Alcohol dependence: the impact of cognitive behaviour therapy with or without naltrexone on subjective health status

Objectives: To examine the health-related quality of life of alcohol-dependent patients across a 12-week cognitive behaviour treatment (CBT) program and identify whether the patient selection of the anticraving medication naltrexone further enhanced these outcomes. Method: One hundred and thirty-six consecutive alcohol-dependent subjects voluntarily participated and were offered naltrexone, of which 73 (54%) participants declined medication. A matched design was used. Of the 136 subjects, 86 (43 naltrexone and CBT; 43 CBT only) could be individually matched (blind to outcome measures) for gender, age, prior alcohol detoxification and dependence severity. Measures of health status and mental health wellbeing included the Rand Corporation Medical Outcomes Short Form 36 Health Survey (SF-36) and the General Health Questionnaire (GHQ-28). Results: Pre-treatment, all had SF-36 and GHQ-28 scores markedly below national norms. Post-treatment, significant improvement in seven of the eight SF-36 subscales and all of the GHQ-28 subscales occurred, approximating national normative levels. Patients in the CBT + naltrexone group were significantly more likely to have increased days abstinent (p = 0.002) and to complete the program abstinent (p = 0.051). The adjunctive use of naltrexone did not provide additional benefit as reflected in SF-36 and GHQ-28 scores, beyond CBT alone. Conclusions: Patients who completed the CBT-based treatment program reported significant improvements in self-reported health status (SF-36) and wellbeing (GHQ-28). The adjunctive use of naltrexone demonstrated no additional improvement in these measures.

Correlates of victimisation amongst people with psychosis

Background While much attention has been given to the prediction of violent offending behaviour amongst people with psychotic disorders, less attention has been given to the fact that these same individuals are often the victims of violence. In this paper, we examine victimisation amongst participants in a prevalence study of psychosis, and describe demographic and clinical correlates of victimisation. Method The study was based on the Australian National Survey of Mental Health and Wellbeing - Low Prevalence (Psychotic) Disorders. The participants were asked if they had been a victim of violence in the previous year. The association between selected demographic and clinical variables and being a victim of violence was examined using logistic regression. Results Of the 962 individuals with psychosis, 172 reported being a victim of violence in the past 12 months (17.9 %). The odds of being a victim were increased in those who: (a) were female, (b) were homeless, (c) had a lifetime history of substance abuse, (d) had been arrested in the previous 12 months, (e) had poorer social and occupational function, and (f) had higher scores on the disorganisation summary score. Conclusions Clinicians should remain mindful that one out of every six individuals with a psychotic disorder reports being a victim of violence in the previous year. Models of care that address issues related to symptom relief, accommodation, and exposure to high-crime areas may reduce the rates of victimisation amongst those with psychotic disorders.

New insights into ancient environments using dental characters in Australian Cenozoic lungfish

Environmentally-related wear conditions and pathologies affecting the dentition of fossil lungfish from freshwater deposits in Australia have been analysed and compared with similar changes in the dentition of the living Australian lungfish, Neoceratodus forsteri. Fossil populations from the Namba, Etadunna, Wipajiri and Katipiri formations in central Australia, and the Carl Creek Limestone and the Camfield beds in northern Australia were assessed. Tooth plates from populations of living lungfish from the Brisbane River and Enoggera Reservoir in southeast Queensland were analysed for comparison. Tooth plates were measured to determine the numbers of different age groups in each population. They were assessed for abrasion, attrition, spur and step wear, erosion and caries, and for trauma and pathological conditions such as malocclusion, hyperplasia, abscesses, osteopenia and parasitic damage. All of these conditions are related to the environment where the fish lived, are found in living members of the group, and can be compared directly with those of fossil relatives. The results suggest that some of the fossil populations were at risk before climatic changes late in the Cainozoic destroyed their habitats. Some fossil lungfish populations, such as those of the Wipajiri Formation, exhibit active spawning and recruitment, good growth rates and a low incidence of disease and environmentally related damage to the tooth plates. Others, like those of the Katipiri and Namba Formations, include no young, and the adult fish were ageing and show environmentally-related damage to the dentition. Etadunna lungfish had active recruitment, but the tooth plates show a high incidence of attrition and caries. Riversleigh lungfish were actively spawning but did not grow large. Tooth plates from this latter deposit have a high incidence of pathological conditions. Fish from the Camfield Beds, where food was severely limiting, had little serious pathology but high levels of caries. Pathologies among living lungfish are common, but fossil fish were comparatively healthy, with few serious dental problems. Information from studies of fossil lungfish confirms that conservation of the few living species of lungfish depends on the maintenance of clean environments that provide adequate supplies of food and suitable sites for spawning and for the growth of young fish.

