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When she started working with the aged more than forty years ago, Ann Burack-Weiss began storing the knowledge and skills she thought would help when she got old herself. It was not until she hit her mid-seventies that she realized she had packed sneakers to climb Mount Everest, not anticipating the crevices and chasms that constitute the rocky terrain of old age. The professional gerontological and social work literature offered little help, so she turned to the late-life works of beloved women authors who had bravely climbed the mountain and sent back news from the summit. Maya Angelou, Colette, Simone de Beauvoir, Joan Didion, Marguerite Duras, M. F. K. Fisher, Doris Lessing, Mary Oliver, Adrienne Rich, May Sarton, and Florida Scott-Maxwell were among the many guides she turned to for inspiration. InThe Lioness in Winter, Burack-Weiss blends an analysis of key writings from these and other famed women authors with her own wisdom to create an essential companion for older women and those who care for them. She fearlessly examines issues such as living with loss, finding comfort and joy in unexpected places, and facing disability and death. This book is filled with powerful passages from women who turned their experiences of aging into art, and Burack-Weiss ties their words to her own struggles and epiphanies, framing their collective observations with key insights from social work practice.

If anything is certain in human existence, it is the exit. Before the universal yet radically singular event of death, however, history leaves its mark on us by determining which exits are possible, necessary or desirable. This collection of essays, which celebrates the achievement of the Swedish Africanist and postcolonial scholar Raoul Granqvist, deal with the broad theme of exit - in the form of exile, displacement, suicide, endings and, indeed, beginnings. After all, \"In my end is my beginning\" (T.S. Eliot). Childhood as exit rite in contemporary African literature (Camara Laye's L'Enfant Noir and Ishmael Beah's Long Way Gone); the Cameroonian director Jean Pierre Bekolo's controversial film Les Saignantes; an early play by Wole Soyinka; Ghana during the First World War; Zakes Mda's Cion; proto-nationalist writing on the Gold Coast; passing in Zoë Wicomb's Playing in the Light; the exile of South African and Caribbean writers; translation theory in the global South; public representations of Africans in north-east Bavaria; oral poetry in rural England; Fred Wah's Swedish-Chinese background in twentieth-century Canada; Toni Morrison's Beloved and infanticide; the open endings of the poetry of Paul Muldoon; the suicide of Virginia Woolf; the viability of global environmental policies - these are some of the topics that this book, in defiance of neat disciplinary boundaries, addresses. The closing section, \"Voicing the Exit,\" transcends the academic format with its evocative literary representations of the experience of exit (in Tanzania, Uganda, Ukrainian Canada and elsewhere).

Background Low levels of physical activity (PA) are a global concern and increasing PA engagement is becoming a priority in current public health policies. Despite the large number of studies and reviews available, the evidence regarding the behavioral determinants of PA is still inconclusive. Thus, the aim of this umbrella systematic literature review (SLR) was to summarize the evidence on the behavioral determinants of PA across the life course. Methods A systematic online search was conducted on MEDLINE, ISI Web of Science, Scopus, and SPORTDiscus databases. The search was limited to studies published in English from January, 2004 to April, 2016. SLRs and meta-analyses (MAs) of observational studies that investigated the behavioral determinants of PA were considered eligible. The extracted data were assessed based on the importance of the determinants, the strength of evidence, and the methodological quality. The full protocol is available from PROSPERO (PROSPERO 2014:CRD42015010616). Results Seventeen reviews on 35 behavioral determinants of PA were eligible for this umbrella SLR. Regardless of age, the most investigated determinants were those related with ‘screen use’ and ‘smoking’. For youth, probable positive evidence emerged for ‘previous PA’ and ‘independent mobility and active transport’ among children and adolescents. For the adult population, ‘transition to university’ and ‘pregnancy/having a child’ showed probable negative associations. Conclusions Although the majority of the evidence was limited and most of the determinants were not associated with PA, this umbrella SLR provided a comprehensive overview of the associations between behavioral determinants and PA. Youth should be physically active in the early years and increase active transportation to/from school, independent mobility, and ‘free-range activities’ without adult supervision, whilst adult PA behaviors are mostly influenced by the life events. Finally, more research is needed that incorporates prospective study designs, standardized definitions of PA, objective measurement methods of PA assessment, and the use of interactionist and mediational approaches for the evaluation of different behavioral determinants influencing PA behaviors.

