We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
This article discusses how and why disorientation is used as an aesthetic strategy in breakdown sections of festival-house tracks and performances. Breakdowns in electronic dance music (EDM) have many sound layers removed from the mix. For house music at EDM festivals, this usually includes drums, therefore in many breakdowns it is easy for listeners to lose their metric entrainment. Breakdowns also often introduce a new sound layer, use metrical dissonance, and feature prominent ‘effects’. Through analyses and interviews, the article argues that festival-house breakdowns can be disorienting both physically and psychologically, but that this fulfils multiple purposes for performers, such as providing contrast that makes musical climaxes more exciting and allowing an opportunity for dancers to physically rest. Breakdowns also encourage visual interaction between performers and dancers and allow performers to communicate a narrative. The analyses in the article make interpretations about the meaning of tracks as communicated primarily in breakdown sections.
To establish quick-reference criteria regarding the frequency of statistically rare changes in seven neuropsychological measures administered to older adults.
Method:
Data from 935 older adults examined over a two-year interval were obtained from the Alzheimer’s Disease Neuroimaging Initiative. The sample included 401 cognitively normal older adults whose scores were used to determine the natural distribution of change scores for seven cognitive measures and to set change score thresholds corresponding to the 5th percentile. The number of test scores that exceeded these thresholds were counted for the cognitively normal group, as well as 381 individuals with mild cognitive impairment (MCI) and 153 individuals with dementia. Regression analyses examined whether the number of change scores predicted diagnostic group membership beyond demographic covariates.
Results:
Only 4.2% of cognitively normal participants obtained two or more change scores that fell below the 5th percentile of change scores, compared to 10.6% of the stable MCI participants and 38.6% of those who converted to dementia. After adjusting for age, gender, race/ethnicity, and premorbid estimates, the number of change scores below the 5th percentile significantly predicted diagnostic group membership.
Conclusions:
It was uncommon for older adults to have two or more change scores fall below the 5th percentile thresholds in a seven-test battery. Higher change counts may identify those showing atypical cognitive decline.
During 2016–2022, Medicare part D beneficiaries filled 8,674,460 clotrimazole-betamethasone dipropionate prescriptions. Annual rates were stable (30.9 prescriptions/1,000 beneficiary-years in 2022, enough for one in every 33 beneficiaries). Diagnostic testing was infrequent, particularly among internal medicine, family medicine, and general practitioners, suggesting potential opportunities to improve diagnostic and prescribing practices.
In 1879, Canon Thomas Frederick Simmons edited the late medieval poem now known as 'The Lay Folks' Mass Book' creating what remains the standard edition of the text. This volume shows how Simmons' interest in the text was related profoundly to contemporary debates about worship in the Church of England, and how he used his medievalist researches as the basis for the most important attempt at Prayer Book revision between the Reformation and the twentieth century.
To investigate the symptoms of SARS-CoV-2 infection, their dynamics and their discriminatory power for the disease using longitudinally, prospectively collected information reported at the time of their occurrence. We have analysed data from a large phase 3 clinical UK COVID-19 vaccine trial. The alpha variant was the predominant strain. Participants were assessed for SARS-CoV-2 infection via nasal/throat PCR at recruitment, vaccination appointments, and when symptomatic. Statistical techniques were implemented to infer estimates representative of the UK population, accounting for multiple symptomatic episodes associated with one individual. An optimal diagnostic model for SARS-CoV-2 infection was derived. The 4-month prevalence of SARS-CoV-2 was 2.1%; increasing to 19.4% (16.0%–22.7%) in participants reporting loss of appetite and 31.9% (27.1%–36.8%) in those with anosmia/ageusia. The model identified anosmia and/or ageusia, fever, congestion, and cough to be significantly associated with SARS-CoV-2 infection. Symptoms’ dynamics were vastly different in the two groups; after a slow start peaking later and lasting longer in PCR+ participants, whilst exhibiting a consistent decline in PCR- participants, with, on average, fewer than 3 days of symptoms reported. Anosmia/ageusia peaked late in confirmed SARS-CoV-2 infection (day 12), indicating a low discrimination power for early disease diagnosis.
