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Elders
Kinds of Elders Terms modified by Elders Selected AbstractsNorthumbria's southern frontier: a reviewEARLY MEDIEVAL EUROPE, Issue 4 2006Nick Higham Northumbria's southern frontier was arguably the most important political boundary inside pre-Viking England. It has, however, attracted little scholarly attention since Peter Hunter Blair's seminal article in Archaeo-logia Aeliana in 1948, which later commentators have generally followed rather uncritically. This essay reviews his arguments in the light of more recent research and casts doubt on several key aspects of his case: firstly, it contests his view that this boundary was fundamental to the naming of both southern and northern England and its kingdoms; secondly, it queries the supposition that the Roman Ridge dyke system is likely to have been a Northumbrian defensive work; thirdly, it critiques the view that the Grey Ditch, at Bradwell, formed part of the frontier; and, finally, it argues against the boundary in the west being along the River Ribble. Rather, pre-Viking Northumbria more probably included those parts of the eleventh-century West Riding of Yorkshire which lie south of the River Don, with a frontier perhaps often identical to that at Domesday, and it arguably met western Mercia not on the Ribble but on the Mersey. It was probably political developments in the tenth century, and particularly under Edward the Elder and his son Athelstan, that led to the Mercian acquisition of southern Lancashire and the development of a new ecclesiastical frontier between the sees of Lichfield and York on the Ribble, in a period that also saw the York archdiocese acquire northern Nottinghamshire. [source] Hope and Purification in the Writings of Ayi Kwei Armah and Ama Ata AidooORBIS LITERARUM, Issue 2 2010Clayton G. MacKenzie Taban Lo Liyong sees the task of the African writer as one of "reconstructing Africa from the imperial wreck of the last two thousand seasons" (Liyong 1990, 171). The erosion of the African culture by modernization and colonialism has deprived indigenous peoples of their religions, their traditions, their mores, and in some cases their languages. It is not clear, though, what form Liyong's "reconstruction" is to take. Other commentators, like the Nigerian poet Tanure Ojaide, seem more specific in demanding that the African artist should take a moral, political line in asserting that his/her active role is to "remedy a bad situation" (Ojaide 1994, 17). The object would be to purify an African way of life that has been tainted by invasive, self-gratifying, materialistic attitudes. But, again, what is that "remedy" to be? While recognition of Africa's postcolonial malaise is widespread, and its cause axiomatically and correctly assigned to the experience of colonialism, African writers have been somewhat tentative in suggesting what exactly it is that should be done. It is one thing to identify a problem, and to express it in the most forthright or damning terms, but quite another to locate and postulate the possible means for its resolution. The two Ghanaian artists whose work this paper addresses, Ayi Kwei Armah and Ama Ata Aidoo, have been all too frequently accused of the pessimistic recitation of African ills. Molly Mahood has spoken of the "almost total disillusionment" (Fraser 1980, 15) of Armah's The Beautyful Ones Are Not Yet Born; and Liyong has described the work as one of those "tearing down exercises" (Liyong 1990, 176). Adeola James has identified a "certain somberness" (James 1990, 17) and Arlene Elder a "pessimism" (Elder 1987, 117) in Aidoo's short stories; and Femi Ojo-Ade has styled the Ghana of No Sweetness Here as "hell" (Oje-Ade 1987, 174). The optimistic dimensions of their work have often gone unnoticed. Even contemporary readings that have attempted to soften the gloom of the two texts have sought in some way to qualify their observations. Tsegaye Wodajo's excellent study of five Armah novels, Hope in the Midst of Despair: A Novelist's Cures for Africa (2005), perceives The Beautyful Ones Are Not Yet Born as a literature of protest that finds a hopeful riposte in the later novels. And while Nanna Jane Opoku-Agyemang's fine 1999 essay brings a valuable comparative dimension to No Sweetness Here, her insights fail to lift the pall of despair that is customarily judged to hang over this collection of eleven stories. This paper will argue that Aidoo's No Sweetness Here and Armah's The Beautyful Ones Are Not Yet Born offer greater scope for optimism than many critics have hitherto suggested; and that both articulate a process of purification that actively opposes the dystopian settings of their respective narratives. [source] Renaissance monuments to favourite sonsRENAISSANCE STUDIES, Issue 4 2005Sarah Blake McHam This essay focuses on a previously unnoticed large group of public monuments that was erected at civic expense in fifteenth-century Italy to honour Roman literary notables like Virgil, Ovid, Livy, Pliny the Elder, Pliny the Younger, Catullus and Virtruvius. All the memorials to Roman authors were civic commissions, prominently located in the public spaces of Italian Renaissance cities, either as freestanding statues in the main square, or installed on the exterior of the town hall, or even on the cathedral. Most of the sculptures were not of high artistic quality, or by famous sculptors, or in major centres of artistic production like Florence or Venice. Some never made it past the design stage. For all these reasons, they have not been integrated into the study of Renaissance art history. Consequently, art historians have not realised that some of these parochial monuments introduce important features associated with the Renaissance revival of ancient art that are usually ascribed to later, more famous sculptures. (pp. 458,486) [source] THE TREASURE OF GUARRAZAR: TRACING THE GOLD SUPPLIES IN THE VISIGOTHIC IBERIAN