One of the most consistently observed phenomena in autobiographical memory research is the reminiscence bump: a tendency for middle-aged and elderly people to access more personal memories from approximately 10-30 years of age. This systematic review (PROSPERO 2017:CRD42017076695) aimed to synthesize peer-reviewed literature pertaining to the reminiscence bump. The researchers conducted searches in nine databases for studies published between the date of inception of each database and the year 2017. Keywords used included: reminiscence, bump, peak, surge, blip, reminiscence effect, and reminiscence component. Sixty-eight quantitative studies, out of 523, met the inclusion criteria. The researchers implemented a thematic analytic technique for data extraction. Four main themes were generated: methods of memory activation/instruction for life scripts, types of memory/life scripts recalled, location of the reminiscence bump, and theoretical accounts for the bump. The two prevailing methods of memory activation implemented were the cuing method and important memories method. Three types of memories/life scripts were recalled: personal/autobiographical memory, memories for public events, and life script events. The findings illustrate differing temporal periods for the bump: approximately 10-30 years for memories for important events, approximately 5-30 years for memories that were induced by word cues, and 6-39 years for studies using life scripts. In explaining the bump, the narrative/identity account and cultural life script account received the most support.

Rationale The investigation of putative effects of early life stress (ELS) in humans on later behavior and neurobiology is a fast developing field. While epidemiological and neurobiological studies paint a somber picture of negative outcomes, relatively little attention has been devoted to integrating the breadth of findings concerning possible cognitive and emotional deficits associated with ELS. Emerging findings from longitudinal studies examining developmental trajectories of the brain in healthy samples may provide a new framework to understand mechanisms underlying ELS sequelae. Objective The goal of this review was twofold. The first was to summarize findings from longitudinal data on normative brain development. The second was to utilize this framework of normative brain development to interpret changes in developmental trajectories associated with deficits in cognitive and affective function following ELS. Results Five principles of normative brain development were identified and used to discuss behavioral and neural sequelae of ELS. Early adversity was found to be associated with deficits in a range of cognitive (cognitive performance, memory, and executive functioning) and affective (reward processing, processing of social and affective stimuli, and emotion regulation) functions. Conclusion Three general conclusions emerge: (1) higher-order, complex cognitive and affective functions associated with brain regions undergoing protracted postnatal development are particularly vulnerable to the deleterious effects of ELS; (2) the amygdala is particularly sensitive to early ELS; and (3) several deficits, particularly those in the affective domain, appear to persist years after ELS has ceased and may increase risk for later psychopathology.

This article reports the results of a scoping review of the literature on life-course patterns of violence that span the developmental periods of childhood, adolescence, and early and middle adulthood. We also assess the evidence on elder mistreatment and its relation to earlier forms of violence. Additionally, we draw on theories and empirical studies to help explain the transmission of violence over time and relational contexts and the factors that appear to mitigate risks and promote resilience in individuals exposed to violence. Results suggest that encounters with violence beginning in childhood elevate the risk for violence in subsequent developmental periods. The strongest connections are between child maltreatment (physical abuse, emotional abuse, sexual abuse, and neglect) and violence in adolescence and between violence in adolescence and violence in early and middle adulthood. Persistence of violence into older adulthood leading to elder mistreatment is less well-documented, but probable, based on available research. We conclude that more attention should be paid to studying developmental patterns and intersecting forms of violence that extend into old age. To eradicate violence in all its forms, considerably more must be done to increase awareness of the repetition of violence; to connect research to actionable steps for prevention and intervention across the life course; and to better integrate systems that serve vulnerable children, youth, and adults. Primary prevention is essential to breaking the cycle of violence within families and to alleviating the risks to children caused by poverty and other external factors such as social disconnection within communities.

