Neurodegeneration in normal brain aging and disease

Normal "healthy" aging is defined as aging without disease. Many aged people do not exhibit symptoms of disease and lead normal lives, but nonetheless display pathological changes that are characteristic of Alzheimer's disease (AD), Parkinson's disease (PD), dementia with Lewy bodies (DLB), and/or cerebrovascular disease (CVD). These changes are restricted to distinct brain regions and might represent preclinical stages of these disorders. This Perspective discusses arguments in favor of and against the hypothesis that pathological changes related to AD, PD, DLB, and CVD in the brains of nondemented elderly people represent early stages of these diseases rather than healthy aging. We conclude that early pathological disease-related changes do indeed constitute the beginning of AD, PD, DLB, and CVD rather than normal concomitants of aging, even in the absence of any clinical symptoms. Aging is, therefore, a major risk factor for these diseases but does not necessarily lead to age-related diseases.     

Healing broken hearts

1. Posttraumatic stress disorder, anxiety, and depression have a significant negative effect on the physical functioning of individuals with coronary artery disease. 2. A diagnosis of major depression is recognized to be an independent risk factor for cardiac events. 3. Preoperative and postoperative interventions can increase individuals' compliance with cardiac and psychiatric self-care after discharge.     

Das Geschäft mit der Gewalt

The business with acts of violence. Why the ?disarmament in TV“ does not advance?Media politics and media industry form a fatal alliance by preventing that there are serious limits to presentations of acts of violence in the media. The media lobby is up to now successful in preventing that real conclusions are drawn from the scientific findings of independent researchers on the effects of media violence. The profit of the media industry is more important than the mental health of children and adolescents. The author delineates the consequences for politics, pedagogics and the media industry with some uncomfortable, but effective recommendations.     

Model-based inference for categorical survey data subject to non-ignorable non-response

We consider non-response models for a single categorical response with categorical covariates whose values are always observed. We present Bayesian methods for ignorable models and a particular non-ignorable model, and we argue that standard methods of model comparison are inappropriate for comparing ignorable and non-ignorable models. Uncertainty about ignorability of non-response is incorporated by introducing parameters describing the extent of non-ignorability into a pattern mixture specification and integrating over the prior uncertainty associated with these parameters. Our approach is illustrated using polling data from the 1992 British general election panel survey. We suggest sample size adjustments for surveys when non-ignorable non-response is expected.     

Addressing the midwifery workforce crisis: evaluating an employment model for undergraduate midwifery students at a tertiary maternity hospital in Melbourne, Australia

Background and aims

In Victoria, maternity services are under significant strain due to increased numbers of women giving birth and critical workforce shortages. Hospitals have experienced challenges in adequately staffing maternity units, particularly on postnatal wards. In 2008, a tertiary maternity hospital in Melbourne introduced a model where undergraduate midwifery students were employed as Division 2 nurses (SMW_Div2) (enrolled nurses), to work in the postnatal area only. This study explored the pilot employment model from the perspective of the SMW_Div2 and hospital midwives.

Methods

A web-based survey was administered to hospital midwives and the SMW_Div2s in the employment model in January 2010. The survey explored the views of midwives and SMW_Div2s regarding the perceived impact of the model on workforce readiness, recruitment and retention, and clinical competence and confidence.

Findings

Forty-seven of 158 midwives (30%) and five of nine SMW_Div2s employed in the model responded to the survey. Both groups considered the model to have benefits for the organisation, including increased: student workforce readiness; clinical confidence and competence; and organisational loyalty. Both groups also considered that the model would facilitate: workforce recruitment; a teaching and learning culture within the organisation; and enhanced partnerships between students, hospitals and universities. Caution was expressed regarding workload and the need for ongoing support for SMW_Div2s working in the model.

Discussion and conclusion

SMW_Div2s and midwives were positive about the introduction of the paid employment model at the Women's. The findings are consistent with evaluations of similar programs in the nursing setting. The employment model has potential short and long term individual and organisational advantages, which is important in the context of increasing births and workforce shortages. Progression of such models will be contingent on the collaboration and cooperation of the various stakeholders involved in maternity workforce and education.     

On Bayesian model and variable selection using MCMC

Several MCMC methods have been proposed for estimating probabilities of models and associated 'model-averaged' posterior distributions in the presence of model uncertainty. We discuss, compare, develop and illustrate several of these methods, focussing on connections between them.