Invalid party wall awards and how to avoid them

Considers the reasons for the invalidity of party wall awards. Examines decided cases under earlier party wall legislation in the context of the Party Wall etc. Act 1996. Explains invalidity on the basis of an excess of the surveyors’ statutory authority. Defines this authority in terms of jurisdiction and power. Demonstrates the limits of the surveyors’ authority and emphasises the importance of strict compliance with statutory procedures. Concludes that surveyors should adopt an inquisitive and analytical approach to the scope of their authority to avoid the possibility of invalid awards. Echoes John Anstey’s earlier warning that surveyors should avoid a broad-brush approach to their duties which will only leave them “covered in soot”

Fathers as Sexuality Educators: Aspirations and Realities. An Interpretative Phenomenological Analysis

Men can play a significant role in teaching their children about sexuality but fathers’ practices and perceptions in this domain remain under explored. This study presents an Interpretative Phenomenological Analysis of eight fathers’ perceptions and practices in educating their ten-year-old children about physical maturation, reproduction and relationships. A Foucauldian analysis with a focus on governmentality and biopower revealed tensions and contradictions between the fathers’ aspirations and their realities, which appeared to be underpinned by the dynamic, contradictory, shifting, plural nature of fatherhood identities. Whilst fathers wished to adhere to the cultural imperative for father–child emotional closeness, a disparity between their ambitions and their conduct emerged. Care appeared to be a deeply gendered concept for the fathers and despite their aspirations for an intimate relationship with their children, gendered norms for motherhood and fatherhood prevailed resulting in passivity in their role as sexuality educators. The study concludes by arguing that challenges to structures and subcultural contexts, which may deter fathers from fully engaging with their sons and daughters in this aspect of communication are required

Relationship between antihypertensive medications and cognitive impairment: Part I. review of human studies and clinical trials

Purpose of review: There is an established association between hypertension and increased risk of poor cognitive performance and dementia including Alzheimer’s disease; however, associations between antihypertensive medications (AHMs) and dementia risk are less consistent. An increased interest in AHM has resulted in expanding publications; however, none of the recent reviews are comprehensive. Our extensive review includes 15 observational and randomized controlled trials (RCTs) published over the last 5 years, assessing the relationship between AHM and cognitive impairment. Recent findings: All classes of AHM showed similar result patterns in human studies with the majority of study results reporting point estimates below one and only a small number of studies (N = 15) reporting statistically significant results in favor of a specific class. Summary: Only a small number of studies reported statistically significant results in favor of a specific class of AHM. Methodological limitations of the studies prevent definitive conclusions. Further work is now needed to evaluate the class of AHM and cognitive outcomes in future RCTs, with a particular focus on the drugs with the promising results in both animals and human observational studies

APOE genotype and entorhinal cortex volume in non-demented community-dwelling adults in midlife and early old age

Copyright © 2012 IOS PressThis article has been made available through the Brunel Open Access Publishing Fund.The apolipoprotein E (APOE) ε4 allele is a risk factor for the neuropathological decline accompanying Alzheimer's disease (AD) while, conversely, the ε2 allele offers protection. One of the brain structures exhibiting the earliest changes associated with the disease is the entorhinal cortex. We therefore investigated the volumes of the entorhinal cortex and other structures in the medial temporal lobe including the parahippocampal gyrus, temporal pole, and inferior, middle, and superior temporal cortices, in relation to APOE genotype. Our main objectives were to determine if (a) volumes systematically varied according to allele in a stepwise fashion, ε2 > ε3 > ε4, and (b) associations varied according to age. We investigate this association in 627 non-demented community-dwelling adults in middle age (44 to 48 years; n = 314) and older age (64 to 68 years; n = 313) who underwent structural MRI scans. We found no evidence of APOE-related variation in brain volumes in the age groups examined. We conclude that if a ε2 > ε3 > ε4 pattern in brain volumes does emerge in non-demented adults living in the community in old age, it is not until after the age of 68 years.This study was funded by the UK Leverhulme Trust, the British Academy, the NHMRC Research Fellowship No. 471501, the NHMRC Research Fellowship No.#1002560, the National Health and Medical Research Council of Australia Unit Grant No. 973302, Program Grant No. 179805, Project grant No. 157125; Program grant no. 350833, and the National Computational Infrastructure. This article is made available through the Brunel Open Access Publishing Fund

Cognitive Deficits Are Associated with Frontal and Temporal Lobe White Matter Lesions in Middle-Aged Adults Living in the Community

BACKGROUND The association between brain white matter lesions and cognitive impairment in old age is well established. However, little is known about this association in midlife. As this information will inform policy for early preventative healthcare initiatives, we investigated non-periventricular frontal, temporal, parietal and occipital lobe white matter hyperintensities (WMH) in relation to cognitive function in 428 (232 women) community-dwelling adults aged 44 to 48 years. RESULTS Frontal white matter lesions were significantly associated with greater intraindividual RT variability in women, while temporal WMH were associated with face recognition deficits in men. Parietal and occipital lobe lesions were unrelated to cognitive performance. These findings did not differ when education and a range of health variables, including vascular risk factors, were taken into account. CONCLUSION Gender differences in WMH-cognition associations are discussed, and we conclude that small vessel disease is present in midlife and has functional consequences which are generally not recognized. Preventative strategies should, therefore, begin early in life.David Bunce's collaboration in this work was supported by the Leverhulme Trust and the British Academy. The study was funded by NHMRC of Australia Unit Grant No. 973302, Program Grant No. 179805, NHMRC project grant No. 157125, grants from the Australian Rotary Health Research Fund and the Australian Brewers Foundation. Nicolas Cherbuin is funded by NHMRC Research Fellowship No. 471501. Kaarin Anstey is funded by NHMRC Research Fellowship No. 366756. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript

