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Recently published diagnostic criteria for mild cognitive impairment with Lewy bodies (MCI-LB) include five neuropsychiatric supportive features (non-visual hallucinations, systematised delusions, apathy, anxiety and depression). We have previously demonstrated that the presence of two or more of these symptoms differentiates MCI-LB from MCI due to Alzheimer's disease (MCI-AD) with a likelihood ratio >4. The aim of this study was to replicate the findings in an independent cohort.
Participants ⩾60 years old with MCI were recruited. Each participant had a detailed clinical, cognitive and imaging assessment including FP-CIT SPECT and cardiac MIBG. The presence of neuropsychiatric supportive symptoms was determined using the Neuropsychiatric Inventory (NPI). Participants were classified as MCI-AD, possible MCI-LB and probable MCI-LB based on current diagnostic criteria. Participants with possible MCI-LB were excluded from further analysis.
Probable MCI-LB (n = 28) had higher NPI total and distress scores than MCI-AD (n = 30). In total, 59% of MCI-LB had two or more neuropsychiatric supportive symptoms compared with 9% of MCI-AD (likelihood ratio 6.5, p < 0.001). MCI-LB participants also had a significantly greater delayed recall and a lower Trails A:Trails B ratio than MCI-AD.
MCI-LB is associated with significantly greater neuropsychiatric symptoms than MCI-AD. The presence of two or more neuropsychiatric supportive symptoms as defined by MCI-LB diagnostic criteria is highly specific and moderately sensitive for a diagnosis of MCI-LB. The cognitive profile of MCI-LB differs from MCI-AD, with greater executive and lesser memory impairment, but these differences are not sufficient to differentiate MCI-LB from MCI-AD.
While recent research points to the potential benefits of clinical intervention before the first episode of psychosis, the logistical feasibility of this is unclear.
To assess the feasibility of providing a clinical service for people with prodromal symptoms in an inner city area where engagement with mental health services is generally poor.
Following a period of liaison with local agencies to promote the service, referrals were assessed and managed in a primary care setting. Activity of the service was audited over 30 months.
People with prodromal symptoms were referred by a range of community agencies and seen at their local primary care physician practice. Over 30 months, 180 clients were referred; 58 (32.2%) met criteria for an at risk mental state, most of whom (67.2%) had attenuated psychotic symptoms. Almost 30% were excluded due to current or previous psychotic illness, of which two-thirds were in the first episode of psychosis. The socio-demographic composition of the 'at risk' group reflected that of the local population, with an over-representation of clients from an ethnic minority. Over 90% of suitable clients remained engaged with the service after 1 year.
It is feasible to provide a clinical service for people with prodromal symptoms in a deprived inner city area with a large ethnic minority population.
The rocky shores of the north-east Atlantic have been long studied. Our focus is from Gibraltar to Norway plus the Azores and Iceland. Phylogeographic processes shape biogeographic patterns of biodiversity. Long-term and broadscale studies have shown the responses of biota to past climate fluctuations and more recent anthropogenic climate change. Inter- and intra-specific species interactions along sharp local environmental gradients shape distributions and community structure and hence ecosystem functioning. Shifts in domination by fucoids in shelter to barnacles/mussels in exposure are mediated by grazing by patellid limpets. Further south fucoids become increasingly rare, with species disappearing or restricted to estuarine refuges, caused by greater desiccation and grazing pressure. Mesoscale processes influence bottom-up nutrient forcing and larval supply, hence affecting species abundance and distribution, and can be proximate factors setting range edges (e.g., the English Channel, the Iberian Peninsula). Impacts of invasive non-native species are reviewed. Knowledge gaps such as the work on rockpools and host–parasite dynamics are also outlined.
Maternal mental health during pregnancy and postpartum predicts later emotional and behavioural problems in children. Even though most perinatal mental health problems begin before pregnancy, the consequences of preconception maternal mental health for children's early emotional development have not been prospectively studied.
