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Published in Paris in 1928 under the leadership of Guadeloupean Maurice Satineau, the newspaper La dépêche africaine featured a mélange of African diasporic contributors from across the French colonies. Chief among them were the Afro-Martinican intellectuals and sisters Jane and Paulette Nardal. It was here that Jane Nardal published her now famous essay “Internationalisme noir,” introducing the idea of “black internationalism” into popular parlance. Nardal documented a new understanding of blackness and collectivity amid post-World War I globalization. Just as wartime had broken down barriers among Europeans and white Americans, so too had it fostered the “sentiment” among black people from the around the world that they “belong[ed] to one and the same race.” Introducing and reifying terms such as “Afro Latino” and “African American” into French and English vernaculars, Nardal focused on black people's efforts to rhetorically and ideologically link the African diaspora while also reconciling these new identities with the “ancient traditions” of Africa. The result: one of the first efforts to define black internationalism as an ideology, worldview, and political practice in a moment in which black people the world over were trying to negotiate the modernizing world and their place in it.
In this paper, we focus on the disruption that the current pandemic has created within the US industrial food system. We suggest that the pandemic has provided an opening for small producers. Attending to small-scale responses to the pandemic can guide policy and public investments towards a more just and sustainable future for food.
Building on the IPES-Food Communique of April 2020, we examine the many ways in which the US industrial food system faltered during the ongoing COVID-19 pandemic. Using Regime Theory as a guide, we suggest that such a catastrophic crisis may create significant opportunities for an emergent food regime. Drawing from our research and participant observation in the US Midwest, we examine changes in the food system occasioned by the pandemic that foreshadow a new food regime. We suggest several blockages and risks to this new regime and suggest policies that would make transition smoother to a more just and sustainable food system.
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What will food be like after the pandemic? This new study outlines an alternative food system emerging in the American Midwest.
This paper is about the effectiveness of qualitative easing, a form of unconventional monetary policy that changes the risk composition of the central bank balance sheet. We construct a general equilibrium model where agents have rational expectations, and there is a complete set of financial securities, but where some agents are unable to participate in financial markets. We show that a change in the risk composition of the central bank’s balance sheet affects equilibrium asset prices and economic activity. We prove that, in our model, a policy in which the central bank stabilizes non-fundamental fluctuations in the stock market is self-financing and leads to a Pareto efficient outcome.
Even though the intention is to offer the whole population services of comparable quality regardless of where they live, there are some challenges with living in rural areas…. (Kirkevold and Kristiansen, from Chapter 4 in this book)
Drawing across the material in this book, in this chapter we raise and discuss the emergent themes as highlighted by the contributions of leading experts and commentators from around the world. In terms of policy we consider systems issues and between-countries similarities and differences; for practice, we examine the relevance of culture and the importance of heeding the central human experience of dementia within the current healthcare system; and in respect of key emergent research topics, we feature the relevance of place-based planning and the role of technology. We end with a collated research agenda, drawing from topics suggested by authors across the chapters.
Policy and systems
Dementia is a costly issue for governments as people with dementia can live for a long time following their diagnosis, variably requiring different health and social care inputs (Prince et al, 2015). The World Health Organization (WHO) has taken a lead in establishing the need for coordinated national policy and planning approaches (2018), and has provided a toolkit for planning, education and community engagement (WHO, 2017), an online training programme for dementia carers (iSupport for Dementia) (WHO, 2020), and a knowledge exchange platform with access to key dementia data and indicators so that progress in meeting global dementia targets can be evaluated (Global Dementia Observatory) (WHO, 2019). The mhGAP toolkit can be adopted by individual countries and adapted to local systems and contexts.
The chapters in this book highlight the relevance of countries’ health systems and the contexts in which services are provided, as well as the characteristics of such services. By one interpretation, chapters depict health systems with features across a wide spectrum, from those with atomised services provided by a mixture of public, private and nongovernmental organisations (in Australia), through those that have become depleted (in Ireland), to apparently more coordinated and adaptive social welfarist models (such as those in Austria and Norway).
