Functional status in relation to depression among elderly individuals in Indonesia: a cross-sectional analysis of the Indonesian National Health Survey 2018 among elderly individuals

Background Depression among elderly individuals is related to physical illness, functional status, prolonged treatment and other factors. Depression is not effectively treated with medication but can be alleviated by treating the physical illness and improving functional status. Therefore, this study aims to determine the relationship between functional status and depression in elderly individuals in Indonesia. Methods The data used were obtained from a national survey dataset, namely, the Basic Health Research and Socio-Economic Survey in 2018, which was carried out in 34 provinces and 514 districts or cities. The total number of respondents was 93,829, aged ≥60 years. Functional status and depression were assessed using the Barthel index and MINI (Mini International Neuropsychiatric Interview), respectively. Furthermore, data processing was carried out with the Statistical Package for Social Sciences (SPSS) version 26 program and analyzed using the chi-square test and multiple logistic regression with the complex sample method. Results Elderly individuals with severe dependence were at the greatest risk of becoming depressed compared to those without functional impairment or with independence after considering sociodemographic factors and disease history have 5.730 (95% CI = 4.302-7.632) the adj odds. Furthermore, this figure was higher than that of individuals with total dependence have 4.147 (95% CI = 3.231-5.231) the adj odds. The physical illness experienced also played a role in the risk for depression, which was higher among elderly individuals with stroke and a history of injury. The sociodemographic factors involved include low education and economic levels. In contrast, the area of residence and marital status had no statistically significant effect on the relationship between functional disorders and depression. Conclusions Elderly individuals with decreased functional status are prone to depression. The highest probability for depression was observed among those with severe dependence compared to those with total dependence. Consequently, interventions that involve various sectors, including social and family support, are needed.

Fulfillment Of Activity Daily Living (ADL) In Breast Cancer Patients Undergoing Chemotherapy At Haji Adam Malik Hospital Medan

Breast cancer arises as a result of abnormal cells forming in the breast at an uncontrolled and irregular rate. There are several types of treatment for breast cancer patients and one of them is chemotherapy. The frequency of chemotherapy can cause several effects that can worsen the patient's functional status. Functional status is an ability to perform daily tasks that include work, self-care, and maintenance of family or social roles. This study aims to identify ADL compliance in breast cancer patients undergoing chemotherapy. This study used a descriptive design, the sample was taken using a non-probability sampling method, namely accidental sampling and the instrument used was a questionnaire compiled using a Likert scale. The reliability test of this study used a Cronbach Alpha of 0.917. Data collection was carried out from September 2015 to August 2016. The description of ADL fulfillment of breast cancer patients undergoing chemotherapy was described to determine the frequency and percentage. The results showed that the fulfillment of ADL in breast cancer patients undergoing chemotherapy was independent (20 people, 54.1%), partial dependence (10 people, 27%), and total dependence (7 people, 18.9%). It can be concluded that most breast cancer patients undergoing chemotherapy can carry out their Activity Daily Living with an independent level of ability. The description of ADL fulfillment of breast cancer patients undergoing chemotherapy is described to determine the frequency and percentage. The results showed that the fulfillment of ADL in breast cancer patients undergoing chemotherapy was independent (20 people, 54.1%), partial dependence (10 people, 27%), and total dependence (7 people, 18.9%). It can be concluded that most breast cancer patients undergoing chemotherapy can carry out their Activity Daily Living with an independent level of ability. The description of ADL fulfillment of breast cancer patients undergoing chemotherapy is described to determine the frequency and percentage. The results showed that the fulfillment of ADL in breast cancer patients undergoing chemotherapy was independent (20 people, 54.1%), partial dependence (10 people, 27%), and total dependence (7 people, 18.9%). It can be concluded that most breast cancer patients undergoing chemotherapy can carry out their Activity Daily Living with an independent level of ability.

IN SEARCH OF LIFE EXPERIENCE AND WISDOM (ORIGINALITY OF THE FAIRY TALE BY IVAN FRANKO “ABOUT A NOBLEMAN LOOKING FOR А TROUBLE”)

