Using the Precede-Proceed Model of Health Program Planning in breast cancer nursing research

Aim: In this paper we discuss the use of the Precede-Proceed model when investigating health promotion options for breast cancer survivors. Background: Adherence to recommended health behaviors can optimize well-being after cancer treatment. Guided by the Precede-Proceed approach, we studied the behaviors of breast cancer survivors in our health service area. Data sources: The interview data from the cohort of breast cancer survivors are used in this paper to illustrate the use of Precede-Proceed in this nursing research context. Interview data were collected from June to December 2009. We also searched Medline, CINAHL, PsychInfo and PsychExtra up to 2010 for relevant literature in English to interrogate the data from other theoretical perspectives. Discussion: The Precede-Proceed model is theoretically-complex. The deductive analytic process guided by the model usefully explained some of the health behaviors of cancer survivors, although it could not explicate many other findings. A complementary inductive approach to the analysis and subsequent interpretation by way of Uncertainty in Illness Theory and other psychosocial perspectives provided a comprehensive account of the qualitative data that resulted in contextually-relevant recommendations for nursing practice. Implications for nursing: Nursing researchers using Precede-Proceed should maintain theoretical flexibility when interpreting qualitative data. Perspectives not embedded in the model might need to be considered to ensure that the data are analyzed in a contextually-relevant way. Conclusion: Precede-Proceed provides a robust framework for nursing researchers investigating health promotion in cancer survivors; however additional theoretical lenses to those embedded in the model can enhance data interpretation.

Explaining Gendered Sentencing Patterns for Men and Women in the Late Victorian Period

Contemporary studies of disparities in the sentencing of male and female offenders claim that the differences found are caused by gender-related contextual factors, but not by a gender bias. In contrast, historical studies have suggested that women were disadvantaged by appearing to offend both against the law and the conventions of femininity. This article analyses minor assaults prosecuted in ten English magistrates’ courts between 1880 and 1920. It is based on a data-set that combines court cases and newspaper reports, and allows for the control of gender differences in sentencing outcomes through four contextual factors: severity of the assault, bonds between victim and assailant, culpability, and evidence. The findings reveal a differentiated pattern of sentences that questions the assumption that ‘doubly deviant’ women were more often convicted, and received higher penalties, throughout the Victorian period. The results show that the contextual factors of the offence affected judicial decision-making to the extent that they virtually account for gender differences in conviction rates, but do not, on their own, account for the different penalties handed out to men and women. Women who committed similar assaults to men were likely to receive a lighter punishment. Magistrates clearly targeted ‘male’ contexts of violence, and handed down more convictions and harsher penalties to men involved in these, in contrast to women involved in 'female' contexts. The findings of a strong gender bias in sentencing that disadvantaged lowerclass men indicate that local magistrates directed their efforts of 'civilizing' lower-class communities at 'dangerous masculinities', and deemed assaults committed by women as less important in this task.

The cancer stem-cell hypothesis : its emerging role in lung cancer biology and its relevance for future therapy

The cancer stem-cell (CSC) hypothesis suggests that there is a small subset of cancer cells that are responsible for tumor initiation and growth, possessing properties such as indefinite self-renewal, slow replication, intrinsic resistance to chemotherapy and radiotherapy, and an ability to give rise to differentiated progeny. Through the use of xenotransplantation assays, putative CSCs have been identified in many cancers, often identified by markers usually expressed in normal stem cells. This is also the case in lung cancer, and the accumulated data on side population cells, CD133, CD166, CD44 and ALDH1 are beginning to clarify the true phenotype of the lung cancer stem cell. Furthermore, it is now clear that many of the pathways of normal stem cells, which guide cellular proliferation, differentiation, and apoptosis are also prominent in CSCs; the Hedgehog (Hh), Notch, and Wnt signaling pathways being notable examples. The CSC hypothesis suggests that there is a small reservoir of cells within the tumor, which are resistant to many standard therapies, and can give rise to new tumors in the form of metastases or relapses after apparent tumor regression. Therapeutic interventions that target CSC pathways are still in their infancy and clinical data of their efficacy remain limited. However Smoothened inhibitors, gamma-secretase inhibitors, anti-DLL4 antagonists, Wnt antagonists, and CBP/β-catenin inhibitors have all shown promising anticancer effects in early studies. The evidence to support the emerging picture of a lung cancer CSC phenotype and the development of novel therapeutic strategies to target CSCs are described in this review.

