Sedimentary n-alkanes, their hydrogen isotopes, GDGTs and d15N as well as d13Corg of lake Nam Co, Tibet

The transition from the last Glacial to the current Interglacial, the Holocene, represents an important period with climatic and environmental changes impacting ecosystems. In this study, we examined the interplay between the Indian Ocean Summer Monsoon (IOSM) and the Westerlies at lake Nam Co, southern Tibet to understand the climatic effects on the ecosystem. Different organic geochemical proxies (n-alkanes, glycerol dialkyl glycerol tetraethers, dD, d13Corg, d15N) are applied to reconstruct the environmental and hydrological changes on one of the longest available paleorecords at the Tibetan Plateau. Based on our paleohydrological dD proxies, the aquatic signal lags the terrestrial one due to specific ecological thresholds, which, in addition to climatic changes, can influence aquatic organisms. The aquatic organisms' response strongly depends on temperature and associated lake size, as well as pH and nutrient availability. Because the terrestrial vegetation reacts faster and more sensitively to changes in the monsoonal and climatic system, the dD of n-C29 and the reconstructed inflow water signal represent an appropriate IOSM proxy. In general, the interplay of the different air masses seems to be primarily controlled by solar insolation. In the Holocene, the high insolation generates a large land-ocean pressure gradient associated with strong monsoonal winds and the strongest IOSM. In the last glacial period, however, the weak insolation promoted the Westerlies, thereby increasing their influence at the Tibetan Plateau. Our results help to elucidate the variable IOSM, and they illustrate a remarkable shift in the lake system regarding pH, d13Corg and d15N from the last glacial to the Holocene interglacial period.

Isis a través de los textos: El culto isíaco en la literatura grecolatina de época altoimperial

El culto a la diosa Isis, de origen egipcio aunque helenizado a partir del dominio macedónico, se expande por el mundo grecorromano hasta abarcar un espacio geográfico muy amplio, como nunca antes había conocido. Los testimonios literarios que se refieren a él en época altoimperial son abundantes y de distinta naturaleza, desde descripciones precisas de elementos clave hasta escritos hostiles por parte de autores cristianos con una intencionalidad muy clara. El análisis pormenorizado de estos textos se antoja necesario si se quiere llegar a conocer el estado en el que se encuentra el culto isíaco en un período como el Alto Imperio.

De Relatie tussen Angst- en Stemmingsklachten en Self-disclosure: het Effect van Emotie-inhibitie en Mindfulness

Angst- en stemmingsklachten worden geassocieerd met verminderde self-disclosure. Met self-disclosure wordt zelfonthulling van ervaren emoties bedoeld. Dit speelt een rol bij zelfacceptatie en zelfinzicht, en is belangrijk bij gesprekstherapie. Deze studie onderzocht of emotie-inhibitie de negatieve relatie tussen angst- en stemmingsklachten en self-diclosure verklaart, en of de relatie gunstig te beïnvloeden is door mindfulness. Het effect van mindfulness op deze relatie was nog niet eerder onderzocht. Deelnemers waren 99 vrouwen van 24 t/m 74 jaar (M = 44.60, SD = 10.55) en 26 mannen van 26 t/m 77 jaar (M = 48.27, SD = 12.68), afkomstig uit de normale Nederlands populatie. Het onderzoeksontwerp betrof een cross-sectioneel online vragenlijstonderzoek, waarbij gebruik gemaakt werd van de Symptom Checklist (Arrindel & Ettema, 1986), Emotional Self-Disclosure Scale (Snell, Miller, & Belk, 1988), Emotion Regulation Questionnaire (Gross & John, 2003) en Five Factor Mindfulness Questionnaire – Short Form (Bohlmeijer, Ten Klooster, Fledderus, Veehof, & Baer, 2011). Resultaten tonen, conform bestaande literatuur, dat angst- en stemmingsklachten negatief samenhangen met self-disclosure. Emotie-inhibitie heeft echter géén mediatie-effect en mindfulness heeft géén moderatie-effect op de negatieve relatie tussen angst- en stemmingsklachten en self-disclosure. Mindfulness heeft wel mediatie-effect op deze relatie. Mindfulness hangt hierbij positief samen met self-disclosure. De relevantie van de bevindingen is vooral praktisch: om mensen met angst- en stemmingsklachten te stimuleren over hun emoties te praten zou mindfulness aangewend kunnen worden.

Nurses' experiences of pain management for people with advanced dementia approaching the end of life: a qualitative study

AIMS AND OBJECTIVES: To explore hospice, acute care and nursing home nurses' experiences of pain management for people with advanced dementia in the final month of life. To identify the challenges, facilitators and practice areas requiring further support.

BACKGROUND: Pain management in end-stage dementia is a fundamental aspect of end of life care; however, it is unclear what challenges and facilitators nurses experience in practice, whether these differ across care settings, and whether training needs to be tailored to the context of care.

DESIGN: A qualitative study using semi-structured interviews and thematic analysis to examine data.

METHODS: 24 registered nurses caring for people dying with advanced dementia were recruited from ten nursing homes, three hospices, and two acute hospitals across a region of the United Kingdom. Interviews were conducted between June 2014 and September 2015.

RESULTS: Three core themes were identified: challenges administering analgesia, the nurse-physician relationship, and interactive learning and practice development. Patient-related challenges to pain management were universal across care settings; nurse- and organisation-related barriers differed between settings. A need for interactive learning and practice development, particularly in pharmacology, was identified.

CONCLUSIONS: Achieving pain management in practice was highly challenging. A number of barriers were identified; however, the manner and extent to which these impacted on nurses differed across hospice, nursing home and acute care settings. Needs-based training to support and promote practice development in pain management in end-stage dementia is required.

RELEVANCE TO CLINICAL PRACTICE: Nurses considered pain management fundamental to end of life care provision; however, nurses working in acute care and nursing home settings may be under-supported and under-resourced to adequately manage pain in people dying with advanced dementia. Nurse-to-nurse mentoring and ongoing needs-assessed interactive case-based learning could help promote practice development in this area. Nurses require continuing professional development in pharmacology. This article is protected by copyright. All rights reserved.