Longitudinal Genetic Analysis of Plasma Lipids

The consensus from published studies is that plasma lipids are each influenced by genetic factors, and that this contributes to genetic variation in risk of cardiovascular disease. Heritability estimates for lipids and lipoproteins are in the range .48 to .87, when measured once per study participant. However, this ignores the confounding effects of biological variation measurement error and ageing, and a truer assessment of genetic effects on cardiovascular risk may be obtained from analysis of longitudinal twin or family data. We have analyzed information on plasma high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, and triglycerides, from 415 adult twins who provided blood on two to five occasions over 10 to 17 years. Multivariate modeling of genetic and environmental contributions to variation within and across occasions was used to assess the extent to which genetic and environmental factors have long-term effects on plasma lipids. Results indicated that more than one genetic factor influenced HDL and LDL components of cholesterol, and triglycerides over time in all studies. Nonshared environmental factors did not have significant long-term effects except for HDL. We conclude that when heritability of lipid risk factors is estimated on only one occasion, the existence of biological variation and measurement errors leads to underestimation of the importance of genetic factors as a cause of variation in long-term risk within the population. In addition our data suggest that different genes may affect the risk profile at different ages.

Women from the Union of Australian Women with banner during Aldermaston Peace march in 1964

Women from the Union of Australian Women with banner during Aldermaston Peace march, Sunday, April 5th 1964. The Aldermaston march covered the distance between Ipswich and Brisbane, Australia, walked in relays covering approximately two miles each. Most relay sections were sponsored by one or more individual organisations. The Union of Australian Women is a national organisation that was formed in 1950. Its aim is to work for the status and wellbeing of women across the world. It has been involved in a wide variety of campaigns that concern women. The Union of Australian Women networks with other women's community and union groups on such issues.

ENGAJAMENTO NO TRABALHO, BEM-ESTAR NO TRABALHO E CAPITAL PSICOLÓGICO: UM ESTUDO COM PROFISSIONAIS DA ÁREA DE GESTÃO DE PESSOAS

É crescente a busca pelo engajamento no trabalho por se tratar de um construto motivacional positivo, caracterizado por vigor, dedicação e absorção, sempre relacionado ao trabalho, implicando sentimento de realização que envolve estado cognitivo positivo e que é persistente no tempo. A busca em conhecer o que gera sentimentos positivos em trabalhadores no ambiente de trabalho é tema corrente em diversos estudos na área do comportamento organizacional. O construto de bem-estar no trabalho é constituído de três dimensões, a saber: satisfação no trabalho, envolvimento no trabalho e comprometimento organizacional afetivo associada aos afetos positivos dirigidos ao trabalho; e por sua vez o capital psicológico está relacionado com resultados de desempenho no trabalho, como otimismo, eficácia, esperança e resiliência. O presente estudo teve como objetivo analisar as relações entre engajamento no trabalho, bem-estar no trabalho e capital psicológico em profissionais da área de gestão de pessoas. Os participantes deste estudo foram 159 profissionais que atuam na área de gestão de pessoas em organizações diversas. A coleta de dados foi realizada por meio de um questionário eletrônico criado no ambiente Surveymonkey. O questionário era autoaplicável contendo as seguintes medidas. A análise dos dados foi realizada por meio do SPSS 19.0, calculando-se estatísticas descritivas e índices de correlação. Foi realizada, a priori, uma análise exploratória dos dados para verificar a precisão de entrada de dados, outliers e respostas omissas. Os resultados revelaram a existência de correlações positivas e significativas entre engajamento no trabalho, capital psicológico e as dimensões de bem-estar no trabalho (satisfação no trabalho, envolvimento no trabalho e comprometimento organizacional afetivo). Conclui-se que o indivíduo que apresenta vigor e absorção tem também em níveis acentuados otimismo, resiliência, esperança e eficácia e as dimensões de bem estar: satisfação no trabalho, envolvimento no trabalho e comprometimento organizacional afetivo.