Offers a new interpretation by employing a musical, literary, theological and political discussion. Encourages new ways of interpreting Tudor and Elizabethan sacred music.
Accurately interpreting cognitive change is an essential aspect of clinical care for older adults. Several approaches to identifying 'true’ cognitive change in a single cognitive measure are available (e.g., reliable change methods, regression-based norms); however, neuropsychologists in clinical settings often rely on simple score differences rather than advanced statistics, especially since multiple scores compose a typical battery. This study sought to establish quick-reference normative criteria to help neuropsychologists identify how frequently significant change occurs across multiple measures in cognitively normal older adults.
Participants and Methods:
Data were obtained from the National Alzheimer’s Coordinating Center (NACC). Participants were 845 older adults who were classified as cognitively normal at baseline and at 24-month follow-up. In NACC, these clinical classifications are made separately from the assessment of cognitive performance, including cognitive change. The sample was 34.9% female, 83.5% White, 13.1% Black 2.3% Asian, and 1.1% other race with a mean age of 70.7 years (SD=10.2). Of the sample, 95.5% identified as non-Hispanic. Mean education was 16.1 years (SD=2.8). The cognitive battery entailed: Craft Story Immediate and Delayed Recall, Benson Copy and Delayed Recall, Number Span (Forward & Backward), Category Fluency (Animals & Vegetables), Trails A&B, Multilingual Naming Test, and Verbal Fluency (F&L). Change scores between baseline performance and follow-up were calculated for each measure. The natural distribution of change scores was examined for each measure and cut points representing the 5th and 10th percentile were applied to each distribution to classify participants who exhibited substantial declines in performance on each measure. We then examined the multivariate frequency of statistically rare change scores for each individual.
Results:
As expected in a normal sample, overall cognitive performance was generally stable between baseline and 24-month follow-up. Across cognitive measures, 81.9% of participants had at least one change score fall below the 10th percentile in the distribution of change scores, and 55.7% had at least one score below the 5th percentile, 49.3% of participants had two or more change scores that fell below the 10th percentile and 21.1% with two or more below the 5th percentile. There were 26.7% participants that had three or more change scores below the 10th percentile, and 6.4% of participants had three change scores below the 5th percentile.
Conclusions:
Among cognitively normal older adults assessed twice at a 24-month interval with a battery of 13 measures, it was not uncommon for an individual to have at least one score fall below the 10th percentile (82% of the sample) or even the 5th percentile (56%) in the natural distribution of change scores. There were 27% participants that had three or more declines in test performance below the 10th percentile; in comparison, only 6% of the sample had three or more change scores at the 5th percentile. This suggests that individuals who exhibit more multivariate changes in performance than these standards are likely experiencing an abnormal rate of cognitive decline. Our findings provide a preliminary quick-reference approach to identifying clinically significant cognitive change. Future studies will explore additional batteries and examine multivariate frequencies of change in clinical populations.
Accurately interpreting change in cognitive functioning is an essential aspect of clinical care for older adults. Several approaches to identifying ‘true’ cognitive change in a single cognitive measure are available (e.g., reliable change methods, regression-based norms); however, neuropsychologists in clinical settings often rely on simple score differences rather than advanced analytical procedures especially since they examine multiple test performances. This study sought to establish quick-reference normative criteria to help neuropsychologists identify how frequently significant change occurs across multiple cognitive measures in cognitively normal older adults.
Participants and Methods:
Data were obtained from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Participants were 401 older adults who were classified as cognitively normal at baseline and at 24-month follow-up. In ADNI, these clinical classifications are made separately from the assessment of cognitive performance, including cognitive change. The sample was 50.1% female, 93.5% non-Hispanic White, 4.0% non-Hispanic Black, 1.5% Asian American, and 1.0% other race/ethnicity, with a mean age of 76.0 years (SD = 4.9). Mean education was 16.4 years (SD = 2.7). The cognitive battery included: Boston Naming Test, Category Fluency Test, Trails A & B, Clock Drawing Test, and Auditory Verbal Learning Test, Trial 1-5 Total and Delayed Recall. Change scores between baseline performance and 24-month follow-up were calculated for each measure. The natural distribution of change scores was examined for each measure and cut points representing the 5th and 10th percentile were applied to each distribution to classify participants who exhibited substantial declines in performance on a given measure. We then examined the multivariate frequency of statistically rare change scores for each individual.