A randomized controlled trial of a correspondence-based intervention for carers of relatives with psychosis

Background Family members play a crucial role in supporting the recovery of loved ones with psychosis. The journey of recovery is not only traversed by the person experiencing the mental illness but also by their family. Interventions to support these families have traditionally either focused on psychoeducation or addressed problematic interactions or expressed emotion. Family programmes have far less frequently emphasized supporting family members' adjustment to the challenges posed by their relative's disorder or their recovery from associated distress. The study compared a control condition that received only a psychoeducational booklet (Information) and a condition also receiving a correspondence-based interactive recovery-oriented intervention (Connections). The Connections group was expected to show greater improvements in recovery knowledge, well-being, experiences of caregiving, hopefulness and distress. Method A randomized controlled trial was conducted to evaluate the effectiveness of two correspondence-based family interventions delivered to 81 carers of relatives with psychosis. Results Intent-to-treat analyses showed no differential outcomes between conditions, but an analysis of participants who substantially completed their allocated treatment showed that carers receiving Connections had significantly more improvements in well-being, positive experiences of caregiving and distress. Conclusions Correspondence interventions that support carer's recovery may result in more positive mental health for those who complete key elements of the programme compared with information alone. However, many carers do not complete a correspondence programme and this may limit its impact.

Maiden, Joseph

Joseph Henry Maiden was born in London in 1859 and sailed for Australia in 1880, where he lived for the remainder of his life. He was an ardent Australian nationalist, and like many immigrants of this time, remained proud of his British heritage. His sweetheart, Eliza Jane Hammond, followed him to Australia in 1883. They married in Kew the day after she made port in Melbourne, and together in Sydney they raised five children. [1] During the first phase of his career Maiden presided over the Technological Museum of Sydney from 1882 to 1896. In the second phase, he was the director of the Sydney Botanic Gardens from 1896 to 1924. There he managed a whole complex of parks including the Domain,Centennial Park and the Governor's residences, a state nursery at Campbelltown and a scientific institution, the National Herbarium of New South Wales, devoted to botany. A short time after his retirement, he died at his home in Turramurra in 1925...

A discussion of “Estimating the historical and future probabilities of large terrorist events'' by Aaron Clauset and Ryan Woodard

The terrorist attacks in the United States on September 11, 2001 appeared to be a harbinger of increased terrorism and violence in the 21st century, bringing terrorism and political violence to the forefront of public discussion. Questions about these events abound, and “Estimating the Historical and Future Probabilities of Large Scale Terrorist Event” [Clauset and Woodard (2013)] asks specifically, “how rare are large scale terrorist events?” and, in general, encourages discussion on the role of quantitative methods in terrorism research and policy and decision-making. Answering the primary question raises two challenges. The first is identify- ing terrorist events. The second is finding a simple yet robust model for rare events that has good explanatory and predictive capabilities. The challenges of identifying terrorist events is acknowledged and addressed by reviewing and using data from two well-known and reputable sources: the Memorial Institute for the Prevention of Terrorism-RAND database (MIPT-RAND) [Memorial Institute for the Prevention of Terrorism] and the Global Terror- ism Database (GTD) [National Consortium for the Study of Terrorism and Responses to Terrorism (START) (2012), LaFree and Dugan (2007)]. Clauset and Woodard (2013) provide a detailed discussion of the limitations of the data and the models used, in the context of the larger issues surrounding terrorism and policy.

The effectiveness of education or behavioral interventions on adherence to phosphate control in adults receiving hemodialysis: A systematic review protocol

The objective of this review is to identify the effectiveness of education or behavioral interventions on adherence to phosphate control in adults with end stage kidney disease (ESKD) receiving hemodialysis (HD).