Effect of uncorrected astigmatism on vision

PURPOSE: To examine the effect of uncorrected astigmatism in older adults. SETTING: University Vision Clinic METHOD: Twenty-one healthy presbyopes, aged 58.9±2.8 years, had astigmatism of 0.0 to -4.0 x 90?DC and -3.0DC of cylinder at 90?, 180? and 45? induced with spectacle lenses, with the mean spherical equivalent compensated to plano, in random order. Visual acuity was assessed binocularly using a computerised test chart at 95%, 50% and 10% contrast. Near acuity and reading speed were measured using standardised reading texts. Light scatter was quantified with the cQuant and driving reaction times with a computer simulator. Finally visual clarity of a mobile phone and computer screen was subjectively rated. RESULTS: Distance visual acuity decreased with increasing uncorrected astigmatic power (F=174.50, p<0.001) and was reduced at lower contrasts (F=170.77, p<0.001). Near visual acuity and reading speed also decreased with increasing uncorrected astigmatism power (p<0.001). Light scatter was not significantly affected by uncorrected astigmatism (p>0.05), but the reliability and variability of measurements decreased with increasing uncorrected astigmatic power (p<0.05). Driving simulator performance was also unaffected by uncorrected astigmatism (p>0.05), but subjective rating of clarity decreased with increasing uncorrected astigmatic power (p<0.001). Uncorrected astigmatism at 45? or 180? orientation resulted in a worse distance and near visual acuity, and subjective rated clarity than 90? orientation (p<0.05). CONCLUSION: Uncorrected astigmatism, even as low as 1.0DC, causes a significant burden on a patient’s vision. If left uncorrected, this could impact significantly on their independence, quality of life and wellbeing.

Beyond personal Leader Member Exchange (LMX) quality:the effects of perceived LMX variability on employee reactions

A fundamental tenet of Leader–Member Exchange (LMX) theory is that leaders develop different quality relationships with their employees; however, little research has investigated the impact of LMX differentiation on employee reactions. The current research investigates whether perceptions of LMX variability (the extent to which LMX relationships are perceived to vary within a team) affects employee job satisfaction and wellbeing beyond the effects of personal LMX quality. As LMX variability runs counter to principles of equality and consistency, which are important for maintaining social harmony in groups, it is hypothesized that perceptions of LMX variability will have a negative effect on employee reactions, via its negative impact on perceived team relations. Two samples of employed individuals were used to investigate the hypothesized relationships. In both samples, an individual's perception of LMX variability in their team was negatively related to employee job satisfaction and wellbeing (above the effects of LMX), and this relationship was mediated by reports of relational team conflict.

Surface coating deterioration studies

This project is concerned with the deterioration of surface coatings as a result of weathering and exposure to a pollutant gas (in this case nitric oxide). Poly(vinyl chloride) (PVC) plastisol surface coatings have been exposed to natural and artificial weathering and a comparison of the effects of these two types of weathering has been made by use of various analytical techniques. These techniques have each been assessed as to their value in providing information regarding changes taking place in the coatings during ageing, and include, goniophotometry, micro-penetrometry, surface energy measurements, weight loss measurements, thermal analysis and scanning electron microscopy. The results of each of these studies have then been combined to show the changes undergone by PVC plastisol surface coatings during ageing and to show the effects which additives to the coatings have on their behaviour and in particular the effects of plasticiser, pigment and uv and thermal stabilisers. Finally a preliminary study of the interaction between five commercial polymers and nitric oxide has been carried out, the polymers being polypropylene, cellulose acetate butyrate, polystyrene, polyethylene terephthalate and polycarbonate. Each of the samples was examined using infra-red spectroscopy in the transmission mode.

