Coroners in London and Middlesex, c. 1820–1888: A Study of Medicalization and Professionalization

The nineteenth century was a period of reform and transition for the office of coroner. Despite its antiquity and its place at the heart of the investigation into sudden and unexplained deaths, various social, political and intellectual changes resulted in a growing debate about the purpose, role and functions of the coronership. Many commentators, as well as coroners themselves, believed the office needed reform. This thesis considers debates about the office of the coroner from c. 1820 to c. 1888, a period that covers the wide-ranging attempts to reform the coronial office by the London coroner Thomas Wakley in the 1820s to the legislative initiatives of the 1880s that shaped the office for the next century. In particular it assesses the extent to which these debates relate to two broad concepts: medicalization and professionalization. For some, the future of the coronial office lay in the increasing application of medical expertise to the inquest, even to the extent of turning the coronership into an exclusively medical role. This study assesses how far such ‘medicalizing’ tendencies impacted on the office. Likewise, it considers whether the office underwent a process of professionalization during the nineteenth century. By considering guides to coronial practice, legislation and the formation and activities of the Coroners’ Society of England and Wales, it explores whether the coronership became a profession over the course of the century. These debates are viewed through a focus on coroners from London and Middlesex, since as a group they were at the forefront of debates. Working in the challenging environment of the metropolis, and close to the centres of political, legal, scientific and medical authority, London and Middlesex coroners such as Wakley, William Baker, William Payne, Edwin Lankester and Samuel Langham were prominent advocates of coronial reform. The thesis assesses how far coronial change was being driven from London; it suggests that there were different phases in the reforming process, each of which was closely associated with London and Middlesex coroners, and which together brought about important reforms that professionalized the office and created a medico-legal (that is, informed and shaped by the disciplines of both medicine and law), if not medicalized, inquest

The relationship between perception of physical features, racial identity, and self-esteem of black adolescent females

The purpose of this study was to examine the relationship between perception of physical features, racial identity attitudes, and self-esteem of Black adolescent females. Thirty-eight Black adolescent females, ranging from 14 to 19 years old, were administered a survey packet including a Demographic Questionnaire, The Rosenberg Self-esteem Scale, and a shortened version of the 50-item Racial Identity Attitude Scale

Confusions of Cantonese tones in teenagers with sensorineural hearing impairment

A dissertation submitted in partial fulfilment of requirements for the Bachelor of Science (Speech and Hearing Sciences), University of Hong Kong, April 30, 1992.Thesis (B.Sc)--University of Hong Kong, 1992Also available in print.published_or_final_versionSpeech and Hearing SciencesBachelorBachelor of Science in Speech and Hearing Science

OMMA enables population-scale analysis of complex genomic features and phylogenomic relationships from nanochannel-based optical maps.

BackgroundOptical mapping is an emerging technology that complements sequencing-based methods in genome analysis. It is widely used in improving genome assemblies and detecting structural variations by providing information over much longer (up to 1 Mb) reads. Current standards in optical mapping analysis involve assembling optical maps into contigs and aligning them to a reference, which is limited to pairwise comparison and becomes bias-prone when analyzing multiple samples.FindingsWe present a new method, OMMA, that extends optical mapping to the study of complex genomic features by simultaneously interrogating optical maps across many samples in a reference-independent manner. OMMA captures and characterizes complex genomic features, e.g., multiple haplotypes, copy number variations, and subtelomeric structures when applied to 154 human samples across the 26 populations sequenced in the 1000 Genomes Project. For small genomes such as pathogenic bacteria, OMMA accurately reconstructs the phylogenomic relationships and identifies functional elements across 21 Acinetobacter baumannii strains.ConclusionsWith the increasing data throughput of optical mapping system, the use of this technology in comparative genome analysis across many samples will become feasible. OMMA is a timely solution that can address such computational need. The OMMA software is available at https://github.com/TF-Chan-Lab/OMTools

RRS James Cook Cruise JC159 28 February - 11 April 2018. Hydrographic sections from the Brazil to the Benguela Current across 24S in the Atlantic

