Suchergebnisse

BACKGROUND: As life expectancies continue to rise, modifiable lifestyle factors that may prevent cognitive decline and dementia in later life become increasingly important in order to maintain quality of life in old age. METHODS: Five meta-analyses were conducted on data from papers identified in a systematic review. Studies were grouped according to outcomes (dementia, cognitive impairment including amnestic Mild Cognitive Impairment (aMCI), Mild Cognitive Impairment (MCI), and cognitive decline) and output (risk (RR), odds (OR), or hazard ratios (HR)). RESULTS: Nineteen studies met our inclusion criteria and quality assessments. Four of five meta-analyses showed significant associations between participation in cognitive leisure activities and reduced risk of cognitive impairment (OR = 0.69, 95% CI: 0.56-0.85) and dementia (HR = 0.58, 95% CI: 0.46-0.74; RR = 0.61, 95% CI: 0.42-0.90; OR = 0.78, 95% CI: 0.67-0.90). However, one pooled analysis of cognitive impairment studies did not reach significance (HR = 0.85, 95% CI: 0.71-1.02). Mentally stimulating leisure activities were significantly associated with later life cognition (β = 0.11, p = 0.05), better memory (β = 0.20, 95% CI: 0.11-0.29), speed of processing (β = 0.37, 95% CI: 0.29-0.45), and executive functioning (β = 0.23, 95% CI: 0.15-0.29), and less decline in overall cognition (β = -0.23, p < 0.01), language (β = -0.11, p < 0.05), and executive functioning (β = -0.13, p < 0.05). Activities were also shown to reduce rate of cognitive decline (estimate = 0.03, SE = 0.01, p = 0.00). CONCLUSIONS: There is increasing evidence that participation in cognitively stimulating leisure activities may contribute to a reduction of risk of dementia and cognitive impairment in later life. Promoting involvement in such activities across lifespan could be an important focus for primary prevention strategies for governments and health services.

IntroductionIt is unclear whether using peers can improve adherence to antiretroviral therapy (ART). To construct the World Health Organization's global guidance on adherence interventions, we conducted a systematic review and network meta‐analysis to determine the effectiveness of using peers for achieving adequate adherence and viral suppression.MethodsWe searched for randomized clinical trials of peer‐based interventions to promote adherence to ART in HIV populations. We searched six electronic databases from inception to July 2015 and major conference abstracts within the last three years. We examined the outcomes of adherence and viral suppression among trials done worldwide and those specific to low‐ and middle‐income countries (LMIC) using pairwise and network meta‐analyses.Results and discussionTwenty‐two trials met the inclusion criteria. We found similar results between pairwise and network meta‐analyses, and between the global and LMIC settings. Peer supporter+Telephone was superior in improving adherence than standard‐of‐care in both the global network (odds‐ratio [OR]=4.79, 95% credible intervals [CrI]: 1.02, 23.57) and the LMIC settings (OR=4.83, 95% CrI: 1.88, 13.55). Peer support alone, however, did not lead to improvement in ART adherence in both settings. For viral suppression, we found no difference of effects among interventions due to limited trials.ConclusionsOur analysis showed that peer support leads to modest improvement in adherence. These modest effects may be due to the fact that in many settings, particularly in LMICs, programmes already include peer supporters, adherence clubs and family disclosures for treatment support. Rather than introducing new interventions, a focus on improving the quality in the delivery of existing services may be a more practical and effective way to improve adherence to ART.

Interdisciplinary teams provide an unparalleled opportunity for peacemaking in families within the consensual dispute resolution continuum. This interdisciplinary environment was born out of the integration of Collaborative Law, in which lawyers limit the scope of their services to settlement by way of a signed agreement, and Collaborative Divorce, a team approach to divorce services that includes a lawyer for each party along with a Collaborative Divorce Coach for each party, a neutral financial specialist, and a neutral child specialist. Taken together, Interdisciplinary Collaborative Practice supports the resolution of legal issues out of court as well as addressing any emotional, relational, or behavioral problems that create obstacles to the successful resolution of the separation process.

Key Points for the Family Court Community:
Collaborative Practice creates legal representation in a consensual environment limiting services to settlement negotiations by way of a written agreement.
The International Academy of Collaborative Professionals includes 5,000 members in twenty‐five countries.
Legal representation in a consensual environment together with interdisciplinary teams create endless possibilities for dispute resolution processes.
Collaborative Lawyers, Collaborative Divorce Coaches, child specialists, and financial specialists can create custom‐fit interdisciplinary teams that work together out of court to support families through marital transition.
Interdisciplinary teams are family centric, bridging appropriate disciplines and resources to the needs of the family to address the vast majority of divorce‐related problems.
Divorcing families are moving targets, learning and evolving through the process.
Therapeutic teams support families with more complex relational, emotional, and mental health problems to find resolutions out of court.
Divorce is a mainstream event in Western culture; we need supportive processes to encourage the best possible outcomes for all family members, especially the children.

