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This study aimed to examine the caregiver burden among offspring of Holocaust survivors (OHS) caring for their parents during the COVID-19 pandemic, hypothesizing that caregivers whose parents suffer from posttraumatic stress disorder (PTSD) would report an increased burden. The sample consisted of 109 caregivers with older adult care recipient parents (average caregivers’ age = 57.67, SD = 8.49). Caregivers were divided into three groups: 20 OHS who reported that at least one care recipient had PTSD, 60 OHS who reported that their care recipients did not have PTSD, and 29 comparison caregivers (whose care recipients did not undergo the Holocaust). Caregivers completed questionnaires about SARS-CoV-2 exposure, COVID-19 concerns, helping their care recipients, their experiences of caregiver burden, and perceived changes to their caregiver burden during the pandemic. The caregivers also reported PTSD symptoms—in themselves as well as in their care recipients. Relative to comparisons, OHS with parental PTSD reported higher caregiver burden in four aspects: time-dependent burden, developmental burden, physical burden, and social burden. Furthermore, OHS reported a greater perceived increase in caregiver burden during the pandemic than the comparisons. The study findings illuminate the difficulties OHS caregivers, especially those whose care recipients have PTSD, face during the COVID-19 pandemic. This group of caregivers is at risk of experiencing more distress and may need help and support. Further research is needed to determine whether people taking care of their posttraumatic parents following other massive traumatic events also feel a heavier caregiver burden—both in general and specifically during the current pandemic.
The mind relies on time to make sense of the flow of experience. Human societies develop different ways of creating and marking time. Although systems for reckoning time in any given society are established by people, they are also based on the temporal sequences of nature and on the inner life of the individual. This chapter deals with two systems of time used in the society of the Jews of the medieval Islamic world whose material remains are preserved in the Genizah. It starts with the cycle of life – from an individual’s birth all the way to death. Then, it proceeds to discuss the community’s rhythms of time and the way time structured the annual cycle.
This chapter deals with family life in the Jewish society of the medieval Islamic world, which is mainly reconstructed on the basis of Genizah finds. It starts with a short survey about the ways in which family, kinship, and pedigree were conceived in this society, and then it goes on to speak about the functions expected and fulfilled by family members. The next paragraph examines the boundaries of the family, focusing on the special role occupied by domestic slaves. Thereafter, I will examine the institution of marriage: its roles, the legal processes required to establish and to end it, and its structure, including a short discussion about polygyny. The chapter ends with a description of the relations between family members as they surface in Genizah documents: spousal relations, relations between parents and children at various ages, and among siblings.
The COVID-19 pandemic may pose a specific threat for Holocaust survivors, as such threats may be linked with increased psychological distress. Moreover, research has demonstrated that engaging in planful problem-solving activities is associated with reduced distress. Accordingly, we aimed to examine the link between engaging in activities during COVID-19 and psychological distress among Holocaust survivors with varying levels of post-traumatic symptoms (PTS) and comparisons (not directly exposed to the Holocaust).
A cross-sectional design composed of Holocaust survivors and a comparison group.
Participants were interviewed face-to-face, over the telephone, or filled the scales online at their leisure.
Data were collected from 131 older Jewish Israelis (age range 76–94, M = 82.73, SD = 4.09), who were divided into three groups (comparisons; low-PTS survivors; high-PTS survivors).
Participants completed scales assessing PTS, activity engagement, and psychological distress and provided additional sociodemographic, medical, and COVID-19-related information.
When activity engagement was low, high-PTS survivors reported extremely high levels of psychological distress relative to low-PTS survivors and comparisons. However, when activity engagement was high, these group differences were considerably reduced, as the psychological distress of high-PTS survivors was significantly lower.
The study highlights the importance of daily planning and activity engagement for Holocaust survivors with high PTS levels in reducing psychological distress. Clinicians are urged to take this factor into account when dealing with the psychological effects of COVID-19 on survivors and on traumatized older adults in general.
Regrasping is a manipulation to alternate between grasp configurations of an object to perform different tasks. We address a regrasping problem termed longitude regrasping to reposition a gripper along an elongated object. We propose an algorithm using the dynamics of the arm and a non-dexterous gripper to perform the manipulation. Energy control is used to toss the object up and catch it under the goal position. Clipped Linear Quadratic Regulator control approach is then applied to the gripper jaws to control the friction force on the object and to let it slide to the final goal position. The object sliding within the gripper is modeled as a semi-active linear joint where only dissipative forces can be applied to it. A set of experiments validated the feasibility of the method.
Previous studies reported an association between advanced paternal age at birth and increased risk for schizophrenia and bipolar disorder. While some hypothesize that this association is caused by de-novo mutations in paternal spermatozoa, others cite factors associated with psycho-social characteristics of fathers who have children at a late age. This study aims to test these hypotheses.
A historical-prospective, population-based cohort study, performed by linking the Israeli Draft Board Registry and the Israeli National Psychiatric Hospitalization Registry (N = 916 439; 4488 with schizophrenia, 883 with bipolar disorder). Odds ratios (OR) and two-sided 95% confidence intervals (CI) were calculated by logistic regression models, using paternal age as predictor and risk for later hospitalizations for schizophrenia or bipolar disorder as outcome measure. Models were first fitted unadjusted, then adjusted for paternal age at birth of the first child.
