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The invitation to reconsider the principles of the Charter listed in the Friendly Relations Declaration obviously raises a fundamental question. Fifty years after their adoption, are these principles still valid or already obsolete in view of the radical changes affecting the political, technological, economic and social environment in which they had previously been reiterated? Here, we can see all the interest of the constitutionalist theses developed with regard to the Charter of the United Nations, despite the exaggerations to which they may have led. From this point of view, and even if the Charter can in no way be reduced to the content of the Declaration itself, the reconsideration of the latter already raises the question of whether the world should radically change its global political constitution. We can see that it is difficult to respond lightly in a positive way! On the contrary, everything points to a response on the basis of two proposals: on the one hand, the nature and scale of the problems facing not only the society of States but also humanity as a whole provides a strong encouragement to reaffirm the need to respect, in particular, the seven principles enshrined in the Declaration as well as in the Charter as a whole; on the other hand, we are no longer in 1970 and each of these principles must be completed and reinterpreted in the light of the new challenges facing the entire international community, which is composed not only of States but also of the different components of civil society.
Successful aging can be generally defined as minimizing disabilities, maintaining functional capacity, and supporting an engaged lifestyle. Given world population changes, this concept is of increasing importance. Technologies have become an integral part of daily life across a range of domains and have potential to support older adults. However, for that potential to be met, the technology must be designed with consideration for older adults’ capabilities, limitations, motivations to use technological support, and opinions regarding the role of technology in their lives. In this context, we review the theoretical background relevant to successful aging and technology support. Moreover, the technology should not impose cognitive demands but should augment or enhance cognitive function. We present older adult personas to highlight how current and emerging technologies can assist aging individuals in meeting their diverse needs and reaching their goals. We provide considerations and future research directions to guide technology design and promote successful aging.
Staff members of psychiatric facilities are at high risk of secondhand smoking. Smoking exposure was assessed in 41 nonsmoking employees of a psychiatry department before and after a ban. Subjective exposure measures decreased in 76% of the subjects. Salivary cotinine decreased in the subsample of seven subjects with high pre-ban levels (32 ±8 vs 40 ± 17 ng/ml, p = .045).
Lipids appear to mediate depressive vulnerability in the elderly, however, sex differences and genetic vulnerability have not been taken into account in previous prospective studies.
Depression was assessed in a population of 1040 women and 752 men aged 65 years and over at baseline and after 7-year follow-up. Clinical level of depression (DEP) was defined as having either a score of 16 and above on the Centre for Epidemiology Studies Depression scale or a diagnosis of current major depression on the Mini International Neuropsychiatric Interview. Lipid levels, apolipoprotein E and serotonin transporter linked promoter region (5-HTTLPR) genotypes were evaluated at baseline.
Multivariate analyses adjusted by socio-demographic and behavioral variables, measures of physical health including ischemic pathologies, and genetic vulnerability indicated gender-specific associations between dyslipidemia and DEP, independent of the use of lipid lowering agents or apolipoprotein E status. Men with low LDL-cholesterol levels had twice the risk of prevalent and incident DEP whereas in women low HDL-cholesterol levels were found to be significantly associated with increased prevalent DEP (OR = 1.5) only. A significant interaction was observed between low LDL-cholesterol and 5-HTTLPR genotype, men with s/s or s/l genotype being at increased risk of DEP (OR = 6.0 and 2.7, respectively). No significant gene-environment interaction was observed for women.
DEP is associated with higher atherogenic risk in women (low HDL-cholesterol), whereas the reverse is observed in men (low LDL-cholesterol). Late-life depression may have a complex gender-specific etiology involving genetic vulnerability in men.
The goal of this prospective investigation was to study the course and the quality of patient-psychiatrist relationships during phase II / phase III clinical trials of antidepressant medication prescribed for depressive disorders. All patients who participated in the clinical trials (and subsequently in this survey) signed written informed consent statements and were subject to random double blind treatment assignment. Retrospective analysis of 118 investigations was carried out, and the patients involved were questioned concerning their experiences and impressions during and after the study. Data show that the outcome of clinical trials of antidepressant drugs are not a function of pre-existing good patient-psychiatrist relationships. On the other hand, no effects on the patient-psychiatrist relationship were found as a result of the experimental procedure, and it can be concluded that no detrimental effects on future patient-psychiatrist relationships were incurred.
