Neuropathologic basis of frontotemporal dementia in progressive supranuclear palsy.

BackgroundProgressive supranuclear palsy (PSP) is a neurodegenerative disorder characterized by neuronal loss in the extrapyramidal system with pathologic accumulation of tau in neurons and glia. The most common clinical presentation of PSP, referred to as Richardson syndrome, is that of atypical parkinsonism with vertical gaze palsy, axial rigidity, and frequent falls. Although cognitive deficits in PSP are often ascribed to subcortical dysfunction, a subset of patients has dementia with behavioral features similar to the behavioral variant of frontotemporal dementia. In this study we aimed to identify the clinical and pathological characteristics of PSP presenting with frontotemporal dementia.MethodsIn this study, we compared clinical and pathologic characteristics of 31 patients with PSP with Richardson syndrome with 15 patients with PSP with frontotemporal dementia. For pathological analysis, we used semiquantitative methods to assess neuronal and glial lesions with tau immunohistochemistry, as well image analysis of tau burden using digital microscopic methods.ResultsWe found greater frontal and temporal neocortical neuronal tau pathology in PSP with frontotemporal dementia compared with PSP with Richardson syndrome. White matter tau pathology was also greater in PSP with frontotemporal dementia than PSP with Richardson syndrome. Genetic and demographic factors were not associated with atypical distribution of tau pathology in PSP with frontotemporal dementia.ConclusionsThe results confirm the subset of cognitive-predominant PSP mimicking frontotemporal dementia in PSP. PSP with frontotemporal dementia has distinct clinical features that differ from PSP with Richardson syndrome, as well as differences in distribution and density of tau pathology. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society

'Forced adulthood': An aspect of 'quarterlife crisis' suffered by young English and Assamese adults

Quarterlife crisis’ describes difficulties experienced by young people in their transition to adulthood. Little is known about how this crisis manifests in different cultural contexts or the impact of educational background. Using photo-elicitation and timeline interviews, we explore the lived experience of ‘quarterlife crisis’ among 22-30 year olds from England (n=16) and Assam, India (n=8), each group including people with and people without a university-level education. Data were analysed with Interpretative Phenomenological Analysis. We report the key theme of ‘forced adulthood’, consisting of the traumatising experience of having to assume adult roles and responsibilities before one feels capable of so doing. We explore how cultural and educational factors shape this experience though: feeling rushed to financial self-sufficiency; having to train oneself to be an adult; and having to be the ‘man of the house’. In conclusion, we demonstrate that, even though there is some consistency around the traumatising effect of too early an assumption of adult responsibility, culture and educational background can change the contours of this experience and its meaning

Recommendations for delivering oral health advice: a qualitative supplementary analysis of dental teams, parents’ and children’s experiences

Background: Tooth decay has a significant impact on children, their families and wider society. The dental consultation provides an opportunity to prevent tooth decay by engaging in an effective oral health conversation with parents and children. However, there is limited literature which explores how these oral health conversations are delivered, received, and understood. Aim: To explore the common facilitators of delivering oral health advice from dental teams, parents' and children's experiences, to identify and inform practical recommendations for clinical practice. Method: The current paper used a qualitative supplementary analysis to reanalyse data of existing published studies by applying a different research question. Qualitative focus groups were undertaken following a semi-structured interview guide with 27 dental team members (dentists, dental nurses, practice managers and receptionists), 37 parents and 120 children (aged 7–10 years old) in the northern region of England. Thematic analysis informed the identification of themes and aggregation of findings. Results: Three overarching themes were developed: (1) An engaging and personalised dental visit for parents and children; (2) Dental teams, parents and children working collaboratively to improve oral health habits; and (3) Recommending appropriate oral health products. Many parents and children had little recollection of any preventive oral health conversations when visiting the dentist. Practical solutions were identified by different stakeholders to facilitate three-way, personalised, non-judgemental and supportive oral health conversations. Adopting these innovative approaches will help to enable parents and their children to adopt and maintain appropriate oral health behaviours. Conclusion: Understanding the context and triangulating the experiences of stakeholders involved in preventive oral health conversations for young children is an essential step in co-designing a complex oral health intervention. This study has provided recommendations for dental practices and wider paediatric health care services. Furthermore, the findings have informed the design of a complex oral health intervention called "Strong Teeth"

Photo-elicitation and time-lining to enhance the research interview: Exploring the quarterlife crisis of young adults in India and the UK

The aim of this article is to convey our experience of using photo-elicitation along with time-lining to enhance the research interview. We reflect on a study on the ‘quarterlife crisis’ in India and the UK. Participants were aged 22-30 years and self-defined as having experienced difficulties ‘finding their place in the world.’ There were 16 British (8 women, 8 men) and 8 Indian participants (4 women; 4 men). First, we consider how photo-elicitation proved highly compatible with our method of analysis – interpretative phenomenological analysis – through affording a deep connection with participant experience. Second, we explore how participants engaged with photo-elicitation and time-lining, providing examples of image content (events and feelings), image form (literal and symbolic), and creative use of timelines. Third, we reflect on how photo-elicitation and time-lining appeared to enhance participant agency, and to have a therapeutic value for participants, as well as providing particularly rich material for analysis

Performance of [(18)F]flutemetamol amyloid imaging against the neuritic plaque component of CERAD and the current (2012) NIA-AA recommendations for the neuropathologic diagnosis of Alzheimer's disease

INTRODUCTION: Performance of the amyloid tracer [(18)F]flutemetamol was evaluated against three pathology standard of truth (SoT) measures including neuritic plaques (CERAD "original" and "modified" and the amyloid component of the 2012 NIA-AA guidelines). METHODS: After [(18)F]flutemetamol imaging, 106 end-of-life patients who died underwent postmortem brain examination for amyloid plaque load. Blinded positron emission tomography scan interpretations by five independent electronically trained readers were compared with pathology measures. RESULTS: By SoT, sensitivity and specificity of majority image interpretations were, respectively, 91.9% and 87.5% with "original CERAD," 90.8% and 90.0% with "modified CERAD," and 85.7% and 100% with the 2012 NIA-AA criteria. DISCUSSION: The high accuracy of either CERAD criteria suggests that [(18)F]flutemetamol predominantly reflects neuritic amyloid plaque density. However, the use of CERAD criteria as the SoT can result in some false-positive results because of the presence of diffuse plaques, which are accounted for when the positron emission tomography read is compared with the 2012 NIA-AA criteria

The silence of the archives:business history, Postcolonialism and archival ethnography

History as a discipline has been accused of being a-theoretical. Business historians working at business schools, however, need to better explicate their historical methodology, not theory, in order to communicate the value of archival research to social scientists, and to train future doctoral students outside history departments. This paper seeks to outline an important aspect of historical methodology, which is data collection from archives. In this area, postcolonialism and archival ethnography have made significant methodological contributions not just for non-Western history, as it has emphasized the importance of considering how archives were created, and how one can legitimately use them despite their limitations. I argue that these approaches offer new insights into the particularities of researching business archives