Dichotomising dementia: is there another way? McParland, Patricia; Kelly, Fiona; Innes, Anthea
Sociology of health & illness,
February 2017, 2017-Feb, 2017-02-00, 20170201, Letnik:
39, Številka:
2
Journal Article
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This article discusses the reduction of the complex experience of dementia to a dichotomised ‘tragedy’ or ‘living well’ discourse in contemporary Western society. We explore both discourses, placing ...them in the context of a successful ageing paradigm, highlighting the complex nature of dementia and the risks associated with the emergence of these arguably competing discourses. Specifically, we explore this dichotomy in the context of societal understandings and responses to dementia. We argue for an acceptance of the fluid nature of the dementia experience, and the importance of an understanding that recognises the multiple realities of dementia necessary for social inclusion to occur. Such an acceptance requires that, rather than defend one position over another, the current discourse on dementia is challenged and problematised so that a more nuanced understanding of dementia may emerge; one that fully accepts the paradoxical nature of this complex condition.
Climate change can affect fish species directly (e.g. through physiological stress) or indirectly (e.g. species interactions). Whether individual species will experience net benefits or net losses is ...important to understand from a fisheries management perspective. Ireland has a unique freshwater fish community that faces considerable uncertainty in relation to the impact of climate change. Vulnerability of fish species and subspecies (n = 32) in Ireland were investigated through an expert‐based questionnaire and a trait‐based assessment. Fish species were assessed based on exposure, sensitivity and adaptive capacity. The expert‐based questionnaire predicted that one species, Arctic char Salvelinus alpinus was assigned the rank of high vulnerability, seven species were assigned moderate to high vulnerability, twenty species were assigned moderate vulnerability, and four species were of low to moderate vulnerability. Life‐history characteristics of the fish species were analysed to identify traits characteristic of vulnerable fish species (e.g. Vulnerability to fishing and Trophic level). Coldwater species are highly vulnerable, with indirect effects through interactions with other species or in combination with non‐climatic stressors (e.g. water quality & barriers to migration) being a significant concern. The results provide a vulnerability ranking for Ireland's freshwater fish, that can be utilised by fisheries managers and allows for prioritising of an often‐limited conservation resource.
About 10% of patients with IBS report the start of the syndrome after infectious enteritis. The clinical features of postinfectious IBS (PI-IBS) resemble those of diarrhoea-predominant IBS (IBS-D). ...While altered faecal microbiota has been identified in other IBS subtypes, composition of the microbiota in patients with PI-IBS remains uncharacterised.
To characterise the microbial composition of patients with PI-IBS, and to examine the associations between the faecal microbiota and a patient's clinical features.
Using a phylogenetic microarray and selected qPCR assays, we analysed differences in the faecal microbiota of 57 subjects from five study groups: patients with diagnosed PI-IBS, patients who 6 months after gastroenteritis had either persisting bowel dysfunction or no IBS symptoms, benchmarked against patients with IBS-D and healthy controls. In addition, the associations between the faecal microbiota and health were investigated by correlating the microbial profiles to immunological markers, quality of life indicators and host gene expression in rectal biopsies.
Microbiota analysis revealed a bacterial profile of 27 genus-like groups, providing an Index of Microbial Dysbiosis (IMD), which significantly separated patient groups and controls. Within this profile, several members of Bacteroidetes phylum were increased 12-fold in patients, while healthy controls had 35-fold more uncultured Clostridia. We showed correlations between the IMD and expression of several host gene pathways, including amino acid synthesis, cell junction integrity and inflammatory response, suggesting an impaired epithelial barrier function in IBS.
The faecal microbiota of patients with PI-IBS differs from that of healthy controls and resembles that of patients with IBS-D, suggesting a common pathophysiology. Moreover, our analysis suggests a variety of host-microbe associations that may underlie intestinal symptoms, initiated by gastroenteritis.
Intensive care is celebrating its 60th anniversary this year. The concept arose from the devastating Copenhagen polio epidemic of 1952, which resulted in hundreds of victims experiencing respiratory ...and bulbar failure. Over 300 patients required artificial ventilation for several weeks. This was provided by 1,000 medical and dental students who were employed to hand ventilate the lungs of these patients via tracheostomies. By 1953, Bjorn Ibsen, the anaesthetist who had suggested that positive pressure ventilation should be the treatment of choice during the epidemic, had set up the first intensive care unit (ICU) in Europe, gathering together physicians and physiologists to manage sick patients – many would consider him to be the ‘father’ of intensive care. Here, we discuss the events surrounding the 1952 polio epidemic, the subsequent development of ICUs throughout the UK, the changes that have occurred in intensive care over the past 10 years and what the future holds for the specialty.
There is increasing international consensus that the best interests of donor-conceived children should be the focal point of laws regulating assisted reproduction, with particular attention given to ...the promotion of children’s health and wellbeing. To achieve this objective, the Australian regulatory system has adopted a position of openness, the presumption being that children’s health is enhanced by access to information about their conception, their donors, and other donor relatives. This article explores the lived experience of 25 single mothers by choice (SMCs) who have attempted to promote the health and wellbeing of their donor-conceived children by exploring the possibility of seeking access to information about their child’s donor and/or other donor relatives. It argues that, while aspects of Australia’s regulatory framework facilitate the type of openness SMCs sought for their children, significant gaps remain. In particular, the absence of legislation in some states, and inconsistencies between and within state laws mean that the rights of donor-conceived children vary dramatically across the country.
Riparian tree cover has been widely proposed as a key climate change adaptation and mitigation strategy for stream temperature management. Riparian tree cover moderates stream temperature by ...intercepting solar radiation, a significant heat source in affected systems. However, many aspects of hydromorphological state can shape the realised temperature regime of a river and these elements may interact with riparian tree cover. This study investigated the thermal buffering effect of tree cover on rivers with varying degrees of hydromorphological alteration for example, modified channel morphology, substrate and floodplain connectivity. Results indicated that the effectiveness of tree cover as a stream temperature management tool can change across systems depending on the extent of hydromorphological alteration. Greater tree cover had a pronounced cooling effect on stream temperature in altered study sites, but temperatures were typically still lower in more natural (less disturbed) sites, irrespective of the extent of tree cover. This finding suggests a hydromorphological threshold at which the effectiveness of riparian tree cover as a temperature management tool diminishes. Climate proofing in some rivers may thus require provision of both riparian tree cover and functioning hydromorphological processes to replicate more natural stream temperature dynamics. This perspective also suggests that more pristine rivers will retain greater resistance to projected temperature disturbance associated with a warming climate because of their inherent thermal buffering capacity.
The efficacy of riparian tree cover in moderating stream temperatures changed across rivers with severity of hydromorphological alterations. Altered channels (A) e.g. channelized, had the highest stream temperatures and least resistance to heating. High stream temperatures in altered channels may be mitigated by extensive riparian tree cover (B), but possibly not fully offset compared to more natural channels (C). Climate proofing strategies should restore riparian cover and hydromorphological function in engineered rivers to replicate more natural stream temperature dynamics.
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