Results:
As expected in a normal sample, overall cognitive performance was generally stable between baseline and 24-month followup. Across cognitive measures, 43.6% of participants had at least one change score fall below the 10th percentile in the distribution of change scores, and 21.9% had at least one score below the 5th percentile. 13.0% of participants had two or more change scores that fell below the 10th percentile, in comparison to 4.5% with two or more below the 5th percentile. 3.2% of participants had three or more change scores below the 10th percentile, versus 0.5% of participants who had three change scores below the 5th percentile.
Conclusions:
Among cognitively normal older adults assessed twice at a 24-month interval with a battery of seven measures, it was not uncommon for an individual to have at least one score fall below the 10th percentile (43% of the sample) or even the 5th percentile (21%) in the natural distribution of change scores. However, only 3.2% of normals had more than two declines in test performance below the 10th percentile, and less than 1% of the sample at more than one change score at the 5th percentile. This suggests that individuals who exhibit more multivariate changes in performance than these standards are likely experiencing an abnormal rate of cognitive decline. Our findings provide a preliminary quick-reference approach to identifying clinically significant cognitive change. Future studies will explore additional batteries and examine multivariate frequencies of change in clinical populations.
Former professional American football players have a high relative risk for neurodegenerative diseases like chronic traumatic encephalopathy (CTE). Interpreting low cognitive test scores in this population occasionally is complicated by performance on validity testing. Neuroimaging biomarkers may help inform whether a neurodegenerative disease is present in these situations. We report three cases of retired professional American football players who completed comprehensive neuropsychological testing, but “failed” performance validity tests, and underwent multimodal neuroimaging (structural MRI, Aß-PET, and tau-PET).
Participants and Methods:
Three cases were identified from the Focused Neuroimaging for the Neurodegenerative Disease Chronic Traumatic Encephalopathy (FIND-CTE) study, an ongoing multimodal imaging study of retired National Football League players with complaints of progressive cognitive decline conducted at Boston University and the UCSF Memory and Aging Center. Participants were relatively young (age range 55-65), had 16 or more years of education, and two identified as Black/African American. Raw neuropsychological test scores were converted to demographically-adjusted z-scores. Testing included standalone (Test of Memory Malingering; TOMM) and embedded (reliable digit span, RDS) performance validity measures. Validity cutoffs were TOMM Trial 2 < 45 and RDS < 7. Structural MRIs were interpreted by trained neurologists. Aß-PET with Florbetapir was used to quantify cortical Aß deposition as global Centiloids (0 = mean cortical signal for a young, cognitively normal, Aß negative individual in their 20s, 100 = mean cortical signal for a patient with mild-to-moderate Alzheimer’s disease dementia). Tau-PET was performed with MK-6240 and first quantified as standardized uptake value ratio (SUVR) map. The SUVR map was then converted to a w-score map representing signal intensity relative to a sample of demographically-matched healthy controls.
Results:
All performed in the average range on a word reading-based estimate of premorbid intellect. Contribution of Alzheimer’s disease pathology was ruled out in each case based on Centiloids quantifications < 0. All cases scored below cutoff on TOMM Trial 2 (Case #1=43, Case #2=42, Case #3=19) and Case #3 also scored well below RDS cutoff (2). Each case had multiple cognitive scores below expectations (z < -2.0) most consistently in memory, executive function, processing speed domains. For Case #1, MRI revealed mild atrophy in dorsal fronto-parietal and medial temporal lobe (MTL) regions and mild periventricular white matter disease. Tau-PET showed MTL tau burden modestly elevated relative to controls (regional w-score=0.59, 72nd%ile). For Case #2, MRI revealed cortical atrophy, mild hippocampal atrophy, and a microhemorrhage, with no evidence of meaningful tau-PET signal. For Case #3, MRI showed cortical atrophy and severe white matter disease, and tau-PET revealed significantly elevated MTL tau burden relative to controls (w-score=1.90, 97th%ile) as well as focal high signal in the dorsal frontal lobe (overall frontal region w-score=0.64, 74th%ile).
