Graphic satire and the rise and fall of the First British Empire: political prints from the Seven Years' War to the Treaty of Paris, c. 1756-1783

This thesis examines the early stages of the transformation of emblematic political prints into political caricature from the beginning of the Seven Years' War (1756) to the Treaty of Paris, which ended the American Revolutionary War (1783). Both contextual and iconographical issues are investigated in relation to the debates occasioned by Britain's imperial project, which marked a period of dramatic expansion during the Seven Years' War, and ended with the loss of the American colonies, consequently framing this thesis as a study of political prints during the rise and fall of the so-called 'First British Empire'. Previous studies of eighteenth-century political prints have largely ignored the complex and lengthy evolutionary process by which the emblematic mode amalgamated with caricatural representation, and have consequently concluded that political prints excluded emblems entirely by the end of the 1770s. However, this study emphasizes the significance of the Wilkite movement for the promotion and preservation of emblems, and investigates how pictorial political argument was perceived and received in eighteenth-century British society, arguing that wider tastes and opinions regarding the utilization of political prints gradually shifted to accept both modes of representation. Moreover, the marketplace, legal status, topicality, and manufacturing methods of political prints are analyzed in terms of understanding the precarious nature of their consumption and those that endeavoured to engage in political printmaking. The evolution, establishment, and subsequent appropriation of pictorial tropes is discussed from the early modern period to the beginning of the so-called Golden Age of caricature, while tracing the adaptation of representational models in American colonial prints that employed emblems already entrenched in British pictorial political debate. Political prints from the two largest print collections, the British Museum and the Lewis Walpole Library at Yale are consulted, along with a number of eighteenth-century newspapers and periodicals, to develop the earlier research by M. Dorothy George, Charles Press, Herbert Atherton, Diana Donald, Amelia Rauser, and Eirwen Nicholson.

Exploring the potential role of allostatic load biomarkers in risk assessment of patients presenting with depressive symptoms

