An Age Old Problem? Estimating the Impact of Dementia on Past Human Populations.

OBJECTIVE: To model the impact of dementia on past societies. METHOD: We consider multiple lines of evidence indicating elderly individuals to have been more common throughout the past than is frequently accepted. We then apply known dementia incidence/prevalence rates to plausible assumptions of past population structures to suggest prevalence in the past. RESULTS: Dementia prevalence in premodern societies is likely to have been around 5% of the rate seen in modern, developed countries but with a total past incidence running into billions. DISCUSSION: Dementia is often seen as a "modern" challenge that humans have not had to contend with before. We argue that this condition has had considerably greater effects than previously envisaged and is a challenge that humans have already withstood successfully, on one hand at a lower incidence but on the other without the considerable clinical, technological, and social advances that have been made in recent times

Using a hypothetical scenario to assess public preferences for colorectal surveillance following screening-detected, intermediate-risk adenomas: annual home-based stool test vs. triennial colonoscopy

Background To assess public preferences for colorectal cancer (CRC) surveillance tests for intermediate-risk adenomas, using a hypothetical scenario. Methods Adults aged 45–54 years without CRC were identified from three General Practices in England (two in Cumbria, one in London). A postal survey was carried out during a separate study on preferences for different first-line CRC screening modalities (non- or full-laxative computed tomographic colonography, flexible sigmoidoscopy, or colonoscopy). Individuals were allocated at random to receive a pack containing information on one first-line test, and a paragraph describing CRC surveillance recommendations for people who are diagnosed with intermediate-risk adenomas during screening. All participants received a description of two surveillance options: annual single-sample, home-based stool testing (consistent with Faecal Immunochemical Tests; FIT) or triennial colonoscopy. Invitees were asked to imagine they had been diagnosed with intermediate-risk adenomas, and then complete a questionnaire on their surveillance preferences. Results 22.1 % (686/3,100) questionnaires were returned. 491 (15.8 %) were eligible for analysis. The majority of participants stated a surveillance preference for the stool test over colonoscopy (60.8 % vs 31.0 %; no preference: 8.1 %; no surveillance: 0.2 %). Women were more likely to prefer the stool test than men (66.7 % vs. 53.6 %; p = .011). The primary reason for preferring the stool test was that it would be done more frequently. The main reason to prefer colonoscopy was its superiority at finding polyps. Conclusions A majority of participants stated a preference for a surveillance test resembling FIT over colonoscopy. Future research should test whether this translates to greater adherence in a real surveillance setting

The trade-off between taxi time and fuel consumption in airport ground movement

Environmental impact is a very important agenda item in many sectors nowadays, which the air transportation sector is also trying to reduce as much as possible. One area which has remained relatively unexplored in this context is the ground movement problem for aircraft on the airport’s surface. Aircraft have to be routed from a gate to a runway and vice versa and it is still unknown whether fuel burn and environmental impact reductions will best result from purely minimising the taxi times or whether it is also important to avoid multiple acceleration phases. This paper presents a newly developed multi-objective approach for analysing the trade-off between taxi time and fuel consumption during taxiing. The approach consists of a combination of a graph-based routing algorithm and a population adaptive immune algorithm to discover different speed profiles of aircraft. Analysis with data from a European hub airport has highlighted the impressive performance of the new approach. Furthermore, it is shown that the trade-off between taxi time and fuel consumption is very sensitive to the fuel-related objective function which is used

Policy instruments in the Common Agricultural Policy

Policy changes in the Common Agricultural Policy (CAP) can be explained in terms of the exhaustion and long-term contradictions of policy instruments. Changes in policy instruments have reoriented the policy without any change in formal Treaty goals. The social and economic efficacy of instruments in terms of evidence-based policy analysis was a key factor in whether they were delegitimized. The original policy instruments were generally dysfunctional, but reframing the policy in terms of a multifunctionality paradigm permitted the development of more efficacious instruments. A dynamic interaction takes place between the instruments and policy informed by the predominant discourses