PENINSULA*ARCHAEOMETRY, Issue 1 2007M. F. GUERRA The treasure of Guarrazar, found in the 19th century in Spain, is the most important illustration of the high level of Visigothic jewellery in the Iberian Peninsula. The votive crowns and crosses of this treasure are an arrangement of pierced gold in a Byzantine,Germanic style, decorated with emeralds, garnets, sapphires and other materials. In order to establish the provenance of the gold, we analysed a group of 46 minute samples from the most important pieces kept in Spain for major and trace elements. The combination of PIXE and PIGE with an external 3 MeV proton µ-beam was used to analyse the samples. Considering the gold sources cited by Pliny the Elder and the composition of contemporary Visigothic coins, we suggest the exploitation of south Iberian mines. Using the same set-up, we complemented these results with the analysis of 11 emeralds inlaid in items from the Guarrazar jewellery that is kept in France. We suggest the use of European sources unknown to the Romans for these gemstones. [source] Spanish Herod, Dutch Innocents: Bruegel's Massacres of the Innocents in Their Sixteenth-century Political ContextsART HISTORY, Issue 1 2001David Kunzle This article approaches the famous Bruegel painting by establishing possible precursors for the politicization of the Massacre of the Innocents in European drama and art. With the wars, the theme moves, suddenly popular, from Italy to the north. I argue that there are, in fact, two distinct compositions of the subject by Bruegel the Elder, the other being much less well known but probably derived from him (both were later much copied), which I place with new evidence in the context of Spanish repression, and other politicized versions of the theme by other Flemish artists. By indicating the severity of the repression well before the arrival of Alva in 1567, I show that arguments in favour of the one autograph version (Hampton Court) having a contemporary application do not depend on a later dating, and that any resemblance of the commander of the massacre to the Duke of Alva in the Vienna version and other copies, is due to their having been done a ,safer' generation later. Other relevant political works by Bruegel are adduced, notably the Census and Preaching of St John. A consciousness of Spanish tyranny and slaughter is carried into the later part of the century, via anti-Spanish cartoons, paintings of (non-biblical) killing and plundering and other Massacres of the Innocents, notably and climactically those by Cornelis Cornelisz. van Haarlem, which must have been affected by his childhood experience of the Siege of Haarlem in 1573. [source] Utility of Base Deficit for Identifying Major Injury in Elder Trauma PatientsACADEMIC EMERGENCY MEDICINE, Issue 9 2007Shahriar Zehtabchi MD Background: Early identification of serious injuries is especially important in elders. Base deficit (BD) is an indicator of serious injury in trauma patients. There are limited data to support the utility of BD in elders who have sustained trauma. Objectives: To assess the diagnostic performance of BD in identifying major injury in elders. Methods: This was a prospective, observational, preliminary study. Elder (age 65 years and older) patients with significant injury mechanisms had BD analyzed during initial emergency department resuscitation. Major injury was defined by an Injury Severity Score ,15, a decrease in hematocrit of more than ten points, or blood transfusion. Patients were stratified into two groups of minor and major injuries. Data were reported as means (±SD). Receiver operating characteristic (ROC) curves tested the diagnostic ability of BD to identify major injury. Results: Seventy-four patients were enrolled; the mean (±SD) age was 75 (±7) years, and 57% were male. Twenty-four patients (32%) had major injury. The mean (±SD) for BD in the major injury group (,2.9 [±6] mmol/L) was significantly different from that in the minor injury group (0.8 [±3] mmol/L), with a mean difference of 3.7 (95% confidence interval = 1.4 to 5.9). ROC curves revealed that BD was able to identify major injury in elder patients (area under the ROC curve, 0.72; 95% confidence interval = 0.60 to 0.85; p = 0.0003). Conclusions: The preliminary data from this study indicate that in trauma patients aged 65 years and older, increased BD at emergency department arrival can predict life-threatening injury. [source] The Elder Patient with Suspected Acute Coronary Syndromes in the Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 8 2007Jin H. Han MD ObjectivesTo describe the evaluation and outcomes of elder patients with suspected acute coronary syndromes (ACS) presenting to the emergency department (ED). MethodsThis was a post hoc analysis of the Internet Tracking Registry for Acute Coronary Syndromes (i,trACS) registry, which had 17,713 ED visits for suspected ACS. First visits from the United States with nonmissing patient demographics, 12-lead electrocardiogram results, and clinical history were included in the analysis. Those who used cocaine or amphetamines or left the ED against medical advice were excluded. Elder was defined as age 75 years or older. ACS was defined by 30-day revascularization, Diagnosis-related Group codes, or death within 30 days with positive cardiac biomarkers at index hospitalization. Multivariable logistic regression analyses were performed to determine the association between being elder and 1) 30-day all-cause mortality, 2) ACS, 3) diagnostic tests ordered, and 4) disposition. Multivariable logistic regression was also performed to determine which clinical variables were associated with ACS in elder and nonelder patients. ResultsA total of 10,126 patients with suspected ACS presenting to the ED were analyzed. For patients presenting to the ED, being elder was independently associated with ACS and all-cause 30-day mortality, with adjusted odds ratios of 1.8 (95% confidence interval [CI] = 