A self-report risk index to predict occurrence of dementia in three independent cohorts of older adults: The ANU-ADRI

Background and Aims: The Australian National University AD Risk Index (ANU-ADRI, http://anuadri.anu.edu.au) is a self-report risk index developed using an evidence-based medicine approach to measure risk of Alzheimer's disease (AD). We aimed to evaluate the extent to which the ANU-ADRI can predict the risk of AD in older adults and to compare the ANU-ADRI to the dementia risk index developed from the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study for middle-aged cohorts. Methods: This study included three validation cohorts, i.e., the Rush Memory and Aging Study (MAP) (n = 903, age ≥53 years), the Kungsholmen Project (KP) (n = 905, age ≥75 years), and the Cardiovascular Health Cognition Study (CVHS) (n = 2496, age ≥65 years) that were each followed for dementia. Baseline data were collected on exposure to the 15 risk factors included in the ANU-ADRI of which MAP had 10, KP had 8 and CVHS had 9. Risk scores and C-statistics were computed for individual participants for the ANU-ADRI and the CAIDE index. Results: For the ANU-ADRI using available data, the MAP study c-statistic was 0.637 (95% CI 0.596-0.678), for the KP study it was 0.740 (0.712-0.768) and for the CVHS it was 0.733 (0.691-0.776) for predicting AD. When a common set of risk and protective factors were used c-statistics were 0.689 (95% CI 0.650-0.727), 0.666 (0.628-0.704) and 0.734 (0.707-0.761) for MAP, KP and CVHS respectively. Results for CAIDE ranged from c-statistics of 0.488 (0.427-0.554) to 0.595 (0.565-0.625). Conclusion: A composite risk score derived from the ANU-ADRI weights including 8-10 risk or protective factors is a valid, self-report tool to identify those at risk of AD and dementia. The accuracy can be further improved in studies including more risk factors and younger cohorts with long-term follow-up. © 2014 Anstey et al

Long term outcomes following hospital admission for sepsis using relative survival analysis: a prospective Cohort study of 1,092 patients with 5 year follow up

Background: Sepsis is a leading cause of death in intensive care units and is increasing in incidence. Current trials of novel therapeutic approaches for sepsis focus on 28-day mortality as the primary outcome measure, but excess mortality may extend well beyond this time period.Methods: We used relative survival analysis to examine excess mortality in a cohort of 1,028 patients admitted to a tertiary referral hospital with sepsis during 2007–2008, over the first 5 years of follow up. Expected survival was estimated using the Ederer II method, using Australian life tables as the reference population. Cumulative and interval specific relative survival were estimated by age group, sex, sepsis severity and Indigenous status.Results: Patients were followed for a median of 4.5 years (range 0–5.2). Of the 1028 patients, the mean age was 46.9 years, 52% were male, 228 (22.2%) had severe sepsis and 218 (21%) died during the follow up period. Mortality based on cumulative relative survival exceeded that of the reference population for the first 2 years post admission in the whole cohort and for the first 3 years in the subgroup with severe sepsis. Independent predictors of mortality over the whole follow up period were male sex, Indigenous Australian ethnicity, older age, higher Charlson Comorbidity Index, and sepsis-related organ dysfunction at presentation.Conclusions: The mortality rate of patients hospitalised with sepsis exceeds that of the general population until 2 years post admission. Efforts to improve outcomes from sepsis should examine longer term outcomes than the traditional primary endpoints of 28-day and 90-day mortality

Using sulcal and gyral measures of brain structure to investigate benefits of an active lifestyle

Background: Physical activity is associated with brain and cognitive health in ageing. Higher levels of physical activity are linked to larger cerebral volumes, lower rates of atrophy, better cognitive function and lesser risk of cognitive decline and dementia. Neuroimaging studies have traditionally focused on volumetric brain tissue 17 measures to test associations between factors of interest (e.g. physical activity) and brain structure. However, cortical sulci may provide additional information to these more standard measures. Method: Associations between physical activity, brain structure, and cognition were investigated in a large, community-based sample of cognitively healthy individuals (N = 317) using both sulcal and volumetric measures. Results: Physical activity was associated with narrower width of the Left Superior Frontal Sulcus and the Right Central Sulcus,while volumetric measures showed no association with physical activity. In addition, Left Superior Frontal Sulcal width was associated with processing speed and executive function. Discussion: These findings suggest sulcalmeasuresmay be a sensitive index of physical activity related to cerebral health and cognitive function in healthy older individuals. Further research is required to confirm these findings and to examine how sulcal measures may be most effectively used in neuroimaging