KARACHI, Pakistan (Reuters) — A Pakistan International Airlines (PIA) plane with around 100 passengers and crew crashed on Friday in a residential area of the southern city of Karachi, with many feared dead, officials said.
The state carrier said flight PK 8303 had crashed with 99 passengers and eight crew members on board, though civil aviation officials said the total for both may be 99.
“The last we heard from the pilot was that he has some technical problem,†PIA spokesman Abdullah H. Khan said in a video statement. “It is a very tragic incident.â€
A senior civil aviation official told Reuters it appeared the plane was unable to open its wheels due to a technical fault prior to landing, but it was to early to determine the cause.
Geo TV broadcaster showed crowds near the scene, which appeared to be a densely populated area, and ambulances trying to make their way through.
Black smoke billowed and several cars were on fire.
The Pakistani army said its quick reaction force and paramilitary troops had reached the site for relief and rescue efforts alongside civil administration bodies.
(Asif Shahzad reported from Islamabad; Editing by Toby Chopra and Andrew Cawthorne)
This is a developing story. Please check back for updates.
Calling all HuffPost superfans!
Sign up for membership to become a founding member and help shape HuffPost’s next chapter
It’s not uncommon for actors, singers or bands to have “ridersâ€, certain conditions that they write into their contracts which the hosting venue must fulfil. Queen once asked for a mud-wrestling ring outside the dressing-room to provide them with some post-show entertainment. Punk icon Iggy Pop once requested “somebody dressed as Bob Hope†to do impersonations of the dead comedian. Most famously, the rock band Van Halen demanded that at every show a bowl of M&Ms be provided in their dressing room, with the brown ones removed. Failure to do so would result in the show’s summary cancellation.
Filmmaker Warwick Thornton’s needs are more prosaic. “When I’m on location, I always ask the producer for a unit with a stove, or a house with a kitchen,†he says. Thornton is no diva – he’s not going to start smashing cameras if he doesn’t get access to a hotplate – it’s just that cooking makes him work better. On shoots, he has been known to make meals for the cast and crew as a sign of his appreciation. He cooks for people to engender familiarity, to foster creativity and, on a more personal level, as a reset, “a wayâ€, he says, “of erasing the day. If I don’t cook at the end of the day, I’ll lie awake worrying about what I’ve shot.†And we’re not talking about throwing together a French omelette or a 10-minute stir-fry. “I might go to bed at 11pm, because it’s taken three or four hours to cook a meal.â€
It seems to be working for him. Over the past decade or so, Thornton, who is 49, has emerged as one of the strongest voices in Australian film. His first feature, Samson and Delilah, a tough love tale set in a remote Aboriginal community, won the Camera d’Or at the Cannes Film Festival in 2009. His second major release, the brutal western Sweet Country, in 2017, won prizes at two of the world’s leading festivals, Venice and Toronto, and took best film at the Asia Pacific Screen Awards. Thornton has also made short films and major art installations, and is, to boot, a talented cinematographer, with a “warm, fresh eyeâ€, as actor Bryan Brown puts it, “and a gift for producing scenes of mesmerising beautyâ€.
He also has a gift for excess. “I live a pretty fortunate life through cinema and art, so I can have a rock ’n’ roll party every bloody night if I want to,†Thornton tells me. “I love the after-party, the bar stool, the pool table, the conversation. It’s all just too exciting.â€
We are sitting at a glass-topped table on the cracked concrete landing of a house that his older sister Erica rents in Annandale, a much sought-after suburb in Sydney’s inner west, where Thornton lives when he is not out making movies. I’d been expecting a tastefully appointed terrace house, boho meets Vogue Living, but this place looks more like a student bedsit, with blankets over the doors and garage-sale furniture. There’s a jumbo-sized packet of Coco Pops on top of the fridge, right next to a bottle of Tanqueray. “It’s not the anal-bleached version [of an Annandale home],†he says. “That’s not my thing.â€
Thornton is an intimidating figure, standing well over six feet tall and dressed almost entirely in black; black jeans, black cap, black boots, black cowboy shirt. The only exception is his T-shirt, which is brown. He is fearsomely hairy, with a beard and swarming neck growth that appears, at least from where I’m sitting, to have grown into and become part of his T-shirt, giving him the aspect of a chain-smoking grizzly bear. “I’m like the ogre under the bridge,†he says. “Sometimes they have to drag me out to have a shower, and then I go off to work.â€
His internal ogre is abetted, to some extent, by his encumbered lifestyle: he has three kids – Luka, 16, Rona, 23 and Dylan, 27 – by two different women, but he lives alone, providing him with ample latitude to over-indulge. “It’s drinking, mainly. I love it,†he says. “I’ve had little interventions, from mates and my two sisters. They were like, ‘Hey Warwick, I love you, and I want to grow old with you and for us both to be 80 and sitting on the verandah having a beer, but the way I see your life going, that ain’t going to f…en happen.’ â€
A reality check was required, a spiritual and physical detox, which is how he ended up making his latest project, The Beach. Part nature documentary, part memoir, part rehab chronicle, The Beach, filmed in May last year, follows Thornton’s transformation as he spends more than a month in a tin shack on a remote beach in Western Australia. In six half-hour episodes, we watch Thornton reckoning with his past, his time growing up as an Indigenous kid in Alice Springs, his flaws, his strengths and his many scars, both internal and external. “We didn’t really go out there with any preconceptions,†he says. “I just knew I wanted to do it, I had to do it.â€
Warwick Thornton during the month-long filming of The Beach in Western Australia’s Dampier Peninsula.Credit:Susan Stitt
The Beach follows in a long tradition of wounded souls who seek redemption by submitting to the wilderness. In Thornton’s case, this meant a one-room shack on the tip of a sand spit surrounded by the dunes, mangroves and ocean of the Dampier Peninsula in the state’s north-west. As settings go, it’s outrageously beautiful. Viewers spend a lot of time in the hut, which was built with help from the local Indigenous community of Lombadina and which, despite the Robinson Crusoe conceit, is a minor- or masterpiece of scavenger chic, with wicker baskets propped against the walls, and coils of old rope hanging from the corner posts.