In the unadjusted model, offspring of fathers aged 45 and above at birth had increased risk of schizophrenia (OR = 1.71, 95% CI 1.49–1.99) and bipolar disorder (OR = 1.63, 95% CI 1.16–2.24). However, taking into account paternal age at birth of first child, advanced paternal age was no longer associated with increased risk of schizophrenia (OR = 0.60, 95% CI 0.48–0.79) or bipolar disorder (OR = 1.03, 95% CI 0.56–1.90).
Controlling for paternal age at birth of the first offspring, advanced paternal age does not predict increased risk for schizophrenia or bipolar disorder. These data indicate that the association between advanced paternal age and having an offspring with schizophrenia and bipolar disorder is likely due to psychos-social factors, or common genetic variation associated with delayed initial fatherhood.
The joint effects of an insoluble surfactant and gravity on the linear stability of a two-layer Couette flow in a horizontal channel are investigated. The inertialess instability regimes are studied for arbitrary wavelengths and with no simplifying requirements on the system parameters: the ratio of thicknesses of the two fluid layers; the viscosity ratio; the base shear rate; the Marangoni number $Ma$; and the Bond number $Bo$. As was established in the first part of this investigation (Frenkel, Halpern & Schweiger, J. Fluid Mech., vol. 863, 2019, pp. 150–184), a quadratic dispersion equation for the complex growth rate yields two, largely continuous, branches of the normal modes, which are responsible for the flow stability properties. This is consistent with the surfactant instability case of zero gravity studied in Halpern & Frenkel (J. Fluid Mech., vol. 485, 2003, pp. 191–220). The present paper focuses on the mid-wave regimes of instability, defined as those having a finite interval of unstable wavenumbers bounded away from zero. In particular, the location of the mid-wave instability regions in the ($Ma$, $Bo$)-plane, bounded by their critical curves, depending on the other system parameters, is considered. The changes of the extremal points of these critical curves with the variation of external parameters are investigated, including the bifurcation points at which new extrema emerge. Also, it is found that for the less unstable branch of normal modes, a mid-wave interval of unstable wavenumbers may sometimes coexist with a long-wave one, defined as an interval having a zero-wavenumber endpoint.
A linear stability analysis of a two-layer plane Couette flow of two immiscible fluid layers with different densities, viscosities and thicknesses, bounded by two infinite parallel plates moving at a constant relative velocity to each other, with an insoluble surfactant monolayer along the interface and in the presence of gravity is carried out. The normal modes approach is applied to the equations governing flow disturbances in the two layers. These equations, together with boundary conditions at the plates and the interface, yield a linear eigenvalue problem. When inertia is neglected the velocity amplitudes are the linear combinations of certain hyperbolic functions, and a quadratic dispersion equation for the increment, that is the complex growth rate, is obtained, where coefficients depend on the aspect ratio, the viscosity ratio, the basic velocity shear, the Marangoni number $Ma$ that measures the effects of surfactant and the Bond number $Bo$ that measures the influence of gravity. An extensive investigation is carried out that examines the stabilizing or destabilizing influences of these parameters. Since the dispersion equation is quadratic in the growth rate, there are two continuous branches of the normal modes: a robust branch that exists even with no surfactant, and a surfactant branch that, to the contrary, vanishes when $Ma\downarrow 0$. Regimes have been uncovered with crossings of the two dispersion curves, their reconnections at the point of crossing and separations as $Bo$ changes. Due to the availability of the explicit forms for the growth rates, in many instances the numerical results are corroborated with analytical asymptotics.
A horizontal channel flow of two immiscible fluid layers with different densities, viscosities and thicknesses, subject to vertical gravitational forces and with an insoluble surfactant monolayer present at the interface, is investigated. The base Couette flow is driven by the uniform horizontal motion of the channel walls. Linear and nonlinear stages of the (inertialess) surfactant and gravity dependent long-wave instability are studied using the lubrication approximation, which leads to a system of coupled nonlinear evolution equations for the interface and surfactant disturbances. The (inertialess) instability is a combined result of the surfactant action characterized by the Marangoni number $Ma$ and the gravitational effect corresponding to the Bond number $Bo$ that ranges from $-\infty$ to $\infty$. The other parameters are the top-to-bottom thickness ratio $n$, which is restricted to $n\geqslant 1$ by a reference frame choice, the top-to-bottom viscosity ratio $m$ and the base shear rate $s$. The linear stability is determined by an eigenvalue problem for the normal modes, where the complex eigenvalues (determining growth rates and phase velocities) and eigenfunctions (the amplitudes of disturbances of the interface, surfactant, velocities and pressures) are found analytically by using the smallness of the wavenumber. For each wavenumber, there are two active normal modes, called the surfactant and the robust modes. The robust mode is unstable when $Bo/Ma$ falls below a certain value dependent on $m$ and $n$. The surfactant branch has instability for $m<1$, and any $Bo$, although the range of unstable wavenumbers decreases as the stabilizing effect of gravity represented by $Bo$ increases. Thus, for certain parametric ranges, even arbitrarily strong gravity cannot completely stabilize the flow. The correlations of vorticity-thickness phase differences with instability, present when gravitational effects are neglected, are found to break down when gravity is important. The physical mechanisms of instability for the two modes are explained with vorticity playing no role in them. This is in marked contrast to the dynamical role of vorticity in the mechanism of the well-known Yih instability due to effects of inertia, and is contrary to some earlier literature. Unlike the semi-infinite case that we previously studied, a small-amplitude saturation of the surfactant instability is possible in the absence of gravity. For certain $(m,n)$-ranges, the interface deflection is governed by a decoupled Kuramoto–Sivashinsky equation, which provides a source term for a linear convection–diffusion equation governing the surfactant concentration. When the diffusion term is negligible, this surfactant equation has an analytic solution which is consistent with the full numerics. Just like the interface, the surfactant wave is chaotic, but the ratio of the two waves turns out to be constant.
