Ted Bundy: The Development of a Serial Murderer

Who is Ted Bundy, and why did he commit the crimes that he did? This study was devised to assess the life of Ted Bundy, one of the most prolific murderers in the United States. This secondary research study was conduct­ed using interviews from Bundy, biopsychosocial analyses conducted of him post-arrest, testimonials from people who knew him, and research regarding serial killer typologies and motivations. This information has been com­plied in the form of a poster board presentation, complete with the researcher’s own biopsychosocial assessment of Bundy, an analysis of the motivations for his crimes, and a timeline of his life. The results of this comprehensive analysis will provide insight on what it took for Ted Bundy to become one of the most prolific serial killers in U.S. history

Conjugative transfer of ICESde3396 between three β-hemolytic streptococcal species

Background: Integrative conjugative elements (ICEs) are mobile genetic elements (MGEs) that possess all genes necessary for excision, transfer and integration into recipient genome. They also carry accessory genes that impart new phenotypic features to recipient strains. ICEs therefore play an important role in genomic plasticity and population structure. We previously characterised ICESde 3396, the first ICE identified in the β-hemolytic Streptococcus dysgalactiae subsp equisimilis (SDSE) and demonstrated its transfer to single isolates of Streptococcus pyogenes (group A streptococcus, GAS) and Streptococcus agalactiae (group B streptococcus, GBS). While molecular studies found the ICE in multiple SDSE and GBS isolates, it was absent in all GAS isolates examined. Results: Here we demonstrate that ICESde 3396:km is transferable from SDSE to multiple SDSE, GAS and GBS isolates. However not all strains of these species were successful recipients under the same growth conditions. To address the role that host factors may have in conjugation we also undertook conjugation experiments in the presence of A549 epithelial cells and DMEM. While Horizontal Gene Transfer (HGT) occurred, conjugation efficiencies were no greater than when similar experiments were conducted in DMEM. Additionally transfer to GAS NS235 was successful in the presence of DMEM but not in Todd Hewitt Broth suggesting that nutritional factors may also influence HGT. The GAS and GBS transconjugants produced in this study are also able to act as donors of the ICE. Conclusion: We conclude that ICEs are major sources of interspecies HGT between β-hemolytic streptococci, and by introducing accessory genes imparting novel phenotypic characteristics, have the potential to alter the population structure of these species

Self-reported visual function in healthy older people in Britain: an exploratory study of associations with age, sex, depression, education and income

Background. Tractable but undetected visual impairment in older people may be relatively common, particularly amongst the very old and in more deprived populations. Measurement of visual acuity is unlikely to be helpful in identifying this impairment, but targeted assessment of visual function may be beneficial. There is uncertainty about the defining characteristics of the target group. Objective. To explore factors associated with self-reported visual impairment in community dwelling older people. Methods. Design: secondary cross sectional analysis of baseline data from a randomised controlled trial. Setting: three large group practices in outer London. Participants: older people aged 65 and over enrolled in a study of health risk appraisal. Method: postal questionnaire using questions from the National Eye Institute Visual Function questionnaire. Results. Moderate or extreme visual function loss occurred in 4 to 12% of community-dwelling older people in this population reporting less than excellent vision, depending on which aspect of visual function is considered. Visual function loss in this subgroup increases in prevalence with advancing age, but is not associated with female sex, low educational attainment or low income. It is associated with depressed mood. Conclusion. Questions about visual function identify a group of older people whose vision and mental state needs further investigatio

Health risk appraisal for older people 5: self-efficacy in patient-doctor interactions

Objective Enhancing self-efficacy is central to programmes promoting self-care and self-management. However, little is known about older people's self-efficacy in doctor-patient interactions. This paper investigates lifestyle, medical and demographic factors associated with self-efficacy in doctor-patient interactions in older people in general practice. Methods A cross-sectional analysis of data from a randomised controlled trial of older people was conducted in a health risk appraisal study in London. Self-efficacy was measured using the Perceived Efficacy in Patient-Physician Interactions Questionnaire. Results Older people with higher self-efficacy were significantly more likely to report having had recent preventive care measures such as recent blood pressure measurement and influenza immunisation. Women were less likely to have higher self-efficacy than men. Older people were significantly less likely to have high self-efficacy if they reported having poor memory, low mood, limited activities due to fear of falling, basic education, difficulties with at least one activity of daily living, reduced physical activity, living alone, or risk of social isolation. Conclusion A third of people had low self-efficacy in doctor-patient interactions. They appear to be a vulnerable group. Low self-efficacy in interactions with doctors may be a symptom or a characteristic of older people who experience social isolation and depression. Policies that depend on enhancing self-care and self-management need to consider the large number of older people with low self-efficacy in using medical services, and understanding characteristics in older people associated with lower confidence in doctor-patient interactions may be useful in clinical practice and researc

