bluuebunny/crossref_metadata_2025 huggingface dataset:
Preventing Parastomal Hernia with a Prosthetic Mesh: A 5‐Year Follow‐up of a Randomized Study
Authors: Jänes Arthur , Cengiz Yucel , Israelsson Leif A.
Published: November 2008

Background

Parastomal hernia is a major clinical problem. In a randomized, clinical trial, a prosthetic mesh in a sublay position at the index operation reduced the rate of parastomal hernia at 12‐month follow‐up, without any increase in the rate of complications. This study was designed to evaluate the rate of complications after 5 years.

Methods

Between January 2001 and April 2003, 54 patients who had a permanent ostomy were randomized to a conventional stoma or to a stoma with the addition of a mesh in a sublay position. A large‐pore, lightweight mesh with a reduced polypropylene content and a high proportion of absorbable material was used.

Results

After 5 years, 21 patients with a conventional stoma were alive and parastomal herniation was recorded in 17 patients, of whom repair had been demanded in 5. In 15 patients operated on with the addition of a mesh herniation, that did not require repair, was present in 2 (P < 0.001). No fistulas or strictures developed. No mesh infection was noted and no mesh was removed during the study period.

Conclusions

At stoma formation, a prophylactic low‐weight mesh in a sublay position is a safe procedure that reduces the rate of parastomal hernia.
Population‐level ecological effect assessment: estimating the effect of toxic chemicals on density‐dependent populations
Authors: Hayashi Takehiko I. , Kamo Masashi , Tanaka Yoshinari
Published: November 2008

We examined the relationship between individual‐level and population‐level effects of toxic chemicals, employing the equilibrium population size as an index of population‐level effects. We first analyzed two‐stage matrix models considering four life‐history types and four density‐dependent models, and then we analyzed ecotoxicological and life‐history data of the fathead minnow (Pimephales promelas) and brook trout (Salvelinus fontinalis) as real examples. Our elasticity analysis showed that toxic impacts on density‐dependent populations depended largely on the differences in density‐dependence and in life histories of the organisms. In particular, the importance of adult survivability was considerably increased in iteroparous organisms with density‐dependent juvenile survivability or fertility. Our results also suggested that population‐level effects, as indicated by the percentage reduction in equilibrium population size, were often greater than the percentage reductions in vital rates of individuals. Our analysis indicates that assessing population‐level risk and developing a risk‐reduction strategy without considering density‐dependence can be risky.
3D-Fluoreszenz-in-situ-Hybridisierung und Zellkernarchitektur
Authors: Cremer M. , Müller S. , Solovei I. , Cremer T.
Published: November 2008

Fluoreszenz-in-situ-Hybridisierung an dreidimensional konservierten Zellkernen (3D-FISH) ist eine effiziente Methode für Untersuchungen zur 3D-Anordnung von Chromatin im Zellkern. Die Zellkernarchitektur stellt eine Ebene epigenetischer Mechanismen der Genregulation dar. 3D-FISH-Untersuchungen belegten eine große Variabilität in den Nachbarschaftsbeziehungen individueller Chromosomenterritorien im Zellkern. Im Gegensatz hierzu konnte eine distinkte radiale, von der Gendichte abhängige Anordnung von Chromatin gezeigt werden, die evolutionär hochkonserviert ist. Genreiches Material ist bevorzugt in der Kernmitte, genarmes in der Kernperipherie angeordnet. Die Frage einer räumlichen Assoziation kotranskriptionell exprimierter Gene (so genannte „expression hubs”) wird derzeit kontrovers diskutiert.
Roitman's theorem for singular projective varieties in arbitrary characteristic
Authors: Mallick Vivek Mohan
Published: November 2008

In this paper, we prove Roitman's theorem regarding torsion 0-cycles for singular projective varieties over algebraically closed fields of arbitrary characteristic, for torsion which is of exponent prime to the characteristic. This generalizes earlier results for complex projective varieties. Our proof even in that case is different from the earlier ones.
Auslander-Reiten triangles in subcategories
Authors: Jørgensen Peter
Published: November 2008

This paper studies Auslander-Reiten triangles in subcategories of triangulated categories. The main theorem shows that the Auslander-Reiten triangles in a subcategory are closely connected with the approximation properties of the subcategory. Namely, let C be an object in the subcategory C of the triangulated category T, and let

be an Auslander-Reiten triangle in T. Then under suitable assumptions, there is an Auslander-Reiten triangle

in C if and only if there is a minimal right-C-approximation of the form

.

The theory is used to give a new proof of the existence of Auslander-Reiten sequences over finite dimensional algebras.
An extended version of additive K-theory
Authors: Garoufalidis Stavros
Published: November 2008

There are two infinitesimal (i.e., additive) versions of the K-theory of a field F: one introduced by Cathelineau, which is an F-module, and the other introduced by Bloch-Esnault, which is an F*-module. Both versions are equipped with a regulator map, when F is the field of complex numbers.