Those expecting the bare-knuckle narrative of Sweet Country will be disappointed. The Beach is slow television, with plenty of long takes and cryptic silences. The effect can be either meditative or maddening, depending on your mood. Not surprisingly, cooking is a big part of it. Thornton brought along three hens for eggs, not to mention an extensive collection of condiments and sauces, together with an array of vintage cooking implements – an iron griddle, some enamel tins and a blackened brazier.
He was, however, expected to catch all his other protein. “That shack didn’t have a fridge or any power,†he says. “So if I didn’t catch anything that day, then I’d have been having steamed rice.†We see his faltering, farcical attempts at spearfishing and cutting coconuts open. His patience wears thin, especially at the beginning, due to boredom and lack of booze. His only vice: cigarettes. “We were already struggling with there being no alcohol and me not being the great black hunter. If I hadn’t been able to smoke, I would have stabbed the whole crew to death.â€
When Thornton likes something, he calls it “rock ’n’ rollâ€. Even things that might not seem especially great, like depression, can turn out to be “rock ’n’ roll”.
After a time, the therapy worked. “I could see the transformation in Warwick,†says co-producer Michelle Parker. “He started to drop some weight. He became lighter, brighter, fitter, happier. His eyes were clear and twinkling. He was even doing yoga.â€
Parker was part of a skeleton crew, which included Thornton’s cinematographer son, Dylan River, who shot the whole series. The crew spent most of the day filming with Thornton, before returning at night to Lombadina, about half an hour’s drive away. “We didn’t know how Warwick would handle the whole experience,†says Parker. “Whether he would be angry, upset or have severe withdrawals. Sometimes he would just say, ‘I’ve had enough, just leave me alone,’ and we’d retreat.â€
The poise of River’s cinematography is a joy in itself. But among the most affecting elements are the stories, or impromptu soliloquies, that Thornton addresses to camera.
One of them concerns a man he calls Uncle Kingy. Kingy was a ngangkari, a traditional healer, whose job was to help people whose spirits had left them due to illness or accident. Kingy would go out, catch their soul and put it back in their body. When Thornton was growing up, Kingy was hugely respected and much in demand.
Years later, Thornton was driving down the main street of Alice Springs when he saw him walking along, drunk, yelling and screaming. Thornton thought he should offer him a lift, but he didn’t. “I thought, ‘I’ll leave him, because he’s pissed and he’ll want to bludge money off me, and then make me drive him around everywhere.’ †The next day, Thornton flew out to a shoot. The day after that, he heard that Kingy had died. Thornton was riven with guilt: “The last time I saw old Kingy, I didn’t want to pick him up.â€
Thornton became so angry with himself that he went and bought a “big knifeâ€, took it back to his hotel room, and started slashing at his upper arms. Every time he cut himself he thought of Kingy, “what an amazing man he was, and what a f…en dickhead I amâ€.
When I heard Thornton tell this story on The Beach, I thought it might have been embellished. So when I interview him, I ask to see his arms. The scars are there, all right, more than a dozen of them, thick and raised like lengths of cord buried in his skin.
Sweet Country, Thornton’s second feature film, received a five-minute ovation at the 2017 Venice Film Festival.Credit:
Thornton grew up the youngest of five children in Alice Springs, a notoriously tough town that sits like a blistered bullseye in the centre of the continent. “Alice in the 1970s was a small place with not a lot to do,†says his sister, Erica Glynn, who is also a filmmaker. “We’d swim in the town pool in summer. Mum took us to the drive-in cinema. There was also a walk-in cinema. Back then, and also now to an extent, it was a racist little town, and so it was a difficult place to be for Aboriginal people.â€
The family lived in a small single-storey fibro house, with a backyard that was so full of bindis you couldn’t play in it. For his seventh birthday Thornton asked for, and received, a huge pile of dirt. “It was the best present I ever had,†he says in The Beach. He played in the dirt pile for two years, making tunnels and fortresses in it, until it spread out and the bindis came back.
When he grew older Thornton rebelled, spending most of his time causing trouble and racing motorbikes with his mates on the claypans out of town. His mother, Freda Glynn, was a pioneer of Indigenous film, TV and radio, a co-founder of the Central Australian Aboriginal Media Association (CAAMA), which includes Imparja Television. In an effort to straighten her son out, she sent him, at the age of 13, to school in New Norcia, Australia’s only monastic town, 132 kilometres north of Perth.
When he returned, two years later, he got a gig as a DJ on Green Bush, one of CAAMA’s most popular radio programs. Green Bush played music, “a lot of requests, mostly from prisonersâ€, Thornton says. But it was more than a radio station. It broadcast to remote communities that might have had only one telephone box and where many people didn’t know how to read or write. Rather than simply playing music, then, the station became like a bulletin board or open telephone line. “You’d get requests like ‘G’day Warwick, can you play My Cheating Heart by Hank Williams, and can you tell my daughter that I’ll be out in three months and can she give me a call because I need to find a way of getting back to my community.’ â€
In 1983, CAAMA started a mobile video unit. By the late 1980s, Thornton had joined as a camera trainee, working alongside other future luminaries, including the sound recordist David Tranter, and Rachel Perkins, who would go on to direct hits such as Radiance and Bran Nue Dae. (Asked in an interview years later to describe what Thornton was like, Perkins said it was hard to say, since “he just used to grunt and not speak muchâ€.) CAAMA’s film teams travelled widely “to all sorts of obscure placesâ€, says Thornton. “We’d take swags, sleep by a campfire, getting bitten by scorpions and centipedes, and spend days filming as many stories as we could.â€
“Warwick is a grumpy bastard. He’s not into small-talking or pleasantries. He’s a deep river, and spends a lot of time in his own private story world.â€
David Jowsey, producer of Sweet Country.