Withdrawal syndrome occurs in 50% of cannabis dependant patients. In our clinical practice, we observed that few patients recognize and attribute abstinence symptoms to cannabis cessation. Insight or awareness of cannabis dependence remains poorly studied.
We propose to study the relationship between insight and cannabis withdrawal syndrome. Our hypothesis is that patients showing a higher score on a cannabis withdrawal scale would have a higher score on an insight scale.
We recruited 35 cannabis dependent outpatients between October 2008 and April 2009 in an addiction clinic. Insight of cannabis dependance was assessed with the insight Q8 scale ranging [0–8]. We designed a cannabis withdrawal scale by checking DSM V withdrawal symptoms, and each symptom was retrospectively scored by an analogue scale (from 0 to 5). Correlation between insight and withdrawal scores was calculated using Spearman's ρ.
Sex ratio was 2.5. Mean age was 35.9 ± 1.4 years. Most patients (85.7%) reported at least one withdrawal symptom. Sleep disturbances (95.8%) and craving (75.8%) were the most frequent. Mean score of insight was of 4.2 ± 0.4 points.
The intensity of withdrawal syndrome and insight score were positively correlated (ρ = 0.594, p < 0.001).
Our results show an association between experiencing more withdrawal symptoms and insight or awareness of cannabis dependence. These results could be used in the treatment of cannabis dependent patients.
Emotional avoidance is a target process, offered by modern psychotherapies. Emotional exposure is often difficult to put in place when there is a major cognitive and behavioral avoidance. Education on emotional processes is necessary but often insufficient during individual follow-up.
The longitudinal study seeks to verify whether work on exposure and emotional identification influences the decreased level of anxiety and depression.
Introduction of interoceptive exposition in psychotherapy decreases the frequency of emotional avoidance.
Group psychotherapy composed of two modules: interoceptive exposure and emotional identification was proposed to patients with anxiety and depressive disorders. A group of 6 participants was evaluated at three times: T0 before the start of the group, T1 post-module 1 and T2 post-group. Assessments of HAMA anxiety, MADRS depression, QEC cognitive avoidance, UPPS impulsivity, MCQ-30 metacognition and emotional regulation REQ-21 have been proposed.
Significant differences were observed between pre- and post-intervention scores (Friedman test). The HAMA anxiety rate (P = 0.006) and the MADRS depression (P = 0.047) decreased. Participants in the group were less likely to use QEC thought substitution (P = 0.009) and urgency in their UPPS reactions (P = 0.03). Moreover, their external dysfunction REQ. 21 decreases (P = 0.03).
Faced with emotional avoidance, work on emotional identification requires prior interoceptive exposure. It is a first stage of work that involves sensitizing to the presence of emotional bodily sensations. Group work facilitates exposure to emotion and its identification; decentration leading to emotional intensity decrease. The work on the interoceptive exhibition facilitates the emotional exposure while participating in the deactivation of the associative emotional network.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Prosper Weil's article in the American Journal of International Law first appeared in 1982 in French in the Revue Générale de Droit International Public. In France, it has probably generated less debate than in the United States. Indeed, the positions taken by this stimulating, agile, and well-written article generally accord with the doctrinal tradition that largely predominates in the land of Jean Bodin, René Descartes, and Auguste Comte, namely, legal positivism. According to this tradition, legal scholars must first focus on the technical analysis of legal norms as they are set out and, above all, practiced by the various actors in legal relations, which on the international level are states and the international judge or arbitrator. After setting out the contexts of Weil's article, I shall state two reservations to its content and then turn to its contemporary relevance.
Bronze Age agro-pastoralist populations with economies and materials that are generally consistent with the Andronovo Culture—but with localised variations—are known throughout the mountains bordering the Eastern Eurasian Steppe. Recently, evidence for this tradition has also been found in north-west Xinjiang, China, although many questions remain about the production, use and significance of ceramics here. The authors’ analyses of a sample of pottery from sites across the Bortala Valley permit the reconstruction of the ceramic chaîne opératoire and offer two distinct stories: one of cultural connectivity with regional networks of Eurasian pastoralists, and another about self-expression through small-scale local ceramic production.