We will introduce an extended version of Cathelineau's group, and a complex-valued regulator map given by the entropy. We will also give a comparison map between our extended version and Cathelineau's group.

Our results were motivated by two unrelated sources: Neumann's work on the extended Bloch group (which is isomorphic to indecomposable K3 of the complex numbers), and the study of singularities of generating series of hypergeometric multisums.
Cancellation problem for projective modules over affine algebras
Authors: Keshari Manoj Kumar
Published: November 2008

Let A be an affine algebra of dimension n over an algebraically closed field k with 1/n! ∈ k. Let P be a projective A-module of rank n − 1. Then, it is an open question due to N. Mohan Kumar, whether P is cancellative. We prove the following results:

(i) If A = R[T,T−1], then P is cancellative.

(ii) If A = R[T,1/f] or A = R[T,f1/f,…,fr/f], where f(T) is a monic polynomial and f,f1,…,fr is R[T]-regular sequence, then An−1 is cancellative. Further, if k = p, then P is cancellative.
Cyclic Cohomology of Corings
Authors: Rangipour Bahram
Published: November 2008

We define cyclic cohomology of corings over not necessarily commutative algebras. Our method is a generalization of Hopf-cyclic cohomology obtained by replacing coalgebras and Hopf algebras with corings and para-Hopf algebroids, respectively. We also study the dual of this theory whose cyclic cohomology, in contrast with the case of algebras and coalgebras, is not trivial.
German Documents in the United States
Authors: Weinberg Gerhard L.
Published: November 2008

At the end of World War II, vast quantities of German documents had fallen into the hands of the Allies either during hostilities or in the immediately following weeks. Something will be said near the end of this report about the archives captured or seized by the Soviet Union; the emphasis here will be on those that came into the possession of the Western Allies. The United States and Great Britain made agreements for joint control and exploitation, of which the most important was the Bissell-Sinclair agreement named for the intelligence chiefs who signed it. The German naval, foreign office, and chancellery archives were to be physically located in England, while the military, Nazi Party, and related files were to come to the United States. Each of the two countries was to be represented at the site of the other's holdings, have access to the files, and play a role in decisions about their fate. The bulk of those German records that came to the United States were deposited in a section of a World War I torpedo factory in Alexandria, Virginia, which had been made into the temporary holding center for the World War II records of the American army and American theater commands. In accordance with the admonition to turn swords into plowshares, the building is now an artists' boutique.
The Visual Arts and Cultural Migration in the 1930s and 1940s: A Literature Review
Authors: Deshmukh Marion F.
Published: November 2008

In 1932, the artist George Grosz offered an optimistic account of his arrival to the United States:

It was really quite a change from Germany at that time, when you saw so few happy faces and heard so much complaining and quarreling. You had the impression that Americans of all races, classes, and occupations were satisfied with the world, and actually, in spite of the Depression, their American world was still much more colorful and richer than the German.
“We Will Never Go Back to the Old Way Again”: Germany in the African-American Debate on Civil Rights
Authors: Höhn Maria
Published: November 2008

This special edition ofCentral European Historyis concerned with how America viewed Germany, and my contribution focuses on how, beginning with Hitler's rise to power, Germany became a point of reference for the emerging American civil-rights movement. By looking atCrisis, published by the National Association for the Advancement of Colored People (NAACP), andOpportunity, published by the National Urban League, as well as African-American newspapers, such as thePittsburgh Courier,Chicago Defender,Amsterdam News, Afro-American, Negro Digest,Ebony, andJet, I will show how the black community discussed developments in Germany, America's struggle against Nazi racism, and the black soldiers' experience in postwar Germany.
The influence of inlet velocity profile and secondary flow on pulsatile flow in a model artery with stenosis
Authors: PETERSON SEAN D. , PLESNIAK MICHAEL W.
Published: November 2008

The results of an experimental investigation to determine the influence of two physiologically relevant inlet conditions on the flow physics downstream of an idealized stenosis are presented. The two inlet conditions are an asymmetric mean inlet velocity profile and an asymmetric mean inlet velocity profile plus secondary flow, as found downstream of a bend. The stenosis is modelled as an axisymmetric 75% area reduction occlusion with a length-to-diameter ratio of 2. The flow was forced by a 10-harmonic carotid artery-inspired waveform with mean, maximum and minimum Reynolds numbers of 364, 1424 and 24, respectively, and a Womersley number of 4.6. Laser Doppler velocimetry and particle image velocimetry were used to characterize the spatial and temporal evolution of a baseline case (no disturbances) as well as the two physiologically relevant inlet conditions. The asymmetric inlet velocity profile was found to reduce the region of influence of the stenosis by forcing the stenotic jet towards the tube wall via an induced non-uniform radial pressure gradient, similar to the Coanda effect. Curvature-induced secondary flow was found to play a minor role in the near-stenosis region. Vortex ring formation was relatively unaffected by the mean velocity gradient and secondary flow. Evidence of remnants of the starting vortex ring was observed far downstream in all cases.
Experimental observation of swirl accumulation in a magnetically driven flow
Authors: GRANTS I. , ZHANG C. , ECKERT S. , GERBETH G.
Published: November 2008