Thornton and his colleagues often found themselves documenting vanishing worlds in real time. “You’d sit down with some old lady who’s living in a corrugated-iron humpy and she tells you her life story and then sings you a song that probably hasn’t changed in 30,000 years. And she’s got her great-granddaughter next to her, to teach her, ’cause she hasn’t sung that song in 30 years and she realises that she’s the last custodian. To see that happen, in front of you, that’s a privilege.†He says that filming in remote communities was a way of saying “You are worthyâ€. “You could see people’s eyes light up with the knowledge that someone had taken notice.â€
In 1993, Thornton went to Sydney to study cinematography at the Australian Film, Television and Radio School. While still a student, he made Payback, a short black and white film about a fictional inmate, Paddy (George Djilaynga), who emerges from a long stint behind bars only to face tribal law. The film, which screened at the prestigious Telluride Film Festival, was followed by his work as a cinematographer on the documentary, Marn Grook: An Aboriginal Perspective on Australian Rules Football. He also worked as the cinematographer on Perkins’s directorial debut, Radiance.
Then, as now, he had a reputation for gruffness. “Warwick is a grumpy bastard,†says David Jowsey, who produced Thornton’s feature film, Sweet Country, and who worked with him on the television series Mystery Road, three episodes of which Thornton directed last year. “He’s not into small-talking or pleasantries. He’s a deep river, and spends a lot of time in his own private story world.â€
Loading
Thornton’s range is unusually broad. His short films can be tender, even funny. Nana, a six-minute film he released in 2007, paints a whimsical portrait of a no-nonsense matriarch as seen through the eyes of her granddaughter. Mimi, in 2002, featured Sophie Lee as a clueless collector of Indigenous art. But his two feature films, Samson and Delilah, about a blighted love affair between two petrol-sniffing teenagers, and Sweet Country, about an Indigenous station hand who is put on trial for killing a white man, are so tough you could break your teeth on them. With its mix of bracing realism and a painterly aesthetic, Sweet Country made Thornton’s name. When the film was shown in Venice, it was lauded as a landmark for Indigenous filmmaking.
“I remember being in that cinema in Venice with Warwick when it was shown,†says Bryan Brown, who played Sergeant Fletcher in the film.
“When it ended, everyone turned around to where we were sitting and applauded for five minutes. I thought, ‘Wow, when Warwick was a young fellow running around Alice Springs in bare feet, we’d all have thought he had a 50/50 chance of being dead or in jail by the time he was 30. But here he was on one of the most sophisticated stages in the world.’ It was him saying, ‘You know what? I don’t have to give in to what everyone else expects. I can be different.’ â€
While filming The Beach, Thornton, who loves to cook, had three hens to supply eggs, but had to catch any other protein – a task he struggled with initially.Credit:Susan Stitt
When Thornton likes something, he calls it “rock ’n’ rollâ€. Making films is “rock ’n’ rollâ€. Cooking is “rock ’n’ rollâ€. His family is “rock ’n’ rollâ€. After-parties are, needless to say, “totally f…en rock ’n’ rollâ€. Even things that might not seem especially great, like depression, can turn out to be “rock ’n’ rollâ€. Winston Churchill called his depression the “black dogâ€. In The Beach, Thornton describes it as his “little black puppyâ€. He explains how every now and again, “sometimes it’s three years, sometimes it’s three times a yearâ€, he will hear that little black puppy outside, at the foot of his door, mewling and moaning, wanting to come in. But Thornton doesn’t answer it. The puppy gets hungrier and hungrier, and it scratches harder and harder. But still Thornton resists the urge to let it in. He has learnt that to accommodate that little puppy, to feed it, entertain its needs, would be inviting disaster. Better to lie in bed and wait until it stops scratching and crying.
“And when I know that’s happened,†he says in The Beach, “the puppy’s dead, and I can open the front door. And then I can go back out into the world.â€
Sitting in his sister’s backyard in Annandale, I suggest that the “little black puppy†might have something to do with booze. “No,†he says. “I don’t blame that on alcohol.â€
“But booze is a known depressant,†I say.
“Nah. [The depression] is just rock ’n’ roll, you know what I mean.â€
“No,†I say, “I don’t know what you mean.â€
“Well, it’s got nothing to do with alcohol. If I stopped drinking I’d be f…en eight times more depressed.â€
This might sound ridiculous coming from anyone else, but with Thornton it has a certain Hemingway-esque plausibility. At one stage he tells me that if “someone says anything bad about me … I just go punch them in the head. It’s horrific. We don’t live in that world any more. [But] that’s how I grew up.â€
“We’d all have thought he had a 50/50 chance of being dead or in jail by the time he was 30. But here he was on one of the most sophisticated stages in the world.â€
Bryan Brown
He has a similarly muscular, two-fisted approach to his work. In 2010, he told a journalist that he was concerned that the Southern Cross was becoming “the new swastikaâ€. The Nazis appropriated the swastika, which had for millennia been a Hindu symbol for good fortune, and made it synonymous with fascism. According to Thornton, right-wing nationalists in Australia had done the same thing with the Southern Cross, turning what for Indigenous people has long been a cosmological beacon into a racist emblem.
His comments, which came following his 2010 nomination for Australian of the Year, caused an uproar. “I went and hid in a cupboard for a while,†he later told the ABC. “And then over a couple of years, I got angry.†In 2017 he emerged with a documentary, called We Don’t Need a Map, that examined Australia’s fraught relationship with the Southern Cross and its use and abuse since colonisation.