"You must trust somebody" : Valtio, liberalismi ja sotatarviketeollisuus Britanniassa 1884-1905

Tutkielmassa on tarkasteltu Britannian sotilasviranomaisten ja maan sotatarviketeollisuuden välisiä suhteita vuosina 1884-1905. Kiihtyvän kilpavarustelun myötä Britannian sotilasbudjetit kasvoivat nopeasti, mikä johti maan sotatarviketeollisuuden saamien tilausten määrän nopeaan kasvuun samalla kun tuotteiden teknologinen kehitys oli nopeaa. Sotilasmenojen nopea kasvu antoi sotamateriaalihankinnoista vastaaville viranomaisille mahdollisuuden vaikuttaa yksityisen teollisuuden kehitykseen. Keskittämällä tilaukset vain luotettavina pitämilleen yrityksille viranomaiset loivat näiden kanssa puolivirallisia yhteistyösuhteita ja edistivät samalla voimakkaasti alan keskittymistä. Toisaalta muutamien suuryritysten hallitsemasta sotatarviketuotannosta muodostui yksi niistä harvoista teollisuuden aloista, joilla Britannian nopeasti kasvavat kilpailijat eivät pystyneet ohittamaan sitä enempää tuotteiden teknologisessa tasossa kuin markkinaosuuksien suuruudessakaan. Tiettyjen yritysten suosimisen taustalla ei ollut vain maanpuolustuksen kannalta rationaalinen pyrkimys hankkia riittävän laadukasta ja kehittynyttä sotamateriaalia, vaan asiaan vaikutti myös upseerien ja sotilasministeriöiden siviilivirkamiesten perinteiset aristokraattiset ajattelu- ja toimintamallit. Taloudellisen liberalismin hengessä tapahtuneet pyrkimykset uudistaa hankintamenettelyä vastaamaan enemmän vapaan kilpailun ja taloudellisuuden ihanteita jäivät yleensä tuloksettomiksi. Sotamateriaalihankintoihin liittyvä päätöksenteko vaati suurta asiantuntemusta, mikä johti sotaministeriön ja amiraliteetin virkamiesten vaikutusvallan kasvamiseen. Sotateollisuuden laajeneminen kytkeytyy läheisesti 1900-luvun alussa Britannian yhteiskunnallisessa elämässä tapahtuneeseen muutokseen, jota yleensä on luonnehdittu laissez fairen lopuksi. Jo 1880-luvulla alkaneella puuttumisellaan yksityisten sotateollisuusyritysten kehitykseen viranomaiset olivat alkaneet harjoittaa suunniteltua teollisuuspolitiikkaa, jonka tuloksena syntynyt puolivirallinen sotilasteollinen sektori oli aatteellisesti liberaaliin yhteiskuntaan soveltumaton ilmiö. Aseteollisuudessa Britannian valtio oli siten joutunut ensimmäisen kerran läheiseen vuorovaikutussuhteeseen modernien suuryritysten kanssa. Kytkentä, joka 1900-luvun kuluessa levisi yhä uusille aloille samalla kun valtion roolia talouselämässä alettiin vahvistaa. Tutkimuksen varsinaisen lähdemateriaalin muodostavat Britannian parlamentin pöytäkirjat ja sen komiteoiden raportit Niiden ohella on käytetty päätöksien tekemiseen osallistuneiden tai niihin vaikuttamiseen pyrkineiden poliitikkojen ja sotilaiden painettuja puheita, kirjekokoelmia, päiväkirjoja ja muistelmia sekä eräitä aikakauden historiaa koskevia dokumenttikokoelmia ja tilastojulkaisuja. Oleellista valaistusta asiaan tuovat osaltaan aikalaisten kirjoittamat teokset sekä lehdistö, joista kuvastuu ajalle ominainen ajattelutapa. Aihetta suoranaisesti koskevaa, tieteellisen tutkimusten kriteerit täyttävää aikaisempaa tutkimusta on vähän, mutta aihetta sivuavien tutkimusten määrä on erittäin suuri. Sotamateriaalihankintoja ja niiden taustalla olevia syitä voidaan tarkastella niin talous-, sota- aate-, kuin poliittisen historiankin näkökulmista, mutta yksinään mikään niistä ei ole riittävä tämän tutkimuksen kysymyksenasettelun kannalta. Siten tutkielmaa varten on perehdytty laajasti aikakautta koskevaan tutkimuskirjallisuuteen.