The relationship between pain intensity and severity and depression in older people: exploratory study

BACKGROUND: Pain and depression are known to be associated in later life, and both have a negative effect on physical performance both separately and in combination. The nature of the relationships between pain intensity and depression in elderly persons experiencing pain is less clear. The objectives of this study were to explore which factors are associated with depressed mood in older people experiencing pain, and to test the hypothesis that older people experiencing pain are at risk of depressed mood according to the severity or frequency of their pain. In addition we explored whether other potentially modifiable factors might increase the risk of depressed mood in these persons. METHODS: The study is a secondary analysis of baseline data for four hundred and six community-dwelling non-disabled people aged 65 and over registered with three group practices in suburban London who had experienced pain in the past 4 weeks. Intensity and frequency of pain was measured using 24 item Geriatric Pain Measure (GPM) and the presence of depressive symptoms using the 5 item Mental Health Inventory. Risk for social isolation was measured using the 6 item Lubben Social Network scale and instrumental activities of daily living (IADL) were also measured. RESULTS: Overall 76 (19%) had depressed mood. Pain frequency and severity were not statistically significantly associated with depressed mood in this population. In multivariate analyses, significant predictors of the presence of depressive symptoms were difficulties with basic ADLs (OR 2.8, 95% CI 1.1.7.8), risk for social isolation (OR 4.1, 95% CI 1.8-9.3), and basic education only (OR 2.2, 95% CI 1.1-4.4). CONCLUSION: Older people experiencing pain are also likely to experience depression. Among those experiencing pain, social network and functional status seem to be more important predictors of depressive symptoms than the severity of pain. Further studies should evaluate whether improvement of social network and functional status might reduce depressive symptoms in older patients

Health risk appraisal for older people 4: case finding for hypertension, hyperlipidaemia and diabetes mellitus in older people in English general practice before the introduction of the Quality and Outcomes Framework

Background Early intervention can help to reduce the burden of disability in the older population, but many do not access preventive care. There is uncertainty over what factors influence case finding in older patients in general practice. Aim To explore factors associated with case finding for hypertension, hyperlipidaemia and diabetes mellitus in older patients. Method Two thousand four hundred and ninety-one patients aged 65 years and above were recruited from three large practices in suburban London before the introduction of the Quality and Outcomes Framework (QOF) completed a questionnaire on health, functional status, health behaviours and preventive care. Findings Those not reporting heart disease, diabetes or hypertension were included in a secondary data analysis to explore factors influencing uptake of preventive care measures. Approximately one-third denied having had a blood pressure check in the previous year. They were more likely to have had little contact with doctors and to have an unhealthy lifestyle (smoking and a high-fat diet). One-third reported a cholesterol test in the previous five years. Cholesterol measurement was reported more often by men and those with a high body mass index. Those with unhealthy lifestyles (smoking and high-fat diet), those who had only received the state pension and those who limited their activities because of a fear of falling were less likely to report cholesterol measurement. About 10% reported a fasting blood glucose measurement and were more likely to consult more often and have more medications, but they were less likely to have a high-fat diet. Preventive care uptake was associated with frequent contacts with doctors, but overall the uptake of preventive care was low. Older people with healthier lifestyles were more likely to have primary preventative care interventions. These findings provide a baseline against which the effect of the QOF on the care of older people can be measured in future studie

Aneurysmal degeneration of the superficial femoral artery after remote endarterectomy

Superficial femoral artery reocclusion is the most common complication of remote endarterectomy with the Mollring device. We present the first reported case of a male patient who developed aneurysmal degeneration of the superficial femoral artery after a previous left common femoral endarterectomy and superficial femoral remote endarterectomy with popliteal stenting. He underwent thrombolysis with subsequent percutaneous transluminal angioplasty after developing acute left lower extremity ischemia. At 12-month follow-up, he was free of claudication symptoms. This case illustrates the need for close surveillance and discusses possible treatment options for patients with this rare complication

Ecological Risk Assessment for the Peel-Harvey Estuarine Fishery

An ecological risk assessment (ERA) of the Peel-Harvey Estuarine Fisheries (Fisheries) was convened by the Department of Primary Industries and Regional Development, Western Australia (WA) on 9 September 2020. ERAs are conducted by the Department as part of its Ecosystem Based Fisheries Management framework and the outputs will inform the updated harvest strategies for these resources, as well as the upcoming Marine Stewardship Council (MSC) re-assessment of the Fisheries. The Fisheries within the scope of this current ERA include the commercial net and crab trap fishery (West Coast Estuarine Managed Fishery: Area 2), and the blue swimmer crab recreational (drop net and scoop net) fishery