1.5 to 2.2) and 2.6 (95% CI = 1.6 to 4.3), respectively. Elder patients were more likely to be admitted to the hospital (adjusted odds ratio, 2.2; 95% CI = 1.8 to 2.6), but there were no differences in the rates of cardiac catheterization and noninvasive stress cardiac imaging. Different clinical variables were associated with ACS in elder and nonelder patients. Chest pain as chief complaint, typical chest pain, and previous history of coronary artery disease were significantly associated with ACS in nonelder patients but were not associated with ACS in elder patients. Male gender and left arm pain were associated with ACS in both elder and nonelder patients. ConclusionsElder patients who present to the ED with suspected ACS represent a population at high risk for ACS and 30-day mortality. Elders are more likely to be admitted to the hospital, but despite an increased risk for adverse events, they have similar odds of receiving a diagnostic test, such as stress cardiac imaging or cardiac catheterization, compared with nonelder patients. Different clinical variables are associated with ACS, and clinical prediction rules utilizing presenting symptoms should consider the effect modification of age. [source] Childhood risks and protective factors in social exclusionCHILDREN & SOCIETY, Issue 5 2001John Bynner Combating social exclusion is a dominant theme in the current policy agenda. Yet the term social exclusion is of relatively recent origin. It was promoted originally in France in policy debates surrounding disability (Evans, 2000) and through theoretical developments in sociology and political science about the increasing detachment of certain individuals and groups from the state in late modernity (Beck and others, 1994). A quite different and more long-standing research tradition is to be found in developmental psychology,respectively in the sub-fields of ,developmental psychopathology' (Rutter, 1993) and ,life course theory and lifespan developmental psychology' (Elder and others 1993, 1998a&b; Lerner,1998; Lerner and others, 2000). The two themes come together in the idea of risk: Which children are most vulnerable to adult psychiatric disorders or criminality? Which children are likely to become socially excluded as adults? A dialogue between risk and social exclusion is likely to be fruitful in bringing together large and diverse research literatures combining both explanatory and intervention studies to bear on a central problem of modern society. The purpose of this paper is to begin such a task, but selectively, focusing on the main themes of research, as illuminated by key findings. The paper concludes with a consideration of recent policy initiatives to combat social exclusion, in which the ideas of risk and protection have a central place. Copyright © 2001 John Wiley & Sons, Ltd. [source] Dendrogeomorphic reconstruction of past debris-flow activity using injured broad-leaved treesEARTH SURFACE PROCESSES AND LANDFORMS, Issue 4 2010Estelle Arbellay Abstract Tree-ring records from conifers have been regularly used over the last few decades to date debris-flow events. The reconstruction of past debris-flow activity was, in contrast, only very rarely based on growth anomalies in broad-leaved trees. Consequently, this study aimed at dating the occurrence of former debris flows from growth series of broad-leaved trees and at determining their suitability for dendrogeomorphic research. Results were obtained from gray alder (Alnus incana (L.) Moench), silver birch and pubescent birch (Betula pendula Roth and Betula pubescens Ehrh.), aspen (Populus tremula L.), white poplar, black poplar and gray poplar (Populus alba L., Populus nigra L. and Populus x canescens (Ait.) Sm.), goat willow (Salix caprea L.) and black elder (Sambucus nigra L.) injured by debris-flow activity at Illgraben (Valais, Swiss Alps). Tree-ring analysis of 104 increment cores, 118 wedges and 93 cross-sections from 154 injured broad-leaved trees allowed the reconstruction of 14 debris-flow events between AD 1965 and 2007. These events were compared with archival records on debris-flow activity at Illgraben. It appears that debris flows are very common at Illgraben, but only very rarely left the channel over the period AD 1965,2007. Furthermore, analysis of the spatial distribution of disturbed trees contributed to the identification of six patterns of debris-flow routing and led to the determination of preferential breakout locations of events. The results of this study demonstrate the high potential of broad-leaved trees for dendrogeomorphic research and for the assessment of the travel distance and lateral spread of debris-flow surges. Copyright © 2010 John Wiley & Sons, Ltd. [source] Structure of two macrolepidopteran assemblages on Salix nigra (Marsh) and Acer negundo L.: abundance, diversity, richness, and persistence of scarce speciesECOLOGICAL ENTOMOLOGY, Issue 4 2000Pedro Barbosa Summary 1. Most insect species occur at low abundance but a greater research effort has been devoted to so-called outbreak species and little research is available on scarce (low abundance) species that are typical of most insect species. 2. Larval free-feeding macrolepidoptera of two riparian trees Salix nigra (Marsh) (black willow) and Acer negundo L. (box elder) were sampled and sorted by species and abundance. 3. Data collected established that the majority of species in the assemblages in each tree species occurred at low abundance in each of the 5 years when larvae were sampled. 4. Species in the Noctuidae and Geometridae dominated both assemblages. 