Bergslagenista Karjalaan : Ruotsalaisten vuorimiesten siirtolaisuus Pitkärantaan 1879 - 1904

Pitkärannan kaivokselle Laatokan Karjalaan saapui vuonna 1880 24 ruotsalaista vuorimiestä perheineen käynnistääkseen sen uudella teholla, tekemään siitä modernin ja johtamaan sen toimintaa. Heidät oli rekrytoinut sinne pietarilainen kansainvälisten liikemiesten omistama pankki suomalaisen vuoriteollisuuden asiantuntijan Hjalmar Furuhjelmin avulla. Pankki oli hankkinut lupaavalla malmialueella sijainneen kaivoksen omistukseensa muutamaa vuotta aikaisemmin. Ruotsalaisten saapumisesta käynnistyi 25 vuotta jatkunut ketjusiirtolaisuus Ruotsin vuoriteollisuuden keskusalueelta Bergslagenista Pitkärantaan, mikä oli pituutensa ja toimintansa vuoksi merkittävä. Vaikka Pitkäranta sijaitsi periferiassa, oli se hyvin kansainvälinen paikka, jossa oli myös muutamia muunmaalaisia työntekijöitä. Pitkäranta eli ruotsalaisten johdossa teollisen kultakautensa. Sieltä louhittiin pääasiassa kuparia, mutta loppuaikoina toiminta keskittyi rautamalmiin, jota rikastettiin. Kaivoksen yhteydessä toimi eri aikoina myös muuta teollisuutta kuten pullotehdas. Monet Pitkärannan ruotsalaisista olivat siirtolaisina perheensä kanssa. Naimattomista muutamat solmivat avioliiton suomalaisen kanssa ja kaksi kaivoksen saksalaisen johtajan O. G. Trüstedtin tyttärien kanssa. Ruotsalaiset siirtolaiset olivat Pitkärannassa johtavassa asemassa niin tehtäviensä pohjalta kuin sosiaalisestikin. Pitkärannan ruotsalaiset eivät pääsaantöisesti integroituneet Suomeen, vaan säilyttivät ruotsalaisen identiteettinsä ja palasivat jossain vaiheessa takaisin Ruotsiin - jopa sellaiset, jotka olivat Suomessa yli kymmenen vuotta. Vain muutama ruotsalainen vuorimies jäi Suomeen. Ruotsalaiset loivat Pitkärannassa ollessaan tiiviin suhdeverkon, johon kuului keskeisesti myös Trüstedtien perhe. Verkosto toimi tiiviisti muutama vuosi Pitkärannan jälkeen perustetun Outokummun kaivoksen alkutaipaleen aikana. Pitkärannan ruotsalaiset liittyivät vielä Petsamon nikkelinkin löytymiseen. Pitkärannan ruotsalaisuus kuului kolmeen historialliseen kontekstiin. Taustalla oli vuosisatoja Ruotsista Suomeen jatkunut vuoriammattilaisten siirtolaisuus, joka ei ollut loppunut, vaikka maiden valtiollinen side oli päättynyt vuonna 1809. Tästä syytä rekrytoijien kannalta Ruotsi oli luonnollinen kohde. Rekrytoidut taas elivät Ruotsin suurinta siirtolaisuusaaltoa, jolloin suuret siirtolaisvirrat suuntautuivat Pohjois-Amerikkaan ja siirtolaisuus kosketti lähes jokaista ruotsalaista. Kolmas taustalla vaikuttanut historiallinen kehitys oli Pietarin nopea kasvu ja kansainvälistyminen sekä sen imussa tapahtunut vaikutusalueiden ja koko Suomen teollistuminen. Pitkärannan kaivos oli Pietarin kansainvälisten liikemiesten omistama ja sen tuotanto palveli täysin Pietaria, jonka laajaan vaikutusalueeseen Pitkäranta kuului hyvin voimakkaasti. Monessa mielessä ruotsalaisten vuorimiesten siirtolaisuus Pitkärantaan olikin enemmän siirtolaisuutta Pietarin vaikutusalueelle kuin Suomeen. Pitkärannan side Suomeen oli lähinnä vain sen fyysinen sijainti, muuten sitä täytyy arvioida kiinteästi osana Pietarin vaiheita. Pitkäranta oli Amerikan siirtolaisuuteen ja vähän myöhemmin alkaneeseen Norrbotteniin muuttoon verrattuna vain pieni sivujuonne ruotsalaisessa 1800-luvun lopun siirtolaisuudessa. Suomeen ja Venäjälle tapahtuneen ruotsalaissiirtolaisuuden joukossa se oli kuitenkin aikanaan merkittävä, monimuotoinen ja kauaskantoinen tapahtuma. Avainsanat: ruotsalaiset, siirtolaisuus, vuoriteollisuus, ruukki, kaivos, Pitkäranta, Impilahti, Falun, Pietari, Bergslagen, kupari, ketjusiirtolaisuus