Purpose
– More journalists died in Syria during 2013 than in any other country experiencing conflict. This statistic raises concerns about the psychological wellbeing of journalists covering the internecine violence. The paper aims to discuss this issue.


Design/methodology/approach
– The study sample was made up of 59 western journalists currently covering the Syrian conflict. To place these results in the broader context of war journalism previously collected data from a group of 84 journalists who had reported the war in Iraq were used as a control sample. Outcome measures included indices of posttraumatic stress disorder (PTSD) (Impact of Event Scale-revised) and psychological distress (General Health Questionnaire-28 item version (GHQ-28)).


Findings
– Compared to journalists who covered the Iraq war, the journalists working in Syria were more likely to be female (p=0.007), single (p=0.018), freelance (p=0.0001) and had worked fewer years as a journalist (p=0.012). They were more depressed according to the GHQ-28 (p=0.001) and endorsed more individual symptoms of depression including worthlessness (p=0.012), helplessness (p=0.02) and suicidal intent (p=0.003). A linear regression analysis revealed that the group differences in depression data could not be accounted for by demographic factors.


Research limitations/implications
– An absence of structured interviews. Results not applicable to local Syrian journalists.


Practical implications
– Western journalists covering Syrian appear to be particularly vulnerable to the development of depression. Journalists and the news organizations that employ them need to be cognizant of data such as these. Given that depression is treatable, there needs to be a mechanism in place to detect and treat those in need.


Originality/value
– This is the first study that highlights the emotional toll on western journalists covering the Syrian conflict.

UA Open Access Publishing Fund ; Rapid molecular testing methods are poised to replace many of the conventional, culturebased tests currently used in fields such as water quality and food science. Rapid qPCR methods have the benefit of being faster than conventional methods and provide a means to more accurately protect public health. However, many scientists and technicians in water and food quality microbiology laboratories have limited experience using these molecular tests. To ensure that practitioners can use and implement qPCR techniques successfully, we developed a week long workshop to provide hands-on training and exposure to rapid molecular methods for water quality management. This workshop trained academic professors, government employees, private industry representatives, and graduate students in rapid qPCR methods for monitoring recreational water quality. Attendees were immersed in these new methods with hands-on laboratory sessions, lectures, and one-on-one training. Upon completion, the attendees gained sufficient knowledge and practice to teach and share these new molecular techniques with colleagues at their respective laboratories. Key findings from this workshop demonstrated: 1) participants with no prior experience could be effectively trained to conduct highly repeatable qPCR analysis in one week; 2) participants with different desirable outcomes required exposure to a range of different platforms and sample processing approaches; and 3) the collaborative interaction amongst newly trained practitioners, workshop leaders, and members of the water quality community helped foster a cohesive cohort of individuals which can advocate powerful cohort for proper implementation of molecular methods. ; This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.

Objetivo. Construir, desde los rasgos arqueológicos de una unidad doméstica, la vida cotidiana social y política de un colectivo humano que habitó las planicies noroccidentales de Yucatán entre 550/600 y 750/800 d. C. Metodología. Para lograr este objetivo relacionaremos información proveniente del análisis cerámico, lítico, arquitectónico y osteológico. Resultados. A través del exhaustivo análisis de un contexto habitacional en el sitio periférico Cholul, al norte de la ciudad de Mérida, se plantean discusiones y resultados sobre distintos temas referentes al grupo doméstico que vivió allí tales como la salud y la enfermedad, la estructura política y social del grupo, las relaciones de género y parentesco. Conclusión. Es un hecho que el grupo humano que se desarrolló durante la segunda mitad del período Clásico al norte de la actual ciudad de Mérida alcanzó cierto grado de prosperidad material. ; Objective. To build, from the archaeological characteristics of a domestic unit, social and political everyday life of a human group that inhabited the northwestern plains of Yucatan between 550/600 and 750/800 A. D. Methodology. To achieve this objective, information from the ceramic, lithic, architectural and osteological analysis was related. Results. Through the comprehensive analysis of a housing context in the peripheral site of Cholul, North of the city of Merida, discussions and outcomes on various topics relating to the domestic group who lived there, such as health and disease issues, the political and social structure of the group, gender relations and kinship, were considered. Conclusion. It is a fact that the human group that developed during the second half of the Classic period North of the present city of Merida reached a degree of material prosperity.

