2,348 research outputs found

    Population-based neuropathological studies of dementia: design, methods and areas of investigation – a systematic review

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    Background Prospective population-based neuropathological studies have a special place in dementia research which is under emphasised. Methods A systematic review of the methods of population-based neuropathological studies of dementia was carried out. These studies were assessed in relation to their representativeness of underlying populations and the clinical, neuropsychological and neuropathological approaches adopted. Results Six studies were found to be true population-based neuropathological studies of dementia in the older people: the Hisayama study (Japan); Vantaa 85+ study (Finland); CC75C study (Cambridge, UK); CFAS (multicentre, UK); Cache County study (Utah, USA); HAAS (Hawaï, USA). These differ in the core characteristics of their populations. The studies used standardised neuropathological methods which facilitate analyses on: clinicopathological associations and confirmation of diagnosis, assessing the validity of hierarchical models of neuropathological lesion burden; investigating the associations between neuropathological burden and risk factors including genetic factors. Examples of findings are given although there is too little overlap in the areas investigated amongst these studies to form the basis of a systematic review of the results. Conclusion Clinicopathological studies based on true population samples can provide unique insights in dementia. Individually they are limited in power and scope; together they represent a powerful source to translate findings from laboratory to populations

    The frequency and validity of self-reported diagnosis of Parkinson's Disease in the UK elderly: MRC CFAS cohort

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    Background: Estimates of the incidence and prevalence of chronic diseases can be made using established cohort studies but these estimates may have lower reliability if based purely on self-reported diagnosis.Methods: The MRC Cognitive Function & Ageing Study ( MRC CFAS) has collected longitudinal data from a population-based random sample of 13004 individuals over the age of 65 years from 5 centres within the UK. Participants were asked at baseline and after a two-year follow-up whether they had received a diagnosis of Parkinson's disease. Our aim was to make estimates of the incidence and prevalence of PD using self-reporting, and then investigate the validity of self-reported diagnosis using other data sources where available, namely death certification and neuropathological examination.Results: The self-reported prevalence of Parkinson's disease ( PD) amongst these individuals increases with age from 0.7% (95% CI 0.5 - 0.9) for 65 - 75, 1.4% ( 95% CI 1.0 - 1.7) for 75 - 85, and 1.6% ( 95% CI 1.0 - 2.3) for 85+ age groups respectively. The overall incidence of self reported PD in this cohort was 200/100,000 per year ( 95% CI 144 - 278). Only 40% of the deceased individuals reporting prevalent PD and 35% of those reporting incident PD had diagnoses of PD recorded on their death certificates. Neuropathological examination of individuals reporting PD also showed typical PD changes in only 40%, with the remainder showing basal ganglia pathologies causing parkinsonism rather than true PD pathology.Conclusion: Self-reporting of PD status may be used as a screening tool to identify patients for epidemiological study, but inevitably identifies a heterogeneous group of movement disorders patients. Within this group, age, male sex, a family history of PD and reduced cigarette smoking appear to act as independent risk factors for self-reported PD

    (SNP050) Butler-Brayne Franklin interviewed by Dorothy Noble Smith, transcribed by Victoria M. Edwards

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    Records an interview with Butler Franklin, (née Butler-Brayne Thornton Robinson), a direct descendant of Francis Thornton, III, who built a plantation near Sperryville, Virginia, in the 1740s. Mrs. Franklin contends that several prominent geographic features now located in Shenandoah National Park, including Thornton Gap, the Thornton River and Mary\u27s Rock, were named for Francis Thornton and his descendants. Includes a genealogical history of the Thornton family in Virginia, from William Thornton, III, who emigrated from England in the 1640s, through Col. John Thornton, who married Jane Washington, aunt of the future first president. Discusses several Thornton estates, including Montpelier, the plantation built on the Rappahannock River near Sperryville, and the Thornton ancestral home, Fall Hill, in Fredericksburg ,where Mrs. Franklin resided at the time of the interview.https://commons.lib.jmu.edu/snp/1040/thumbnail.jp

    Wave transformation across a macrotidal shore platform under low to moderate energy conditions

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    We investigate how waves are transformed across a shore platform as this is a central question in rock coast geomorphology. We present results from deployment of three pressure transducers over four days, across a sloping, wide (~200 m) cliff-backed shore platform in a macrotidal setting, in South Wales, United Kingdom. Cross shore variations in wave heights were evident under the predominantly low to moderate (significant wave height < 1.4 m) energy conditions measured. At the outer transducer 50 m from the seaward edge of the platform (163 m from the cliff) high tide water depths were 8+ m meaning that waves crossed the shore platform without breaking. At the mid platform position water depth was 5 m. Water depth at the inner transducer (6 m from the cliff platform junction) at high tide was 1.4 m. This shallow water depth forced wave breaking, thereby limiting wave heights on the inner platform. Maximum wave height at the middle and inner transducers were 2.41 and 2.39 m respectively and significant wave height 1.35 m and 1.34 m respectively. Inner platform high tide wave heights were generally larger where energy was up to 335% greater than near the seaward edge where waves were smaller. Infragravity energy was less than 13% of the total energy spectra with energy in the swell, wind and capillary frequencies accounting for 87% of the total energy. Wave transformation is thus spatially variable and is strongly modulated by platform elevation and the tidal range. While shore platforms in microtidal environments have been shown to be highly dissipative, in this macro-tidal setting up to 90% of the offshore wave energy reached the landward cliff at high tide, so that the shore platform cliff is much more reflective

    The changing depiction of homosexual people in twentieth-century British drama

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    This thesis studies how the image of homosexual people has evolved on the British stage during the present century. It aims to discern general trends rather than compile an exhaustive list of plays containing homosexual characters. Similarly, it is not intended to be a compendium of homosexual playwrights, but will focus on the contents of the drama rather than the biographical details of authors' lives. It makes no attempt to analyse work that is not ostensibly homosexual which could be argued to contain latent homosexual content. Nor, finally, does it discuss phenomena of interest in this field which are tangential to the area of study - for example, cross-dressing in pantomime and music hall. At the risk of superficiality, it concentrates on plays that have tried to discuss homosexuality and depict gay characters in an open, straight-forward manner. The approach taken to the subject has been historical and sociological, linking developments in gay drama to the social and political situation facing homosexual people throughout the present century. As such, this thesis argues for the existence of seven stages in homosexual drama during this time. While plays cannot always be fitted into a rigid chronological schema - some overlap clearly occurs - the history of homosexual drama can be briefly summarised as follows: - 1) Silence. 2) The first plays depict homosexual characters, but these are generally censored heavily or closed down. 3) Plays begin to raise the subject more boldly, but only by portraying characters who are wrongly accused of homosexuality or about whose sexuality there is left some doubt. 4) Homosexual characters are depicted openly as such, but they conform to degrading stereotypes. 5) Gay people break away to create their own separatist drama, generally intending to proselytise in favour of gay rights. 6) Mainstream plays on the West End and television begin to feature gay people in an unsensationalised way. 7) AIDS arrives and dominates homosexual drama. Although this study concentrates on British drama, theatre is now an international phenomenon, and this has been especially true of gay drama. Therefore, it has often been necessary to refer to the drama of other countries, in particular America

    Quality-Lite for Clinics: Appropriate Accountability within ‘Live-Client’ Clinical Legal Education

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    Our paper will explore the tensions. We are not going to be able to jettison quality assurance, even if we wish to. So we will propose a ‘quality-lite’ agenda for law clinic objectives and student outcomes, asserting that self-governance and our own QA processes will protect live-client clinics from ill-designed, externally imposed bureaucratic pressures. Encouragement of innovation in clinical legal education – and its support via quality-lite – need not be restricted to a few institutions that are independently funded. Ultimately, QA must be facilitative of development in technique and policy or there will be less and less to ‘assure’, let alone deliver to communities in need

    A study of dementia in a rural population

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    Dementia, in particular Alzheimer's disease, has been widely investigated in clinical settings. Moreover, many epidemiological studies have been carried out to estimate the prevalence and incidence of dementia and, less frequently, Alzheimer's disease. There have also been studies of ageing cohorts to examine mental changes associated with ageing. There has, however, been little research on unselected elderly populations which has been detailed enough to examine the relationship between normal and abnormal mental ageing. The aim of this study was to investigate the distribution of the indices of dementia in a rural population. This allowed investigation of the hypothesis that variables associated with dementia, in particular Alzheimer's disease, are distributed bimodally in the population and allowed investigation of possible associations with these distributions. It also provided prevalence estimates of dementia in a rural population. A population sample of women aged 70 to 79 was selected from a rural Cambridgeshire health centre. Using the Cambridge Examination for Mental Disorders in the Elderly all aspects required for the diagnosis of dementia and tentative differential diagnosis were collected on 365 women. There was no evidence of bimodality in any of the derived scales, whether cognitive, behavioural or ischaemic. The prevalence of dementia of all types and levels, including mild, was 4.3% in the 70 to 74 age group and 11.7% in the 75 to 79 age group. For more severe dementia a prevalence of 2.8% was found in the 75 to 79 age group, and 0% in the 70 to 74 age group. The rates for more severe dementia were lower than other recent prevalence studies in the UK, whereas the rates for all levels of severity were higher. The tentative diagnosis of Alzheimer's disease accounted for 52% of the diagnoses of dementia and multi-infarct dementia for 31%. Age, social class and education were all significantly and independently associated with scores on the longer cognitive scales (Mini-Mental State Examination and the CAMCOG scale of CAMDEX). Risk factors suggested in the literature for dementia, Alzheimer's disease and cognitive impairment was also investigated. Few factors were associated with either cognitive function or dementia. Age was the only variable associated with both cognitive function and the diagnosis of dementia. Only small proportions of the population were exposed to postulated risk factors and these risk factors, if proven, would account for little population excess risk. In this study no significant separation of performance on cognitive or behavioural scales between the demented and the non-demented was found. This could have been due to the small numbers in the tails of the frequency distributions but, if true, it is suggested that this observation might be related to the continuous distribution of underlying neuropathological lesions, such as plaques and tangles, noted in autopsy series of unselected populations. If so, current research into the mechanisms of the dementias may have implications for the understanding of cognitive decline noted in the non-demented elderly over time

    Surveillance Technologies and Constitutional Law

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    This review focuses on government use of technology to observe, collect, or record potential criminal activity in real-time, as contrasted with “transaction surveillance” that involves government efforts to access already-existing records and exploit Big Data, topics that have been the focus of previous reviews (Brayne 2018, Ridgeway 2018). Even so limited, surveillance technologies come in many guises, including closed-circuit television, automated license plate and facial readers, aerial cameras, and GPS tracking. Also classifiable as surveillance technology are devices such as thermal and electromagnetic imagers that can “see” through walls and clothing. Finally, surveillance includes wiretapping and other forms of communication interception. The following discussion briefly examines the limited evidence we have about the prevalence and effectiveness of these technologies and then describes the law governing surveillance, focusing principally on constitutional doctrine, and how it might-—and might not-—limit use of these technologies in the future
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