A Hydrographic section was occupied at a nominal latitude of 24°S in the Atlantic Ocean during March and April 2018 on Cruise JC159 of RRS James Cook. The primary objective of this cruise was to measure ocean physical, chemical and biological parameters in order to establish regional budgets of heat, freshwater and carbon, and to infer decadal variability. In addition, 371 Niskin Bottles were sampled for microplastics, reflecting increasing awareness of plastics pollution in the oceans. A total of 121 CTD/LADCP stations were conducted, including one test station and two CFC bottle blank stations. In addition to temperature, salinity and oxygen profiles from the sensors on the CTD package, water samples from a 24 x 20 litre rosette were analysed for the following parameters at all stations: salinity; dissolved oxygen; inorganic nutrients; alkalinity and dissolved inorganic carbon; CFCs. Samples were collected for shore analysis for oxygen and carbon isotopes (del-18O, del13C and del-14C). Samples were collected and filtered for pigments (shore analysis) at 44 stations and for microplastics at 45 stations. 8 Argo floats were deployed, including two Bio-PROVOR floats and 2 Deep ARVORs. In addition, samples were collected from the ships’ underway system to calibrate and compliment the data continually collected by the TSG (thermosalinograph). Full depth velocity measurements were made at every station by LADCP (Lowered Acoustic Doppler Current Profiler) mounted on the frame of the rosette. Throughout the cruise, velocity data in the upper few hundred metres of the water column were collected by the ship’s VMADCP (Vessel Mounted Acoustic Doppler Current Profiler) transducers (75Hz and 150Hz) mounted on one of the two drop keels. Meteorological variables were monitored using the onboard surface water and meteorological sampling system (SURFMET). Bathymetric data were collected using the Kongsberg EM122 multibeam system and the EA640 echo sounder. This report describes the methods used to acquire and process the data on board the ship during cruise JC159

Assessing the efficacy of oral immunotherapy for the desensitisation of peanut allergy in children (STOP II): a phase 2 randomised controlled trial

SummaryBackgroundSmall studies suggest peanut oral immunotherapy (OIT) might be effective in the treatment of peanut allergy. We aimed to establish the efficacy of OIT for the desensitisation of children with allergy to peanuts.MethodsWe did a randomised controlled crossover trial to compare the efficacy of active OIT (using characterised peanut flour; protein doses of 2–800 mg/day) with control (peanut avoidance, the present standard of care) at the NIHR/Wellcome Trust Cambridge Clinical Research Facility (Cambridge, UK). Randomisation (1:1) was by use of an audited online system; group allocation was not masked. Eligible participants were aged 7–16 years with an immediate hypersensitivity reaction after peanut ingestion, positive skin prick test to peanuts, and positive by double-blind placebo-controlled food challenge (DBPCFC). We excluded participants if they had a major chronic illness, if the care provider or a present household member had suspected or diagnosed allergy to peanuts, or if there was an unwillingness or inability to comply with study procedures. Our primary outcome was desensitisation, defined as negative peanut challenge (1400 mg protein in DBPCFC) at 6 months (first phase). Control participants underwent OIT during the second phase, with subsequent DBPCFC. Immunological parameters and disease-specific quality-of-life scores were measured. Analysis was by intention to treat. Fisher's exact test was used to compare the proportion of those with desensitisation to peanut after 6 months between the active and control group at the end of the first phase. This trial is registered with Current Controlled Trials, number ISRCTN62416244.FindingsThe primary outcome, desensitisation, was recorded for 62% (24 of 39 participants; 95% CI 45–78) in the active group and none of the control group after the first phase (0 of 46; 95% CI 0–9; p<0·001). 84% (95% CI 70–93) of the active group tolerated daily ingestion of 800 mg protein (equivalent to roughly five peanuts). Median increase in peanut threshold after OIT was 1345 mg (range 45–1400; p<0·001) or 25·5 times (range 1·82–280; p<0·001). After the second phase, 54% (95% CI 35–72) tolerated 1400 mg challenge (equivalent to roughly ten peanuts) and 91% (79–98) tolerated daily ingestion of 800 mg protein. Quality-of-life scores improved (decreased) after OIT (median change −1·61; p<0·001). Side-effects were mild in most participants. Gastrointestinal symptoms were, collectively, most common (31 participants with nausea, 31 with vomiting, and one with diarrhoea), then oral pruritus after 6·3% of doses (76 participants) and wheeze after 0·41% of doses (21 participants). Intramuscular adrenaline was used after 0·01% of doses (one participant).InterpretationOIT successfully induced desensitisation in most children within the study population with peanut allergy of any severity, with a clinically meaningful increase in peanut threshold. Quality of life improved after intervention and there was a good safety profile. Immunological changes corresponded with clinical desensitisation. Further studies in wider populations are recommended; peanut OIT should not be done in non-specialist settings, but it is effective and well tolerated in the studied age group.FundingMRC-NIHR partnership

Disease severity accounts for minimal variance of quality of life in people with dementia and their carers: analyses of cross-sectional data from the MODEM study

