A classification system for delirium subtyping with the use of a commercial mobility monitor

The usefulness of motor subtypes of delirium is unclear due to inconsistency in subtyping methods and a lack of validation with objective measures of activity. The activity of 40 patients was measured over 24 h with a commercial accelerometer-based activity monitor. Accelerometry data from patients with DSM-IV delirium that were readily divided into hyperactive, hypoactive and mixed motor subtypes, were used to create classification trees that were Subsequently applied to the remaining cohort to define motoric subtypes. The classification trees used the periods of sitting/lying, standing, stepping and number of postural transitions as measured by the activity monitor as determining factors from which to classify the delirious cohort. The use of a classification system shows how delirium subtypes can be categorised in relation to overall activity and postural changes, which was one of the most discriminating measures examined. The classification system was also implemented to successfully define other patient motoric subtypes. Motor subtypes of delirium defined by observed ward behaviour differ in electronically measured activity levels. Crown Copyright (C) 2009 Published by Elsevier B.V. All rights reserved.

A continuous wavelet transform and classification method for delirium motoric subtyping

The usefulness of motor subtypes of delirium is unclear due to inconsistency in subtyping methods and a lack of validation with objective measures of activity. The activity of 40 patients was measured over 24 h with a discrete accelerometer-based activity monitor. The continuous wavelet transform (CWT) with various mother wavelets were applied to accelerometry data from three randomly selected patients with DSM-IV delirium that were readily divided into hyperactive, hypoactive, and mixed motor subtypes. A classification tree used the periods of overall movement as measured by the discrete accelerometer-based monitor as determining factors for which to classify these delirious patients. This data used to create the classification tree were based upon the minimum, maximum, standard deviation, and number of coefficient values, generated over a range of scales by the CWT. The classification tree was subsequently used to define the remaining motoric subtypes. The use of a classification system shows how delirium subtypes can be categorized in relation to overall motoric behavior. The classification system was also implemented to successfully define other patient motoric subtypes. Motor subtypes of delirium defined by observed ward behavior differ in electronically measured activity levels.

Air flow influences on local climate: observed and simulated mean relationships for the United Kingdom

Synoptic-scale air flow variability over the United Kingdom is measured on a daily time scale by following previous work to define 3 indices: geostrophic flow strength, vorticity and direction. Comparing the observed distribution of air flow index values with those determined from a simulation with the Hadley Centre’s global climate model (HadCM2) identifies some minor systematic biases in the model’s synoptic circulation but demonstrates that the major features are well simulated. The relationship between temperature and precipitation from parts of the United Kingdom and these air flow indices (either singly or in pairs) is found to be very similar in both the observations and model output; indeed the simulated and observed precipitation relationships are found to be almost interchangeable in a quantitative sense. These encouraging results imply that some reliability can be assumed for single grid-box and regional output from this climate model; this applies only to those grid boxes evaluated here (which do not have high or complex orography), only to the portion of variability that is controlled by synoptic air flow variations, and only to those surface variables considered here (temperature and precipitation).

Self-centred memories: the reminiscence bump and the self

The self-memory relationship is thought to be bidirectional, in such a way that memories provide context for the self, and equally, the self exercises control over retrieval (Conway, 2005). Autobiographical memories are not distributed equally across the life span; instead, memories peak between ages 10 and 30. This reminiscence bump has been suggested to support the emergence of a stable and enduring self. In the present study, the relationship between memory accessibility and self was explored with a novel methodology that used generation of self images in the form of I am statements. Memories generated from I am cues clustered around the time of emergence for that particular self image. We argue that, when a new self-image is formed, it is associated with the encoding of memories that are relevant to that self and that remain highly accessible to the rememberer later in life. This study offers a new methodology for academics and clinicians interested in the relationship between memory and identity.

Autobiographical memory and amnesia: using conceptual knowledge to ground the self

A case of retrograde amnesia, PJM, elucidated the relationship between self, episodic memory and autobiographical knowledge. Results from a variety of measures including the I Am Memory Task (IAM Task), where memories are cued by self-generated self concepts, demonstrate that PJM has a coherent, continuous sense of self, despite having lost episodic memories for an 18-month period. Her use of conceptual autobiographical knowledge, in episodic tasks and to support aspects of identity, shows how autobiographical knowledge can support the self when episodic memories are inaccessible. These results are discussed with relation to current neuropsychological models of self and memory.

Remembering and imagining: the role of the self

This study investigated whether temporal clustering of autobiographical memories (AMs) around periods of self-development ( [Rathbone et al., 2008] and [Rathbone et al., 2009]) would also occur when imagining future events associated with the self. Participants completed an AM task and future thinking task. In both tasks, memories and future events were cued using participant-generated identity statements (e.g., I am a student; I will be a mother). Participants then dated their memories and future events, and finally gave an age at which each identity statement was judged to emerge. Dates of memories and future events were recoded as temporal distance from the identity statement used to cue them. AMs and future events both clustered robustly around periods of self-development, indicating the powerful organisational effect of the self. We suggest that life narrative structures are used to organise future events as well as memories.