The paper deals with the story “About a Nobleman Looking for а Trouble” (1887) by Ivan Franko and highlights its genre peculiarities. The major attention is drawn to the dominant features indicating the fairy-tale nature of the story. The literary sources of the plot, the system of characters, biblical allusions, main issues as well as the reception of the work by contemporary criticism have been explored. The story by Ivan Franko was based on Ukrainian folk tales about the search for trouble performed by a nobleman or a priest. In the field of struggle between the forces of good and evil, the images of the young magician — Messiah — Jesus Christ and the Тrouble become the central symbols of the tale. The Misfortune archetype, which is directly linked to Franko’s perception of the people, suffering under circumstances of total dependence on the landlords, must be analyzed with attention to the people’s outlook and the author’s individual thinking. The young magician appears as Messiah, and it helps to bring a nobleman closer to something eternal and make him reevaluate his own life. These images perform important functions in the plot and composition of the work, revealing active changes in the character of a nobleman and forming the philosophical and psychological discourse of the author. There is a variety of associations between the light in the Bible and in Franko’s tale. The “light that enlightens everyone” causes enlightenment of а nobleman. The inner state of the hero at the moment of enlightenment is revealed in prayer. The prayer monologue demonstrates openness, sincerity, the immediacy of self-expression and despair, and at the same time hopelessness. The plot of the tale “About a Nobleman Looking for а Trouble” is related to Franko’s unfinished poem “About a Richman Who Went to Buy а Trouble” (written in 1887). The research also involves some other prose works by the writer.

525 - Anger expression among survivors after stroke in Greek elderly

Introduction:Individuals may consider stroke complications as a threat to their well-being and self- esteem. Anger often occurs in patients after stroke and can disrupt the course of patient’s recovery.The aim of the present study was to investigate anger expression and degree of functionality in patients after stroke. Additionally, the relationship between the above parameters, as well as their correlation with socio-demographic characteristics and clinical factors of these patients were explored.Method:A total of 110 patients after stroke (69 men and 41 women) with a mean age of 69.3 ± 13.7 years were recruited and completed (a) a sociodemographic-clinical questionnaire, (b) the State - Trait Anger Expression Inventory and (c) Barthel Index.Results:76.4% of the participants had ischemic stroke; while the 60% were retired. and the 20% of the sample showed severe to total dependence on self-care of basic parameters such as mobility, personal hygiene, feeding, incontinence and standing alone using the toilet. There was a positive statistically significant correlation between the degree of functionality and anger control. Patient, who were more independent and functional, exhibited more control of their anger. Women had statistically significant lower functionality/ independence score (BI) and anger-in score than men. Finally, patients with a history of prior stroke had higher anger-out score compared to patients with no previous history.Conclusions:People with a previous history were more likely to suffer from greater and/or permanent functional impairment, disability, dependence, and experience emotional distress for longer periods of time. Women usually take care of other family members. Their inability to fulfill their role as well as their own dependence make the situation even more stressful, resulting in expressing anger. The results can be exploited by health professionals in order to recognize patients’ difficulties in rehabilitation programs.

A review of research in soil fertility management and plant nutrition of cashew (Anacardium occidentale L.) in Nigeria

The paper reviewed researches conducted in soil fertility management and plant nutrition of cashew in Nigeria. It also examines the history and importance of cashew to the Nigerian economy. The paper highlights ways of improving soil fertility and plant nutrition in cashew cultivation through the use of different sources of organic fertilizers which are cheap and readily available for the farmers rather than total dependence on costly chemical fertilizers. Also highlighted, are some recommended rates of organic and inorganic fertilizers for the cultivation of cashew from research findings. The paper also discussed status of Nigeria cashew production, research efforts, achievements, constraints, and areas of possible improvement in relation to soil fertility management and plant nutrition.

D. W. Winnicott, André Green, and Rosemary Dinnage: Some Thoughts on the Interplay of Transitional Objects and Object Destruction

In this paper, the author attempts to arrive at a comprehensive outline of Winnicott's developmental theory. This theory encompasses the infant's emergence from total dependence and subject/object merging to what the author refers to as relative independence and relative subject/object separation (in Winnicott's words, “separation that is a not a separation but a form of union” [1971a, p. 98]). This conceptualization is based mainly on an amalgam of Winnicott's two well-known papers, on transitional objects and phenomena (1953) and on the use of an object (1969). The author also refers to André Green's notions of the importance of the negative and of the “dead mother” in reference to Winnicott's work. To demonstrate the clinical implications of the paper, the author discusses in detail the case of Rosemary Dinnage, as described by both Winnicott and Green and as reported directly by herself.

Masseter Muscle Thickness Measured by Ultrasound as a Possible Link with Sarcopenia, Malnutrition and Dependence in Nursing Homes