Background Due to the progressive nature of dementia, it is important to understand links between disease severity and health-related outcomes. The aim of this study is to explore the relationship between disease severity and the quality of life (QoL) of people with dementia and their family carers using a number of disease-specific and generic measures. Methods In the MODEM cohort study, three-hundred and seven people with clinically diagnosed dementia and their carers were recruited on a quota basis to provide equal numbers of people with mild (standardised Mini-Mental State Examination (sMMSE), n = 110), moderate (sMMSE 10–19, n = 100), and severe (sMMSE 0–9, n = 97) cognitive impairment. A series of multiple regression models were created to understand the associations between dementia severity and the QoL of people with dementia and the QoL of their carers. QoL was measured using self- (DEMQOL, EQ-5D, CASP-19) and proxy-reports (DEMQOL-Proxy, EQ-5D) of disease-specific and generic QoL of the person with dementia. Carer generic QoL was measured by self-report (EQ-5D, SF-12). Results Disease severity, as measured by the sMMSE, was not significantly associated with the QoL of the person with dementia or the carer (p > 0.05), even after controlling for potential confounding variables for self-reported instruments. Proxy measures (rated by the carer) differed systematically in that there were small, but statistically significant proportions of the variance of QoL was explained by severity of cognitive impairment in multiple adjusted models. We also found little in the way of statistically significant relationships between the QoL of people with dementia and that of their carers except between DEMQOL-Proxy scores and the carer EQ-5D scores and carer SF-12 mental sub-scores. Conclusions The data generated supports the somewhat counterintuitive argument that severity of cognitive impairment (and therefore severity of dementia) is not associated with lower QoL for the person with dementia when self-report measures are used. However, in absolute terms, as judged by the variance in the multivariate models, it is clear that the contribution of dementia severity to the QoL of people with dementia is minimal whatever the measurement used, be it self- or proxy-rated, or disease-specific or generic

Factors affecting consistency and accuracy in identifying modern macroperforate planktonic foraminifera

Planktonic foraminifera are widely used in biostratigraphic, palaeoceanographic and evolutionary studies, but the strength of many study conclusions could be weakened if taxonomic identifications are not reproducible by different workers. In this study, to assess the relative importance of a range of possible reasons for among-worker disagreement in identification, 100 specimens of 26 species of macroperforate planktonic foraminifera were selected from a core-top site in the subtropical Pacific Ocean. Twenty-three scientists at different career stages – including some with only a few days experience of planktonic foraminifera – were asked to identify each specimen to species level, and to indicate their confidence in each identification. The participants were provided with a species list and had access to additional reference materials. We use generalised linear mixed-effects models to test the relevance of three sets of factors in identification accuracy: participant-level characteristics (including experience), species-level characteristics (including a participant’s knowledge of the species) and specimen-level characteristics (size, confidence in identification). The 19 less experienced scientists achieve a median accuracy of 57 %, which rises to 75 % for specimens they are confident in. For the 4 most experienced participants, overall accuracy is 79 %, rising to 93 % when they are confident. To obtain maximum comparability and ease of analysis, everyone used a standard microscope with only 35× magnification, and each specimen was studied in isolation. Consequently, these data provide a lower limit for an estimate of consistency. Importantly, participants could largely predict whether their identifications were correct or incorrect: their own assessments of specimen-level confidence and of their previous knowledge of species concepts were the strongest predictors of accuracy

Cruciferous vegetable feeding alters UGT1A1 activity: diet- and genotype-dependent changes in serum bilirubin in a controlled feeding trial.

Chemoprevention by isothiocyanates from cruciferous vegetables occurs partly through up-regulation of phase-II conjugating enzymes, such as UDP-glucuronosyl-transferases (UGT). UGT1A1 glucuronidates bilirubin, estrogens, and several dietary carcinogens. The UGT1A1*28 polymorphism reduces transcription compared to the wild-type, resulting in decreased enzyme activity. Isothiocyanates are metabolized by glutathione-S-transferases (GST); variants may alter isothiocyanate clearance, such that response to crucifers may vary by genotype. We evaluated, in a randomized, controlled, cross-over feeding trial in humans (n=70), 3 test diets, (single- and double-“dose” cruciferous and cruciferous plus apiaceous) compared to a fruit-and-vegetable-free basal diet. We measured serum bilirubin concentrations on days 0, 7, 11 and 14 of each 2-week feeding period to monitor UGT1A1 activity, and determined effects of UGT1A1*28 and GSTM1/GSTT1-null variants on response. Aggregate bilirubin response to all vegetable-containing diets was statistically significantly lower compared to the basal diet (p<0.03 for all). Within each UGT1A1 genotype, lower bilirubin concentrations were seen in: *1/*1 in both single and double-dose cruciferous diets compared to basal (p<0.03 for both); *1/*28 in double-dose cruciferous and cruciferous plus apiaceous compared to basal, and cruciferous plus apiaceous compared to single-dose cruciferous (p<0.02 for all); and *28/*28 in all vegetable-containing diets compared to basal (p<0.02 for all). Evaluation of the effects of diet stratified by GST genotype revealed some statistically significant genotypic differences however, the magnitude was similar and not statistically significant between genotypes. These results may have implications for altering carcinogen metabolism through dietary intervention, particularly among UGT1A1*28/*28 individuals