5. On both trees, assemblages were dominated numerically by relatively few species, a pattern that has been observed for insect assemblages on plants in managed and unmanaged habitats. [source] Providing care for an elderly parent: interactions among siblings?HEALTH ECONOMICS, Issue 9 2009Roméo Fontaine Abstract This article is focused on children providing and financing long-term care for their elderly parent. The aim of this work is to highlight the interactions that may take place among siblings when deciding whether or not to become a caregiver. We look at families with two children using data from the Survey of Health, Ageing and Retirement in Europe; our sample contains 314 dependent elderly and their 628 adult children. In order to identify the interactions between siblings, we have specified a two-person discrete game model. To estimate this model, without invoking the ,coherency' condition, we have added an endogenous selection rule to solve the incompleteness problem arising from multiplicity or absence of equilibrium. Our empirical results suggest that the three classical effects identified by Manski could potentially explain the observed correlation between the siblings' caregiving behaviour. Correlated effects alone appear to be weak. Contextual interactions and endogenous interactions reveal cross-effects. The asymmetric character of the endogenous interactions is our most striking result. The younger child's involvement appears to increase the net benefit of caregiving for the elder one, whereas the elder child's involvement decreases the net benefit of caregiving for the younger child. Copyright © 2009 John Wiley & Sons, Ltd. [source] Gender, kinship and caregiver burden: the case of community-dwelling memory impaired seniorsINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 8 2003Neale R. Chumbler Abstract Background This study examined whether there were gender and kinship (spouse, child, more distant relative) differences in caregiver burden. It further examined the constellation of gender and kinship by examining whether adult daughter caregivers experienced greater burden compared to wives, husbands, sons, and other more distant relatives. Methods The sample consisted of 305 family caregivers of memory-impaired individuals who were age 70 years or older and resided in non-institutional settings in Arkansas. A cross-sectional design was employed using validated measures to assess both the memory-impaired elders' and family caregivers' self-reported physical and memory status. Results After controlling for the age and health status characteristics of the memory-impaired elder, sociodemographic and health status characteristics of the family caregiver, and the caregiver coping response (measured by the sense of coherence), multiple regression analyses found kinship, but not gender differences in caregiver burden. Adult children experienced more caregiver burden than more distant relatives. There were no significant differences in caregiver burden between adult children and spouses. Adult daughters had greater caregiver burden scores compared to more distant relatives, but had comparable scores to wives, sons, and husbands. Other significant correlates of burden included caregiver personal characteristics (age and ethnicity) and the sense of coherence. Conclusions The study discusses the practice implications of adult children and adult daughters' propensity to suffer burden when caring for their memory-impaired parents living in the community. It also discusses the relevance of caregiver personal characteristics and the sense of coherence as correlates of burden. Copyright © 2003 John Wiley & Sons, Ltd. [source] Effects of Provider Practice on Functional Independence in Older AdultsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2004Elizabeth A. Phelan MD Objectives: To examine provider determinants of new-onset disability in basic activities of daily living (ADLs) in community-dwelling elderly. Design: Observational study. Setting: King County, Washington. Participants: A random sample of 800 health maintenance organization (HMO) enrollees aged 65 and older participating in a prospective longitudinal cohort study of dementia and normal aging and their 56 primary care providers formed the study population. Measurements: Incident ADL disability, defined as any new onset of difficulty performing any of the basic ADLs at follow-up assessments, was examined in relation to provider characteristics and practice style using logistic regression and adjusting for case-mix, patient and provider factors associated with ADL disability, and clustering by provider. Results: Neither provider experience taking care of large numbers of elderly patients nor having a certificate of added qualifications in geriatrics was associated with patient ADL disability at 2 or 4 years of follow-up (adjusted odds ratio (AOR) for experience=1.29, 95% confidence interval (CI)=0.81,2.05; AOR for added qualifications=0.72, 95% CI=0.38,1.39; results at 4 years analogous). A practice style embodying traditional geriatric principles of care was not associated with a reduced likelihood of ADL disability over 4 years of follow-up (AOR for prescribing no high-risk medications=0.56, 95% CI=0.16,1.94; AOR for managing geriatric syndromes=0.94, 95% CI=0.40,2.19; AOR for a team care approach=1.35, 95% CI=0.66,2.75). Conclusion: Taking care of a large number of elderly patients, obtaining a certificate of added qualifications in geriatrics, and practicing with a traditional geriatric orientation do not appear to influence the development of ADL disability in elder, community dwelling HMO enrollees. [source] Isolation and characterization of microsatellite markers from Zale galbanata (Lepidoptera: Noctuidae) and amplification in other members of the genusMOLECULAR ECOLOGY RESOURCES, Issue 3 2002A. Caldas Abstract The noctuid moth Zale galbanata is described as feeding on maples (Acer sp.) in general, but its primary food plant is box elder (Acer negundo). We isolated five microsatellite loci to investigate the association of food plant use and the genetic similarity of populations in these moths. These markers are polymorphic to various degrees (5,13 alleles), and are presented here. Our initial tests show that some of these loci also work on other Zale