Passion vallassa : Hermostunut aika Minna Canthin teoksissa

Under the power of passion. The age of nervousness in Minna Canth s works This research contemplates the psychology of Minna Canth s characters through the historical image of man in late 19th century Europe. The central operative term of the study is passion , understood as a twofold philosophical concept that includes both desire and suffering. The method of this study is historical and contextual. The study interprets the passions and the psychology of Canth s characters as they were understood in their own time. The indicator of the relevant contexts is the realist and naturalist genre of Canth s works. New research on the genre of the time is also the basis of a new kind of psychological approach to Canth s works. The most important context of passion in Canth s works is the positivistic and pathological image of man at the end of the 19th century. Then, passion was widely discussed, and was perceived as a physiological phenomenon that influenced humans neurologically and caused different kinds of physiological symptoms and nervous disorders. But at the same time, passion was understood as a manifestation of human instincts and drives. The naturalistic literature of the day aimed at creating deterministic studies of human morality and psychology following Émile Zola s application of experimental science methods in his writing. The pathological image of man is most explicitly manifested in Canth s formerly unknown short story Lääkäri (Doctor, 1891), in which a doctor who is interested in psychology visits a jail to meet a peculiar criminal, a girl who feels no remorse for her multiple crimes. In other works of Canth the medically motivated viewpoint is more hidden in the deterministic narrative and depiction of the characters. The present study approaches the passion in Minna Canth s works through five thematic chapters, in witch characters are interpreted suffering from blind love, ennui, crippling romantic idealism, melancholy, guilt and nostalgia, and their stories can be prescribed as medical histories which depict the born of the passion and its development towards ruin. All protagonists are also manifestations of their own time. Canth criticises the modern life and its demands as well as social defects through the tragic stories of individuals. The study demonstrates that Canth did not, like previous research has suggested, wait until the 1890s before writing works of a psychological nature but had already written according to the psychological paradigm of her time in Työmiehen vaimo (1885). The social and psychological interests intertwine in Canth s works and are not exclusionary as has formerly been interpreted. Canth is also critical of the medical power implicit in the naturalist experimental method and this shows itself especially in her depiction of working class women.

Le naturalisme finlandais : Une conception entropique du quotidien

Le naturalisme finlandais. Une conception entropique du quotidien. Finnish Naturalism. An Entropic Conception of Everyday Life. Nineteenth century naturalism was a strikingly international literary movement. After emerging in France in the 1870s, it spread all over Europe including young, small nations with a relatively recent literary tradition, such as Finland. This thesis surveys the role and influence of French naturalism on the Finnish literature of the 1880s and 1890s. On the basis of a selection of works of six Finnish authors (Juhani Aho, Minna Canth, Kauppis-Heikki, Teuvo Pakkala, Ina Lange and Karl August Tavaststjerna), the study establishes a view of the main features of Finnish naturalism in comparison with that of French authors, such as Zola, Maupassant and Flaubert. The study s methodological framework is genre theory: even though naturalist writers insisted on a transparent description of reality, naturalist texts are firmly rooted in general generic categories with definable relations and constants on which European novels impose variations. By means of two key concepts, entropy and everyday life , this thesis establishes the parameters of the naturalist genre. At the heart of the naturalist novel is a movement in the direction of disintegration and confusion, from order to disorder, from illusion to disillusion. This entropic vision is merged into the representation of everyday life, focusing on socially mediocre characters and discovering their miseries in all their banality and daily grayness. By using Mikhail Bakhtin s idea of literary genres as a means of understanding experience, this thesis suggests that everyday life is an ideological core of naturalist literature that determines not only its thematic but also generic distinctions: with relation to other genres, such as to Balzac s realism, naturalism appears primarily to be a banalization of everyday life. In idyllic genres, everyday life can be represented by means of sublimation, but a naturalist novel establishes a distressing, negative everyday life and thus strives to take a critical view of the modern society. Beside the central themes, the study surveys the generic blends in naturalism. The thesis analyzes how the coalition of naturalism and the melodramatic mode in the work of Minna Canth serves naturalisms ambition to discover the unconscious instincts underlying daily realities, and how the symbolic mode in the work of Juhani Aho duplicates the semantic level of the apparently insignificant, everyday naturalist details. The study compares the naturalist novel to the ideological novel (roman à these) and surveys the central dilemma of naturalism, the confrontation between the optimistic belief in social reform and the pessimistic theory of determinism. The thesis proposes that the naturalist novel s contribution to social reform lies in its shock effect. By means of representing the unpleasant truth the entropy of everyday life it aims to scandalize the reader and make him aware of the harsh realities that might apply also to him.