The mechanisms of melt stabilisation of polyolefins

The effects of melt stabilisers on the oxidative degradation of polyolefins (polypropylene, low density polyethylene) have been studied under a variety of processing conditions . The changes in the both chemical and physical properties of unstabilised polymers occurring during processing were found to be strongly dependent on the amount of oxygen present in the mixer. 2 ,6 ,3' ,5' -tetra-tert-butyl-4'-phenoxy-4-methylene-2, 5-cyclohexadiene-1- one (galvinoxyl), iodine, nitroxyl radicals and cupric stearate were found to be very efficient melt stabilisers particularly when processed in a restricted amount of air. The mechanisms of their melt stabilising action have been investigated and a common cyclical regenerative mechanism involving both chain-breaking electron acceptor (CB-A) and chain-breaking electron donor (CB-D) antioxidant activity was found to be involved in each case. 2,6,3',5'-tetra-tert-butyl-4'-hydroxy phenyl-4-rrethylene-2,5-cyclohexadiene- 1-one (hydrogalvinoxy1), 4-hydroxy, 2,2,6, 6-tetra methyl-N-hydroxy piperidine and hydrogen iodide were formed together with olefinic unsaturation in the substrates during the melt processing of the polymers containing galvinoxyl, 4-hydroxy, 2,2,6, 6-tetra methyl piperidine oxyl and iodine respectively. No bonding of the melt stabilisers to the polymers was found to occur. Cupric stearate was found to undergo a similar redox reaction during its action as a melt stabiliser with the formation of unsaturation in the polymer. Evidence for the above processes is presented. The behaviours of melt stabilisers in the subsequent thermal and photooxidation of polyolefins have also been studied. Galvinoxyl which is very effective under both mild and severe processing canditions has been found to be an effective antioxidant during thermal oxidation (oven ageing) and it is also moderately good. as a photo-stabiliser. Iodine and cupric stearate acted efficiently during melt stabilisation of polymers, however they were both ineffective as thermo-oxidative antioxidants and UV stabilisers. Although the melt stabilisation effectiveness of stable nitroxyl radicals (e.g. 4-hydroxy, 2,2,6,6-tetra methyl piperidineoxyl and Bis- (2,2,6 ,6-tetra methyl-4- piperidinyl-N-oxyl) sebacate) is not as high as that of galvinoxyl during processing particularly in excess of air, they have been found to be much more efficient as UV stabilisers for polyolefins. The reasons for this are discussed.

The behaviour of polymer quenchants

The internationally accepted Wolfson Heat Treatment Centre Engineering Group test was used to evaluate the cooling characteristics of the most popular commercial polymer quenchants: polyalkylene glycols, polyvinylpyrrolidones and polyacrylates. Prototype solutions containing poly(ethyloxazoline) were also examined. Each class of polymer was capable of providing a wide range of cooling rates depending on the product formulation, concentration, temperature, agitation, ageing and contamination. Cooling rates for synthetic quenchants were generally intermediate between those of water and oil. Control techniques, drag-out losses and response to quenching in terms of hardness and residual stress for a plain carbon steel, were also considered. A laboratory scale method for providing a controllable level of forced convection was developed. Test reproducibility was improved by positioning the preheated Wolfson probe 25mm above the geometric centre of a 25mm diameter orifice through which the quenchant was pumped at a velocity of 0.5m/s. On examination, all polymer quenchants were found to operate by the same fundamental mechanism associated with their viscosity and ability to form an insulating polymer-rich-film. The nature of this film, which formed at the vapour/liquid interface during boiling, was dependent on the polymer's solubility characteristics. High molecular weight polymers and high concentration solutions produced thicker, more stable insulating films. Agitation produced thinner more uniform films. Higher molecular weight polymers were more susceptible to degradation, and increased cooling rates, with usage. Polyvinylpyrrolidones can be cross-linked resulting in erratic performance, whilst the anionic character of polyacrylates can lead to control problems. Volatile contaminants tend to decrease the rate of cooling and salts to increase it. Drag-out increases upon raising the molecular weight of the polymer and its solution viscosity. Kinematic viscosity measurements are more effective than refractometer readings for concentration control, although a quench test is the most satisfactory process control method.