species. [source] Habitat Overlap and Facilitation in Tamarisk and Box Elder Stands: Implications for Tamarisk Control Using Native PlantsRESTORATION ECOLOGY, Issue 3 2010John M. DeWine Invasive plants are typically managed using top-down control techniques that focus on the removal of the target organism. Bottom-up control limits the resources available to the undesired species by manipulating disturbance, competition, and successional processes, and thus may prevent reinvasion. Tamarisk species (Tamarix sp.) have invaded riparian areas throughout western North America, resulting in expansive control efforts. A companion study has shown that a native competitor, Box elder (Acer negundo), is capable of outcompeting and killing established Tamarisk through light interception in canyons of Dinosaur National Monument (DNM), Colorado. The goal of this study was to determine the feasibility of using Box elder as a bottom-up control agent by (1) determining the distributional overlap of the two species in DNM; (2) determining if Tamarisk facilitates Box elder establishment; and (3) analyzing Box elder seedling survival across a range of physical gradients. The distribution of Tamarisk and Box elder overlapped considerably throughout the study area. Box elder seedlings were planted under Tamarisk canopies or areas with the canopy removed. Survival was significantly higher under Tamarisk canopies, indicating that Tamarisk facilitates Box elder seedling survival. Box elder seedling survival was tested across soil texture, litter depth, groundwater depth, and shade intensities indicative of conditions found in the canyons of DNM, and survival was high for all treatments. The manipulation of competitive and successional processes through the promotion of Box elder and other native tree establishment is suggested as a means of bottom-up Tamarisk control to complement traditional control techniques. [source] Front and Back Covers, Volume 23, Number 1.ANTHROPOLOGY TODAY, Issue 1 2007February 200 Front and back cover caption, volume 23 issue 1 Front cover A Dutch participant in the reality television series Groeten uit de rimboe, in which Dutch and Belgian families immerse themselves in the daily life of the world's ,most primitive tribes'. Some time afterwards, their hosts pay a return visit to experience life in Europe, screened on television in the sequel Groeten terug. The two series have been subject to heated debate in the Dutch media, having been both lauded as unpretentious entertainment and condemned as unethical ,popular anthropology'. The attention of Myrna Eindhoven, Laurens Bakker and Gerard Persoon was first drawn to the series when a family was sent to Mentawai, where all three have done fieldwork. While they themselves are critical of the unashamed focus on entertainment, they became intrigued by the reactions of other anthropologists to the series. Here they connect this case from the Netherlands to the ongoing debate on ,popular anthropology' in ANTHROPOLOGY TODAY, triggered by the UK series Tribe. Dutch anthropologists have mostly dismissed the series as ,not anthropology', criticizing it as exploitative and as ethnocentric. But do anthropologists have the authority to define ,popular anthropology'? How do we come to terms with blatant commercialization of our fieldwork sites, and their conversion into exotic locations for popular entertainment? Back cover NATION-BUILDING IN EAST TIMOR East Timor celebrates its Independence Day on 20 May each year. The day forms the backdrop for the largest annual encounter between the political centre and the periphery. In this photo, an elder (katuas) member of Fretilin, the largest political party, blends traditional and modern at the Independence Day celebrations in the capital, Dili, in 2005. As an exemplar of the United Nations' capacity for ,nation-building', the Democratic Republic of Timor Leste (or ,East Timor' as it is more popularly known) developed into something of a ,poster boy' for the United Nations from the day it became a sovereign nation on 20 May 2002. But in April 2006, some months after the last remaining UN staff had left, violence in the streets of the capital began to undermine social and political stability, resulting in the overthrow of prime minister Mari Alkatiri. Under the more engaged leadership of his successor, José Ramos-Horta, the threat of unrest has abated to some extent. Nevertheless, the country faces an array of serious problems , political, social and economic. In his article in this issue, David Hicks draws on his anthropological fieldwork to highlight the widening gap between the ,centre' and the ,periphery'. Hicks argues that the former embodies the institutions and quasi-Western values professed by the national leaders in Dili, while the latter centres around the traditional, largely indigenous values of the country's local communities, who comprise the overwhelming majority of the population. Although already latent before the United Nations left, this widening divergence in values is eroding the political integrity of the first nation-state to become a member of the United Nations in the 21st century, and if it continues to grow, will call into question the ability of the United Nations to ,manufacture' nation-states. Anthropology has an important role to play in highlighting and analysing the implications of grassroots discrepancies between local populations and political elites. More than this, it has a role to play in confronting the international community with the ethical and other consequences of its increasingly regular interventions in third countries. [source] The Elder Patient with Suspected Acute Coronary Syndromes in the Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 8 2007Jin H. Han MD ObjectivesTo describe the evaluation and outcomes of elder patients with suspected acute coronary syndromes (ACS) presenting to the emergency department (ED). MethodsThis was a post hoc analysis