We used data from two prospective Australian intergenerational cohorts, with 756 women assessed repeatedly for mental health problems before pregnancy between age 13 and 29 years, and during pregnancy and at 1 year postpartum for 1231 subsequent pregnancies. Offspring infant emotional reactivity, an early indicator of differential sensitivity denoting increased risk of emotional problems under adversity, was assessed at 1 year postpartum.
Thirty-seven percent of infants born to mothers with persistent preconception mental health problems were categorised as high in emotional reactivity, compared to 23% born to mothers without preconception history (adjusted OR 2.1, 95% CI 1.4–3.1). Ante- and postnatal maternal depressive symptoms were similarly associated with infant emotional reactivity, but these perinatal associations reduced somewhat after adjustment for prior exposure. Causal mediation analysis further showed that 88% of the preconception risk was a direct effect, not mediated by perinatal exposure.
Maternal preconception mental health problems predict infant emotional reactivity, independently of maternal perinatal mental health; while associations between perinatal depressive symptoms and infant reactivity are partially explained by prior exposure. Findings suggest that processes shaping early vulnerability for later mental disorders arise well before conception. There is an emerging case for expanding developmental theories and trialling preventive interventions in the years before pregnancy.
A recent paper, “Parkinson's disease mild cognitive impairment classifications and neurobehavioral symptoms” (McDermott et al., 2017), provides an interesting comparison of the influence of different criteria for Parkinson's disease with mild cognitive impairment (PD-MCI) on progression to dementia (PDD). Unfortunately, McDermott et al. (2017) incorrectly stated that “only 21% of PD-MCI participants (identified with a 1.5 SD cut-off) converted to PDD within four years” (p.6) in our study (Wood et al., 2016). However, the important point made by Wood et al. (2016) was that the proportion of conversions to PDD was 51% when the PD-MCI diagnosis required a minimum of two 1.5 SD impairments within any single cognitive domain, whereas additional PD-MCI patients classified with one impairment at 1.5 SD in each of the two domains (but never two impairments in the same domain) had a non-significant risk of dementia relative to non-MCI patients (11% vs. 6% converted, respectively). Our PDD conversion rate was 38% when combining both 1.5 SD criteria (21/56 PD-MCI patients vs. 4/65 non-MCI patients converted); McDermott et al. (2017) found a 42% conversion rate over three years for similarly described PD-MCI patients (10/24 PD-MCI patients vs. 0/27 non-MCI patients converted). Our study was also part of a multinational study (n = 467) showing that PD-MCI has predictive validity beyond known demographic and PD-specific factors of influence (Hoogland et al., 2017). All three studies found that multiple cognitive domain impairments are common in PD-MCI. Nonetheless, the research community needs to clarify the association between PD-MCI subtypes and, especially, the optimal cognitive markers for dementia risk in PD patients.
The subsurface exploration of other planetary bodies can be used to unravel their geological history and assess their habitability. On Mars in particular, present-day habitable conditions may be restricted to the subsurface. Using a deep subsurface mine, we carried out a program of extraterrestrial analog research – MINe Analog Research (MINAR). MINAR aims to carry out the scientific study of the deep subsurface and test instrumentation designed for planetary surface exploration by investigating deep subsurface geology, whilst establishing the potential this technology has to be transferred into the mining industry. An integrated multi-instrument suite was used to investigate samples of representative evaporite minerals from a subsurface Permian evaporite sequence, in particular to assess mineral and elemental variations which provide small-scale regions of enhanced habitability. The instruments used were the Panoramic Camera emulator, Close-Up Imager, Raman spectrometer, Small Planetary Linear Impulse Tool, Ultrasonic drill and handheld X-ray diffraction (XRD). We present science results from the analog research and show that these instruments can be used to investigate in situ the geological context and mineralogical variations of a deep subsurface environment, and thus habitability, from millimetre to metre scales. We also show that these instruments are complementary. For example, the identification of primary evaporite minerals such as NaCl and KCl, which are difficult to detect by portable Raman spectrometers, can be accomplished with XRD. By contrast, Raman is highly effective at locating and detecting mineral inclusions in primary evaporite minerals. MINAR demonstrates the effective use of a deep subsurface environment for planetary instrument development, understanding the habitability of extreme deep subsurface environments on Earth and other planetary bodies, and advancing the use of space technology in economic mining.
