Sexuality in older age: essential considerations for healthcare professionals

This review describes the fact that many elderly people enjoy an active sex life and examines the evidence against the general perception of an 'asexual' old age. It offers an overview of the evidence for healthcare professionals who had not previously considered the sexuality of their older patients. It also describes some of the sexual problems faced by older people, especially the difficulties experienced in disclosing such problems to healthcare professionals. It examines why healthcare professionals routinely avoid discussing sexual problems with older patients, and how this can be improved. It also offers some recommendations for future research in the area, as well as a word of caution regarding the temptation of over-sexualising the ageing process.

Befriending carers of people with dementia: randomised controlled trial

Objective To evaluate the effectiveness of a voluntary sector based befriending scheme in improving psychological wellbeing and quality of life for family carers of people with dementia. Design Single blind randomised controlled trial. Setting Community settings in East Anglia and London. Participants 236 family carers of people with primary progressive dementia. Intervention Contact with a befriender facilitator and offer of match with a trained lay volunteer befriender compared with no befriender facilitator contact; all participants continued to receive “usual care.” Main outcome measures Carers’ mood (hospital anxiety and depression scale—depression) and health related quality of life (EuroQoL) at 15 months post-randomisation. Results The intention to treat analysis showed no benefit for the intervention “access to a befriender facilitator” on the primary outcome measure or on any of the secondary outcome measures. Conclusions In common with many carers’ services, befriending schemes are not taken up by all carers, and providing access to a befriending scheme is not effective in improving wellbeing.

Solar cycle 24: what is the sun up to?

March 2012 brought the first solar and geomagnetic disturbances of any note during solar cycle 24. But perhaps what was most remarkable about these events was how unremarkable they were compared to others during the space-age, attracting attention only because solar activity had been so quiet. This follows an exceptionally low and long-lived solar cycle minimum, and so the current cycle looks likely to extend a long-term decline in solar activity that started around 1985 and that could even lead to conditions similar to the Maunder minimum within 40 years from now, with implications for solar-terrestrial science and the mitigation of space weather hazards and maybe even for climate in certain regions and seasons.

Evaluating the legacies of state-building: success, failure, and the role of responsibility

What impact do international state-building missions have on the domestic politics of states they seek to build, and how can we measure this impact with confidence? This article seeks to address these questions and challenge some existing approaches that often appear to assume that state-builders leave lasting legacies rather than demonstrating such influence with the use of carefully chosen empirical evidence. Too often, domestic conditions that follow in the wake of international state-building are assumed to follow as a result of international intervention, usually due to insufficient attention to the causal processes that link international actions to domestic outcomes. The article calls for greater appreciation of the methodological challenges to establishing causal inferences regarding the legacies of state-building and identifies three qualitative methodological strategies—process tracing, counterfactual analysis, and the use of control cases—that can be used to improve confidence in causal claims about state-building legacies. The article concludes with a case study of international state-building in East Timor, highlighting several flaws of existing evaluations of the United Nations' role in East Timor and identifying the critical role that domestic actors play even in the context of authoritative international intervention

Weaning diet induces sustained metabolic phenotype shift in the pig and influences host response to Bifidobacterium lactis NCC2818

Background The process of weaning causes a major shift in intestinal microbiota and is a critical period for developing appropriate immune responses in young mammals.Objective To use a new systems approach to provide an overview of host metabolism and the developing immune system in response to nutritional intervention around the weaning period.Design Piglets (n=14) were weaned onto either an egg-based or soya-based diet at 3 weeks until 7 weeks, when all piglets were switched onto a fish-based diet. Half the animals on each weaning diet received Bifidobacterium lactis NCC2818 supplementation from weaning onwards. Immunoglobulin production from immunologically relevant intestinal sites was quantified and the urinary (1)H NMR metabolic profile was obtained from each animal at post mortem (11 weeks).Results Different weaning diets induced divergent and sustained shifts in the metabolic phenotype, which resulted in the alteration of urinary gut microbial co-metabolites, even after 4 weeks of dietary standardisation. B lactis NCC2818 supplementation affected the systemic metabolism of the different weaning diet groups over and above the effects of diet. Additionally, production of gut mucosa-associated IgA and IgM was found to depend upon the weaning diet and on B lactis NCC2818 supplementation.ConclusionThe correlation of urinary (1)H NMR metabolic profile with mucosal immunoglobulin production was demonstrated, thus confirming the value of this multi-platform approach in uncovering non-invasive biomarkers of immunity. This has clear potential for translation into human healthcare with the development of urine testing as a means of assessing mucosal immune status. This might lead to early diagnosis of intestinal dysbiosis and with subsequent intervention, arrest disease development. This system enhances our overall understanding of pathologies under supra-organismal control.

