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Background: People with behavioural variant frontotemporal dementia, Lewy body dementia, posterior cortical atrophy and young onset Alzheimer's disease may experience language and communication difficulties. However, the role of speech and language interventions for people with these non-language led dementias has received little attention. Aims: This study aimed to explore the experiences and perspectives of people living with these conditions, and their families, regarding their language and communication difficulties and how speech and language therapy could address these needs. Methods: This study employed a qualitative design to explore the experiences of people living with or caring for somebody with behavioural variant frontotemporal dementia, Lewy body dementia, posterior cortical atrophy or young onset Alzheimer's disease, and to understand their opinions about speech and language therapy. Participants were recruited from a support service connected to a dementia clinic to attend one of five focus group meetings. Videorecorded focus groups and interviews were transcribed, and reflexive thematic analysis was used to analyse data from people affected by each type of dementia. Results: A total of 25 participants were recruited to the study, with representation across the different forms of non-language led dementias. The four main themes identified were: (1) communication difficulties as a key difficulty, (2) loss and loneliness, (3) speech and language therapy, and (4) the role of the caregiver. Sixteen subthemes were also identified which highlighted individual issues across disease types. Discussion: Although all the forms of dementia studied here are not considered to be language-led, people with these conditions and/or their care partners identified speech, language and communication as common challenges. These communication difficulties were reported to have a negative impact on their social participation and mental health and participants felt speech and language interventions could help. There is a need for research exploring speech and language interventions developed for and with people with non-language led dementias and their care partners, to ensure they meet the needs of the people they are designed for.

This article investigates how a key stratum of the partisan elite—party activists—have been positioned across time and policy issues. We examine the extent to which activists have polarized symmetrically or asymmetrically and find that only on the issue of abortion has one party’s activists (Republicans) polarized notably more than the other’s. The article also analyzes party activist proximity to the mass public’s policy preferences and finds that Democrats are consistently closer to the public on economic issues, and Republicans are consistently closer on a subset of non-economic issues. Our findings suggest the need for more nuanced theories of party activism and polarization along with providing a useful lens through which to view party electoral competition.

We propose a modified spatial-voting rule to explain why congressional candidates adopt more extreme ideological positions than their constituents' preferences. Our model accepts the standard spatial-voting model with one critical exception: voters in the same party as a candidate tolerate extremism without imposing an electoral penalty. This, in turn, creates “leeway” for candidates to adopt extreme positions as they increasingly depend on voters from their own party. Electoral simulations demonstrate that a key election-level implication of this model is that it explains candidate polarization without relying on institutional factors like primary elections. Finally, we show that asymmetry in perceptual bias is one possible mechanism and that real-world patterns of ideological representation are consistent with our simulation results.

Since the beginning of the new millennium, the partisan leanings and presidential voting of state white electorates have been changing. Drawing on party realignment theories and analyses of cultural politics, this paper hypothesizes that cultural issues may be the dimension along which the realignment is occurring. The empirical findings are consistent with this view. The cultural issue preferences of state white electorates are strongly related to change in partisanship from 2000 to 2016. Further, only cultural issue attitudes have become a stronger predictor of state white presidential voting over this period. The apparent effects of partisanship, economic issue attitudes, and racial attitudes have either declined over time or been substantial in some elections and less so in others.

This paper analyzes the positions Members of Congress take on important aspects of public policy, voters’ preferences on those issues, and individual-level voting behavior in congressional elections. Minimal evidence of issue accountability is found, and its form is different from that reported in previous research. The central implication is that representatives appear to have a good deal of discretion to take positions—at least with respect to voters—without paying an electoral penalty. The “electoral blind spot” (Bawn et al. Perspect Polit 10(3):571–597, 2012) in congressional elections may be substantial.

This is a review of patients managed by our single-site breast surgery service for complications of cosmetic surgeries performed abroad and within the UK, across September 2022–2023. A retrospective review of outpatient clinic and emergency theatre lists was used to identify patients; data was collected from their electronic records. 25 patients (23 female) were identified, 20 had surgery abroad. Turkey was the most common destination that patients travelled to (n = 15), with bilateral breast augmentation being the most common procedure (n = 15). Post-operative infection and wound dehiscence (n = 10 and n = 8, respectively) were the most common complications; 72% (n = 18) of patients presented within 8 weeks of their surgery. There was incomplete recording of surgical details including precise date (recorded for 48%), clinic name (8%), and name of the surgeon (0%). 17 microbiological samples were sent, with 11 resulting in a named organism - Staphylococcus aureus was most common (n = 5). 17 (68%) cases were treated conservatively, without radiological or surgical interventions. When surgical management occurred (n = 6), it was for removal of breast implants (n = 5) or evacuation of haematoma (n = 1). The cost of managing these complications was at least £37,000. Complications from cosmetic tourism present more commonly to the NHS than those resulting from private surgery performed in the UK. This has significant financial implications for the NHS. More accurate recording of relevant data, engagement in audits, and disseminating findings may help raise awareness of the risks and complications of cosmetic surgery performed abroad. [ABSTRACT FROM AUTHOR]