of the Internet Tracking Registry for Acute Coronary Syndromes (i,trACS) registry, which had 17,713 ED visits for suspected ACS. First visits from the United States with nonmissing patient demographics, 12-lead electrocardiogram results, and clinical history were included in the analysis. Those who used cocaine or amphetamines or left the ED against medical advice were excluded. Elder was defined as age 75 years or older. ACS was defined by 30-day revascularization, Diagnosis-related Group codes, or death within 30 days with positive cardiac biomarkers at index hospitalization. Multivariable logistic regression analyses were performed to determine the association between being elder and 1) 30-day all-cause mortality, 2) ACS, 3) diagnostic tests ordered, and 4) disposition. Multivariable logistic regression was also performed to determine which clinical variables were associated with ACS in elder and nonelder patients. ResultsA total of 10,126 patients with suspected ACS presenting to the ED were analyzed. For patients presenting to the ED, being elder was independently associated with ACS and all-cause 30-day mortality, with adjusted odds ratios of 1.8 (95% confidence interval [CI] = 1.5 to 2.2) and 2.6 (95% CI = 1.6 to 4.3), respectively. Elder patients were more likely to be admitted to the hospital (adjusted odds ratio, 2.2; 95% CI = 1.8 to 2.6), but there were no differences in the rates of cardiac catheterization and noninvasive stress cardiac imaging. Different clinical variables were associated with ACS in elder and nonelder patients. Chest pain as chief complaint, typical chest pain, and previous history of coronary artery disease were significantly associated with ACS in nonelder patients but were not associated with ACS in elder patients. Male gender and left arm pain were associated with ACS in both elder and nonelder patients. ConclusionsElder patients who present to the ED with suspected ACS represent a population at high risk for ACS and 30-day mortality. Elders are more likely to be admitted to the hospital, but despite an increased risk for adverse events, they have similar odds of receiving a diagnostic test, such as stress cardiac imaging or cardiac catheterization, compared with nonelder patients. Different clinical variables are associated with ACS, and clinical prediction rules utilizing presenting symptoms should consider the effect modification of age. [source] The contributions of the Bartholin family to the study and practice of clinical anatomyCLINICAL ANATOMY, Issue 2 2007Robert V. Hill Abstract Between 1585 and 1738, four members of the celebrated Bartholin family made significant contributions to anatomical science and medicine. Caspar Bartholin (the elder), two of his sons (Thomas and Rasmus), and his grandson (Caspar the younger) all served on the medical faculty of the University of Copenhagen, and helped to gain international acclaim for the institution. Over three generations, the Bartholins challenged traditional ideas about science and the human body, and discovered anatomical structures and phenomena that would prove crucial to the practice of modern medicine. Clin. Anat. 20:113,115, 2007. © 2006 Wiley-Liss, Inc. [source] The Father's Friend: Returning to the Tuareg as an ,elder'ANTHROPOLOGY TODAY, Issue 4 2000Jeremy Keenan [source] FATHERS, SONS, AND THE STATE: Discipline and Punishment in a Wolof HinterlandCULTURAL ANTHROPOLOGY, Issue 1 2009DONNA L. PERRY ABSTRACT This essay builds on fieldwork in rural Senegal to examine three cases in which elder household heads called on gendarmes to physically discipline rebellious youths. These cases, which revolved around harsh acts of corporal punishment, invite inquiry into common assumptions about African families and states. The first assumption is the common dichotomy drawn between African youths, portrayed as modern and menacing, and African elders, portrayed as "traditional" and hence benign. The second assumption is the dichotomy drawn between the African family, conceived as solidary and nurturing, and the African state, conceived as alien and predatory. In examining these cases of discipline and punishment, this essay reveals the ever-shifting power relations that link Wolof household heads, dependent junior males, and state agents, and simultaneously introduces new questions about the morality of farmer,state relations and generational conflict. My analysis reveals the spatial geography of Senegal's youth crisis, which takes different forms in rural and urban locales. The anxiety of rural patriarchs is fed by a fear-mongering media obsessed with youthful anarchy in the cities, and a long-standing political rhetoric about the threat of rural out-migration. Elder men in the countryside, who experience diminishing household authority under neoliberalism, make proactive efforts to keep the urban youth crisis at bay. They seek to augment their domestic power by reestablishing links with a state that has long bolstered patriarchy but whose power is currently in decline. By lending patriarchs their coercive force, gendarmes attempt to accomplish through private, indirect means, what the postcolonial state is unable to do: maintain social order by reining in disruptive youths. The harsh disciplinary measures that gendarmes employ are not alien to Wolof culture, but integral to Wolof conceptions of child rearing. [source] A Community Intervention by Firefighters to Increase 911 Calls and Aspirin Use for Chest PainACADEMIC EMERGENCY MEDICINE, Issue 4 2006Hendrika Meischke PhD Abstract Objectives: To test the effectiveness of an intervention, delivered face-to-face by local firefighters, designed to increase utilization of 911 and self-administration of aspirin for seniors experiencing chest pain. Methods: King County, Washington was divided into 126 geographically distinct areas that were randomized to intervention and control areas. A mailing list identified households of seniors within these