Dentro de las políticas sanitarias actuales, los indicadores duros de natalidad y mortalidad adquieren enorme influencia. En ese escenario macro, la asistencia de niños nacidos prematuros que requieren intervenciones cada vez más complejas, es un punto emergente. A la luz de nuevas estrateégias integrales para abordar la atención de mujeres embarazadas y sus hijos, como el modelo Maternidades Seguras y Centradas en la Familia, adquiere relevancia un dispositivo institucional conocido como Residencia Hospitalaria de Madres. A partir del trabajo de campo en una maternidad pública de la Ciudad Autónoma de Buenos Aires, se analizan los modos en que las mujeres usuarias se apropian de ese espacio y sus relaciones con demás actores institucionales. Se explora en las representaciones de cuidado y la construcción de experiencias de maternidad, que se desenvuelven en escenarios tecnologizados, atravesados por el discurso de la Biomedicina. Inside the current sanitary politics, the hard outcomes of birth rate and mortality acquire enormous influence. In this macro scenaryscenario, the assistance of premature bornchildren, who need more and more complex interventions, is an emergent point. In Argentina, there is recent health strategy to give interdisciplinary attention, based in human rights perspective, to pregnant women and her babies, which is called Safe and Family Centered Care Maternity Hospital. This model proposes an institucional device known as Hospital Residence for Mothers, inside the Materintiy Hospital. The field work took place in a big public Maternity Hospital of Buenos Aires City. It analizes the different ways that women users appropiate this space an her relations with other institutcional actors. It explores the representations of care giving and the construction of maternity experience for these mothers, inside of very technological medical stages, crossed by the speech of the Biomedicine.

Since 2009 the Professional Practice Committee of the Physical and Rehabilitation Medicine (PRM) Section of the European Union (EU) of Medical Specialists (UEMS) is producing Position Papers (PPs) on the role of PRM physicians for patients with different health conditions or related topics of PRM Interest. These PPs represent the Official Position of the EU in the specific field. Until now, 16 papers have been produced, recently collected in an e-book (http://issuu.com/parisstylianides/docs/section_of_physical_and_rehabilitat/0). To proceed with the future PPs, the UEMS PRM Section defines with this paper the methodological approach to a PP, so to have a common and validated scientific structure. The final aim is to increase the quality, representativeness and visibility of this production for the benefit of all PRM specialists in (and out) of Europe. The Position Papers must be Evidence Based (EBPP). Therefore it comprises a systematic review as well as a Consensus procedure among the EU Countries delegates. All the sections of an EBPP are presented in details (Title, Authors, Abstract, Introduction, Material and Methods, Results, Discussion, Conclusion). The systematic review must focus on Cochrane reviews, Randomised Controlled Trials and Guidelines of PRM professional practice interest. The Consensus on the recommendations must be reached through a Delphi procedure, usually in four major rounds (each round can have repeated voting). The EBPP must produce Final Recommendations for Physical and Rehabilitation Medicine Professional Practice in Europe. The following overall structure for recommendations is suggested: one overall general recommendation on PRM professional practice; PRM physicians' role in Medical Diagnosis - ICD; PRM diagnosis and assessment according to ICF; PRM process (Project definition, Team, PRM interventions, Outcome criteria, Length and continuity of treatment); future research on PRM professional practice.

Gabriel M Fonseca,1 Esther Mora,2 Joaquin Lucena,3 Mario Cantin,4 1Faculty of Dentistry, Laboratory of Forensic Dentistry, University of La Frontera, Temuco, Chile; 2Dental Sinai Hospital & Research Center, 3Forensic Pathology Service, Institute of Legal Medicine, Seville, Spain; 4Faculty of Dentistry, Doctoral Program in Morphological Science, Universidad La Frontera, Temuco, Chile Abstract: The interaction between domestic animals and humans has not been free of conflicts, and dog attacks represent a real problem, not only for the health consequences, but also for the possible criminal, and can affect the legal or financial outcomes. Dogs' teeth have particular features, and the resulting bite marks are a major point of forensic interest mainly in the absence of witnesses or in cases where postmortem dog interference can be misinterpreted. An appropriate forensic approach should include an exhaustive analysis of the scene, the victim, and the dog. Bite marks must be discriminated from other traumas, and the familiarity of the investigator with different patterns of animal behavior can be of great importance in the correct assessment of the offending specie. A scientific inclusion/exclusion of the dog involved is possible and also recommended because of the possible consequences for the owner of the animal. Since dog bite mark analysis should involve different forensic professionals such as pathologists, odontologists, veterinarians, biologists, and also police investigators, a review focused on this type of evidence from a multidisciplinary point of view is presented. Prevention and mitigating strategies focused on both breed-specific legislation and the legal responsibility of the owner for the dog's behavior are discussed. Keywords: fatal dog attack, scavenging, bite mark, dog behavior, forensic pathology, forensic dentistry