A techno-economic study of the recycling of mixed plastics to useful products

The techno-economic implications of recycling the components of mixed plastics waste have been studied in a two-part investigation: (a) An economic survey of the prospects for plastics recycling, the plastics waste arisings from retailing, building, automotive, light engineering and chemical industries have been surveyed by mans of questionnaires and interviews. This was partially successful and indicated that very considerable quantities of relatively clean plastics packaging was available in major department chains and household stores. The possibility of devising collection systems for such sources, which do not lead to any extra cost, have been suggested. However, the household collection of plastics waste has been found to be uneconomic due to high cost of collection, transportation and lack of markets for the end products. (b) In a technical study of blends of PE/PP and PE/PS which are found in admixture in waste plastics, it has been shown that they exhibit poor mechanical properties due to incompatibility. Consequently reprocessing of such unsegregated blends results in products of little technological value. The inclusion of some commercial block and graft copolymers which behave as solid phase dispersants (SPES) increase the toughness of the blends (e.g. EPDM in PE/PP blend and SBS in PE/PS blend). Also, EPDM is found to be very effective for improving the toughness of single component polypropylene. However, the improved Technical properties of such blends have been accompanied by a fast rate of photo-oxidation and loss of toughness due to the presence of unsaturation in SPD's. The change in mechanical properties occurring during oven ageing and ultra-violet light accelerated weathering of these binary and ternary blends was followed by a viscoelastonetric technique (Rheovibron) over 9,, wide range of temperatures, impact resistance at room temperature (20-41'G) and changes in functional groups (i.e. carbonyl and trans-1,4-polybutadiene). Also the heat and light stability of single and mixed plastics to which thiol antioxidants were bound to SPE1 segment have been studied and compared with conventional antioxidants. The long-term performance of the mixed plastics containing SPE1 have been improved significantly by the use of conventional and bound antioxidants. It is concluded that an estimated amount of 30000 tonnes/year of plastics waste is available from department chains and household stores which can be converted to useful end products. This justifies pilot-experiments in collaboration with supermarkets, recyclers and converters by use of low cost SPD's and additives designed to make the materials more compatible.

Tetrahydrobiopterin metabolism in dementia

The aim of this study was to establish levels of the enzymes involved in tetrahydrobiopterin (BH4) metabolism in human and rat brain preparations; to determine whether BH4 metabolism is altered in dementia, particularly in relation to senile dementia of the Alzheimer type (SDAT); and to examine the effect of aluminium on BH4 metabolism. Overall BH4 synthesis and dihydropteridine reductase (DHPR) activity were greater in the locus coeruleus than in the neocortex of elderly subjects. Sepiapterin reductase and DHPR activity showed a linear correlation with age in the temporal cortex. DHPR activity in the frontal cortex was relatively constant until the mid 60s and then fell with age. Overall BH4 synthesis showed a non-significant decline in temporal cortex and was significantly reduced in locus coeruleus preparations from SDAT subjects compared to control subjects. As DHPR, sepiapterin reductase and GTP cyclohydrolase activity were unaltered in SDAT we suggested that there is a lesion on the biosynthetic pathway between dihydroneopterin in triphosphate and BH4 in SDAT, possibly at the level of 6-pyruvoyl tetrahydropterin synthase. DHPR activity and BH4 synthesis capacity were unaltered in temporal cortex preparations from Huntingdon's disease subjects indicating that the defect in BH4 metabolism in SDAT is specific to the disease process and not a secondary consequence of dementia. The implications of altered BH4 metabolism in ageing and dementia are discussed. BH4 metabolism was examined in temporal and frontal cortex preparations from 4 subjects who had received peritoneal dialysis treatment. All patients had elevated serum aluminium levels. The data suggests that aluminium may inhibit DHPR activity in the frontal cortex resulting in diminished BH4 levels in the cells which leads to a compensatory increase in the activity of the biosynthetic pathway. Aluminium reversibly inhibited sepiapterin reductase activity in rat brain preparations but did not alter sepiapterin reductase activity in vivo. Overall BH4 synthesis and OTP cyclohydrolase activity were not affected by aluminium in vitro. The biosynthetic pathway was unaltered in rat brain preparations from animals receiving aluminium orally compared to control animals. DHPR activity was unaltered or increased in rat brain preparations from aluminium treated rats compared to the control group.

Terminal galactose residues on transferrin are increased in mid-life adults compared to young adults

Humans undergo biological ageing at different rates. This associates with functional decline in a number of physiological systems and increasing incidence of age-related pathologies. The discovery of robust biomarkers of ageing could be used to identify early divergence from a path of healthy ageing towards age-related disease. In the present study, we undertook proteomic analysis of plasma from healthy young men (mean age = 21.4 ± 1.5 years) and healthy mid-life men (mean age = 57.0 ±1.6 years). We identified twelve spots including transferrin, complement C3b and transthyretin that differed in abundance between the age groups. Transferrin spots showed an acidic pI shift in older males. Sandwich ELISAs were used to investigate the changes further. C3b levels were below the level of detection by ELISA and plasma concentrations of total transferrin or transthyretin were not different between the age groups studied here. However, analysis of transferrin N-glycan structures showed an increase in terminal galactose residues in older men, suggesting that the loss of terminal N-acetyl neuraminic acid residues contributes to the more acid pI of transferrin spots observed with age. Terminal galactosylation of transferrin may be a biomarker of healthy ageing and is now under investigation in the MARKAGE study.