The historicity of books – their role as a force in history – has been addressed in post-war literary studies from different perspectives and across various disciplines. Nevertheless, the scholarship on the history of the book in medieval Islam is still relatively sparse, even though this society underwent a thorough process of textualization. But even authors who do consider the social and cultural role of books in medieval Islam look only at the production and consumption of Arabic books within the boundaries of Muslim society, relying on Islamic sources which reflect mainly the courtly milieu of scribes and secretariats. None discuss books produced and consumed by the religious minorities that were an indispensable part of this society, and none have made use of the abundant Genizah documents as source material. In the present programmatic article, I call attention to the many book lists found in the Cairo Genizah and to their potential as significant tools for developing a better understanding of the cultural and social history of the medieval Islamicate world.
Introduction: Point of care ultrasound has become an established tool in the initial management of patients with undifferentiated hypotension. Current established protocols (RUSH, ACES, etc) were developed by expert user opinion, rather than objective, prospective data. We wished to use reported disease incidence to develop an informed approach to PoCUS in hypotension using a “4 F’s” approach: Fluid; Form; Function; Filling. Methods: We summarized the incidence of PoCUS findings from an international multicentre RCT, and using a modified Delphi approach incorporating this data we obtained the input of 24 international experts associated with five professional organizations led by the International Federation of Emergency Medicine. The modified Delphi tool was developed to reach an international consensus on how to integrate PoCUS for hypotensive emergency department patients. Results: Rates of abnormal PoCUS findings from 151 patients with undifferentiated hypotension included left ventricular dynamic changes (43%), IVC abnormalities (27%), pericardial effusion (16%), and pleural fluid (8%). Abdominal pathology was rare (fluid 5%, AAA 2%). After two rounds of the survey, using majority consensus, agreement was reached on a SHoC-hypotension protocol comprising: A. Core: 1. Cardiac views (Sub-xiphoid and parasternal windows for pericardial fluid, cardiac form and ventricular function); 2. Lung views for pleural fluid and B-lines for filling status; and 3. IVC views for filling status; B. Supplementary: Additional cardiac views; and C. Additional views (when indicated) including peritoneal fluid, aorta, pelvic for IUP, and proximal leg veins for DVT. Conclusion: An international consensus process based on prospectively collected disease incidence has led to a proposed SHoC-hypotension PoCUS protocol comprising a stepwise clinical-indication based approach of Core, Supplementary and Additional PoCUS views.
Introduction: Point of care ultrasound (PoCUS) provides invaluable information during resuscitation efforts in cardiac arrest by determining presence/absence of cardiac activity and identifying reversible causes such as pericardial tamponade. There is no agreed guideline on how to safely and effectively incorporate PoCUS into the advanced cardiac life support (ACLS) algorithm. We consider that a consensus-based priority checklist using a “4 F’s” approach (Fluid; Form; Function; Filling), would provide a better algorithm during ACLS. Methods: The ultrasound subcommittee of the Australasian College for Emergency Medicine (ACEM) drafted a checklist incorporating PoCUS into the ACLS algorithm. This was further developed using the input of 24 international experts associated with five professional organizations led by the International Federation of Emergency Medicine. A modified Delphi tool was developed to reach an international consensus on how to integrate ultrasound into cardiac arrest algorithms for emergency department patients. Results: Consensus was reached following 3 rounds. The agreed protocol focuses on the timing of PoCUS as well as the specific clinical questions. Core cardiac windows performed during the rhythm check pause in chest compressions are the sub-xiphoid and parasternal cardiac views. Either view should be used to detect pericardial fluid, as well as examining ventricular form (e.g. right heart strain) and function, (e.g. asystole versus organized cardiac activity). Supplementary views include lung views (for absent lung sliding in pneumothorax and for pleural fluid), and IVC views for filling. Additional ultrasound applications are for endotracheal tube confirmation, proximal leg veins for DVT, or for sources of blood loss (AAA, peritoneal/pelvic fluid). Conclusion: The authors hope that this process will lead to a consensus-based SHoC-cardiac arrest guideline on incorporating PoCUS into the ACLS algorithm.