Independent poloidal and azimuthal body forces are induced in a liquid metal cylinder by travelling and rotating magnetic fields of different frequencies, respectively. The bulk axial and azimuthal velocities are measured by the ultrasound Doppler method. Particle image velocimetry is used to observe the upper free surface velocity distribution. The transition from the poloidal to the azimuthal body force governed regime occurs at a fixed ratio of the respective force magnitude of around 100. This transition is marked by the formation of a concentrated vortex revealing several similarities to intense atmospheric vortices. The vortex structure is controlled by a relatively weak azimuthal force while the maximum speed of the swirl is mainly governed by the poloidal one. Under a certain force ratio the average axial velocity changes its direction in the vortex core, resembling the subsidence in an eye of a tropical cyclone or a large tornado. Multiple moving vortices encircle the vortex core in this regime.
The thinning of lamellae in surfactant-free foams with non-Newtonian liquid phase
Authors: BRUSH L. N. , ROPER S. M.
Published: November 2008

Thinning rates of liquid lamellae in surfactant-free non-Newtonian gas–liquid foams, appropriate for ceramic or polymer melts and also in metals near the melting point, are derived in two dimensions by matched asymptotic analysis valid at small capillary number. The liquid viscosity is modelled (i) as a power-law function of the shear rate and (ii) by the Ellis law. Equations governing gas–liquid interface dynamics and variations in liquid viscosity are derived within the lamellar, transition and plateau border regions of a corner of the liquid surrounding a gas bubble. The results show that the viscosity varies primarily in the very short transition region lying between the lamellar and the Plateau border regions where the shear rates can become very large. In contrast to a foam with Newtonian liquid, the matching condition which determines the rate of lamellar thinning is non-local. In all cases considered, calculated lamellar thinning rates exhibit an initial transient thinning regime, followed by a t−2 power-law thinning regime, similar to the behaviour seen in foams with Newtonian liquid phase. In semi-arid foam, in which the liquid fraction is O(1) in the small capillary number, results explicitly show that for both the power-law and Ellis-law model of viscosity, the thinning of lamella in non-Newtonian and Newtonian foams is governed by the same equation, from which scaling laws can be deduced. This result is consistent with recently published experimental results on forced foam drainage. However, in an arid foam, which has much smaller volume fraction of liquid resulting in an increase in the Plateau border radius of curvature as lamellar thinning progresses, the scaling law depends on the material and the thinning rate is not independent of the liquid viscosity model parameters. Calculations of thinning rates, viscosities, pressures, interface shapes and shear rates in the transition region are presented using data for real liquids from the literature. Although for shear-thinning fluids the power-law viscosity becomes infinite at the boundaries of the internal transition region where the shear rate is zero, the interface shape, the pressure and the internal shear rates calculated by both rheological models are indistinguishable.
Lagrangian stochastic models for turbulent relative dispersion based on particle pair rotation
Authors: PAGNINI GIANNI
Published: November 2008

The physical picture of a fluid particle pair as a couple of material points rotating around their centre of mass is proposed to model turbulent relative dispersion in the inertial range. This scheme is used to constrain the non-uniqueness problem associated to the Lagrangian models in the well-mixed class and the properties of the stochastic process derived are analysed with respect to some turbulent velocity characteristics. A simple illustrative Markov model is developed in stationary homogeneous isotropic turbulence and the particle separation statistics are compared with direct numerical simulation data. In spite of the simplicity of the model, a consistent comparison is observed in the inertial range, supporting the formulation proposed.
Gravity currents and internal waves in a stratified fluid
Authors: WHITE BRIAN L. , HELFRICH KARL R.
Published: November 2008