J. L. Austin and literal meaning

Alice Crary has recently developed a radical reading of J. L. Austin's philosophy of language. The central contention of Crary's reading is that Austin gives convincing reasons to reject the idea that sentences have context-invariant literal meaning. While I am in sympathy with Crary about the continuing importance of Austin's work, and I think Crary's reading is deep and interesting, I do not think literal sentence meaning is one of Austin's targets, and the arguments that Crary attributes to Austin or finds Austinian in spirit do not provide convincing reasons to reject literal sentence meaning. In this paper, I challenge Crary's reading of Austin and defend the idea of literal sentence meaning.

Attention, visual consciousness and indeterminacy

I propose a new argument showing that conscious vision sometimes depends constitutively on conscious attention. I criticise traditional arguments for this constitutive connection, on the basis that they fail adequately to dissociate evidence about visual consciousness from evidence about attention. On the same basis, I criticise Ned Block's recent counterargument that conscious vision is independent of one sort of attention (‘cognitive access'). Block appears to achieve the dissociation only because he underestimates the indeterminacy of visual consciousness. I then appeal to empirical work on the interaction between visual indeterminacy and attention, to argue for the constitutive connection.

The gut microbiota elicits a profound metabolic reorientation in the mouse jejunal mucosa during conventionalisation

Objective: Proper interactions between the intestinal mucosa, gut microbiota and nutrient flow are required to establish homoeostasis of the host. Since the proximal part of the small intestine is the first region where these interactions occur, and since most of the nutrient absorption occurs in the jejunum, it is important to understand the dynamics of metabolic responses of the mucosa in this intestinal region.Design: Germ-free mice aged 8-10 weeks were conventionalised with faecal microbiota, and responses of the jejunal mucosa to bacterial colonisation were followed over a 30-day time course. Combined transcriptome, histology, (1)H NMR metabonomics and microbiota phylogenetic profiling analyses were used.Results: The jejunal mucosa showed a two-phase response to the colonising microbiota. The acute-phase response, which had already started 1 day after conventionalisation, involved repression of the cell cycle and parts of the basal metabolism. The secondary-phase response, which was consolidated during conventionalisation (days 4-30), was characterised by a metabolic shift from an oxidative energy supply to anabolic metabolism, as inferred from the tissue transcriptome and metabonome changes. Detailed transcriptome analysis identified tissue transcriptional signatures for the dynamic control of the metabolic reorientation in the jejunum. The molecular components identified in the response signatures have known roles in human metabolic disorders, including insulin sensitivity and type 2 diabetes mellitus.Conclusion: This study elucidates the dynamic jejunal response to the microbiota and supports a prominent role for the jejunum in metabolic control, including glucose and energy homoeostasis. The molecular signatures of this process may help to find risk markers in the declining insulin sensitivity seen in human type 2 diabetes mellitus, for instance.

The determinants of competitive success in the interwar British radio industry

This article discusses the sources of competitive advantage in the interwar British radio industry. Specifically, it examines why sections of the industry that reaped substantial monopoly rents from the downstream value chain failed to dominate the industry. During the 1920s Marconi (which controlled the fundamental UK patents) had a key cost advantage, as had other members of the ‘Big Six’ electrical engineering firms which formed the BBC and were granted preferential royalties. Meanwhile the valve manufacturers' cartel was also able to extract high rents from set manufacturers. The vertical integration literature suggests that input monopolists have incentives to control downstream production. Yet—in contrast to the gramophone industry, which became concentrated into two huge companies following market saturation in the 1930s—radio retained a much more competitive structure. The Big Six failed to capitalize fully on their initial cost advantages owing to logistical weaknesses in supplying markets subject to rapid technical and design obsolescence. Subsequently, during the 1930s, marketing innovations are shown to have played a key role in allowing several independents to establish successful brands. This gave them sufficient scale to provide strong bargaining positions with input suppliers, negating most of their initial cost disadvantage.

