the treatment outcome for patients with cardiovascular implantable electronic device (CIED) infections after extraction. Methods: Patients who underwent CIED extractions due to an infection at Karolinska University Hospital 2006–2015 were analyzed. Results: In total, 165 patients were reviewed, 104 (63%) with pocket infection and 61 (37%) with systemic infection. Of the patients with systemic infection, 34 and 25 patients fulfilled the criteria for definite and possible endocarditis, respectively. Complications after extraction occurred only in one patient. Reimplantation was made after a mean of 9.5 days and performed in 81% of those with pocket infection and 44.3% in systemic infection. Infection with the new device occurred in 4.6%. The mean length of hospital stay for patients with pocket infection was 5.7 days, compared to 38.6 days in systemic infection. One-year mortality was 7.7% and 22.2% in pocket infection and systemic infection, respectively. Patients with Staphylococcus aureus infection had a higher mortality. Conclusions: In this study, the majority of the patients had a pocket CIED infection, with a short hospital stay. Patients with a systemic infection, and S. aureus etiology, had a prolonged hospital stay and a higher mortality

The role of the Swedish municipalities in the transition towards sustainable energy systems

Climate change is affecting the planet on a global level and it is of vital importance that actors in the energy system work together to achieve political goals, such as the United Nations' goal which states that the global temperature increase should be kept far below 2 °C. There is a need of actions and collaboration throughout the society. The aim of this paper is to make visible the role of Swedish municipalities in the transition towards sustainable energy systems. The paper presents a study of some ongoing activities and collaborations for increased sustainability where municipalities play a clear role. The study focuses on three areas; (1) municipalities´ activities towards citizens and business community, (2) municipalities’ activities linked to collaboration with other actors, and (3) challenges related to these activities. The study is based on information from a literature search and interviews. Representatives from eight Swedish municipalities have been interviewed. The result shows that the municipalities are involved in various activities and collaborations. This is done via networks, projects, consulting, information dissemination, showing good examples, tryout activities and nudging. Some important challenges have been found. One of them is the transport sector and how to reduce the dependence on fossil fuels. Another is to consider that the Swedish energy system is spread over a large geographical area with different opportunities and limitations concerning electricity production and the sizes of the municipalities. Energy system measures and policy programs need to consider these differences to minimize the risk for sub-optimal energy-system measures. A third challenge is the lack of time and resources within the municipalities to engage enough in energy and climate issues.This is an open access article under the CC BY License (http://creativecommons.org/licenses/BY/4.0/)</p

Is melancholia a distinct syndrome? : Recurrence, chronicity, and severity give evidence in the 50 year follow-up of the Lundby Study

INTRODUCTION: Whether melancholia is a distinct syndrome has long been debated. One aspect of a valid syndrome is whether it allows for determination of a prognosis. The aim of this study is to investigate the course of melancholic depression versus non-melancholic depression with a focus on: (i) time to and probability of recovery from the first depressive episode, (ii) time to and risk of the first recurrence, (iii) rate of recurrence, (iv) time with depression or antidepressant medication, and (v) suicide risk.METHODS: The Lundby Study is a longitudinal community study on mental health that followed a geographically defined population ( N = 3,563) for up to 50 years, 1947-1997. Subjects with first onset depression were assessed as melancholic ( N = 46) or non-melancholic ( N = 381) using the DSM-IV melancholic specifier. These diagnoses were made in retrospect using all available information from semi-structured interviews by psychiatrists, key informants, registers, and patient records. RESULTS: We found no significant difference between melancholic- and non-melancholic depression in time to and probability of recovery from the first depressive episode. The time to first recurrence was shorter in melancholic than in non-melancholic depression and the risk of first recurrence for the melancholic group was 2.77 (95% confidence interval [CI] 1.83-4.20) times the risk in the non-melancholic group. The median rate of recurrence was higher in the melancholic group, at 0.19 recurrences per year at risk (interquartile range [IQR] 0.08-0.47), compared to the non-melancholic group, at 0.10 recurrences per year at risk (IQR 0.05-0.21) ( p < 0.03). The median percentage of time being depressed or on antidepressant medication was higher in the melancholic group, 17% (IQR 3-20%), compared to the non-melancholic group, 8% (IQR 7-33%) ( p < 0.001). The risk of suicide was higher in the melancholic group, hazard ratio 4.13 (95% CI 1.49-11.48, p < 0.01). DISCUSSION: To conclude, melancholic depression had a more recurrent, chronic, and severe course with a higher suicide risk than did non-melancholic depression in the Lundby population. Although our use of retrospective diagnosis might limit interpretation of results, the findings indicate that melancholia may be useful in determining prognosis and may be a valid psychopathological syndrome

Contribution of Enterobacteriaceae to Sensory Characteristics in Soft Cheeses Made from Raw Milk

Microbiological and sensory methods were used to analyze 22 soft cheeses, of which 19 were made from raw milk, one was made from both raw and pasteurized milk and two were made from pasteurized milk. Moderate correlations (r-value 0.5–0.6 and p-value &lt;0.01–0.05) were found between the levels of Enterobacteriaceae 37°C and the intensity of the sensory characteristics “bitter”, “metallic”, “pungent”, “manure” and “ammonia”. The present study indicates that it is possible to predict high levels of Enterobacteriaceae in soft cheeses made from raw milk using only the human senses (odor and taste)