A steady theory is presented for gravity currents propagating with constant speed into a stratified fluid with a general density profile. Solution curves for front speed versus height have an energy-conserving upper bound (the conjugate state) and a lower bound marked by the onset of upstream influence. The conjugate state is the largest-amplitude nonlinear internal wave supported by the ambient stratification, and in the limit of weak stratification approaches Benjamin's energy-conserving gravity current solution. When the front speed becomes critical with respect to linear long waves generated above the current, steady solutions cannot be calculated, implying upstream influence. For non-uniform stratification, the critical long-wave speed exceeds the ambient long-wave speed, and the critical-Froude-number condition appropriate for uniform stratification must be generalized. The theoretical results demonstrate a clear connection between internal waves and gravity currents. The steady theory is also compared with non-hydrostatic numerical solutions of the full lock release initial-value problem. Some solutions resemble classic gravity currents with no upstream disturbance, but others show long internal waves propagating ahead of the gravity current. Wave generation generally occurs when the stratification and current speed are such that the steady gravity current theory fails. Thus the steady theory is consistent with the occurrence of either wave-generating or steady gravity solutions to the dam-break problem. When the available potential energy of the dam is large enough, the numerical simulations approach the energy-conserving conjugate state. Existing laboratory experiments for intrusions and gravity currents produced by full-depth lock exchange flows over a range of stratification profiles show excellent agreement with the conjugate state solutions.
Ships advancing near the critical speed in a shallow channel with a randomly uneven bed
Authors: ALAM MOHAMMAD-REZA , MEI CHIANG C.
Published: November 2008

Effects of random bathymetric irregularities on wave generation by transcritical ship motion in a shallow channel are investigated. Invoking Boussinesq approximation in shallow waters, it is shown that the wave evolution is governed by an integro-differential equation combining features of Korteweg–deVries and Burgers equations. For an isolated ship, the bottom roughness weakens the transient waves radiated both fore and aft. When many ships advance in tandem, a steady mount of high water can be formed in front and a depression behind. Wave forces on both an isolated ship and a ship in a caravan are obtained as functions of the mean-square roughness, ship speed and the blockage coefficient.
Wall effects in non-Boussinesq density currents
Authors: BONOMETTI THOMAS , BALACHANDAR S. , MAGNAUDET JACQUES
Published: November 2008

We report on the results of a numerical study of nearly immiscible contrasted density currents aimed at shedding light on the influence of wall effects on current dynamics in the lock-exchange configuration. The numerical approach is an interface-capturing method which does not involve any explicit reconstruction of the interface. Navier–Stokes equations are solved on a fixed grid and a hyperbolic equation is used for the transport of the local volume fraction of one of the fluids. This allows us to describe the density currents for the complete range of density contrast 10−3≤ρL/ρH≤0.99 (ρL and ρH being the density of the light and heavy fluids) and a wide range of Reynolds number 70≤Re≤5×104 (based on the channel height and the viscosity of the heavy fluid). The use of free-slip vs. no-slip boundary conditions enables us to separate the dissipation at the interface from the dissipation at the boundaries. Present results reveal that wall effects play a significant role on the propagation of contrasted density currents, unlike dissipation at the interface. It is first shown that when wall friction can be neglected, theoretical models based on the inviscid shallow-water approximations and Benjamin's steady-state result describe fairly well the light and heavy front velocities of density currents for the complete range of density ratio. However, when wall friction cannot be neglected, the results depart significantly from the prediction of inviscid theories. It is observed that most of the dissipation in highly contrasted currents takes place at the bottom wall and is a maximum at the head of the heavy current. This dissipation is shown to be responsible for the decrease of the front velocity. We propose a simple model based on Benjamin's analysis that includes wall friction. Keeping in mind the simplicity and limitations of the present model, the prediction of the front velocity of both the heavy and light currents is observed to be in good agreement with the numerical results for the complete range of density contrast. This gives further support to the idea that wall effects are the crucial ingredient for accurately predicting the front velocity of highly contrasted density currents.
Associations with Changes in Level of Functional Ability. Results from a Follow-up Survey at Two and a Half Years of People Aged 85 Years and Over at Baseline Interview
Authors: Bowling Ann , Farquhar Morag , Grundy Emily
Published: November 2008

This paper describes association with changes in functional ability among very elderly people who were interviewed first in 1987 when they were aged 85+, and followed-up in 1990. It focuses, in particular, on those with severe difficulties with ADL. It was notable that while those with chronic problems with disability used more health and social services, few received services specific to rehabilitation and social support (e.g. physiotherapy, occupational therapy and social work), and substantial numbers in this group (30–45%) did not receive any chiropody services; although the provision of instrumental aid with tasks of daily living was relatively high from home help services, and, in particular, from relatives.
Empowering the Elderly: Gerontological Health Promotion in Latin America
Authors: Checkoway Barry
Published: November 2008

Older people are increasing in number and proportion of the population in Latin America and, as they do their health needs and social resources are becoming more apparent. In response, gerontologiacal health promotion is emerging as a new field emphasizing the community as a unit of health and the participation of older people in the process. Recognizing the need for more empirical research on the topic, this paper identifies initiatives that promote the health of perople in Costa Rica, Chile, and Argentina, by enabling them to plan programmes, develop services, and advocate change at the community level. It analyzes some of their common themes, and discusses general prospects for the future.
Living Arrangements of Non-Married Elderly People in the Netherlands in 1990
Authors: Van Solinge Hanna
Published: November 2008