Conclusions:
Low scores on performance validity tests complicate the interpretation of the severity of cognitive deficits, but do not negate the presence of true cognitive impairment or an underlying neurodegenerative disease. In the rapidly developing era of biomarkers, neuroimaging tools can supplement neuropsychological testing to help inform whether cognitive or behavioral changes are related to a neurodegenerative disease.
Antibiotic prescribing at hospital discharge is an important focus for antimicrobial stewardship efforts. This study set out to determine the impact of a pharmacist-led intervention at hospital discharge on appropriate antimicrobial prescribing.
Design:
This was a pre-/post-study evaluating the impact of a pharmacist-led review on antibiotic prescribing at hospital discharge. Pharmacists evaluated antibiotic prescriptions at discharge for appropriate duration, spectrum of activity, frequency, and strength of dose. Each of these criteria needed to be met for an antibiotic regimen to be considered appropriate.
Setting:
Moses Cone Hospital is a 535-bed community teaching hospital in Greensboro, North Carolina.
Patients or Participants:
Patients ≥18 years of age discharged from the hospital with an antibiotic prescription were included. Exclusion criteria included patients discharged against medical advice, discharged to a skilled nursing facility, or prescribed indefinite prophylactic antimicrobial therapy.
Interventions:
A review of patients discharged with antibiotics in 2020 was performed. Patients discharged with antibiotic prescriptions from January 2021 to April 2022 were evaluated prior to discharge by pharmacists. The pharmacist made recommendations to providers based on their evaluations.
Results:
162 retrospective patients were screened, and 136 patients were screened at discharge from the hospital in the prospective cohort. 76/162 (47%) retrospective patients received appropriate antibiotic therapy at discharge, while 92/136 (68%) of prospective patients received appropriate discharge therapy (p = 0.001).
Conclusions:
In this study examining the efficacy of stewardship pharmacist intervention at hospital discharge, pharmacist review and recommendations were associated with an increased rate of appropriate antimicrobial prescribing.
Ethics statement:
This study was conducted under the approval of the Institutional Review Board of the Moses H. Cone Health System. The approval protocol number was 1483117-1 and took effect on September 2nd, 2019. As the research was either retrospective in nature or part of the standard of care recommendations, the project was granted expedited review.
Thomas Frederick Simmons, churchman, liturgist, and textual editor, was born in Woolwich, Kent, into a military family, the eldest son of twelve children of a captain in the Royal Artillery, another Thomas Frederick Simmons (d. 1842). The father was a prolific writer on military matters whose most successful work, running through some seven editions, was The Constitution and Practice of Courts Martial (London, 1830). Of the younger Thomas Frederick’s eight brothers, six were army officers, most notably General Sir John Lintorn Arabin Simmons (1821–1903), a highly distinguished soldier whose later appointments included governor of the Royal Arsenal and Military Academy at Woolwich, colonel-commandant of the Royal Engineers, and chief technical military adviser for the British delegation at the Congress of Berlin (1878). Another brother, Major Egbert Simmons, was killed at the Siege of Lucknow in 1857 while in temporary command of the 5th Fusiliers.
The younger Thomas Frederick was educated at Winchester College, matriculating as ‘post-master’ at Merton College, Oxford in 1832 or 1833. However, he left Merton in 1834 to pursue a career in the army, like his brothers; on 6 November 1840 a ‘Lieut. T. F. Simmons’ of the 72 Foot not only obtained a Certificate of Qualification from the Royal Military College at Sandhurst but was also commended with two others for:
having extended their acquirements into the highest branches of Mathematical Science, farther than any Officers had ever done before them at the Institution, the Board marked their sense of the very superior merits and talents of the three, by awarding them all the highest Class of Certificate of Qualification which had ever been given at the College.