“Warwick is very conscious of the history of Australia, and what has happened to his people,†says David Jowsey. “He also has an ironic, sardonic, witty take on White Australian culture.â€
Take Ned Kelly. “If Ned Kelly were alive today,†Thornton has said, “he’d be a meth-head holding up a 7-Eleven.†For this year’s Biennale of Sydney, Thornton made a film installation deconstructing the bushranger’s legend, showing Kelly robbing a 7-Eleven, overlaid with readings of jingoistic White Australia-era poetry and verse. (The installation was on show for 10 days before closing due to COVID-19.)
Making this kind of art takes a certain self-confidence, or at least a thick hide. “People say he’s got a big ego,†says his sister Erica, “but he’s a leader, and one of the requirements of that is that you have to self-sell. I want to run and hide from all that, but he’s really taken it on, and it’s one of the reasons he is where he is.†She mentions The Beach: “That’s courageous, exposing yourself like that, but probably more than that, exposing a little bit of arrogance thinking that people would care enough about it.â€
To an extent, whether audiences take note is beside the point. One of an artist’s chief obligations is to take risks, and Thornton has delivered on that. Besides, The Beach was always going to fall somewhere between art and therapy. “It’s important to slow down and look at your life,†he says. “To think about who you are – the empowering moments and the absolute f…ups that I’ve made, and how they are all part of who I am today. And The Beach gave me that space.â€
It also allowed him more clarity, and to be more honest with himself about what he can change and what he can’t. After a month in the wilds, Thornton returned to civilisation, which in this case meant Broome. One of the first things he did was go to the pub, put some trifectas on and order a beer.
“That’s the reality,†he says. “But you know what? I didn’t stay at the pub till I was maggotted, or until I’d had 12 beers. I stayed for three beers. I lost the trifecta, walked out of the pub, went to a restaurant and had something to eat with a glass of wine.†His internal ogre had found a degree of peace. “Maybe. It was just that I didn’t need to get f…ed up. I didn’t need it, and that was the most important thing.â€
The Beach airs on NITV and SBS on May 29 at 7.30pm.
Kampala, Uganda — When she heard the news of her abuser’s death, Hope said that she felt like her heart had stopped beating for a few seconds. “I didn’t know how to respond. I was broken, I shivered. I didn’t know whether to believe it or not, to cry or not,” she wrote to CNN.
Hope is one of the young women and girls who for the past year have been traveling to Ugandan courts ready to testify against German national Bernhard “Bery” Glaser, who is alleged to have sexually abused vulnerable girls like her, who were living in his care.
“I credit him for the good deeds he did but no one is perfect, there is also a dark side of him and that’s what people have failed to understand,” said Hope, whose name has been changed to protect her identity.
Glaser died in early May at Murchison Bay Hospital, a facility treating inmates of Luzira Prison in Kampala, Uganda. The day before his death, he had been granted bail, including international leave for medical treatment for stage four skin cancer.
He had been detained since last February, when he turned himself in, and charged with 19 counts of human trafficking, then formally charged and arrested in April with 19 counts of human trafficking, seven counts of aggravated defilement, one count of indecent assault and one count of operating an unauthorized children’s home, known as ‘Bery’s Place.’ He was first arrested in 2013, but the case was dismissed when survivors and their parents did not appear in court to testify.
“Obviously, Bery’s condition was serious and we feel for his family during this time. But, we also feel saddened for the victims in this case, and there are many,” said Rachel W. Bikhole, Uganda’s Assistant Director of Public Prosecutions, who described the evidence against the accused as “overwhelming.”
Bikhole told CNN that when a search of ‘Bery’s Place’ was carried out in February 2019, Glaser’s laptop was recovered and subjected to examination, during which naked videos and photos of the victims — some as young as five years old — were found on it. When questioned, Bikhole said Glaser claimed the material was used for fundraising purposes.
“These girls and young women will not see the day that Bery was held accountable for his crimes.”
Rachel W. Bikhole, Uganda’s Assistant Director of Public Prosecutions
Investigators also found email and Facebook messages on Glaser’s computer from him to a key witness in the 2013 case offering her money not to testify, according to Bikhole. CNN has reached out to his lawyer for response.
“These girls and young women will not see the day that Bery was held accountable for his crimes,” added Bikhole. “They will not get to tell of the terrible sexual abuse they endured for so many years and the lasting impact it has had and will have on them for the rest of their lives.”
Lawyers supporting the prosecution and a police source told CNN earlier this year that Glaser’s trial was postponed due to delaying tactics by the defense such as applying for a plea bargain deal and requesting a Flemish interpreter despite his demonstrated English proficiency. As a result, he did not make a plea before his death. Glaser’s lawyers have denied attempting to delay proceedings. In a February statement sent by WhatsApp to CNN, a lawyer representing Glaser denied that he had committed the alleged crimes.
Patricia, another survivor whose name has also been changed, told CNN that she had “never missed a court session,” traveling to testify in Kampala and Masaka eight times — only to be told again and again that the case would again be adjourned.
“We ended up performing poorly due to the trauma and endless journeys to court, resulting in us missing out on exams,” said Patricia, 20, who says she was abused from the age of 11 and is now at university.
Hope described the past year as a “very difficult year of abuse and accusations.” After speaking out about their experiences, survivors like Hope and Patricia have been victim-blamed and had their testimonies called into question, including in some Ugandan media reports and social media.
Before they had time to process the news of Glaser’s death, Hope said she and other witnesses started to receive calls and messages with threats and curses, labeling them “murderers.”
As reported in a CNN investigation into the case in February, Asia Namusoke Mbajja — a social worker with connections to Bery’s Place who eventually reported Glaser — has opened a police case of offensive communication and threatening violence following similar interactions.