In 1990, approximately one out of every three elderly persons in the Netherlands was living alone. This proportion has almost doubled since 1960. This sharp increase in living alone among the elderly has attracted attention in political circles and among policy makers. An understanding of living arrangements of elderly people is critical for a determination of the likely need for public care, such as home help and district nursing, and institutional care. Elderly persons who live alone require public care services sooner, whether or not as supplement to informal care from persons outside the household. This article examines the living arrangements of the elderly in the Netherlands. Special attention is paid to the household structure of unmarried and no longer married elderly persons, and why so many of then live alone. The data used in this study are taken from the 1989/90 Housing Demand Survey (WBO), which is a large-scale sample survey containing approximately 50,000 Dutch households.
Caring for Family Caregivers in Australia: A Model of Psychoeducational Support
Authors: Schultz Cynthia L. , Smyrnios Kosmas X. , Grbich Carolyn F. , Schultz Noel C.
Published: November 2008

The present paper describes and traces the emergence of an innovative psychoeducational model of support for family caregivers of dependent elderly persons, its associated systematic evaluation and leadership training process, provides details of a small group programme and its underlying philosophy, and reports on outcome evaluation research ascertained from both quantitative and qualitative data analyses. Details of these analyses are presented within the context provided by a three-level model of support, which recruits and trains professionals from a range of disciplines to help families in caregiving situations. The 72 treatment and 29 waiting-list control subjects were assessed at pretreatment and at posttest on measures of anxiety and psychological well-being. Statistically significant differences emerged between the treatment and waiting-list control groups on these measures. Positive changes for programme participants were further demonstrated by contextual analysis of evaluative responses. Implications for practitioners, educators, and policy specialists, as well as for research and programme development are discussed.
A Very Special Relationship: Granddaughters' Perceptions of Grandmothers
Authors: Hyde Valerie , Gibbs Ian
Published: November 2008

The article reports on a study which explored the relationship female undergraduates and student nurses experienced with their maternal and paternal grandmothers. In addition, the article identifies some of the factors closely associated with the relationship, considers the role played by grandmothers with regard to their granddaughters and examines differences in granddaughters' perceptions of maternal and paternal grandmothers. The results highlight the intimate relationship between granddaughter and grandmother. When compared to paternal grandmothers, maternal grandmothers were perceived by granddaughters to be emotionally closer, provide a greater sense of security, be more influential in shaping their beliefs and were more likely to be preferred. They were also found to play a more active role in granddaughters' lives.
Self-Esteem and its Sources: Stability and Change in Later Life
Authors: Coleman Peter G. , Ivani-Chalian Christine , Robinson Maureen
Published: November 2008

Stability and change in self-esteem and its reported sources were investigated in a sample of older people re-interviewed 10 and 13 years after initial study. Most indicated a continuing high to medium-high level of self-esteem, and apart from an increase in mention of interest activities their pattern of illustrations also remained consistent. Variables in the initial study which predicted a maintained high level of self-esteem included number of hobbies, number of types of outings, self perceived activity level, and mention of people other than family members as sources of self-esteem. The usefulness of collecting data on expressed sources is exemplified in two case histories. Consideration is given to the implications of these findings for conceptualising identity processes in later life.
U3A (the University of the Third Age) in Australia: a Model For Successful Ageing
Authors: Swindell Richard
Published: November 2008

Education may have an important role to play in helping to enhance older people's quality of life. The University of the Third Age (U3A) has operated successfully in many countries for nearly two decades, yet few studies have described the characteristics of those who are attracted to the movement, or the benefits to the individual and, possibly, to wider society of the U3A approach to education. This study discusses major findings from 770 responses to a postal survey involving members from twelve independent U3A campuses in three Australian States, and compares these findings with data reported for older learners in other countries. Some implications for Australian U3As undertaking research activities which have the potential to benefit the wider ageing community are raised.
Socio-Economic Resources and Differential Ageing
Authors: Mayer Karl Ulrich , Wagner Michael
Published: November 2008

The Sociology and Social Policy Research Unit of the Berlin Aging Study focuses on four substantive areas: (1) life course antecedents and generational experiences, (2) later phases of the family life course, (3) action resources and social participation, and (4) economic situations and the provision of care. This paper reports results on the relationship between social and economic inequality and differential ageing, using the BASE multidisciplinary Intake Assessment (N = 360). The socio-economic position of older people is measured along three dimensions: economic resources, social status and prestige, and cultural status. Several ageing outcomes are considered, including functional physical health, cognitive functioning and mental health, overall subjective well-being, social autonomy and dependency. First, we show that old people as a group are neither socially nor economically homogeneous: very old women possess unusually low economic resources; and cohort differences in educational attainment are carried into old age. Second, cognitive functioning and mental health are positively correlated with socio-economic resources, while functional physical health is not. For women, socio-economic resources slightly affect overall subjective well-being, and are linked to the likelihood of living in a nursing home. We speculate that the wide availability of compulsory health insurance reduces social differentials in physical health and that these inequalities may determine who survives into old age.
Health Differences in Advanced Old Age
Authors: Steinhagen-Thiessen Elisabeth , Borchelt Markus
Published: November 2008