The main theme of this part is the collapse and partial restoration of the liberal, capitalist, and imperial orders that allowed Europeans to dominate most of the world. For Europeans, the nineteenth century was a time of unprecedented prosperity and power. Their mastery of the new industrial technologies had given them direct control of over half of the world’s peoples and huge influence over the rest. The great global linkages created by the European empires drew in commodities and labor from all over the world to create the products that went out to consumers everywhere. The USA, too, enjoyed its Gilded Age of wealth and empire, and Japan was rising quickly to join the elite club of great powers. It seemed that this machinery of expanding production and power could continue indefinitely. Many predicted, in the words of the historian Arnold Toynbee, the coming of an age of universal peace, wealth, and justice, an “earthly paradise.”
It was not to be. The Great War which broke out in 1914 destroyed the international imperial order, devastating all the European societies far beyond anyone’s expectations. Worse was to come. The brief, precarious stability of the 1920s fell apart in the 1930s under the impact of a savage world depression and the rise of a new, vicious mass movement: fascism. The world plunged into a new global war even more destructive than the first.
The first textbook to present world history via social history, drawing on social science methods and research. This interdisciplinary, comprehensive, and comparative textbook is authored by distinguished scholars and experienced teachers, and offers expert scholarship on global history that is ideal for undergraduate students. Volume 2 takes us from the early modern period to speculation about the world in 2050, visiting diverse civilizations, nation-states, ecologies, and people along the journey through time and place. The book pays particular attention to the ways in which ordinary people lived through the great changes of their times, and how everyday experience connects to great political events and the commercial exchanges of an interconnected world. With 75 maps, 65 illustrations, timelines, boxes, and primary source extracts, the book enables students to use historical material and social science methodologies to analyze the events of the past, present, and future.
The lawyer Nelson Mandela (1918–2013) spent twenty-five years in jail for organizing against the South African apartheid regime, but in 1994 he was elected president of South Africa. The young Mandela was an activist against the racist policies of the white regime; only later in life did he endorse non-violent political action. In his inauguration speech, he called for the “healing of wounds” and an end to the “pernicious ideology and practice of racism and racial oppression.” His Korean counterpart, Kim Dae-jung (1925–2009), also spent time in jail under military rule, but as prime minister pursued policies of democratization and reconciliation with his colonial rulers, the Japanese. Both won the Nobel Peace Prize.
Other anti-imperial leaders took different paths. Mao Zedong (1893–1976) and Kim Il-sung (1912–94) strongly endorsed violent struggle, isolating their countries from the world. Ho Chi Minh (1890–1969) and his Viet Minh nationalists successfully fought off both the French and the Americans during a thirtyyear struggle. The bloody contest between Palestinians and Israelis continues today, despite intensive efforts at mediation. The struggle to rid the world of imperial domination has led to many unpredicted outcomes, and it is not yet over.
We conclude with a discussion of two critical issues: global terrorism and global warming. Both of them threaten to harm huge numbers of people, and both have roots far back in the human past. The greatest recent terrorist threat, that of al-Qaeda, derives directly from the imperial domination of the Middle East in the nineteenth and twentieth centuries, but al-Qaeda's supporters find their inspiration in the founding of Islam in the seventh century. Yet only the globalization of the late twentieth century made al-Qaeda's actions possible.
Global warming is a more subtle, but equally dangerous trend which, if nothing is done to avert it, will bring catastrophe to hundreds of millions of vulnerable people. It is a direct result of global industrialization since the nineteenth century. Scientists have carefully documented the warming of the planet over the past century, but the nations of the world have so far only taken very small steps to address this vital threat to human existence.