The case is ongoing, with five phone numbers used to threaten to “injure or harm” Mbajja under investigation — including one registered in the name of Glaser’s wife, Ingrid Dilen, according to a preliminary police report see by CNN. Dilen told CNN she has not threatened anyone.
Mbajja too has received a fresh barrage of threats following Glaser’s death, and government prosecutor Bikhole also told CNN she has been “attacked a lot” and received threats on social media.
“I want to hide, I want to run, run far away so that no one will ever find me,” wrote Hope. “But is this the right thing? I’m just a witness,” she said, adding that even “a simple thing from him just to say sorry to us” would have meant so much. Hope also told CNN that she is struggling to support the other survivors, many younger than her, who she is currently living with at a shelter.
“I can’t lend them a shoulder to cry because I also need one to cry on,” she wrote.
“We will continue to find ways to help these victims,” said Bikhole. “And we will continue to fight against trafficking in persons in Uganda as there are still many cases and victims that require our attention.”
Cognition is an important function of the brain that enables us to acquire and process information, to enhance our understanding of thoughts, experiences, and our senses. Any condition that affects our ability to think, reason, memorize, or be attentive affects our cognitive ability. Some cognitive decline is a normal part of aging, but there are many things you can do to prevent or forestall cognitive changes as you age, including when planning for surgery.
Older adults are having more surgical procedures
As our population ages and medicine and healthcare advances, more older adults are likely to develop serious conditions (like heart problems) and undergo surgical procedures to treat or manage these conditions. Recent surveys suggest that progress in surgical techniques and control of anesthesia has increased surgical procedures in older people, with approximately 30% of all surgeries being conducted in people over the age of 70.
While advances in medicine may help people live longer, older adults are more likely to develop complications due to surgery. Some research suggests approximately one-quarter of those over 75 undergoing major surgery will develop significant cognitive decline, and about half of those people will suffer permanent brain damage.
Why do surgery and anesthesia cause problems with thinking for older adults?
There are degenerative changes in the brain with aging that predispose people to cognitive changes from surgery. Hence, age is a risk factor that needs to be considered when making decisions about surgery. Education level, mental health, and pre-existing medical conditions are also factors that affect an older person’s postsurgical cognitive functioning. People with higher levels of education tend to have more active brains due to regular mental stimulation. Mental and social activities promote brain health and decrease the risk of dementia and cognitive decline with normal aging.
Pre-existing medical conditions such as obesity, hypertension, coronary artery disease, diabetes, chronic kidney disease, stroke, and dementia predispose older adults undergoing surgery to more risk of postoperative cognitive decline. The reason these diseases cause cognitive decline is related to systemic inflammatory markers in the blood — proteins that are released into the bloodstream as a result of inflammation in the body. These markers enter the brain following a break in the blood-brain barrier (protective membrane) during the postoperative period, resulting in inflammation in the brain. This blood-brain barrier dysfunction is frequently seen in older people (even in the absence of surgery), and has been seen in approximately 50% of patients undergoing cardiac surgery.
Does the type of surgery and anesthesia matter?
Many surgical factors and techniques, blood pressure fluctuations during surgery, and longer time in surgery can adversely affect the cognitive function of older patients. Each factor affects cognitive functioning in a unique way. Younger patients tend to respond better to surgical stresses compared to older people.
Minor surgical procedures such as skin biopsies, excision of cysts, suturing of lacerations, and related procedures performed on an outpatient basis are unlikely to result in cognitive decline. However, as the complexity of a surgical procedure increases, with longer operative periods and greater exposure to more anesthesia medication, the likelihood of postoperative cognitive decline increases. This is especially true for cardiac surgery.
Studies suggest that incidence of postoperative cognitive decline is approximately 30% to 80% after cardiac surgery, while for noncardiac surgeries the prevalence is approximately 26%. While all major surgeries (such as orthopedic, abdominal, or gynecological) pose a risk for cognitive decline, cardiac surgeries have a much higher proportion of cognitive decline after surgery. The most common determinants of cognitive decline involving cardiac surgical procedures are the presence of pre-existing cognitive dysfunction and the use of bypass machines to replace the function of the heart and lungs during the surgery.
Anesthesia management before and during surgery affects what happens after surgery
The perioperative period refers to the time span of a surgical procedure, and includes three phases: preoperative, operative, and postoperative. Anesthesia management encompasses all three phases. The type and dose of anesthesia medication, the use of opioid analgesics, fluid, and glucose management can all influence a person’s cognitive function in the perioperative period. The use of multimodal anesthesia (where a combination of intravenous medications is used, instead of only inhaled agents) may protect against some cognitive dysfunction, as may using non-opioid analgesics for pain management in the postoperative period.
Are there strategies to avoid cognitive decline in the postoperative period?
Benjamin Franklin once said, “An ounce of prevention is worth a pound of cure.â€Â No other condition exemplifies this saying better than preventing postoperative cognitive decline.
The following are some strategies you and your caregivers can use to prepare for surgery.
Schedule a comprehensive geriatric assessment. This enables your physician to diagnose reversible aspects of frailty preoperatively (if they exist) and take adequate measures in a timely manner, such as altering medications you may be taking, and/or postponing surgery if you are extremely frail, to improve nutrition and incorporate lifestyle changes.
Talk to your surgeon about the risks and complications of the procedure. If you are having heart surgery, ask if a cardiopulmonary bypass machine will be used, and whether it is important to your surgery.
Talk to your anesthesiologist about
The types of medications they plan to use, and if there are alternatives for those medications. Have a conversation about need for opioid analgesics, and if alternative non-opioid pain medication can be used to decrease the risk of postoperative cognitive decline.