Sarcopenia is a progressive and generalized loss of skeletal muscle mass and strength. It is frequently associated with malnutrition and dependence in nursing homes. Masticatory muscle strength could be the link between sarcopenia, malnutrition and dependence. We aimed to study the relation between sarcopenia, malnutrition and dependence with masseter muscle thickness measured by ultrasound. A cross-sectional study was realized, with 464 patients from 3 public nursing homes in Zaragoza (Spain). The diagnosis of sarcopenia was assessed according to the European Working Group on Sarcopenia in Older People 2 criteria, malnutrition by the Mini Nutritional Assessment (MNA) and the Global Leadership Initiative on Malnutrition (GLIM) criteria and functional capacity by the Barhel Index and the texture diet. Masseter muscle thickness (MMT) was measured by ultrasound. The median age was 84.7 years, and 70% of the participants were women. Sarcopenia was confirmed in 39.2% of patients, malnutrition in 26.5% (risk 47.8%), total dependence in 37.9% and diet texture was modified in 44.6%. By logistic regression, once the model was adjusted for age, sex, Barthel index and texture diet, our analyses indicated that each 1 mm decrease in MMT increased the risk of sarcopenia by ~57% (OR: 0.43), the risk of malnutrition by MNA by ~63% (OR: 0.37) and the risk of malnutrition by GLIM by ~34% (OR: 0.66). We found that MMT was reduced in sarcopenic, malnourished and dependent patients, and it could be the common point of a vicious cycle between sarcopenia and malnutrition. Further studies are needed to establish causality.

Functional Status in Relation to Depression Among Elderly Individuals in Indonesia

Background: Depression among elderly individuals is related to physical illness, functional status, prolonged treatment and other factors. Depression is not effectively treated with medication but can be alleviated by treating the physical illness and improving functional status. Therefore, this study aims to determine the relationship between functional status and depression in elderly individuals in Indonesia.Methods: The data used were obtained from a national survey dataset, namely, the Basic Health Research and Socio-Economic Survey in 2018, which was carried out in 34 provinces and 514 districts or cities. The total number of respondents was 93,829, aged ≥ 60 years. Functional status and depression were assessed using the Barthel index and MINI (Mini International Neuropsychiatric Interview), respectively. Furthermore, data processing was carried out with the Statistical Package for Social Sciences (SPSS) version 26 program and analyzed using the chi-square test and multiple logistic regression with the complex sample method.Results: Elderly individuals with severe dependence were at the greatest risk of becoming depressed compared to those without functional impairment or with independence after considering sociodemographic factors and disease history have 5.730 (95% CI= 4.302-7.632) the adj odds. Furthermore, this figure was higher than that of individuals with total dependence have 4.147 (95% CI=3.231-5.231) the adj odds. The physical illness experienced also played a role in the risk for depression, which was higher among elderly individuals with stroke and a history of injury. The sociodemographic factors involved include low education and economic levels. In contrast, the area of residence and marital status had no statistically significant effect on the relationship between functional disorders and depression.Conclusions: Elderly individuals with decreased functional status are prone to depression. The highest probability for depression was observed among those with severe dependence compared to those with total dependence. Consequently, interventions that involve various sectors, including social and family support, are needed.

How digital strategy increases overtourism the case of Barcelona

The term ‘overtourism’ made the headlines in 2017 to denote the antithesis of a fair, well-planned form of tourism. An overtourism destination is a destination perceived as the victim of uncontrolled flows of tourists. Some authors have contributed to analysing the first stages of this perception. Boissevain (1996) published ‘Coping with tourists: European reactions to mass tourism’, in which he analysed how a massive flow of tourists in Malta generated negative side effects and a total dependence on touristic economy. Tyler et al. (1998) offered one of the first analyses of ways to control tourism flow from a sustainable point of view. Bosselman et al. (1999) published a pioneering analysis on the relationships between hosts and tourists. The paper discusses the risks and benefits of growth in tourism and the need for long-term management to avoid overexploitation of tourist destinations. These research projects laid the foundations for reflection on sustainable tourism and were the starting point for studying the risks of overtourism. Fyall and Garrod (1998) discussed the impacts of overtourism on heritage sites. On the one hand, the phenomenon contributes to a short-term economic boost; on the other hand, it impacts negatively on the way of life of local communities.

Modeling a Sustainable, Self-Energized Pine Dust Pyrolysis System With Staged Condensation for Optimal Recovery of Bio-Oil

This simulation study explores sustainable improvements that could be made to a pine dust pyrolysis system to eliminate total dependence on external electrical energy supply and improve the yield of high-quality dry bio-oil. The components, stoichiometric yield and composition of oil, char and gas were modeled in ChemCAD using data from literature and results from biomass characterization and pyrolysis. A fast pyrolysis regime was used to increase the overall yield of dry oil fraction recovered and the char by-product was utilized to make the system energy self-sufficient. The optimization study focused on the condensation system whose parameters were varied at the provided optimum pyrolysis temperature. The recommended temperature for the primary condenser was 96–110°C which yielded 23.3–29.8 wt% dry oil with 2.4–4.4 wt% water content. The optimum temperature for the secondary condenser was 82°C whose bio-oil (∼2.92 wt%) had a moisture content of 7.5–10 wt% at constant primary condenser temperature between 96–110°C. The third condenser could be operated at ambient temperature. The results were validated using both information reported in literature and results from the previous experimental study. Such a simple model built by careful selection of the model bio-oil components is useful in estimating the optimal parameters for the biomass pyrolysis staged condensation system.