areas. More than 20,000 homes in the intervention areas were contacted by local firefighters. Data on all 911 calls for chest pain and self-administration of aspirin were collected from the medical incident report form (MIRF). The unit of analysis was the area. Firefighters delivered a heart attack survival kit (that included an aspirin) and counseled participants on the importance of aspirin and 911 use for chest pain. Main outcome measures were 911 calls for chest pain and aspirin ingestion for a chest pain event, obtained from the MIRFs that are collected by emergency medical services personnel for 2 years after the intervention. Results: There were significantly more calls (16%) among seniors on the mailing list in the intervention than control areas in the first year after the intervention. Among the seniors who were not on the mailing list, there was little difference in the intervention and control areas. The results were somewhat sensitive to the analytical model used and to an outlier in the treatment group. Conclusions: A community-based firefighter intervention can be effective in increasing appropriate response to symptoms of a heart attack among elders. [source] Diabetes in the elderly: problems of care and service provisionDIABETIC MEDICINE, Issue 2002S. Croxson Abstract Diabetes is common in the elderly and old UK citizens, affecting between 10% and 25%. There is considerable associated morbidity and mortality, with dementia being a common problem. The diabetic elder is also at risk of drug side-effects. Most of the evidence base for treatment is based on trials performed in younger diabetic subjects or older nondiabetic subjects; however, we can practice evidence-biased medicine whilst awaiting the results of ongoing trials. The older persons national service framework (NSF) may share some similarities with the diabetes NSF; it was 1 year late, and had no clear funding, amongst several other worries. Residential care, which is more likely to be required by diabetic elders, is also under-funded with major concerns about the quality of care for the diabetic resident. The little evidence that we have regarding care of the older diabetic person also suggests inadequacies. Given the likelihood that we will have to manage with present resources, managed clinical networks may be one way to cope. [source] Paying attention to attention: New economies for learningEDUCATIONAL THEORY, Issue 4 2004Suzanne De Castell Challenging formal education's traditional monopoly over the mass-scale acculturation of youth, the technological infrastructure of the new economy brings in its wake a new "attentional economy" in which any "connected" adult or child owns and controls a full economic share of her or his own attention. For youth who have never known the text-bound world from which their elders have come, new technologies afford them far greater power and greatly expanded rights that enable them to decide for themselves what they can see, think, and do, as their teachers grapple with ways to attract, rather than compel, students' voluntary attention. This paper reviews various formulations of "attentional economy," and it urges the study of popular forms of technologically enabled play. These technologies effectively mobilize, direct, and sustain the engaged attention of youth, whose learning in and through play far exceeds the kind of glazed-eyed button-mashing complained of by those who have made little effort to understand the educative prospects of computer gaming. [source] Growing old with epilepsy: the neglected issue of cognitive and brain health in aging and elder persons with chronic epilepsyEPILEPSIA, Issue 5 2008Bruce Hermann Summary The purpose of this review is to examine what is known about cognitive and brain aging in elders with chronic epilepsy. We contend that much remains to be learned about the ultimate course of cognition and brain structure in persons with chronic epilepsy and concern appears warranted. Individuals with chronic epilepsy are exposed to many risk factors demonstrated to be associated with abnormal cognitive and brain aging in the general population, with many of these risk factors present in persons with chronic epilepsy as early as midlife. We suggest that a research agenda be developed to systematically identify and treat known modifiable risk factors in order to protect and promote cognitive and brain health in aging and elder persons with chronic epilepsy. [source] Tricks of Festival: Children, Enculturation, and American HalloweenETHOS, Issue 2 2005CINDY DELL CLARK The American children's ritual, Halloween, involves an emergent, active and complex process rather than unidirectional socialization of children by adults. Inversions of meaning are prominent in Halloween through: 1) adult support for inverted, anti-normative themes, and 2) a turnabout by which children gain ascendance through costumed trick-or-treating. Based on interviews with six and seven year old children and their parents, as well as participant observation at Halloween events, Halloween's inversions had different interpretations for adults compared to children. For example the degree and quality of fear associated with Halloween varied between elders and children. Following the traumatic events of September 11, 2001, adult-rendered meanings of Halloween were shown to be unfixed and subject to modification. These findings raise critical questions about simplistic notions of socialization and cultural reduplication. [source] The Effect of Seatbelt Use on Injury Patterns, Disposition, and Hospital Charges for EldersACADEMIC EMERGENCY MEDICINE, Issue 12 2002Andrew Coley MD Objective: To study the relationships between seatbelt use and injury patterns, hospital charges, morbidity, and mortality in elder motor vehicle crash victims. Methods: A retrospective review of individuals at least 65 years old presenting to an urban emergency department (ED) after a motor vehicle