This study explores Wikipedia as a site for learning. It traces how people learn to become Wikipedia editors through engagement in an editathon, a training event for people who want to become a volunteer editor. The study is original in its emphasis on the various types of knowledge editors acquire as they develop expertise. Determining the knowledge needed to contribute to Wikipedia is significant in terms of understanding Wikipedia as a site for learning. Data was gathered from nine participants who took part in an "editathon" event. The study used a rigorous methodology, combining quantitative social network analysis, documenting the online activity of participants as they created and edited Wikipedia pages, with qualitative interviews about participants' lived experiences during the editathon. Conceptual and procedural knowledge are representative of the foundational knowledge needed to contribute to Wikipedia actively as an editor. However, these knowledge types on their own are not sufficient. Editors also develop socio-cultural and relational forms of knowledge to enable them to operate and problem-solve effectively. The relationship between the physical and the digital is important, since socio-cultural and relational knowledge are developed through active experimentation as the editathon engage with physical objects to create the online wiki pages.

Do economic performance and economic news coverage influence public perceptions of the economy? Efforts to assess the effects are hampered by the interrelationships among the variables. In this paper, we bring to bear a more careful accounting of available economic variables than previous studies have used. We find that both media tone and economic attitudes are strongly related to actual economic performance. Moreover, after taking into account the economy itself, a substantial relationship between media tone and economic attitudes persists. Given that economic attitudes influence a wide variety of political outcomes, this finding carries important normative and political significance.

This article analyzes the relationship between U.S. senators and their constituencies over the entire period of time that senators have been selected by direct election. Focusing on preference change within states, we identify three mechanisms that might produce responsiveness in senators’ ideological locations. We find that it is not merely the case that responsiveness is produced by party representation. Replacement of one senator with another of the same party facilitates responsiveness, too. And, even without electoral replacement, individual senators appear to adjust their ideological locations in response to changes in their electorates’ preferences. We also investigate how the mechanisms of responsiveness changed with the erosion of Democratic dominance in the South and as the parties grew stronger over time.

Due to its stringent entry requirements, academic reputation and world ranking, Oxford University in the United Kingdom is perceived by some as being a closed, exclusive, and elitist institution. As learning technologists working in the institution, we have experienced an enthusiasm amongst academic colleagues for openness in publication and practice enhanced by new technologies, which reflects their long-demonstrated commitment to publication and the dissemination of new knowledge. Advances in digital technologies and the emergence of online platforms for global dissemination have enabled Oxford University seminars, lectures, and public addresses, many by famous figures, to be shared with an international audience. This article charts the journey Oxford has made in opening up educational content and describes the ways in which we have worked to ensure that the value added by technology aligns with current academic practice in the institution.

This paper analyzes some of the general election consequences of the top-two primary system in California elections beginning in 2012.  In particular we focus on general election contests between candidates of the same party that were not possible under the previous primary system, but have occurred with some regularity with the top-two.  We find that same party elections are characterized by greater competitiveness, lower turnout, and less—but still substantial—polarized voting.

A common observation about the 2014 Senate elections is that one advantage the Republicans had was that the set of states holding elections tilted Republican in partisanship. In this article, we quantify that advantage and demonstrate that the constitutional requirements of equality for state representation in the Senate plus the division of seats into three classes were critical elements in the Republicans' pickup of nine seats and retaking partisan control. Markedly less important was the national Republican partisan tide.

This paper analyzes the influence of the two most commonly examined causes of presidential vote choice, policy preferences and party identification. The focus is on change across elections in order to assess how the effects of issues and partisanship respond to the larger political context in which voters make their decisions. In contrast to party centric views of politics, I find little direct responsiveness to party issue contrast and substantial influence of candidate issue contrast. Further, I find that leading hypotheses for the “resurgence in partisanship” are not consistent with some important facts suggesting that the explanation remains elusive.

Amongst elderly people with type 2 diabetes (T2D) over prescribing can result in emergency ambulance call-outs, falls and fractures and increased mortality, particularly in frail patients. Current clinical guidelines, however, remain focused on medication intensification rather than deintensification where appropriate. This study aims to evaluate the effectiveness of an electronic decision-support system and training for the deintensification of potentially inappropriate medications amongst older frail people with T2D, when compared to 'usual' care at 12-months. This study is an open-label, multi-site, two-armed pragmatic cluster-randomised trial. GP practices randomised to the 'enhanced care' group have an electronic decision support system installed and receive training on the tool and de-intensification of diabetes medications. The system flags eligible patients for possible deintensification of diabetes medications, linking the health care professional to a clinical algorithm. The primary outcome will be the number of patients at 12-months who have had potentially inappropriate diabetes medications de-intensified. Study recruitment commenced in June 2022. Data collection commenced in January 2023. Baseline data have been extracted from 40 practices (3145 patients). Digital technology, involving computer decision systems, may have the potential to reduce inappropriate medications and aid the process of de-intensification. International Standard Randomised Controlled Trial Number: ISRCTN53221378. Available at: https://www.isrctn.com/ISRCTN53221378. • Overprescribing of diabetes medications causes hypoglycaemia, falls. • Problem in older, frail patients, yet limited guidance for deprescribing. • Limited long-term benefit of tight glycaemic control in older patients. • Electronic decision support and training may guide deprescribing. [ABSTRACT FROM AUTHOR]