The methods of measuring medications that can reduce your risk of cognitive changes. For example, use of EEG machines during surgical procedures enhances the anesthesiologist’s ability to monitor the depth of anesthesia. Anesthesia depth is the degree to which the central nervous system is depressed by an anesthetic medication. EEG monitoring will result in adequate usage of anesthetic agents, avoid overuse, and reduce risk for postoperative cognitive decline by reducing anesthesia exposure.
Gather relevant information on your perioperative management. Discuss which medications you currently take and should continue taking, and which ones should be avoided.
After surgery and during recovery:
Caregivers need to be informed about the need for keeping their loved one active and following physical rehab recommendations, and providing mental stimulation in the postoperative period. Puzzles, sudoku, board games, books, etc., will keep someone entertained while simultaneously providing them with some brain activity.
Finally, it is necessary to understand that although there is no cure for postoperative cognitive decline, preventive strategies and pre-planning with your team of surgeons, anesthesiologists, and geriatricians can help reduce the risks of cognitive problems that older adults often face following surgery.
The bride’s mother drew the line at seeing her daughter, Hope Wolf, married at the booking window of the Caswell County detention center in Yanceyville, N.C.
But the coronavirus pandemic made it clear that their wedding, planned for May 2, “was a public-health disaster waiting to happen,†Ms. Wolf said. So they canceled in mid-March and began casting about for an alternative. And that’s how they ended up in Yanceyville.
The couple met when they were attending the University of North Carolina at Chapel Hill. Ms. Wolf says that they shared a friend group and met a number of times over the years, but it wasn’t until her senior year that they were all out together at a bar and Mr. Hill noticed her.
“I remember seeing her and thinking, ‘Wow! She’s cute!’†he said.
“He didn’t remember me for four years, so I always say, I know he doesn’t just like me for my looks,†she said.
The couple went out for coffee, and soon were dating steadily. In 2017, when she decided to go to graduate school, she remembers asking him if he wanted to move to Richmond with her. “Where do you see this going?†she asked.
He moved with her. And in 2018, they were engaged. “By the time we moved together to Richmond, it was firmly in my mind that we would one day get married,†Mr. Hill said.
Ms. Wolf’s mother passed along the bride’s grandmother’s engagement ring, which she then gave to Mr. Hill. “She was obviously hinting something,†he said. “She said, ‘Do with it what you will.’ I was like, ‘All right.’â€
After canceling their planned wedding, the two tried to obtain a marriage license in Virginia, to no avail. They then began calling county after county over the border, in North Carolina, where both grew up, looking for an official who would issue a license to a pair of nonresidents.
In Yanceyville, the register of deeds was willing to accommodate them, and said that a magistrate could marry them immediately after they had obtained the license. The setting would be austere, with the magistrate behind glass in the sheriff’s office at the detention center.
And that’s when Ms. Wolf’s mother stepped in. “My mom really didn’t want us to get married in the jail,†Ms. Wolf said. “She said that would be too sad.â€
The Rev. Elizabeth McNair Ayscue, a Presbyterian minister and the pastor of the bride’s childhood church as well as a family friend and neighbor of the Wolf family, also objected. “She’s not just my parishioner — she’s also my friend,†she said. “I said, ‘We’re not going to do that. We’re going to do something better.â€
So instead of marrying in the county jail, on May 1, the couple, their parents and two friends met in the arboretum behind Caswell County’s historic courthouse, also in Yanceyville, and the Rev. Ayscue officiated.
“It was really nice,†Ms. Wolf said. “At the end of the day, I was just really happy we were able to be married, and that’s all that mattered to me.â€
Laurie Moise made an impression on Horton Sears the first time he saw her, in the fall of 2009, at an orientation for new students at Providence College, in Providence, R.I.
“I remember she was wearing yellow shoes and yellow earrings and had this yellow bow,†he said. “I knew I needed to get to know this person.â€
Ms. Moise, now 30, was a year ahead of Mr. Sears, now 28, at the school. Both studied psychology, so he soon was visiting her room to borrow notes from courses she’d completed. They quickly became friends.
During the winter holiday, Ms. Moise said, they talked every day, and his mother still teases them about it. “We were on Skype every night,†she said. “He would fall asleep and she would come in and close the computer, and I would be asleep on the other side.â€
The following February, he said to her, “Why don’t we just be together?â€
In 2012, she graduated and left for St. George’s University in Grenada, where she completed a master’s degree in public health. She is now the director of community health integration at One Neighborhood Builders, a community development organization in Providence.
After his graduation the following year, he went to Boston as a corps member of Teach for America, and is now studying for a master’s degree in school counseling at Providence College, where he is also a residence hall director and graduate assistant.
“We were bouncing around in different places, never in the same state at the same time,†he said.
In 2015, he took a job in Newark, where he grew up, at his old prep school. And the couple broke up. “We didn’t know when the distance would end,†Ms. Moise said.
Two years later, Ms. Moise called Mr. Sears and their relationship rekindled.
“You would never think we were apart for two years,†she said.
Engaged and both now back in Providence, they began planning a wedding for more than 250 people in Newport, R.I., on April 19, 2020. The marriage was to be preceded by a kwe kwe, a prewedding celebration that is a tradition in the Guyanese culture of the groom’s family.
But in March, they realized the celebrations wouldn’t happen because of coronavirus restrictions. A few days before they had planned to marry, they found a town clerk who was still open in Bridgewater, Mass., and drove 40 minutes to obtain a marriage license.
“We just had made a decision that we weren’t going to stop living our lives because of this pandemic,†Ms. Moise said.
They chose the driveway of Ms. Moise’s childhood home, in Malden, Mass., as their new venue, and began wedding planning again.
With her wedding dress in lockdown at the tailor’s, Ms. Moise wore her bridal shower dress instead. She made a veil with a hot-glue gun. A friend fashioned a bouquet from flowers bought at Trader Joe’s.