Background: Depression is a major health problem worldwide and the majority of patients presenting with depressive symptoms are managed in primary care. Current approaches for assessing depressive symptoms in primary care are not accurate in predicting future clinical outcomes, which may potentially lead to over or under treatment. The Allostatic Load (AL) theory suggests that by measuring multi-system biomarker levels as a proxy of measuring multi-system physiological dysregulation, it is possible to identify individuals at risk of having adverse health outcomes at a prodromal stage. Allostatic Index (AI) score, calculated by applying statistical formulations to different multi-system biomarkers, have been associated with depressive symptoms. Aims and Objectives: To test the hypothesis, that a combination of allostatic load (AL) biomarkers will form a predictive algorithm in defining clinically meaningful outcomes in a population of patients presenting with depressive symptoms. The key objectives were: 1. To explore the relationship between various allostatic load biomarkers and prevalence of depressive symptoms in patients, especially in patients diagnosed with three common cardiometabolic diseases (Coronary Heart Disease (CHD), Diabetes and Stroke). 2 To explore whether allostatic load biomarkers predict clinical outcomes in patients with depressive symptoms, especially in patients with three common cardiometabolic diseases (CHD, Diabetes and Stroke). 3 To develop a predictive tool to identify individuals with depressive symptoms at highest risk of adverse clinical outcomes. Methods: Datasets used: ‘DepChron’ was a dataset of 35,537 patients with existing cardiometabolic disease collected as a part of routine clinical practice. ‘Psobid’ was a research data source containing health related information from 666 participants recruited from the general population. The clinical outcomes for 3 both datasets were studied using electronic data linkage to hospital and mortality health records, undertaken by Information Services Division, Scotland. Cross-sectional associations between allostatic load biomarkers calculated at baseline, with clinical severity of depression assessed by a symptom score, were assessed using logistic and linear regression models in both datasets. Cox’s proportional hazards survival analysis models were used to assess the relationship of allostatic load biomarkers at baseline and the risk of adverse physical health outcomes at follow-up, in patients with depressive symptoms. The possibility of interaction between depressive symptoms and allostatic load biomarkers in risk prediction of adverse clinical outcomes was studied using the analysis of variance (ANOVA) test. Finally, the value of constructing a risk scoring scale using patient demographics and allostatic load biomarkers for predicting adverse outcomes in depressed patients was investigated using clinical risk prediction modelling and Area Under Curve (AUC) statistics. Key Results: Literature Review Findings. The literature review showed that twelve blood based peripheral biomarkers were statistically significant in predicting six different clinical outcomes in participants with depressive symptoms. Outcomes related to both mental health (depressive symptoms) and physical health were statistically associated with pre-treatment levels of peripheral biomarkers; however only two studies investigated outcomes related to physical health. Cross-sectional Analysis Findings: In DepChron, dysregulation of individual allostatic biomarkers (mainly cardiometabolic) were found to have a non-linear association with increased probability of co-morbid depressive symptoms (as assessed by Hospital Anxiety and Depression Score HADS-D≥8). A composite AI score constructed using five biomarkers did not lead to any improvement in the observed strength of the association. In Psobid, BMI was found to have a significant cross-sectional association with the probability of depressive symptoms (assessed by General Health Questionnaire GHQ-28≥5). BMI, triglycerides, highly sensitive C - reactive 4 protein (CRP) and High Density Lipoprotein-HDL cholesterol were found to have a significant cross-sectional relationship with the continuous measure of GHQ-28. A composite AI score constructed using 12 biomarkers did not show a significant association with depressive symptoms among Psobid participants. Longitudinal Analysis Findings: In DepChron, three clinical outcomes were studied over four years: all-cause death, all-cause hospital admissions and composite major adverse cardiovascular outcome-MACE (cardiovascular death or admission due to MI/stroke/HF). Presence of depressive symptoms and composite AI score calculated using mainly peripheral cardiometabolic biomarkers was found to have a significant association with all three clinical outcomes over the following four years in DepChron patients. There was no evidence of an interaction between AI score and presence of depressive symptoms in risk prediction of any of the three clinical outcomes. There was a statistically significant interaction noted between SBP and depressive symptoms in risk prediction of major adverse cardiovascular outcome, and also between HbA1c and depressive symptoms in risk prediction of all-cause mortality for patients with diabetes. In Psobid, depressive symptoms (assessed by GHQ-28≥5) did not have a statistically significant association with any of the four outcomes under study at seven years: all cause death, all cause hospital admission, MACE and incidence of new cancer. A composite AI score at baseline had a significant association with the risk of MACE at seven years, after adjusting for confounders. A continuous measure of IL-6 observed at baseline had a significant association with the risk of three clinical outcomes- all-cause mortality, all-cause hospital admissions and major adverse cardiovascular event. Raised total cholesterol at baseline was associated with lower risk of all-cause death at seven years while raised waist hip ratio- WHR at baseline was associated with higher risk of MACE at seven years among Psobid participants. There was no significant interaction between depressive symptoms and peripheral biomarkers (individual or combined) in risk prediction of any of the four clinical outcomes under consideration. Risk Scoring System Development: In the DepChron cohort, a scoring system was constructed based on eight baseline demographic and clinical variables to predict the risk of MACE over four years. The AUC value for the risk scoring system was modest at 56.7% (95% CI 55.6 to 57.5%). In Psobid, it was not possible to perform this analysis due to the low event rate observed for the clinical outcomes. Conclusion: Individual peripheral biomarkers were found to have a cross-sectional association with depressive symptoms both in patients with cardiometabolic disease and middle-aged participants recruited from the general population. AI score calculated with different statistical formulations was of no greater benefit in predicting concurrent depressive symptoms or clinical outcomes at follow-up, over and above its individual constituent biomarkers, in either patient cohort. SBP had a significant interaction with depressive symptoms in predicting cardiovascular events in patients with cardiometabolic disease; HbA1c had a significant interaction with depressive symptoms in predicting all-cause mortality in patients with diabetes. Peripheral biomarkers may have a role in predicting clinical outcomes in patients with depressive symptoms, especially for those with existing cardiometabolic disease, and this merits further investigation.

Clydebank in the inter-war years: a study in economic and social change

The main theme of this thesis is the social, economic and political response of a single community to economic dislocation in the interwar years. The community under consideration is Clydebank., The thesis is divided into several parts. Part I establishes the development of the burgh and considers the physical framework of the community, mainly in the years before 1919. The town's characteristics are examined in terms of population structure and development between the world wars. In the last part of this section there is a review of the economic structure of the burgh and changes occurring in it between 1919 and 1939. In Part II consideration is given to the actual extent and form of the unemployment affecting Clydebank at this time, and comparison is made with other communities and geographic/economic areas. Attention is then focussed more narrowly on the actual individuals suffering unemployment in the burgh during the 1930s, in an attempt to personalise the experience of the unemployed. Part III reviews central and local government responses to the situation in which Clydebank found itself oetween 1919 and 1939. Central government policies discussed include unemployment insurance, public works, the Special Areas legislation, assistance in the construction of the 534 "Queen Mary" and the direction of financial support to areas of particular need. Amongst local authority actions described are additional local support for the poor, public works, efforts to attract new industry to the town, attempts to deal with the housing problem which was particularly acute at times of high unemployment and measures to maintain health standards in the community. In Part IV the responses of the community to unemployment and government policies are detailed. The burgh's commercial sector is surveyed as are developments in leisure provision, religion, temperance and crime, and local politics. A number of individual responses are also given consideration such as migration, commuting, changes in birth and marriage rates and suicide.