Simmons seems to have been a successful soldier, becoming like his father a specialist on legal procedures in the military, although before the Crimean War (1853–56) graduates from the College, being ‘experts’, seem to have been discriminated against by the more gentlemanly officers who achieved rank through purchase. Nevertheless, although he left the army and later returned to Oxford and eventually a career in the church, graduating from Worcester College with a BA in 1848 and supplicating for his MA in 1859, Simmons never lost his interest in army matters.
The Salisbury, or Sarum, ‘use’ was ‘the local modification of the Roman rite in use during the Middle Ages at the cathedral church of Salisbury’ (ODCC). Traditionally ascribed to St Osmund, Bishop of Salisbury (d.1099), it is, in fact, much later. By 1457 it was claimed that it was used in public worship throughout most of England, Wales and Ireland, and it furnished the primary material for the 1549 Book of Common Prayer. The most comprehensive modern edition of the ‘Use of Sarum’ (not including the Missal) remains that edited in two volumes by W. H. Frere in 1898 and 1901.
The purpose of this appendix is to illustrate many of the contentions of this book. The following parallel analysis of the LFMB and the Sarum Mass is, it has to be admitted, a necessarily artificial exercise. Simmons, it is true, linked the LFMB more closely with the York (Ebor) rite, since he was keen to make connexions between his Yorkshire parish and the usage of the metropolitan see, but the text aligns more closely in many ways to that of Salisbury (Sarum). Present-day indications of the provenance of versions of LFMB, however, show that it was circulated across a wide area of the north midlands as well as Yorkshire (see Appendix I).
Apart from Simmons’ edition of the LFMB we have deliberately used nineteenth-or early twentieth-century editions of the Sarum Missal in Latin and in English translation, as these texts were understood and revivified in the Victorian period. The LFMB is not, of course, a liturgical text as such, but rather a vernacular guide for those attending the Latin Mass.
Simmons, as we have seen, was perfectly well aware that this late medieval form of public worship should not be understood or viewed through the lens of the Anglican Book of Common Prayer. Nevertheless, in the context of Victorian medievalism and the Tractarian sense of the catholic continuity of the English Church, learned churchmen like Simmons, many of them devout parish priests, moved from the early Tractarian emphasis on doctrine to a growing and living sense of liturgy and later ritual.
At The End of the first quarter of the twenty-first century the practice of textual criticism remains as racked by controversy as it has always been. However, one positive outcome of the various debates currently circulating has been an increasing habit of reflection on the editorial craft. Tim Machan, for instance, has called for ‘editorial and interpretive self-conscious[ness, and] … greater historical sensibility in an activity that is inherently historical’ and his views have, with pithy perceptiveness, been more recently echoed by Derek Pearsall: ‘the only rule that all scholarly editors and editors of critical editions must observe is – Show your working, as we used to be exhorted when we were doing maths problems at school’. There is above all an awareness that the editorial process is not, and never has been, ‘neutral’ or ‘objective’ but is rather a hermeneutic act constrained by the conditions of publication dominant at the time of the edition’s creation, and, perhaps even more importantly, the edition’s intended audience.
Simmons himself would have agreed with all these sentiments. His inheritance from the Oxford Movement included, as we have seen, an engagement with history, linked to their concern for the catholic and apostolic nature of the English church; Newman had, for instance (and rather unfairly), criticised his high-church predecessors for their ‘lack of historical sense’. And Simmons was impressively explicit about his editorial practice, even if his manner of expression is somewhat personal for the austere critical and editorial tastes of the present day: unsurprisingly, perhaps, given his immersion in the pressing liturgical and theological debates of his time. For it is possible, on the basis of ‘The Editor’s Preface’ that he placed at the beginning of his edition, to reconstruct in detail how he set about his editorial task.
Simmons tells us that his attention was drawn to LFMB by William Maskell, who took extracts from what was to become Simmons’ B-version4 and reprinted them in his book The Ancient Liturgy of the Church of England (1844): a parallel text of the eucharistic rites of Sarum, York, Hereford and Bangor, and the Roman Liturgy. Simmons also mentions his projected edition of Archbishop Thoresby’s Catechism in English, which, later published as the Lay Folks’ Catechism, remained unfinished at his death and was completed by his friend and fellow Yorkshire clergyman, Henry Edward Nolloth.