The first part of this paper provides a general outline of objectives and methods of the Internal Medicine and Geriatrics Unit of the Berlin Aging Study (BASE). Based on a multi-dimensional conceptualization of health, objective and laboratory data collected about different organ systems, e.g. cardiovascular and musculoskeletal, and functional capacity are complemented by qualitative clinical diagnoses and judgements as well as self-reported health problems and functional limitations. Some of the central questions that can be addressed using these data relate to understanding the nature and processes of differential ageing. The second part of the paper includes initial analyses of inter-individual health differences in advanced old age (70 to 105 years). Initial findings indicated that heterogeneity in somatic morbidity and functional capacity was at least as large in old adults (70 to 84 years) as in very old adults (85 to 105 years), even though higher rates of somatic morbidity and lower levels of functional capacity were observed in the very old. Chronological age and morbidity as well as psychosocial and demographic factors were found to be independent predictors of functional capacity in advanced old age. Additionally, the relative importance of psychosocial factors was found to be a function of age with lower predictive ability among the very old. In conclusion, these initial findings support the hypothesis of significant health differences in advanced old age due to differential ageing.
Everyday Competence in Old and Very Old Age: An Inter-disciplinary Perspective
Authors: Baltes Margret M. , Mayr Ulrich , Borchelt Markus , Maas Ineke , Wilms Hans-Ulrich
Published: November 2008

In the present paper the focus is on structural aspects of everyday competence and its relationship with various personal resources, such as health, social status, self concept and cognition. The findings support the hypothesis that two distinct, albeit intercorrelated, components of everyday competence are differentially related to the various resources examined in this paper. The two components are a basic level of competence (BaCo) which is defined mainly by self-care related activities, and an expanded level of competence (ExCo) associated mostly with leisure and social activities and advanced instrumental activities of daily living. In general, BaCo is more strongly related to health-related resources, and ExCo is more strongly associated with behavioural, psychological and social resources. 90.6% of the reliable variance in ExCo and 82.4% in BaCo are explained by these selected resources. Furthermore, all of the age-related variance in everyday competence is accounted for by these health-related and socio-behavioural resources.
Allocation of Care and Services in an Area-Based System for Long-Term Care of Elderly and Disabled People
Authors: Lagergren Mårten
Published: November 2008

In order to analyse the allocation of public care services in the city of Solna, Sweden, and how they changed in response to a rapid growth of the number of elderly people, a comparison was made between two surveys, 1985 and 1991.

The surveys comprised all citizens of Solna who, on the day of the survey, were receiving long-term public medical and/or social care services. Living arrangements and services received were registered together with assessments of social support and disability/dependency. The latter was measured according to a special scale (the ASIM index) and – for 1991 – the Katz index of ADL. The assessments were made by the ordinary staff. The analysis showed that older and non-married persons were more likely to become clients of the public care system. Institutionalisation was also more common among the non-married – especially for men.

Connected to the rapid increase in the number of the very old in the context of limited resources was a sharp decline during the period 1985–1991 in the proportion of the Solna population that received public care services in some form. This decline concerned all age-groups of both sexes, married as well as non-married, but the married were more affected than the non-married – especially among the women. The reductions in the proportion of the population that received care in the home affected mostly married persons in the oldest age group. Reductions in institutionalisation had most impact on very old, non-married men – partly counteracted by increases in the provision of home help. Multivariate analysis showed functional disability – in 1991 dependency in ADL according to Katz - and living arrangements to be the most important variables in explaining the allocation of home help in domiciliary care and sheltered housing.
Multi-Purpose Residential Homes: A Fair Deal for Residents?
Authors: Wright Fay
Published: November 2008

The paper reports on a study carried out in 1990 for the Department of Health looking at the development of local authority multi-purpose residential homes for elderly people in England and Wales. A national survey showed that one in five public sector residential homes for elderly people would soon be multi-purpose. This proportion could be expected to increase in the 1990S. Many of these homes had become the centre for virtually all the community support services for elderly people in the neighbourhood. Despite some obvious management advantages in making use of residential home facilities for older people in the community, there have to be serious reservations about a multi-purpose model. Case studies in six multi-purpose homes suggest that residents themselves may gain little or nothing from this arrangement. Few interact with elderly people from the neighbourhood in the day centre. So much activity on the premises meant that invasions of residents' privacy and space were common.
The National Policy on Elderly People in Singapore
Authors: Teo Peggy
Published: November 2008