Determining which factors influence the optimum multifocal contact lens correction for presbyopia

Presbyopia is a consequence of ageing and is therefore increasing inprevalence due to an increase in the ageing population. Of the many methods available to manage presbyopia, the use of contact lenses is indeed a tried and tested reversible option for those wishing to be spectacle free. Contact lens options to correct presbyopia include multifocal contact lenses and monovision.Several options have been available for many years with available guides to help choose multifocal contact lenses. However there is no comprehensive way to help the practitioner selecting the best option for an individual. An examination of the simplest way of predicting the most suitable multifocal lens for a patient will only enhance and add to the current evidence available. The purpose of the study was to determine the current use of presbyopic correction modalities in an optometric practice population in the UK and to evaluate and compare the optical performance of four silicone hydrogel soft multifocal contact lenses and to compare multifocal performance with contact lens monovision. The presbyopic practice cohort principal forms of refractive correction were distance spectacles (with near and intermediate vision providedby a variety of other forms of correction), varifocal spectacles and unaided distance with reading spectacles, with few patients wearing contact lenses as their primary correction modality. The results of the multifocal contact lens randomised controlled trial showed that there were only minor differences in corneal physiology between the lens options. Visual acuity differences were observed for distance targets, but only for low contrast letters and under mesopic lighting conditions. At closer distances between 20cm and 67cm, the defocus curves demonstrated that there were significant differences in acuity between lens designs (p < 0.001) and there was an interaction between the lens design and the level of defocus (p < 0.001). None of the lenses showed a clear near addition, perhaps due to their more aspheric rather than zoned design. As expected, stereoacuity was reduced with monovision compared with the multifocal contact lens designs, although there were some differences between the multifocal lens designs (p < 0.05). Reading speed did not differ between lens designs (F = 1.082, p = 0.368), whereas there was a significant difference in critical print size (F = 7.543, p < 0.001). Glare was quantified with a novel halometer and halo size was found to significantly differ between lenses(F = 4.101, p = 0.004). The rating of iPhone image clarity was significantly different between presbyopic corrections (p = 0.002) as was the Near Acuity Visual Questionnaire (NAVQ) rating of near performance (F = 3.730, p = 0.007).The pupil size did not alter with contact lens design (F = 1.614, p = 0.175), but was larger in the dominant eye (F = 5.489, p = 0.025). Pupil decentration relative to the optical axis did not alter with contact lens design (F = 0.777, p =0.542), but was also greater in the dominant eye (F = 9.917, p = 0.003). It was interesting to note that there was no difference in spherical aberrations induced between the contact lens designs (p > 0.05), with eye dominance (p > 0.05) oroptical component (ocular, corneal or internal: p > 0.05). In terms of subjective patient lens preference, 10 patients preferred monovision,12 Biofinity multifocal lens, 7 Purevision 2 for Presbyopia, 4 AirOptix multifocal and 2 Oasys multifocal contact lenses. However, there were no differences in demographic factors relating to lifestyle or personality, or physiological characteristics such as pupil size or ocular aberrations as measured at baseline,which would allow a practitioner to identify which lens modality the patient would prefer. In terms of the performance of patients with their preferred lens, it emerged that Biofinity multifocal lens preferring patients had a better high contrast acuity under photopic conditions, maintained their reading speed at smaller print sizes and subjectively rated iPhone clarity as better with this lens compared with the other lens designs trialled. Patients who preferred monovision had a lower acuity across a range of distances and a larger area of glare than those patients preferring other lens designs that was unexplained by the clinical metrics measured. However, it seemed that a complex interaction of aberrations may drive lens preference. New clinical tests or more diverse lens designs which may allow practitioners to prescribe patients the presbyopic contact lens option that will work best for them first time remains a hope for the future.