Asparagus: a horticultural ballet

Asparagus: A Horticultural Ballet was a live performance and film narrating the rise of capital in the medium of asparagus. The project stemmed from an obscure reference to an art piece of the same name by Waw Pierogi of the band xex. However, the its re-enactment had little to do with the original exploration of the growth and branching patterns of the asparagus plant. Instead, a rigid choreography inspired by Oskar Schlemmer's Triadic Ballet and based on Karl Marx's Capital dictated the movements of six performers in asparagus costumes. Bringing together the organic and the geometric, the ballet investigated the transition from the Fordist assembly line to immaterial labour through a reanimation of modernist abstraction. Being itself the story of abstraction, Capital shows how human relationships are replaced by those between commodities in the joyless grind of endless accumulation. This process results in the transcendent mythical figure of capital, which frames, transfigures and even produces the natural world. Asparagus: A Horticultural Ballet was produced in collaboration with Montreal based band Les Georges Leningrad and commissioned by The Showroom Gallery, London. It was presented live at Conway Hall in London on 6.3.07 and at the Montreal Biennale at SAT on 12.5.07. The performance was accompanied by a film at the Showroom gallery and preceded by a production residency at the Pump House Gallery. The film has subsequently been shown at The Golden Thread Gallery, Bluecoat Liverpool and as part of A-Lot-Ment in Portsmouth. Props from Asparagus: A Horticultural Ballet, were included in The Eagle Document at the Stephen Lawrence Gallery, London.

Diaspora return of transnational migrants to Trinidad and Tobago: the additional contributions of social remittances

Current enthusiasm among development stakeholders for the enticement and recruitment ‘back home’ of skilled Diaspora migrants has predominantly revolved around how human capital gains and transfers of capital, knowledge, technical skills and workplace entrepreneurialism and innovation can be facilitated. In this article, we widen the conceptual basis of this dimension of the migration–development nexus, by bringing the additional contributions of the social remittances that return migrants offer, and practice, into the mix. As evidence, the article examines how and why a sample of ‘middling’1 Trinidadian transnational professionals engage in social development activities and why experiences vary widely on their return. Their views are appraised through the verbal optic of their narratives, which they shared with us during in-depth interviews. Several among these Diaspora returnees appear to be agents for the diffusion and infusion of social capital and non-monetary, social remittances in the homeland to which they have returned in mid-life and mid-career. Others are disappointed, or frustrated, and have their hopes dashed, leading to thoughts of re-migration, or re-return. Despite such difficulties, we find that family belonging and national pride strengthens many of these return migrants’ development potential through their deeply felt commitments to local ‘capacity-building’.

Assessment of depression, anxiety and apathy in prodromal and early Huntington disease

The Functional Rating Scale Taskforce for pre-Huntington Disease (FuRST-pHD) is a multinational, multidisciplinary initiative with the goal of developing a data-driven, comprehensive, psychometrically sound, rating scale for assessing symptoms and functional ability in prodromal and early Huntington disease (HD) gene expansion carriers. The process involves input from numerous sources to identify relevant symptom domains, including HD individuals, caregivers, and experts from a variety of fields, as well as knowledge gained from the analysis of data from ongoing large-scale studies in HD using existing clinical scales. This is an iterative process in which an ongoing series of field tests in prodromal (prHD) and early HD individuals provides the team with data on which to make decisions regarding which questions should undergo further development or testing and which should be excluded. We report here the development and assessment of the first iteration of interview questions aimed to assess Depression, Anxiety and Apathy in prHD and early HD individuals.

Nitrogen flows from European watersheds to coastal marine waters

Nitrogen flows from European watersheds to coastal marine waters Executive summary Nature of the problem • Most regional watersheds in Europe constitute managed human territories importing large amounts of new reactive nitrogen. • As a consequence, groundwater, surface freshwater and coastal seawater are undergoing severe nitrogen contamination and/or eutrophication problems. Approaches • A comprehensive evaluation of net anthropogenic inputs of reactive nitrogen (NANI) through atmospheric deposition, crop N fixation,fertiliser use and import of food and feed has been carried out for all European watersheds. A database on N, P and Si fluxes delivered at the basin outlets has been assembled. • A number of modelling approaches based on either statistical regression analysis or mechanistic description of the processes involved in nitrogen transfer and transformations have been developed for relating N inputs to watersheds to outputs into coastal marine ecosystems. Key findings/state of knowledge • Throughout Europe, NANI represents 3700 kgN/km2/yr (range, 0–8400 depending on the watershed), i.e. five times the background rate of natural N2 fixation. • A mean of approximately 78% of NANI does not reach the basin outlet, but instead is stored (in soils, sediments or ground water) or eliminated to the atmosphere as reactive N forms or as N2. • N delivery to the European marine coastal zone totals 810 kgN/km2/yr (range, 200–4000 depending on the watershed), about four times the natural background. In areas of limited availability of silica, these inputs cause harmful algal blooms. Major uncertainties/challenges • The exact dimension of anthropogenic N inputs to watersheds is still imperfectly known and requires pursuing monitoring programmes and data integration at the international level. • The exact nature of ‘retention’ processes, which potentially represent a major management lever for reducing N contamination of water resources, is still poorly understood. • Coastal marine eutrophication depends to a large degree on local morphological and hydrographic conditions as well as on estuarine processes, which are also imperfectly known. Recommendations • Better control and management of the nitrogen cascade at the watershed scale is required to reduce N contamination of ground- and surface water, as well as coastal eutrophication. • In spite of the potential of these management measures, there is no choice at the European scale but to reduce the primary inputs of reactive nitrogen to watersheds, through changes in agriculture, human diet and other N flows related to human activity.