Expanding longevity among elderly people and fertility decline are contributing to the ageing of Singapore's population. By 2030, the proportion of persons aged 60 and above will be 26% of the total population. A national policy on elderly persons was formulated in 1989 which incorporated four issues: employment of elderly persons in the workforce; attitudes toward elderly people; community care; and residential care. This paper discusses each of these agenda with the view of assessing their strengths and weaknesses. The section on residential care is supported by empirical data. The paper concludes that elderly people in Singapore suffer from a high degree of enforced dependence which will need to be reviewed. In particular, a consultative approach in keeping with the more liberal attitude of the second generation leadership will help Singapore to achieve higher standards of care for an increasingly affluent elderly population.
Photographic Memory, Ageing and the Life Course
Authors: Blaikie Andrew
Published: November 2008

Although photographs are frequently used to illustrate discussions about ageing they have not been assessed critically as gerontological sources. This paper argues that the pictorial record since the 1840s contains many problems and possibilities. A case study of Victorian Scotland indicates the methodological pitfalls of acknowledging images at face value. Uncritical acceptance of the assumptions of modernisation theory has underlain much of the received wisdom on ageing in former times. More generally, both academics and advocates in Postwar Britain have reworked stereotypes of old age to suit their own aims. Against this, the convergence of reminiscence and a willingness to develop more interactive approaches to understanding the life course allows photographs to provide a resource for interpreting the ageing self. Nevertheless, as the examples show, difficulties again arise as the ambiguity and malleability of images all too easily enables generalised fictions to shroud the diversity of individual experience.
Relatives of Persons Suffering from Dementia: Differences in the Burden
Authors: Duijnstee Mia S. H.
Published: November 2008

Partners and children play a key role in home care for persons suffering from dementia. When we compare the burdens placed on these relatives, we find large differences. On the one hand, these result from actual differences in the care situation. On the other, they arise from the differences in the way the people involved experience more or less comparable circumstances. To determine the sources of the differences in the burden on the relatives, a distinction was made between objective and subjective care-giver burden. Qualitative research, therefore, aimed to provide an understanding of the personal interpretation by the people involved. This was realised in about 40 case studies involving relatives.
Effects of Spouses' Characteristics on the Social Roles and Activities of Married Elderly Persons in Israel
Authors: Matras Judah , Caiden Miriam
Published: November 2008

In this paper, we present findings from a recent national study of elderly persons in Israel which cover two related questions: I. How do spouses' characteristics and activities affect the social participation of married older men and women? 2. Is the effect of husbands' characteristics and activities on wives equivalent or symmetrical to that of wives' characteristics and activities on husbands? The study is based on analyses of data collected in the Israel Survey of Persons Aged 60 and Over in Households, 1985, a national sample survey of households conducted by the Israel Central Bureau of Statistics which included approximately 4,500 persons age 60 and over. An innovation of our study has been the design of a data file which enables us to study the activities, role incumbency, and participation of the respondents in relation to the characteristics and activities of their spouses.

We study the performance by husbands and wives of social roles designated as ‘major commitment’ roles (MCRs), in that they are roles performed in social contexts invoving commitments over time to the activity and to the social units in which they are carried out: (a) employment, (b) continued parenting involving assistance to adult children, (c) full housekeeping, and (d) volunteer activity. Characteristics and roles of the wives of older married male respondents, and of the husbands of older married female respondents in Israel, are significantly associated with the respondents' performance of the MCRs which we have identified. However, the ‘marginal effects coefficients’ based on logistic regression equations show that the relative weight of spouses' characteristics and roles is small compared with that of the respondents' own characteristics and other competing or mutually supportive roles. There are both symmetries and assymmetries in the patterns of effects of husbands' and wives' characteristics and roles on prevalences of MCRs among the older married respondents.
A Classical Indian Philosophical Perspective on Ageing and the Meaning of Life
Authors: Ram-Prasad Chakravarthi
Published: November 2008

Indian thought conceives of life in four normative stages: of student, householder, forest-dweller and renouncer. A metaphysical theory related to the conception of life-stages is that of the ends or purposes of life: appropriate conduct, material well-being, physical satisfaction and liberation. The theory of the ends of life is reconstructed here in the light of contemporary philosophical discussions about the meaning of life. The first three ends are part of a world-oriented attitude; the last end, of world-transcending contemplation. Among age-neutral and age-specific ways of relating life stages and life ends, that of taking old age as the time for the renunciatory stage is important and is examined in the context of the two main theories of meaning: world-oriented and world-transcending. Old age is secondary to earlier stages in a world-oriented theory, more significant in the world-transcendent one. However, both theories, seen independently, are paradoxical. In a synthesis, the world-transcendence of renunciation in old age is paramount in Indian thought, but worldly action is significant because renunciation depends on the richness of the life renounced. This reconstruction of an ancient ideal is offered as a philosophical paradigm for transculturally relevant attitudes to life in old age.
A Comparison of Urban with Rural Support Networks: Liverpool and North Wales
Authors: Wenger G. Clare
Published: November 2008