Sairaanhoitajaksi kasvattaminen : Sairaanhoitajakoulutus ja siinä käytetyt oppikirjat Suomessa vuoteen 1967 asti

The historical development of Finnish nursing textbooks from the late 1880s to 1967: the training of nurses in the Foucauldian perspective. This study aims, first, to analyse the historical development of Finnish nursing textbooks in the training of nurses and in nursing education: what Foucauldian power processes operate in the writing and publishing processes? What picture of nursing did early nursing books portray and who were the decision makers? Second, this study also aims to analyse the processes of power in nurse training processes. The time frame extends from the early stages of nurse training in the late 1880s to 1967. This present study is a part of textbook research and of the history of professional education in Finland. This study seeks to explain how, who or what contributed the power processes involved in the writing of nursing textbooks and through textbooks. Did someone use these books as a tool to influence nursing education? The third aim of this study is to define and analyse the purpose of nurse training. Michel Foucault´s concept of power served as an explanatory framework for this study. A very central part of power is the assembling of data, the supplying of information and messages, and the creation of discourses. When applied to the training of nurses, power dictates what information is taught in the training and contained in the books. Thus, the textbook holds an influential position as a power user in these processes. Other processes in which such power is exercised include school discipline and all other normalizing processes. One of most powerful ways of adapting is the hall of residence, where nursing pupils were required to live. Trained nurses desired to separate themselves from their untrained predecessors and from those with less training by wearing different uniforms and living in separate housing units. The state supported the registration of trained nurses by legislation. With this decision the state made it illegal to work as a nurse without an authorised education, and use these regulations to limit and confirm the professional knowledge and power of nurses. Nurses, physicians and government authorities used textbooks in nursing education as tools to achieve their own purposes and principles. With these books all three groups attempted to confirm their own professional power and knowledge while at the same time limit the power and expertise of others. Public authorities sought to unify the training of nurses and the basis of knowledge in all nursing schools in Finland with similar and obligatory textbooks. This standardisation started 20 years before the government unified nursing training in 1930. The textbooks also served as data assemblers in unifying nursing practices in Finnish hospitals, because the Medical Board required all training hospitals to attach the textbooks to units with nursing pupils. For the nurses, and especially for the associations of Finnish nurses, making and publishing their own textbooks for the training of nurses was a part of their professional projects. With these textbooks, the nursing elite and the teachers tended to prepare nursing pupils’ identities for nursing’s very special mission. From the 1960s, nursing was no longer understood as a mission, but as a normal vocation. Nurses and doctors disputed this view throughout the period studied, which was the optimal relationship between theory and practice in nursing textbooks and in nurse education. The discussion of medical knowledge in nursing textbooks took place in the 1930s and 1940s. Nurses were very confused about their own professional knowledge and expertise, which explains why they could not create a new nursing textbook despite the urgency. A brand new nursing textbook was published in 1967, about 30 years after the predecessor. Keyword: nurse, nurse training, nursing education, power, textbook, Michel Foucault

Meeting of the Joint Distribution Committee and the Executive Committee of the American Jewish Relief Committee 1918 in New York

Reproduction of a painting of a meeting of the Joint Distribution Committee (representing the American Jewish Relief Committee, the Central Rellief Committee and the People's Relief Committee) and the Executive Committee of the American Jewish Relief Committee, with chairman Felix Warburg, secretary Albert Lucas, stenographer Mrs. F. Friedman, executive director Boris Bogen, comptroller Harriet Lowenstein, associate treasurer Paul Baerwald and treasurer Arthur Lehman; Office of Mr. Felix M. Warburg, 52 William Street, New York

Studio portrait of Richard Molling, Margot Molling, Adolf Molling, Ilse Molling, Lena Molling nee Marx; Schoenau am Koenigssee, Germany.

Digital Image