The present study explored chronic disease management over the monthly benefit cycle among primary food shoppers from households receiving Supplemental Nutrition Assistance Program (SNAP) benefits in Philadelphia, PA, USA.
In-depth interviews, participant observation and surveys were conducted with the primary food shopper of SNAP households.
Interviews and surveys were conducted in a clinical setting at Children’s Hospital of Philadelphia, at participants’ homes, and in food procurement settings including grocery stores, food pantries and soup kitchens.
Eighteen adults who received SNAP; five with a diet-related chronic condition, five managing the chronic condition of a family member and thirteen with overweight or obesity.
All households had at least one member with a chronic disease or condition. Households reported that the dietary demands of managing chronic illnesses were expensive and mentally taxing. Food and financial shortfalls at the end of the benefit cycle, as well as reliance on charitable food assistance programmes, often had negative impacts on chronic disease self-management.
Drawing from nearly 50 h of in-depth qualitative interviews with SNAP participants, the study highlights the dual cognitive burden of poverty and chronic disease and elucidates the particular challenges of food procurement and maintenance of diet quality throughout the benefit month faced by SNAP households with diet-related chronic diseases. Interventions targeted at reducing the cost of medically appropriate, healthy foods may help to improve chronic disease self-management within SNAP populations.
A new species, Contarinia brassicola Sinclair (Diptera: Cecidomyiidae), which induces flower galls on canola (Brassica napus Linnaeus and Brassica rapa Linnaeus (Brassicaceae)), is described from Saskatchewan and Alberta, Canada. Larvae develop in the flowers of canola, which causes swelling and prevents opening, pod formation, and seed set. Mature larvae exit the galls, fall to the soil, and form cocoons. Depending on conditions, larvae will either pupate and eclose in the same calendar year or enter facultative diapause and emerge the following year. At least two generations of C. brassicola occur each year. Adults emerge from overwintering cocoons in the spring and lay eggs on developing canola flower buds. The galls produced by C. brassicola were previously attributed to the swede midge, Contarinia nasturtii (Kieffer) in Saskatchewan; here, we compare and list several characters to differentiate the two species.
Hearing loss is highly prevalent in older adults and can pose challenges for neuropsychologists, as assessment and intervention procedures often involve orally presented information which must be accurately heard. This project examined the hearing status of 20 clients (mean age = 71 years) in a hospital-based outpatient neuropsychology clinic, and explored whether information about hearing loss informed neuropsychologists’ clinical practice. A research assistant administered a brief hearing screening test to each participant. Four treating neuropsychologists were asked to comment on their client’s hearing status before and after being shown their client’s hearing screen test results. Screening revealed that the majority of participants had at least mild hearing loss, and that the neuropsychologists were relatively accurate (60%) at estimating their clients’ hearing status. Neuropsychologists used information about a client’s hearing status to make recommendations that clients pursue audiologic services, and to educate clients and family members about hearing loss and communication.
The role that vitamin D plays in pulmonary function remains uncertain. Epidemiological studies reported mixed findings for serum 25-hydroxyvitamin D (25(OH)D)–pulmonary function association. We conducted the largest cross-sectional meta-analysis of the 25(OH)D–pulmonary function association to date, based on nine European ancestry (EA) cohorts (n 22 838) and five African ancestry (AA) cohorts (n 4290) in the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium. Data were analysed using linear models by cohort and ancestry. Effect modification by smoking status (current/former/never) was tested. Results were combined using fixed-effects meta-analysis. Mean serum 25(OH)D was 68 (sd 29) nmol/l for EA and 49 (sd 21) nmol/l for AA. For each 1 nmol/l higher 25(OH)D, forced expiratory volume in the 1st second (FEV1) was higher by 1·1 ml in EA (95 % CI 0·9, 1·3; P<0·0001) and 1·8 ml (95 % CI 1·1, 2·5; P<0·0001) in AA (Prace difference=0·06), and forced vital capacity (FVC) was higher by 1·3 ml in EA (95 % CI 1·0, 1·6; P<0·0001) and 1·5 ml (95 % CI 0·8, 2·3; P=0·0001) in AA (Prace difference=0·56). Among EA, the 25(OH)D–FVC association was stronger in smokers: per 1 nmol/l higher 25(OH)D, FVC was higher by 1·7 ml (95 % CI 1·1, 2·3) for current smokers and 1·7 ml (95 % CI 1·2, 2·1) for former smokers, compared with 0·8 ml (95 % CI 0·4, 1·2) for never smokers. In summary, the 25(OH)D associations with FEV1 and FVC were positive in both ancestries. In EA, a stronger association was observed for smokers compared with never smokers, which supports the importance of vitamin D in vulnerable populations.
