Competence of Long-Term Care Residence to Participate in Decisions About Their Medical Care: A Brief, Objective Assessment

Data from 50 residents of a long-term care facility were used to examine the extent to which performance on a brief, objective inventory could predict a clinical psychologist's evaluation of competence to participate in decisions about medical care. Results indicate that the competence to participate in medical decisions of two-thirds of the residents could be accurately assessed using scores on a mental status instrument and two vignette-based measures of medical decision-making. These procedures could enable nursing home staff to objectively assess the competence of residents to participate in important decisions about their medical care.

Residence near power lines and mortality from neurodegenerative diseases: longitudinal study of the Swiss population

The relation between residential magnetic field exposure from power lines and mortality from neurodegenerative conditions was analyzed among 4.7 million persons of the Swiss National Cohort (linking mortality and census data), covering the period 2000-2005. Cox proportional hazard models were used to analyze the relation of living in the proximity of 220-380 kV power lines and the risk of death from neurodegenerative diseases, with adjustment for a range of potential confounders. Overall, the adjusted hazard ratio for Alzheimer's disease in persons living within 50 m of a 220-380 kV power line was 1.24 (95% confidence interval (CI): 0.80, 1.92) compared with persons who lived at a distance of 600 m or more. There was a dose-response relation with respect to years of residence in the immediate vicinity of power lines and Alzheimer's disease: Persons living at least 5 years within 50 m had an adjusted hazard ratio of 1.51 (95% CI: 0.91, 2.51), increasing to 1.78 (95% CI: 1.07, 2.96) with at least 10 years and to 2.00 (95% CI: 1.21, 3.33) with at least 15 years. The pattern was similar for senile dementia. There was little evidence for an increased risk of amyotrophic lateral sclerosis, Parkinson's disease, or multiple sclerosis.

A STUDY OF A LANDSLIDE IN BIRMINGHAM, ALABAMA

In 1988 a landslide occurred at a construction site in Birmingham, Alabama in which a portion of the construction site required excavating a rock slope with a group of apartments that were located at the top of the slope. During construction, two separate landslides occurred causing one and half of the apartment buildings to collapse downslope. The slope failure was investigated by two firms. One firm investigated the site conditions and the second firm investigated the design of the cut slope. The main concerns in the investigation were (1) the lack of consideration for the existing joint system, (2) using averaged the strength parameters, (3) the possibility of damaging the slope with blasting, and (4) the potential that there were underground mines at the site. The Rocscience program RocPlane was used to model the in situ conditions and the excavation. The model showed that the joint system’s pore water pressure was most likely the main factor in the failure.

High life in the sky? Mortality by floor of residence in Switzerland

Living in high-rise buildings could influence the health of residents. Previous studies focused on structural features of high-rise buildings or characteristics of their neighbourhoods, ignoring differences within buildings in socio-economic position or health outcomes. We examined mortality by floor of residence in the Swiss National Cohort, a longitudinal study based on the linkage of December 2000 census with mortality and emigration records 2001-2008. Analyses were based on 1.5 million people living in buildings with four or more floors and 142,390 deaths recorded during 11.4 million person-years of follow-up. Cox models were adjusted for age, sex, civil status, nationality, language, religion, education, professional status, type of household and crowding. The rent per m² increased with higher floors and the number of persons per room decreased. Mortality rates decreased with increasing floors: hazard ratios comparing the ground floor with the eighth floor and above were 1.22 [95% confidence interval (CI) 1.15-1.28] for all causes, 1.40 (95% CI 1.11-1.77) for respiratory diseases, 1.35 (95% CI 1.22-1.49) for cardiovascular diseases and 1.22 (95% CI 0.99-1.50) for lung cancer, but 0.41 (95% CI 0.17-0.98) for suicide by jumping from a high place. There was no association with suicide by any means (hazard ratio 0.81; 95% CI 0.57-1.15). We conclude that in Switzerland all-cause and cause-specific mortality varies across floors of residence among people living in high-rise buildings. Gradients in mortality suggest that floor of residence captures residual socioeconomic stratification and is likely to be mediated by behavioural (e.g. physical activity), and environmental exposures, and access to a method of suicide.

„Es war, als hätte das Virus mich geschwängert.“ Vertextungsformen in Aids-Autobiographien

Die vorliegende Untersuchung der Vertextung von Aids in Autobiografien fokussiert die Frage, welcher Darstellungsstrategien diese sich bedienen und welche Funktionen sie in den westlichen Kulturen übernehmen. Vier Autobiografien werden exemplarisch mit Hilfe der Systemtheorie und der Diskursanalyse analysiert und auf folgende Leitfragen hin untersucht: Sind die AutorInnen an Aids erkrankt oder nicht? Welche Lebenszeit steht ihnen zur Verfügung? Sind sie professionelle Schriftsteller oder Laien? Welche Rolle spielt ihr Geschlecht? Welche Werte werden wie vermittelt? Wird Akzeptabilität geschaffen? Wie wird mit den Grenzen des Akzeptablen umgegangen? Wie wird die Konstruktion und Destruktion des schreibenden Subjektes angesichts der Krankheitserfahrung verhandelt? Das untersuchte Material umfasst ein Spektrum, das • das schnelle Sterben an Aids, das lange Leben mit Aids sowie das Leben als HIV-Negativer in Gegenwart von Aids zeigt. • von gesellschaftlich orientierter Bewältigung der Krankheitserfahrung über individuelle Bewältigung bis hin zur Verweigerung der gesellschaftlichen Integration reicht. • den unterschiedlichen Einsatz von Metaphern bei der Sinngebung und der Vertextung von Körpererfahrung aufzeigt: Sterben als Geburt (Normalisierungsrhetorik), Sterben als Holocaust (Eskalationsrhetorik), Krankheitserfahrung als Generator immer neuer, überbordender Sprachbilder.