Object lessons: the question of cultural property in the age of repatriation

Object lessons: the question of cultural property in the age of repatriation. Northwest Coast material culture has become increasingly identified as cultural property, a quasi-legal concept that denotes objects of a collective patrimony. This represents a radical shift from earlier notions of property, seen strongly as privately owned by individuals and family groups. Moreover, the status of these objects as art, that is, framed in a museum setting and partaking of certain transcendent qualities derived from the Western tradition, represents a dramatic redefinition of pieces that were considered analogous to human beings, as temporary entities. This process of redefinition, which is generational, political, and an invention of tradition, is probably inevitable.Leçons d’objets: la question de la propriété culturelle au temps du rapatriement. La culture matérielle de la Côte nord-ouest est de plus en plus conçue comme une propriété culturelle, un concept quasi légal qui identifie les objets comme éléments d’un patrimoine collectif. Il s’agit là d’une modification radicale par rapport aux conceptions anciennes de la propriété: celle-ci était fortement ancrée dans la possession privée par des individus et des groupes familiaux. Par ailleurs, l’accession de ces mêmes objets au statut d’œuvres d’art, par leur inscription dans les musées et l’affectation qui leur est faite, sur le mode occidental, d’une valeur transcendante, redéfinit complètement leur nature puisque, jusqu’alors, ils étaient considérés, à l’instar des êtres humains, comme des entités passagères. Ce processus de redéfinition, qui est dans l’air du temps, a une dimension politique et représente l’invention d’une tradition, est probablement inévitable.Lección de los objetos: el problema de la propiedad cultural en el tiempo de la rapatriación. La cultura material de la costa del Noroeste aparece más y más como una propiedad cultural, un concepto casi legal que se aplica a objetos formando un patrimonio colectivo. Eso representa un cambio radical respecto a las antiguas nociones de propiedad, las cuales remitían a la posesión privada por parte de individuos y grupos de familia. Aparte de eso, la adquisición por estos objetos del estatuto de obras de arte, ya que se exponen en museos y se les reconoce, al modo occidental, un valor transcendental, modifica su naturaleza misma: en efecto, antes eran considerados, al igual que los hombres, como entidades temporarias

Pathogenic copy number variants and SCN1A mutations in patients with intellectual disability and childhood-onset epilepsy

Background Copy number variants (CNVs) have been linked to neurodevelopmental disorders such as intellectual disability (ID), autism, epilepsy and psychiatric disease. There are few studies of CNVs in patients with both ID and epilepsy. Methods We evaluated the range of rare CNVs found in 80 Welsh patients with ID or developmental delay (DD), and childhood-onset epilepsy. We performed molecular cytogenetic testing by single nucleotide polymorphism array or microarray-based comparative genome hybridisation. Results 8.8 % (7/80) of the patients had at least one rare CNVs that was considered to be pathogenic or likely pathogenic. The CNVs involved known disease genes (EHMT1, MBD5 and SCN1A) and imbalances in genomic regions associated with neurodevelopmental disorders (16p11.2, 16p13.11 and 2q13). Prompted by the observation of two deletions disrupting SCN1A we undertook further testing of this gene in selected patients. This led to the identification of four pathogenic SCN1A mutations in our cohort. Conclusions We identified five rare de novo deletions and confirmed the clinical utility of array analysis in patients with ID/DD and childhood-onset epilepsy. This report adds to our clinical understanding of these rare genomic disorders and highlights SCN1A mutations as a cause of ID and epilepsy, which can easily be overlooked in adults

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes