To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The years between 1780 and 1830 are vital decades in the history of Irish writing in English. This book charts the confluence of Enlightenment, antiquarian, and romantic energies within Irish literary culture and shows how different writers and genres absorbed, dispersed and remade those interests during five decades of political change. During those same years, literature made its own history. By the 1840s, Irish writing formed a recognizable body of work, which later generations would draw on, quote, anthologize and dispute. Questions raised by novels, poems and plays of the late eighteenth- and early nineteenth-century - the politics of language and voice; the relationship between literature and locality; the possibility of literature as a profession - resonated for many Irish writers over the centuries that followed and continue to matter today. This comprehensive volume will be a key reference for scholars and students of Irish literature and romantic literary studies.
As the population ages, the proportion of older people requiring functional support will increase significantly, as will the ‘dependency ratio’ (the number of dependent people divided by the working-age population). These demographic changes will place significant strain on society and systems of long-term care (LTC). Growing expectations of standards of care will, in the future, amplify tensions between quality and affordability. Although there is significant international variation, the LTC system in many countries has become increasingly sophisticated, with services provided in both the home and residential LTC provision. The roles of informal carers and family are also being acknowledged as part of a complex system of care .
Background: SMA1 is a neurodegenerative disease caused by bi-allelic survival motor neuron 1 gene (SMN1) deletion/mutation. In the phase 1 study, SMN GRT onasemnogene abeparvovec (AVXS-101) improved outcomes of symptomatic SMA1 patients. We report preliminary data of STR1VE, a pivotal study (NCT03306277) evaluating efficacy and safety of a one-time intravenous AVXS-101 infusion. Methods: STR1VE is a phase 3, multicenter, open-label, single-arm study in SMA1 patients aged <6 months (bi-allelic SMN1 loss, 2xSMN2). Primary outcomes: independent sitting for ≥30 seconds (18 months) and survival (14 months). Secondary outcomes: ability to thrive and ventilatory support (18 months). Exploratory outcomes: CHOP-INTEND and Bayley Scales of Infant and Toddler Development scores. Results: Enrollment is complete with 22 patients dosed. Mean age at symptom onset, genetic diagnosis, and enrollment was 1.9 (0–4.0), 2.1 (0.5–4.0), and 3.7 (0.5–5.9) months. At baseline, no patient required ventilatory/nutritional support, and all exclusively fed by mouth. Mean baseline CHOP-INTEND score was 32.6 (17.0–52.0), which increased 6.9 (-4.0–16.0, n=20), 10.4 (2.0–18.0, n=12), and 11.6 (-3.0–23.0, n=9) points at 1, 2, and 3 months; updates provided at congress. Conclusions: Preliminary data from STR1VE show rapid motor function improvements in SMA1 patients, paralleling phase 1 findings.
Background: Status epilepticus (SE) is the most common pediatric neurological emergency. Timely treatment is crucial, yet administration of rescue medications is often delayed and under-dosed. We aim to improve SE management by ensuring that every child at risk of SE in our province has an individualized seizure action plan (SAP) outlining the steps that should be taken during SE. Methods: A survey was distributed to parents of epilepsy patients aged 1 month to 19 years. Primary outcome was percentage of patients with SAPs. Secondary outcome was parental interest in a SAP mobile application. Following chart review, univariate and multivariate analysis was performed to identify variables that predict whether patients have SAPs. Results: Of 192 participants, 61.5% have SAPs. On univariate analysis, history of prior SE and male gender increased likelihood of having a SAP. On logistic regression, Nagelkerke R2 was 0.204 and our model correctly predicted 82.2% of patients with SAPs. 83.3% of parents were interested in a SAP mobile application. Conclusions: This is one of the first studies to examine SAP prevalence in a pediatric epilepsy population. There is a need to increase the percentage of epilepsy patients with SAPs. Most parents would find a SAP mobile application valuable in their child’s management.
THE BOOK THAT A LATE-MEDIEVAL or early-Tudor reader was most likely to possess was a book of hours. By the end of the fifteenth century this type of volume was widely available in England in a variety of forms designed to appeal to all tastes and pockets, ranging from de luxe manuscripts with fabulously illuminated borders and full-page miniatures to small printed horae with woodcut illustrations. Book of hours were used in private daily devotions and thus became very personal, highly valued possessions that their owners were likely to bequeath to near relatives or close friends; with other spiritual books they are the types of volumes most likely to be mentioned in wills of this period. The ownership and donation inscriptions that such exchanges generated, the memorialization of family members through the entry of their obits in the prefatory calendars, and the tendency to fill up blank leaves with records of the births of children, combine to make books of hours valuable sources of information about personal social networks. They are thus particularly rich resources of biographical detail about late-medieval and early modern readers and reading communities, yet tend to be treated rather reductively as sources of evidence about reading itself. They are assumed to be books that were only used in the practice of devotion, at home or in church, for the saying of daily prayers in imitation of monastic brethren, for the correct observance of fast days and festivals, for venerating local or personally favoured saints – in short, for fulfilling all manner of religious obligations. All of this activity, much of it literate, is somehow not factored as indicative of reading habits and practices. Books of hours are more typically cited merely as evidence of an owner's piety and wealth; in literary terms they tend to be regarded as ‘just’ books of hours and not something more interesting.
In fact, the contents of books of hours are more varied and copious than might be imagined. Certain differences in original content, such as in prescribed use (in England normally of Sarum or York), or in the provision of prayers to particular saints, may reveal information about the circumstances of the book's production and intended market, but these aspects, which are usually well-documented in catalogue entries for books of hours, are not the features that concern me here.
Childhood maltreatment (CM) plays an important role in the development of major depressive disorder (MDD). The aim of this study was to examine whether CM severity and type are associated with MDD-related brain alterations, and how they interact with sex and age.
Within the ENIGMA-MDD network, severity and subtypes of CM using the Childhood Trauma Questionnaire were assessed and structural magnetic resonance imaging data from patients with MDD and healthy controls were analyzed in a mega-analysis comprising a total of 3872 participants aged between 13 and 89 years. Cortical thickness and surface area were extracted at each site using FreeSurfer.
CM severity was associated with reduced cortical thickness in the banks of the superior temporal sulcus and supramarginal gyrus as well as with reduced surface area of the middle temporal lobe. Participants reporting both childhood neglect and abuse had a lower cortical thickness in the inferior parietal lobe, middle temporal lobe, and precuneus compared to participants not exposed to CM. In males only, regardless of diagnosis, CM severity was associated with higher cortical thickness of the rostral anterior cingulate cortex. Finally, a significant interaction between CM and age in predicting thickness was seen across several prefrontal, temporal, and temporo-parietal regions.
Severity and type of CM may impact cortical thickness and surface area. Importantly, CM may influence age-dependent brain maturation, particularly in regions related to the default mode network, perception, and theory of mind.