Climate extremes will elicit responses from the individual to the ecosystem level. However, only recently have ecologists begun to synthetically assess responses to climate extremes across multiple levels of ecological organization. We review the literature to examine how plant responses vary and interact across levels of organization, focusing on how individual, population and community responses may inform ecosystem-level responses in herbaceous and forest plant communities. We report a high degree of variability at the individual level, and a consequential inconsistency in the translation of individual or population responses to directional changes in community- or ecosystem-level processes. The scaling of individual or population responses to community or ecosystem responses is often predicated upon the functional identity of the species in the community, in particular, the dominant species. Furthermore, the reported stability in plant community composition and functioning with respect to extremes is often driven by processes that operate at the community level, such as species niche partitioning and compensatory responses during or after the event. Future research efforts would benefit from assessing ecological responses across multiple levels of organization, as this will provide both a holistic and mechanistic understanding of ecosystem responses to increasing climatic variability. This article is part of the themed issue ‘Behavioural, ecological and evolutionary responses to extreme climatic events’.

BACKGROUND : Africa faces diverse and complex population/human health challenges due to climate change. Understanding the health impacts of climate change in Africa in all its complexity is essential for implementing effective strategies and policies to mitigate risks and protect vulnerable populations. This study aimed to outline the major climate change-related health impacts in Africa in the context of economic resilience and to seek solutions and provide strategies to prevent or reduce adverse effects of climate change on human health and well-being in Africa. METHODS : For this narrative review, a literature search was conducted in the Web of Science, Scopus, CAB Abstracts, MEDLINE and EMBASE electronic databases. We also searched the reference lists of retrieved articles for additional records as well as reports. We followed a conceptual framework to ensure all aspects of climate change and health impacts in Africa were identified. RESULTS : The average temperatures in all six eco-regions of Africa have risen since the early twentieth century, and heat exposure, extreme events, and sea level rise are projected to disproportionately affect Africa, resulting in a larger burden of health impacts than other continents. Given that climate change already poses substantial challenges to African health and well-being, this will necessitate significant effort, financial investment, and dedication to climate change mitigation and adaptation. This review offers African leaders and decision-makers data-driven and action-oriented strategies that will ensure a more resilient healthcare system and safe, healthy populations—in ways that contribute to economic resiliency. CONCLUSIONS : The urgency of climate-health action integrated with sustainable development in Africa cannot be overstated, given the multiple economic gains from reducing current impacts and projected risks of climate change on the continent’s population health and well-being. Climate action must be integrated into Africa’s development plan to meet the Sustainable Development Goals, protect vulnerable populations from the detrimental effects of climate change, and promote economic development.

Post-traumatic stress disorder (PTSD) occurs in 5–10% of the population and is twice as common in women as in men. Although trauma exposure is the precipitating event for PTSD to develop, biological and psychosocial risk factors are increasingly viewed as predictors of symptom onset, severity and chronicity. PTSD affects multiple biological systems, such as brain circuitry and neurochemistry, and cellular, immune, endocrine and metabolic function. Treatment approaches involve a combination of medications and psychotherapy, with psychotherapy overall showing greatest efficacy. Studies of PTSD pathophysiology initially focused on the psychophysiology and neurobiology of stress responses, and the acquisition and the extinction of fear memories. However, increasing emphasis is being placed on identifying factors that explain individual differences in responses to trauma and promotion of resilience, such as genetic and social factors, brain developmental processes, cumulative biological and psychological effects of early childhood and other stressful lifetime events. The field of PTSD is currently challenged by fluctuations in diagnostic criteria, which have implications for epidemiological, biological, genetic and treatment studies. However, the advent of new biological methodologies offers the possibility of large-scale approaches to heterogeneous and genetically complex brain disorders, and provides optimism that individualized approaches to diagnosis and treatment will be discovered. Post-traumatic stress disorder (PTSD) can develop after a person experiences a traumatic event, such as natural disaster or violent crime. However, not everyone who experiences trauma develops PTSD. In this Primer, the authors describe at-risk populations and the factors that modulate PTSD risk.