Given the urgency of finding cost-effective and innovative solutions to providing community services for aging in place, novel solutions that take advantage of existing infrastructure are clearly needed. In this sequential mixed-method study, we chose to explore the role that nursing homes could play in offering services to a non-traditional target population, namely seniors with loss of independence living in the community. Forty-two (n = 42) nursing homes in the province of New Brunswick completed an online survey, and 10 agreed to participate in face-to-face interviews. Results show that 100 per cent of participants agreed that nursing homes could offer services to seniors in their communities for aging in place. Results suggest that nursing homes are cost-effective, innovative solutions for aging in place.
In this paper, we report the analysis, design, and implementation of stacked transistors for power amplifiers realized on InP Double Heterojunction Bipolar Transistors (DHBTs) technology. A theoretical analysis based on the interstage matching between all the single transistors has been developed starting from the small-signal equivalent circuit. The analysis has been extended by including large-signal effects and layout-related limitations. An evaluation of the maximum number of transistors for positive incremental power and gain is also carried out. To validate the analysis, E-band three- and four-stacked InP DHBT matched power cells have been realized for the first time as monolithic microwave integrated circuits (MMICs). For the three-stacked transistor, a small-signal gain of 8.3 dB, a saturated output power of 15 dBm, and a peak power added efficiency (PAE) of 5.2% have been obtained at 81 GHz. At the same frequency, the four-stacked transistor achieves a small-signal gain of 11.5 dB, a saturated output power of 14.9 dBm and a peak PAE of 3.8%. A four-way combined three-stacked MMIC power amplifier has been implemented as well. It exhibits a linear gain of 8.1 dB, a saturated output power higher than 18 dBm, and a PAE higher than 3% at 84 GHz.
In the preceding chapters, we have discussed the substantive regulation of environmental problems at the international level. In particular, we have analysed the obligations imposed on States in relation to the protection of the hydrosphere, the atmosphere, the biosphere and dangerous substances and activities. We now turn to the processes through which these obligations are implemented.
The traditional approach in this area assumed that compliance with international obligations only depended upon a State's will to comply. From a substantive law perspective, the main mechanism to encourage compliance was to make any violation costly for the State, notably through the application of secondary norms of State responsibility. From a procedural standpoint, breaching a norm could have several consequences, ranging from the first allegations of non-compliance, often followed by negotiations and consultations between the States concerned, to judicial mechanisms of dispute settlement and, where appropriate, alternative dispute settlement, such as mediation, conciliation or inquiry.
However, the transition from compliance to non-compliance with the requirements of a norm is better understood as a process, which admits degrees. Such degrees provide a useful basis for the discussion in this chapter because they help to locate the different implementation mechanisms at the stage where they are most likely to intervene. Four ‘stages’ may be distinguished along the compliance spectrum. Figure 8.1 summarises this understanding graphically.
Some mechanisms only play a role ‘upstream’ before allegations of noncompliance emerge (Stage 1). The main mechanism at this stage is the monitoring and reporting of information showing a State's behaviour in relation to its international obligations (section 8.2). By contrast, ‘downstream’ (Stage 4), we find the more formal mechanisms for the characterisation of a breach by third parties (adjudicatory or quasi-adjudicatory mechanisms) and the determination of the ensuing consequences attached by the law of State responsibility (section 8.3) or other secondary norms. Between these two extremes lies a grey area where the level of compliance is unclear. This area has traditionally been the province of so-called diplomatic or political mechanisms for the peaceful settlement of disputes. However, we will see in Chapter 9 that in international environmental law, this area has been populated by new methods of facilitating compliance (Stage 2) and managing non-compliance (Stage 3) with environmental standards.