Purpose - More journalists died in Syria during 2013 than in any other country experiencing conflict. This statistic raises concerns about the psychological wellbeing of journalists covering the internecine violence. The paper aims to discuss this issue. Design/methodology/approach - The study sample was made up of 59 western journalists currently covering the Syrian conflict. To place these results in the broader context of war journalism previously collected data from a group of 84 journalists who had reported the war in Iraq were used as a control sample. Outcome measures included indices of posttraumatic stress disorder (PTSD) (Impact of Event Scale-revised) and psychological distress (General Health Questionnaire-28 item version (GHQ-28)). Findings - Compared to journalists who covered the Iraq war, the journalists working in Syria were more likely to be female ( p =0.007), single ( p =0.018), freelance ( p =0.0001) and had worked fewer years as a journalist ( p =0.012). They were more depressed according to the GHQ-28 ( p =0.001) and endorsed more individual symptoms of depression including worthlessness ( p =0.012), helplessness ( p =0.02) and suicidal intent ( p =0.003). A linear regression analysis revealed that the group differences in depression data could not be accounted for by demographic factors. Research limitations/implications - An absence of structured interviews. Results not applicable to local Syrian journalists. Practical implications - Western journalists covering Syrian appear to be particularly vulnerable to the development of depression. Journalists and the news organizations that employ them need to be cognizant of data such as these. Given that depression is treatable, there needs to be a mechanism in place to detect and treat those in need. Originality/value - This is the first study that highlights the emotional toll on western journalists covering the Syrian conflict. Adapted from the source document.

Purpose
– Cognitive self-rehabilitation lacks updated means and tools. The purpose of this paper is to evaluate the effect of cognitively simulating mobile games on the cognitive skills and recreation of older people with memory impairment.


Design/methodology/approach
– Mobile games that require cognitive skills were developed. The games were tested by memory-impaired older adults, average age of 90. Gaming interventions took place for three months on a daily basis. Game outcomes were automatically recorded and user feedback was collected by interviews. The progress of the testees was also evaluated by means of Trial Making Test A.


Findings
– Improvement in game scores was found. Other significant effects of game play were enhanced recreation and self-managed activity level. Game play did not have any effect on the traditional Trail Making Test results but the results of the Trail Making game showed improvement. The Trail Making game also showed a large variance in daily scores, which implies that performing just a single Trail Making Test might lead to misreading a person's condition.


Research limitations/implications
– The results are an encouragement for conducting further testing (on a larger test group, over a longer time) and continuing with game development for cognitively impaired older adults. A similar game trial will also be arranged for a younger population with better overall health condition.


Practical implications
– New business opportunities are also possible in game development and gaming services.


Social implications
– Games have the potential for self-rehabilitation and to support extending independent living at home.


Originality/value
– The paper provides a synopsis of novel cognitive recreation tools, an analysis of their effect and user feedback from professional staff as well as potential new ideas for game developers.

Conference Theme: promoting social and economic equality ; E-Poster ; Online education is a new trend in higher education, which has significant implications for social work education within the global context. The ease of access to the Internet internationally and the development of web-management systems, such as, Blackboard, are creating easy access for faculty and students to interact in an online learning environment. A course titled, International Social Work, was taught using an online global classroom with students residing in their home countries of the USA, Hong Kong, South Africa, Mexico and Australia. The course was designed to introduce students to international social work and the theories and perspectives that underpin current thinking and practice in international social work. Students explored how historical, environmental, cultural, religious, political and economic factors impact social welfare policies and the delivery of human services in different regions of the world. Students engaged in critical thinking and analysis of global social welfare issues including poverty, child welfare, health, issues particular to women and the results of catastrophic events including conflict and natural disaster. Students and faculty participated weekly in blogs, a course "coffee shop", discussion boards, live online class lectures, and critical thinking exercises. Qualitative data was collected from the weekly blogs and discussion boards. Analysis of the data revealed that the online global course had a positive impact on the students' views toward international social work, an increase in their desire to address international issues in their professional goals, and an increase in networking with each other across countries. The use of technology presents both challenges and opportunities for global social work education and teaching across borders. The authors will discuss the logistical challenges as well as the outcomes of this international teaching collaboration. ; published_or_final_version