On September 11, 2001, members of the terrorist group al-Qaeda hijacked four transcontinental airliners taking off from Boston’s Logan airport. They crashed two of them into the two World Trade Center towers in New York City (see Figure 1). The explosion of the gasoline in the airplanes incinerated the twin towers and their occupants. The third plane crashed into the Pentagon. Passengers on the fourth plane, probably intended for the White House, brought it down in a field in Pennsylvania. Nearly 3,000 people died in these attacks. The boldness of the al-Qaeda attacks stunned and horrified the world. Never before had so many civilians been killed by a deliberate attack on American soil. President George W. Bush vowed to make a War on Terror the theme of his administration.
Between 1850 and 1914 both commerce and coercion expanded on a more global scale than ever before in human history. The technologies of the Second Industrial Revolution and the advance of the consolidated state powered this expansion. The Second Industrial Revolution was a North Atlantic revolution. The new centrality of Canada and the USA in the industrial order and the beginnings of industrial development in Japan were already laying the ground for a further shift toward the Pacific. Its technologies made possible the imperialist conquests characteristic of the era. At the same time, the model of the consolidated state that had emerged in the Age of Revolution spread throughout Europe and North America and then around the world. Existing states increasingly sought to unify and homogenize their national territories, while national minorities resisting such assimilation advocated the establishment of their own unified, homogeneous independent states. One important response to the expansion of industry and centralized state power was global popular protest. Worldwide protest evolved new forms and these innovative tactics showed similarities from Hankou to Chicago; in one guise or another, social spread throughout most of the world.
Between 1850 and 1914, in Western and Central Europe, North America, and Japan, a Second Industrial Revolution occurred whose impact on the daily life of men and women around the world was greater than that of the First Industrial Revolution. This revolution produced the large factory, the great corporation, and the factory worker, transforming steel production, machine construction, chemicals, and rubber. The Second Industrial Revolution depended heavily on fossil fuels, on coal and oil, and the geography of production and distribution were heavily affected by access to these resources.
World War II left Eurasia in ruins, and two huge continental superpowers, the USA and the USSR, dominating the world. Of the two, the USA had by far the bigger economy and superior military force. The wartime alliance of the two powers did not last long: Within two years, they had begun a bitter global conflict, the Cold War. Because both sides had nuclear weapons, this war threatened to exterminate humanity itself. Fortunately, the conflict quickly stabilized in Europe, dividing it into two spheres of influence, and both powers stepped back from nuclear confrontation over Cuba. But in the rest of the world, local upheavals threatened to draw in the superpowers, making each civil war and rebellion in the Third World a test of the superpowers’ “credibility.”
The two most destructive wars took place in Korea and Vietnam. In neither one did either superpower gain total victory. Korea remains a divided nation, and in Vietnam revolutionary nationalists successfully expelled French colonialists, their Vietnamese collaborators, and their American supporters. The Soviet Union, emboldened by American defeat, moved into Afghanistan, but faced its own Vietnam there. By 1980, the superpowers no longer seemed to dominate the world.
Despite the superpower confrontation, the postwar world economy grew at an unprecedented rate for thirty years.
In 1682, the boyars of Russia chose the vigorous 10-year-old boy Peter as their new tsar, with his mother Natalia as regent. Unfortunately, Peter's accession was immediately challenged by relatives of his older half-sister Sophia. A mob of dissatisfied musketeers broke into the Kremlin square, slaughtered the top boyars, murdered Peter's brother, but swore loyalty to the new tsar. Peter and his mother, still fearing for their lives, fled the capital. For the rest of his life, Peter hated Moscow, the Kremlin, and all it represented: intrigue, violence, superstition, and anarchy. He resolved to build an orderly state that insisted on honest service from all its subjects. As a youngster growing up in the suburbs of Moscow, he played with foreigners who taught him how to train his own soldiers. He learned to build his own ships. When he grew up, Peter forced the Russian people into the world of Western European states. But Russia also expanded to the borders of China, where it met the equally dynamic Kangxi emperor. The Kangxi emperor also came to the throne as a young man, challenged his elder relatives, and made China both strong and actively engaged with Western European powers. By 1700, these two vigorous rulers had made their states the dominant powers of Eurasia.