This book is the first edited collection to focus on dementia in remote and rural areas. Drawing on examples of research studies and innovative practice from remote and rural locations globally, it highlights the implications of living with dementia in remote and rural areas for dementia policy, practice and future research. The chapters represent countries with considerable experience and expertise in developing support and services for their rural and remote populations, such as Canada, Australia, the UK, Ireland and Austria. However, many other countries have rural geographies and ageing populations, and are likely to face similar challenges of meeting the needs of people living with dementia in remote and rural areas. To promote knowledge translation, the book's contributors share ideas from their countries to help practitioners working in challenging geographical landscapes anywhere as they strive to provide the highest standards of support for those living with dementia. The book draws on research conducted in different countries with longstanding histories of conducting remote and rural dementia research, and as such it is a resource for academics who teach or research rurality and dementia. The edited structure allows international examples of innovative research/practice in the remote and rural dementia field to be showcased with the implications of such national examples to be considered in relation to research, policy and practice globally. In this way, we hope that you, the reader, will find this edited collection to be a resource, whether you are a student, practitioner, policy influencer or academic, to assist you in enhancing the experience of living with dementia in remote and rural areas in the future.
Dementia has been defined by the World Health Organization as:
… an umbrella term for several diseases that are mostly progressive, affecting memory, other cognitive abilities and behaviour, and that interfere significantly with a person's ability to maintain the activities of daily living. (WHO, 2017c: 5)
Although the symptoms of dementia may be similar, how these are experienced and the impact on individuals’ lives can vary significantly. The experience of dementia is one that is fraught with challenges for the person diagnosed with dementia, and for families, friends and communities. It may require coming to terms with new identity and functionality and may require significant adaptation and resilience at individual, family and community levels (Innes et al, 2011).
The purpose of this chapter is to consider the issues experienced by people with dementia, their carers and families – and the issues of providing services for people with dementia – in rural areas around the world. The chapter endeavours to focus in particular on issues for low-and middle-income countries (LMICs), also sometimes referred to here as developing countries. The chapter seeks to highlight issues in rural experiences of dementia that policy makers in resource-depleted settings need to consider at national and regional levels. The chapter specifically acknowledges supra-national efforts to improve experiences of dementia and care, and to influence development of dementiaspecific policy, and considers the specific role of these efforts for rural places. This includes supra-national policy organisations – primarily the leadership of the World Health Organization (WHO) – and civil society and research organisations that advocate for people with dementia to have their voice heard and that drive knowledge and solutions about, for and with, people with dementia in LMIC settings.
While across the world ‘rural’ is differentiated from ‘urban’ by its distance from large centres of services and amenities coupled with sparse population distribution, rural places are highly diverse internationally and can be so even within one country setting. Thus, as discussed, ‘the nature, context and needs of rural communities and rural practice will differ around the world. Local solutions will require … local initiatives’ (WONCA, 2014: 1).
While rural places differ around the world, they tend to share some key features that are essential to understand and acknowledge when making and applying rural policy. In social terms, rural places tend to have cultural norms and values that, due to small populations repeatedly interacting, become strongly enforced and reinforced, making it hard to be different. Difference can be stigmatised and people strive to ‘fit in’, which drives attempts to be resilient and get through rather than to show weakness. Gender roles and power dynamics can be strongly enforced, with formal and informal leaders having significant power. Internationally, people in rural areas tend to experience higher levels of poverty, and lower levels of education and access to welfare compared with those in urban areas. Transportation and technology-related imbalances result in rural dwellers experiencing spatial social exclusion (Strasser et al, 2016; Salemink et al, 2017).
As the number of people affected by dementia continues to rise, this is the first in-depth examination of related services dedicated to the unique demands of remote and rural settings. Contributors from the UK, Australia, North America and Europe explore the experiences and requirements of those living with dementia and those caring for them in personal and professional capacities in challenging geographical locations. For practitioners, researchers, academics and policy makers, this book is an essential review of evidence and strategies to date, and a guide to future research needs and opportunities for improvements in rural dementia practice.
Suicidal behaviour shows evidence of familial clustering and the twin data on completed suicide suggest moderate heritability. The extent to which the genetics of suicidal behaviour overlaps with the genetics of affective disorders is unclear but there is overwhelming evidence that both bipolar and unipolar disorder are substantially influenced by genes. So far, candidate gene studies of suicidality have provoked much interest, but recently, attention has also turned to candidate gene approaches to suicidal ideation emerging during antidepressant treatment. The advent of genome-wide association studies (GWAS) has had a major impact on studies of affective disorder with some provocative new findings. The GWAS approach is also beginning to be applied in the search for genes that underlie suicidal ideation and behaviour.