This special issue of Environmental Science and Policy presents the outcomes of the WETwin project (enhancing the role of wetlands in integrated water resources management for twinned river basins in EU, Africa and South-America in support of EU Water Initiatives), an international research project funded by the FP7 programme of the European Commission. The project aimed to improve wetland management by maximising benefits from wetland use while maintaining ecological health, using case studies from Europe, Africa and South America. In much of the less developed world, data on wetland functions, processes and values are scarce even while wetlands often provide a critical component of livelihoods. Management decisions on balancing competing demands for wetland use must often be made in the absence of comprehensive information. This paper introduces the approach developed and tested under WETwin to evaluate wetland management structures and solutions in datapoor contexts, summarising a conceptual framework which has evolved from seven very diverse case studies. A structured, modular approach was devised which combined multi-criteria analysis, trade-off analysis and vulnerability analysis, drawing on best available information, including quantitative modelling, qualitative ''expert opinion'', and local stakeholders' knowledge and values. The approach used in WETwin has three important strengths: it involves stakeholders at all stages of the decision process, it combines qualitative and quantitative data (and therefore allows inclusion of poorly known and potentially important system components) and finally, it provides a relatively simple and structured approach to evaluate wetland management interventions and integrate impact, feasibility and institutional assessments, vulnerability analysis and trade-off analysis. The overall conceptual framework developed for WETwin was found to be robust and transfer-able to different contexts.

IntroductionThe provision of voluntary medical male circumcision (VMMC) services was piloted in three public sector facilities in a high HIV disease burden, low circumcision rate province in South Africa to inform policy and operational guidance for scale‐up of the service for HIV prevention. We report on adverse events (AEs) experienced by clients following the circumcision procedure.MethodsProspective recruitment of HIV‐negative males aged 12 and older volunteering to be circumcised at three select public health facilities in KwaZulu‐Natal between November 2010 and May 2011. Volunteers underwent standardized medical screening including a physical assessment prior to the surgical procedure being performed. AEs were monitored at three time intervals over a 21‐day period post‐operatively to determine safety outcomes in this pilot demonstration programme.ResultsA total of 602 volunteers participated in this study. The median age of the volunteers was 22 years (range 12–56). Most participants (75.6%) returned for the 48‐hour post‐operative visit; 51.0% for day seven visit and 26.1% for the 21st day visit. Participants aged 20–24 were most likely to return. The AE rate was 0.2% intra‐operatively. The frequency of moderate AEs was 0.7, 0.3 and 0.6% at 2‐, 7‐ and 21‐day visits, respectively. The frequency of severe AEs was 0.4, 0.3 and 0.6% at 2‐, 7‐ and 21‐day visits, respectively. Swelling and wound infection were the most common AEs with mean appearance duration of seven days. Clients aged between 35 and 56 years presented with most AEs (3.0%).ConclusionsVMMC can be delivered safely at resource‐limited settings. The intensive three‐visit post‐operative review practice may be unfeasible due to high attrition rates over time, particularly amongst older men.

Purpose– The purpose of this paper is to discuss the experience of carrying out an ethnographic research in the real world with six different participant groups from different backgrounds and embodying different expertise in traditional medicine. The paper will discuss why some approaches do not go well with some key informant groups and will demonstrate a suitable method that function better with those groups. The paper also argues that there is unpredictability of doing research in the real world, and this is crucial knowledge for novice researchers, and researchers who wish to embark on their research in different communities.Design/methodology/approach– Ethnography comprising of in-depth interviews, participant observation, focus group and unobtrusive methods.Findings– Listening to traditional healers' explanation of their roles, patients' perspectives of their treatments and the views of other participant groups will help us to understand the role of traditional healers, how effective their treatment is, and the possibilities for, and barriers to co-operation with the modern health care system. Ethnographic approach addresses deep understanding about cultural phenomena and issues in the real world because it captures everyday life and practices among local people.Practical implications– The principle of ethnography requires a researcher being in the field and living with the local people for a long period of time. This provides the researcher with the opportunity to learn and experience a new world on his/her own.Originality/value– Although the process of carrying out an ethnographic study is unpredictable, the methodological approach the paper employs in this study has resulted in valuable outcomes to a novice ethnographer. The paper would suggest to other novice ethnographers that this methodology is a very worthwhile approach in terms of exploring, learning and understanding the new world.