A simple digital-optical system to improve accuracy of hot-wire measurements

A high precision traverse mechanism with micro-resolution was designed to capture accurately the velocity profile of the very thin turbulent attachment line on a swept body. To ensure that the traverse mechanism could position the hot wire reliably, a simple digital optical system was designed to check the performance of the traverse by measuring the displacement of the hot wire: a vertical displacement of 2.4µm was achievable and this could be further reduced to 0.6µm using micro-stepping. Due to the simplicity of the set-up it was equally useful for probe wall positioning and the velocity profiles captured clearly demonstrated that the optical set-up helped in resolving the near wall flow more accurately, regardless of the thinness of the boundary layer. The captured data compare well with the results from similar investigations, with arguably higher precision achieved

Friction-induced heating in nozzle hole micro-channels under extreme fuel pressurisation

Fuel pressurisation up to 3000 bar, as required by modern Diesel engines, can result in significant variation of the fuel physical properties relative to those at atmospheric pressure and room temperature conditions. The huge acceleration of the fuel as it is pushed through the nozzle hole orifices is known to induce cavitation, which is typically considered as an iso-thermal process. However, discharge of this pressurised liquid fuel through the micro-channel holes can result in severe wall velocity gradients which induce friction and thus heating of the liquid. Simulations assuming variable properties reveal two opposing processes strongly affecting the fuel injection quantity and its temperature. The first one is related to the de-pressurisation of the fuel; the strong pressure and density gradients at the central part of the injection hole induce fuel temperatures even lower than that of the inlet fuel temperature. On the other hand, the strong heating produced by wall friction increases significantly the fuel temperature; local values can exceed the liquid’s boiling point and even induce reverse heat transfer from the liquid to the nozzle’s metal body. Local values of the thermal conductivity and heat capacity affect the transfer of heat produced at the nozzle surface to the flowing liquid. That creates strong temperature gradients within the flowing liquid which cannot be ignored for accurate predictions of the flow through such nozzles

The rectus sling to prevent loop colostomy retraction: a case series

Diverting stomas are being used increasingly in the management of rectal cancer, particularly with low anterior resection following neoadjuvant therapy. We describe a simple anchorage method for loop colostomy using a rectus fascial sling. This has been used successfully in fifteen patients with no complications or evidence of significant spill over of faecal contents into the efferent loop

An energy literacy matrix: a tool for adult and continuing education curriculum design

In this article the authors report on the outcome of a mixed methods study which assessed the renewable energy literacies of adults’ in rural communities across Britain. The research team used a stratified sample survey (n=6000), interviews with householders (n=97), stakeholder interviews (n=7) and one focus group meeting to collect primary data. Data from the study highlighted a series findings: a) there is a clear disjuncture between individuals’ awareness and understanding of energy related matters and government and industry rhetoric; b) there is a public appetite for more reliable (trustworthy) information on renewable energy; c) the public is not well informed about renewable energy debates and government schemes to save energy. Responding to the findings an energy literacy matrix which can be used to plot knowledge of, against, knowledge about renewable energy sources has been developed. The literacy matrix provides a development education tool to focus adult educators’ efforts on raising awareness and understanding of how local, national and global issues affect the everyday lives of individuals and communities

Higher Order Analogues of Tracy-Widom Distributions via the Lax Method

We study the distribution of the largest eigenvalue in formal Hermitian one-matrix models at multicriticality, where the spectral density acquires an extra number of k-1 zeros at the edge. The distributions are directly expressed through the norms of orthogonal polynomials on a semi-infinite interval, as an alternative to using Fredholm determinants. They satisfy non-linear recurrence relations which we show form a Lax pair, making contact to the string literature in the early 1990's. The technique of pseudo-differential operators allows us to give compact expressions for the logarithm of the gap probability in terms of the Painleve XXXIV hierarchy. These are the higher order analogues of the Tracy-Widom distribution which has k=1. Using known Backlund transformations we show how to simplify earlier equivalent results that are derived from Fredholm determinant theory, valid for even k in terms of the Painleve II hierarchy.Comment: 24 pages. Improved discussion of Backlund transformations, in addition to other minor improvements in text. Typos corrected. Matches published versio