This book had its beginnings some years ago when we were both teaching at the University of Glasgow. A battered volume in the liturgical library of the late Dean Ronald Jasper of York Minster entitled The Lay Folks’ Mass Book attracted our attention. It drew us towards the forgotten figure of its editor, Thomas Frederick Simmons – liturgist, churchman, second-generation Tractarian parish priest, philologist, and one of the earliest members of the Early English Text Society – and to the late medieval poem that lies at the heart of this study.
This study of the text now known as The Lay Folk’s Mass Book, and of its editing for the Early English Text Society (EETS) in 1879 by Canon Thomas Frederick Simmons, is by two authors coming from very different academic backgrounds. David Jasper is a student of the relationship between theology and literature, with a particular interest in the nineteenth century, and is thus at home in the ecclesiastical – and indeed wider cultural – world of Canon Simmons and his church. Jeremy Smith specialises in English philology, with a particular interest in late medieval and early modern textual cultures. Our project brings these two different disciplinary perspectives and their readerships into articulation, hoping to develop new insights into the Victorian encounter with the Middle Ages, with relevance to contemporary liturgical and medieval studies.
Many people have helped us towards the completion of this book over the years. We thank in particular the staff of the following: the Archives Service of the East Riding of Yorkshire in Beverley; the Bodleian Library, Oxford; the Borthwick Institute for Archives in the University of York; the British Library, London; Cambridge University Library; the Community of the Resurrection, Mirfield; the Library of Corpus Christi College, Oxford; Glasgow University Library; the Libraries of Gonville and Caius and Newnham Colleges, Cambridge; the Hull History Centre of the University of Hull; Liverpool University Library; the National Library of Scotland, Edinburgh; York Minster Library.
Warm thanks are due to the present Lord Hotham and to Giles Peacock, current Church Wardens of St Mary’s Church, South Dalton (as it is again), for their patience and generosity during our visits to their magnificent church, and our endless questions.
That Simmons’ Work was taken very seriously in his time is evidenced by a lengthy and – in accordance with contemporary fashion – anonymous review of his edition, in the Church Quarterly Review (CQR), the high-church journal encountered in the previous chapter. Discussion of Simmons’ work is there linked to reviews of the work of Maskell (Monumenta Ritualia Ecclesiae Anglicanae), of Henderson on the York Rite, and of H. T. Kingdon (Vice-Principal of what was then Salisbury Theological College), and of the third Marquess of Bute.
Beginning with the Roman liturgy, and ‘books provided for the use of Roman Catholic laymen in England’, the CQR review goes on to observe that ‘since the early days of the Catholic revival, the study of our early insular services has received considerable impulse’. Reference is made to Palmer’s Origines Liturgicae, and to the recognition by Isaac Williams that attention to the Sarum Use quickly dispels the false assumption of ‘innovations on the part of the Reformers’. After Newman in 1839, Williams had brought to popular attention ‘the hymns of a nearer continental Breviary (the Parisian, no longer now a living use.)’ The developing understanding of the history and forms of the BCP is noted alongside such works as Scudamore’s Notitia Eucharistica (1866), Medd’s The Priest to the Altar (1861), John Fuller Russell’s (1813–1884) Hierurgia Anglicana, published for the Cambridge Camden Society in 1848, (and re-edited by Vernon Staley in 1902), and – another work already referred to – Proctor’s History of the Book of Common Prayer (1855), which remains even today in authoritative use through its substantial revision by Walter Howard Frere (1901).
The CQR review-article continues with a substantial bibliographical commen-tary on nineteenth-century scholarship in the medieval English liturgical tradition, beginning with Francis Henry Dickinson’s still useful List of Printed Service Books, According to the Ancient Uses of the Anglican Church (London, 1850), and with texts of breviaries, missals and pontifical published by the Bannatyne Club, and, in particular, the Surtees Society. Significant also is the publication of C. Walker’s Sarum Missal in English.
The writer in the CQR, like most of his contemporaries and unlike their modern successors, accepts Simmons’ thesis about the identity of ‘Dan Jeremy’ and the French origin of the LFMB in Rouen without question, and also acknowledges Simmons’ interest in language and dialect.