On April 19, the couple married. Mr. Sears’s family dressed for a wedding but watched on Zoom (with more than 40 other people) from their living room in Newark, and Ms. Moise’s relatives parked in their cars at the end of the driveway. Femi O. Adeduji, a minister of the Jubilee Christian Church in Boston, officiated.
“Despite the craziness, we were still able to zero in on what’s really important to us, and that’s being together,†Ms. Moise said.
Brian Clarke was exhausted the first time he met Mariana Ranz in 2015. By the time they were married on May 11, he had cause to feel frazzled again.
On May 8, two days before their surprise Zoom wedding planned in Central Park, they hit a snag securing an online marriage license through New York City’s “Project Cupid.†So instead of throwing one socially distant wedding, they scrambled to put together two: A ceremonial one in the park, and a legal one a day later.
Ms. Ranz, 34, is the community arts partnership manager at Ballet Hispanico, a New York City dance company. Mr. Clarke, 37, is a financial analyst at Deutsche Bank. Their first date, on May 8, 2015, was an attempt by Mr. Clarke to regain some energy after a week of 14-hour workdays in a city then unfamiliar. “I had only been at Deutsche Bank a couple of weeks when they sent me to New York to take on a two-week training assignment,†said Mr. Clarke, a native of Jamaica who was living in Jacksonville, Fla. A former roommate, Shirley Godefroy, connected them. “She knew I needed a break and someone to show me around.â€
Ms. Godefroy, who had grown up with Ms. Ranz in Bolivia, wasn’t playing cupid. “She’s just a connector,†Ms. Ranz said. “We both knew that, so we had no expectations, and that made it a lot lighter and a lot easier to get to know each other.†Over drinks at Tao Downtown, they talked about their love of food, family and their experiences as immigrants. By midweek, after back-to-back get-togethers before Mr. Clarke’s May 15 return trip to Florida, their dates were becoming marathons.
He was enchanted by Ms. Ranz, then a dance teacher. But “I thought she was way out of my league. She’s got a much better personality than I do, and she’s way better looking.†He hid his feelings.
“I was getting the feels for him, but he would not give me any sign at all,†Ms. Ranz said.
The night before he flew home, she kissed him in a photo booth at the Standard Hotel. A New York-Florida romance was born, and lasted until 2017, when Mr. Clarke successfully petitioned his bosses to move him to New York. Weeks after his arrival, Ms. Ranz left her home in Inwood and moved in with him to an apartment in Hell’s Kitchen, where they still live. On May 10, 2019, a proposal on the High Line sealed the deal.
Then came March, and social distancing, and uncertainty about whether to cancel the wedding in Santa Cruz, Bolivia, that they had planned for a year to the day after their engagement.
“My dad is almost 90,†Ms. Ranz said. “I didn’t want to postpone.†They decided to keep the date, with a twist. With a wedding planner she had already hired in Bolivia, Ms. Ranz cooked up a surprise wedding for the couple’s 80 guests disguised as a Zoom happy hour.
At 5:05 p.m. on May 10, after all their guests had logged in, Ms. Ranz’s cousin, Natalie Robbins, made an announcement on the Zoom call. In both Spanish and English, she said, “It is my honor to welcome you to Brian and Mariana’s wedding.†Though the union, which took place in Central Park at Hallett Nature Sanctuary and led by their friend Anthea Song, wasn’t legal, the gasps and tears of their loved ones as they said their “I do’s,†watched later that night via recording, made it feel like nothing was missing, Ms. Ranz said.
Securing their license and filing the paperwork one day later with the help of a different officiant, Joshua Alex Preston, a friend ordained through the Universal Life Church, was less romantic but a relief. “This definitely wasn’t what we planned,†Ms. Ranz said. “But we did it. And it exceeded our expectations.â€
Residents in regional Victoria have flocked to social media to share their videos of an unidentified flying object, believed to be a piece of space junk, soaring across the night’s sky.
The object which was seen over Ballarat and spotted as far as Colac heats up as it enters the atmosphere, leaving a trail of bright fluorescent light behind it.
The object could also be a meteor caught in the pull of Earth’s gravitational system.
A still image of the meteor seen against a dark night sky in Ballarat. (Twitter)
It appears the unidentified, glowing object may have been seen across the skies from as far away as northern Tasmania.
While there is yet no confirmation as to what the object may have been, some took to social media to speculate that it was a disintegrating satellite, shooting star or the product of another life form.
“Space rocks” ranging in size and have generally collected their size from comets, other asteroids or moons and planets are only given the name meteorites after they enter the Earth’s atmosphere, NASA says.
“When meteoroids enter Earth’s atmosphere, or that of another planet, like Mars, at high speed (they) burn up,” according to NASA.
“This is also when we refer to them as ‘shooting stars’.
“Sometimes meteors can even appear brighter than Venus – that’s when we call them ‘fireballs’.
“Scientists estimate that about 44,000 kilograms of meteoritic material falls on Earth each day.”
For breaking news alerts and livestreams straight to your smartphone sign up to the9News appand set notifications to on at theApp StoreorGoogle Play.
Butlin’s vacation resorts were an institution in post-war Britain. The self-contained camps — where guests were housed in wooden chalets, fed and entertained on-site — provided a new kind of inexpensive luxury for working families.
At a time when few could afford overseas travel, the resorts offered “a week’s holiday for a week’s pay,” as they were first advertised.
Beyond the likelihood of rain, Butlin’s summer vacations were a uniquely British proposition.
Exuberant in-house entertainers, known as Redcoats, hosted singalongs, pantomimes and rounds of bingo. They held “glamorous grandmother” competitions, and “knobbly knees” contests to see which guest had the lumpiest legs. Ringo Starr’s band (no, not that one) even played residencies there in the early 1960s, before he was invited to join the Beatles.