Experimenting on contextualism

In this article we refine the design of context shifting experiments, which play a central role in contextualist debates, and we subject a large number of scenarios involving different types of expressions of interest to contextualists, including ‘know’ and color adjectives like ‘green’, to experimental investigation. Our experiment (i) reveals an effect of changing contexts on the evaluation of uses of the sentences that we examine, thereby overturning the absence of results reported in previous experimental studies (so-called null results), (ii) uncovers evidence for a ‘truth bias' in favor of positive over negative sentences, and (iii) reveals previously unnoticed distinctions between the strength of the contextual effects displayed by scenarios involving knowledge ascriptions and scenarios concerning color and other miscellaneous scenarios.

Joint criminal enterprise

The doctrine of joint criminal enterprise is in disarray. Despite repeated judicial scrutiny at the highest level, the doctrine's scope, proper doctrinal basis and function in relation to other modes of complicity remain uncertain. This article examines the doctrine's elements and underlying principles. It argues that while joint criminal enterprise is largely used to make individuals liable for offences committed by their associates in excess of the common criminal purpose, its proper function is to police the limits of associate liability and thus to exculpate rather than inculpate. The doctrine governs not only instances of accessorial liability; it also applies where the parties involved are joint principal offenders. As this puts into question the prevalent view that joint criminal enterprise is a form of secondary participation that results in accessorial liability, the article concludes that it is best seen as a doctrine sui generis.

The market in freehold land, 1300-1509: the evidence of feet of fines

This article provides time series data on the medieval market in freehold land, including the changing social composition of freeholders, level of market activity, size and complexity of landholdings, and shifts in the market value of land. These are subjects hitherto largely ignored due, in part, to the disparate nature of the evidence. It argues that feet of fines, despite archival limitations, if employed with care and an understanding of the underlying changes in the common law of real property, are capable of providing quantifiable evidence spanning hundreds of years and comparable across large areas of England.

Insight into the prebiotic concept: lessons from an exploratory, double blind intervention study with inulin-type fructans in obese women

Objective To highlight the contribution of the gut microbiota to the modulation of host metabolism by dietary inulin-type fructans (ITF prebiotics) in obese women. Methods A double blind, placebo controlled, intervention study was performed with 30 obese women treated with ITF prebiotics (inulin/oligofructose 50/50 mix; n=15) or placebo (maltodextrin; n=15) for 3 months (16 g/day). Blood, faeces and urine sampling, oral glucose tolerance test, homeostasis model assessment and impedancemetry were performed before and after treatment. The gut microbial composition in faeces was analysed by phylogenetic microarray and qPCR analysis of 16S rDNA. Plasma and urine metabolic profiles were analysed by 1H-NMR spectroscopy. Results Treatment with ITF prebiotics, but not the placebo, led to an increase in Bifidobacterium and Faecalibacterium prausnitzii; both bacteria negatively correlated with serum lipopolysaccharide levels. ITF prebiotics also decreased Bacteroides intestinalis, Bacteroides vulgatus and Propionibacterium, an effect associated with a slight decrease in fat mass and with plasma lactate and phosphatidylcholine levels. No clear treatment clustering could be detected for gut microbial analysis or plasma and urine metabolomic profile analyses. However, ITF prebiotics led to subtle changes in the gut microbiota that may importantly impact on several key metabolites implicated in obesity and/or diabetes. Conclusions ITF prebiotics selectively changed the gut microbiota composition in obese women, leading to modest changes in host metabolism, as suggested by the correlation between some bacterial species and metabolic endotoxaemia or metabolomic signatures.

Varieties of capitalism and investments in human capital

This paper explores the relationship between national institutional archetypes and investments in training and development. A recent trend within the literature on comparative capitalism has been to explore the nature and extent of heterogeneity within the coordinated market economies (CMEs) of Europe. Based on a review of the existing comparative literature on training and development, and comparative firm-level survey evidence of differences in training and development practices, we both support and critique existing country clusters and argue for a more nuanced and flexible categorization.