In an empirical study on the classification of the psychoses, 302 patients were rated using the Longitudinal Psychopathology Schedule. The data were condensed by factor analysis, which yielded 10 factors - mania and schizomania, depression and suicidal activity, and 6 factors concerned with psychotic symptoms (verbal hallucinosis/passivity, delusion formation, defect symptoms, social decline, cycloid symptomatology and a factor loading depressive auditory hallucinations and visual hallucinations). Provisional diagnostic groups were obtained using DSM III. Discriminant function analyses showed that the only clearly distinct diagnostic group was bipolar disorder, and this was true for various definitions. Canonical variate analyses were performed using 3- and 4-criterion groups. These showed that a group corresponding approximately to cycloid psychosis also met criteria for being a distinct group. The most detailed examination pf the data, using 4-criterion groups and serial reclassification, suggested that the psychoses might fall into 5 groups - bipolar disorder, cycloid psychosis, depression, defect states and schizoaffective depression.
Catechol-O-methyltransferase (COMT) has a central role in brain dopamine, noradrenalin and adrenalin signaling, and has been suggested to be involved in the pathogenesis and pharmacological treatment of affective disorders. The functional single nucleotide polymorphism (SNP) in exon 4 (Val158Met, rs4680) influences the COMT enzyme activity. The Val158Met polymorphism is a commonly studied variant in psychiatric genetics, and initial studies in schizophrenia and bipolar disorder presented evidence for association with the Met allele. In unipolar depression, while some of the investigations point at an association between the Met/Met genotype and others have found a link between the Val/Val genotype and depression, most of the studies cannot detect any difference in Val158Met allele frequency between depressed individuals and controls.
In the present study, we further elucidated the impact of COMT polymorphisms including the Val158Met in MDD. We investigated 1,250 subjects with DSM-IV and/or ICD-10 diagnosis of major depression (MDD), and 1,589 control subjects from UK. A total of 24 SNPs spanning the COMT gene were successfully genotyped using the Illumina HumaHap610-Quad Beadchip (22 SNPs), SNPlex™ genotyping system (1 SNP), and Sequenom MassARRAY® iPLEX Gold (1 SNP). Statistical analyses were implemented using PASW Statistics18, FINETTI (http://ihg.gsf.de/cgi-bin/hw/hwa1.pl), UNPHASED version 3.0.10 program and Haploview 4.0 program.
Neither single-marker nor haplotypic association was found with the functional Val158Met polymorphism or with any of the other SNPs genotyped. Our findings do not provide evidence that COMT plays a role in MDD or that this gene explains part of the genetic overlap with bipolar disorder.
According to Oedegaard et al. (2010) the co-morbidity of migraine and bipolar disorder (BPD) is well documented in numerous epidemiological and clinical studies, and there are clear pathophysiological similarities. Interestingly, in a genome-wide scan, Lea et al. (2005) identified a susceptibility locus for a severe heritable form of common migraine on chromosome 3q29. With respect to BPD, a susceptibility region on chromosome 3q29 was identified in a genome-wide linkage scan (Bailer et al. 2002) and follow-up linkage analysis (Schosser et al. 2004). These findings were also supported by further fine-mapping of this region (Schosser et al. 2007). Since 3q29 is among the chromosomal regions implicated in migraine and bipolar linkage studies, the aim of the current study is to test for 3q29 association of migraine in sample of patients with BPD. The sample consists of 463 patients with a diagnosis of BPD (34.63% men, 65.37% women; mean age ± SD: 48.01 ± 11.26), as defined by the Diagnostic and Statistical Manual 4th edition operational criteria (DSM-IV) and the International Classification of Diseases 10th edition operational criteria (ICD-10), derived from the Bipolar Affective Disorder Case Control Study (BACCS). A total of 51 SNPs in the region of the 3q29 were genotyped using Sequenom MassARRAY® iPLEX Gold and tested for association with migraine. The results of this association study investigating the 3q29 region in a sample of patients with BPD will be presented.