By the time photographer Barry Lewis arrived in the 1980s, however, the camps were “getting a little bit seedy,” as he put it.
There were fewer families and more singles, with plenty of sex and alcohol mixed in with the entertainment, Lewis said. But the 71-year-old still recalls the resorts’ glamorous early reputation.
“When I was a kid, Butlin’s was seen as very grand, but my parents could never afford to go,” he said in a phone interview. “It was made to sound amazing — you’d have top stars performing, everything was free and there were fairgrounds.”
Launched by Billy Butlin in 1936, the camps’ initial popularity was bolstered by the UK government’s Holidays with Pay Act, which gave workers the right to paid leave for the first time. A site was opened in Skegness, on Britain’s east coast, though more than half a dozen more would be built in British seaside towns over the next three decades.
The camps boomed after World War II, welcoming more than a million annual visitors in their mid-1960s heyday. Upon taking a teenage summer job at a Butlin’s kitchen in 1966, Lewis found them to be “enclosed, hermetic worlds” equipped with theaters, recreation halls, ballrooms, pools, funfairs, boating lakes, hair salons and even churches.
“You were in this enclosed system,” he recounted. “You went to this other world. Russia could have invaded America and we wouldn’t even have known about it — there were no TVs in the chalets.
“But there was actually something wonderful about it. You felt you’d joined this weird club. It was very clever in making you feel (as if you were) part of a family.”
Lewis’ teenage experiences hint at the wilder behavior he would later encounter. This “enclosed fantasy world” (as the photographer describes it in his new book) was also equipped with bars, discos and betting shops.
“I served breakfasts and learned about becoming a man. I was desperate to fall in love, and all the stuff that goes with leaving home for the first time,” he said, adding that he often “served breakfast on a hangover” after late-night attempts to meet women. “To be completely frank, I was trying to get laid most of the time.”
After going on to university and establishing himself as a professional photographer, Lewis returned to Butlin’s in 1982 on assignment for the UK’s Observer newspaper. Then aged 34, he was initially astonished at how little had changed.
Many of his images are alive with the communality and good cheer he’d remembered — kids enjoying activities and parents singing and dancing in the entertainment halls. But things, he said, had become more salacious.
“There was a whole sex thing that was never really talked about. A lot of people went there to get laid, so there was quite a lot of sexism,” Lewis said. “Alcohol was the drug of choice and people got hammered. Absolutely.
“If you were trying to be part of the gang, you drank with (the Redcoats). They were young lads, but they were adored and they loved that.”
The photographer’s fondness for the camps is nonetheless apparent (he describes the images as “warts and all, but in a loving way”). He took an immersive approach to the assignment — which meant partying and drinking with the other campers. “That’s how we worked,” he said, referring to the journalist he accompanied, Ian Walker. “We’d integrate ourselves.”
Yet, Lewis also acknowledges there was a certain “darkness” to it all.
An image from the book shows a Redcoat pinching a female guest’s breast. Another shows male judges keeping an uncomfortably close eye on a participant in a “miss lovely leg” contest. Elsewhere, an employee is pictured asleep on the lobby floor after a heavy night, while Walker wrote in the Observer at the time that “two skinheads started smashing up glasses,” in a resort bar in the early hours.
An unlikely renaissance
In one of Lewis’ most striking photos, he captured a man frozen mid-air just before splashing into an outdoor pool. Huge letters behind spell out one of the camps’ slogans: “Our true intent is all for your delight.”
That Billy Butlin might use a quote from “A Midsummer Night’s Dream” speaks of his lofty ambitions for the resorts. But in the 1980s, the glamour was fading. Package trips to Europe had become affordable, dampening the prestige of domestic vacations. Butlin’s went into economic decline, and a number of its camps closed in the years that followed.
Yet, if the Butlin’s of the 1980s differed from that of previous decades, then today’s is perhaps less recognizable still. The company has since changed owners and rebranded itself, its resorts fitted with new water parks and subjected to multi-million-dollar expansions. As such, the camps are undergoing something of a renaissance, Lewis ventured.
“I think, now, it’s booming again,” he said. “With Brexit coming up, and the currency weakened — and also with Covid-19 — people aren’t going to travel abroad as much.
“There is something nice about not having to think about (your vacation). You just book and that’s it, whereas a lot of trips are just full of planning. People like that everything’s laid on.”
In a statement to CNN, Butlin’s said: “Butlin’s has always been a family brand and we’ve been delighting families for decades. We can’t wait until we can reopen our resorts and welcome our guests back to Butlin’s for a much needed holiday.”
We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits. By clicking “Accept”, you consent to the use of ALL the cookies.
This website uses cookies to improve your experience while you navigate through the website. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may affect your browsing experience.
Necessary cookies are absolutely essential for the website to function properly. These cookies ensure basic functionalities and security features of the website, anonymously.
Cookie
Duration
Description
cookielawinfo-checbox-analytics
11 months
This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Analytics".
cookielawinfo-checbox-functional
11 months
The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional".
cookielawinfo-checbox-others
11 months
This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Other.
cookielawinfo-checkbox-necessary
11 months
This cookie is set by GDPR Cookie Consent plugin. The cookies is used to store the user consent for the cookies in the category "Necessary".
cookielawinfo-checkbox-performance
11 months
This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Performance".
viewed_cookie_policy
11 months
The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. It does not store any personal data.
Functional cookies help to perform certain functionalities like sharing the content of the website on social media platforms, collect feedbacks, and other third-party features.
Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors.
Analytical cookies are used to understand how visitors interact with the website. These cookies help provide information on metrics the number of visitors, bounce rate, traffic source, etc.
Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. These cookies track visitors across websites and collect information to provide customized ads.