This paper compares findings on the distribution of support networks in the City of Liverpool and in rural communities in North Wales. It demonstrates that while support network type is highly correlated with a wide range of demographic and social variables in both urban and rural samples, the nature of the relationships are not always comparable. The paper shows how cultural, migration and socio-economic factors interact to affect the formation of different types of support networks. As a result of a more stable elderly population, more old people in Liverpool have network types able to provide a high level of informal care and support.
Introduction: Special Issue on Resource Allocation and Societal Responses to Old Age
Authors: Callahan Daniel , Meulen Ruud Ter , Topinková Eva
Published: November 2008

There is a special feature of the health and welfare problems of the elderly population that sets them off from the other domestic problems of the developed countries of the world. They combine two difficult elements, complex enough when taken alone but much more so when combined. There is, on the one hand, the economic problem of finding ways to make adequate provision for the needs of the old, barely met with full adequacy in any country and full of greater threats in the future. There is also, on the other hand, the extraordinary delicacy needed to conduct serious public debate on the issues. At a time when many countries still struggle against a pervasive ageism, trying to open up new possibilities for elderly people and to foster new attitudes, it is exceedingly painful to contemplate further economic constraints, even rationing, to meet the impending economic problems.
Strategies for an Ageing Population: Expanding the Priorities Discussion
Authors: Thorslund Mats , Parker Marti G.
Published: November 2008

The growing number of oldest old has increased the need for social services and medical care in many countries during the last decade. These needs have been met with various strategies to make more effective and efficient use of resources. In many ways these changes have been successful, but at the same time the amount of success correlates negatively to the potential for further gains. That is, when the slack in the system has been drawn in, it is doubtful whether further gains can be made with these strategies. So what can be done if the public resources are restricted and needs continue to increase? Adequate solutions will require a wide perspective encompassing all the various services needed by elderly people. Decisions made in one sector necessarily have repercussions in other service areas. It is also essential to recognize the differences between sectors; guidelines and strategies developed within the medical sector are not always applicable in the social services sector. With Sweden as an example, the organizational and administrative changes that have occurred during the last decades are presented along with arguments for extending the discussion of strategies and priorities to include all kinds of service to the elderly population.
The Meaning of Old Age and the Distribution of Health-Care Resources
Authors: Houtepen Rob
Published: November 2008

Daniel Callahan has maintained that a common understanding of the meaning of old age and the proper role of old people in society is a prerequisite for decisions on the distribution of health-care resources to the elderly. The call for such a common understanding is traced to the writings of Thomas Cole and Harry Moody. A discussion of their ideas is followed by a philosophical analysis of communitarian accounts of meaning and the good life in general. It is concluded that viable interpretations of the meaning of old age should comply with the values of liberal individualism. Meaning should be localised less at the level of global ideas and images and more at the level of local and heterogeneous practices. The practice of distributing health-care resources cannot and should not be regulated by communitarian interpretations of the value of old age. It would seem to be sufficiently infused by liberal individualist interpretations of meaning and justice.
Retired British Home Owners in Rural France
Authors: Hoggart Keith , Buller Henry
Published: November 2008

Drawing on a survey of 406 British home owners in France, this study examines the origins, destinations and reasons for purchasing homes in rural France. In doing so it compares first home retired households with their pre-retirement counterparts and with second home owners who are retired. No notable differences are found in the geographical distribution or reasons for selecting home locations between these groups. However, patterns of retirement migration to France do appear to differ from intra-national long-distance migration within Britain and North America. Pointers to these differences are given and suggestions for future research are made. In addition, despite family visits and the friendship that people find in their recipient French communities, it is suggested that potential problems could arise for residents in relatively isolated rural communes. More research is needed to assess whether the positive attractions that are drawing retirement migrants from Britain to France will outweigh the negative consequences of their new home location.
Improving Work Satisfaction amongst Nursing Staff and Quality of Care for Elderly Patients with Dementia: Some Policy Implications
Authors: Gilloran Alan , Robertson Alex , McGlew Tom , McKee Kevin
Published: November 2008

This paper discusses the policy implications for encouraging a high quality of service provision in hospital for elderly people with dementia. Contemporary policy is examined and the continuing need for long-stay beds is highlighted, particularly in Scotland. The measurement of the quality of care in nursing is reviewed and concern is expressed over whether the patients or only the audit score will benefit from any change in practice. Ways of improving both work satisfaction and the quality of care are recommended on the basis of a study of psychogeriatric wards in NHS hospitals in Scotland.