crash. Results: Over a two-year period, 339 patients had documentation of seatbelt use or non-use at the time of the crash. Of these, 241 (71%) patients had been wearing a seatbelt and 98 (29%) had not. Elders not using seatbelts were more likely to require hospitalization (29% unbelted vs. 17% belted) and had a higher mortality rate. Injury patterns were different in the two groups. Emergency department charges were significantly different between belted and unbelted elders ($351 vs. $451, p = 0.01) and head computed tomography (CT) utilization was higher in the unbelted group (25.6% vs 12.7%, p = 0.005). Conclusions: Improved seatbelt compliance in elders can reduce injuries, hospitalization rates, ED charges, and mortality resulting from motor vehicle crashes. [source] Emergency Department Utilization by Noninstitutionalized EldersACADEMIC EMERGENCY MEDICINE, Issue 3 2001Manish N. Shah MD Abstract. Objectives: To the best of the authors knowledge, no nationally representative, population-based study has characterized the proportion of elders using the emergency department (ED) and factors associated with ED use by elders. This article describes the proportion of elder Medicare beneficiaries using the ED and identifies attributes associated with elder ED users as compared with nonusers. Methods: The 1993 Medicare Current Beneficiary Survey was used, a national, population-based, cross-sectional survey of Medicare beneficiaries linked with Medicare claims data. The study population was limited to 9,784 noninstitutionalized individuals aged 66 years or older. The Andersen model of health service utilization was used, which explains variation in ED use through a combination of predisposing (demographic and social), enabling (access to care), and need (comorbidity and health status) characteristics. Results: Eighteen percent of the sample used the ED at least once during 1993. Univariate analysis showed ED users were older; were less educated and lived alone; had lower income and higher Charlson Comorbidity Index scores; and were less satisfied with their ability to access care than nonusers (p < 0.01, chi-square). Logistic regression identified older age, less education, living alone, higher comorbidity scores, worse reported health, and increased difficulties with activities of daily living as factors associated with ED use (p < 0.05). Need characteristics predicted ED use with the greatest accuracy. Conclusions: The proportion of elder ED users is slightly higher than previously reported among Medicare beneficiaries. Need (comorbidity and health status) characteristics predict ED utilization with the greatest accuracy. [source] Perceptions of Elderly Self-Neglect: A Look at Culture and CohortFAMILY & CONSUMER SCIENCES RESEARCH JOURNAL, Issue 3 2007Sylvia Marie San Filippo Abuse and neglect are issues of concern that face the elderly population. This study investigated differences in perception of self-neglect behaviors among four cohort and four cultural groups. Data were collected from students, staff, and faculty at a large state university, attendees at multiple senior centers, and people attending cultural fairs in Southern California. Using this convenience sample of 494 participants, age 18 years or older, researchers identified factors influencing self-neglect perceptions in the culture and cohort models. Significant variables identified in both models are: having a daily caloric intake of fewer than 1,000 calories, avoiding friends and social events, drinking three to four alcoholic drinks at social occasions, and working part-time. It is important for professionals working with self-neglecting elders to understand differences in perception by culture and cohort. Agreement on a definition of self-neglect is a step toward better addressing self-neglect in the elderly community. [source] Should we offer herbal treatments that raise blood pressure to normotensive elders?FOCUS ON ALTERNATIVE AND COMPLEMENTARY THERAPIES AN EVIDENCE-BASED APPROACH, Issue 2 2010Article first published online: 14 JUN 2010 [source] Implant overdentures for edentulous elders: study of patient preferenceGERODONTOLOGY, Issue 1 2009Shahrokh Esfandiari Background:, Studies show that elders wearing implant overdentures have improved nutrition and quality of life. However, upfront costs of this therapy are high, and the income of elderly edentulous populations is low. Objectives:, This study was designed (i) to measure the preferences of edentulous patients for mandibular two-implant overdentures using Willingness-To-Pay (WTP) and Willingness-To-Accept (WTA), (ii) to assess the effect of long-term financing on WTP and (iii) to assess the desired role of health care plans in financing dental prostheses. Methods:, Edentulous elders (68,79 years; n = 36) wearing maxillary dentures and either a mandibular conventional denture (CD, n = 13) or a two-implant overdenture with ball attachments (IOD, n = 23) participated in this study. All had received their prostheses 2 years previously, as part of a randomised clinical trial. A three-part questionnaire was completed during a 20-min interview with a trained researcher. Results:, Forty-six per cent (6/13) of the CD wearers and 70% (16/23) of the IOD wearers were willing to pay three times more than the current cost of conventional dentures for implant prostheses. These percentages were increased to 77% (CD) and 96% (IOD) if participants could pay for implant overdentures in monthly instalments. Eighty-six per cent (31/36) of all participants in both groups (21/23 IOD; 10/13 CD) thought that the government should cover at least some of the cost of implant overdentures. Conclusions:, This study shows that, the majority of elderly edentate individuals who have not experienced mandibular two-implant overdenture therapy are willing to pay the cost, particularly when payment can be made in monthly instalments. [source] | ||||||||||||||||||||||||||||||||||||||||||||||