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Trends of patient referral to a memory clinic and towards earlier diagnosis from 1985–2009
- Timo Grimmer, Stephanie Beringer, Victoria Kehl, Panagiotis Alexopoulos, Aurel Busche, Hans Förstl, Oliver Goldhardt, Bianca Natale, Marion Ortner, Henning Peters, Lina Riedl, Carola Roßmeier, Wiebke Valentin, Janine Diehl-Schmid, Alexander Kurz
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- Journal:
- International Psychogeriatrics / Volume 27 / Issue 12 / December 2015
- Published online by Cambridge University Press:
- 01 October 2015, pp. 1939-1944
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Background:
It may be assumed that increased public awareness of dementia due to Alzheimer's disease (AD) together with the availability of efficacious treatment will result in diagnostic evaluation at earlier stages of cognitive decline and diagnosis of dementia due to AD at earlier stages.
Methods:All persons that were examined at a university based memory clinic, in Germany, between 1985 and 2009 were included.
Results:In the 3,951 persons identified, linear regression analysis revealed a positive association between Mini Mental State Examination (MMSE) score and year of initial examination (yearIE) (β = 0.266; p < 0.001). In the 1,821 patients diagnosed with dementia due to AD, a positive association between MMSE score and yearIE (β = 0.230; p < 0.001) was revealed. MMSE scores were higher (β = 0.195; p < 0.001) after the introduction of cholinesterase inhibitors in Germany in 1997.
Conclusions:Diagnostic evaluation of individuals occurred at progressively earlier stages of cognitive decline. Dementia due to AD was diagnosed at progressively earlier stages, and this trend was associated with the availability of efficacious treatment. This is the first study on changes in patient referral and diagnosis based on a continuous 25 years period.
Chapter 7 - Decadence and the fin de siècle
- from i. - The arts
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- By Marion Schmid, University of Edinburgh
- Edited by Adam Watt, University of Exeter
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- Book:
- Marcel Proust in Context
- Published online:
- 05 November 2013
- Print publication:
- 05 December 2013, pp 51-58
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Summary
In French literary history, Proust occupies the position of an interstitial, ‘entre-deux’ writer poised between the literary experiments of the second half of the nineteenth century (spearheaded by, amongst others, Flaubert, Baudelaire and Mallarmé) and the high modernism that was to challenge traditional genre conventions in the period between the two world wars. The young Proust made his first steps in literary criticism and fiction during the last decades of the nineteenth century and this transitional period with its effervescent intellectual atmosphere, rugged literary landscapes and diverse cultural preoccupations was to have a lasting influence on the future author of the Recherche. Like his fellow early modernists Joyce, Thomas Mann and Gide, Proust found in the cultural and literary imaginary of the fin de siècle a vast repertoire of themes and motifs which he appropriated for his own writing in a complex process of absorption, distancing and, ultimately, overcoming. The Zeitgeist of the fin de siècle, and more specifically the figures and aesthetics of one of its most prominent artistic movements – Decadence – offered him ample raw material for a novel that is both a reflection and a catalyst of the influences that have shaped it.
Chapter 9 - The novelistic tradition
- from i. - The arts
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- By Hugues Azérad, Magdalene College, Cambridge, Marion Schmid, University of Edinburgh
- Edited by Adam Watt, University of Exeter
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- Book:
- Marcel Proust in Context
- Published online:
- 05 November 2013
- Print publication:
- 05 December 2013, pp 67-74
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Summary
The publication of À la recherche du temps perdu between 1913 and 1927 constitutes both a summa of and a new departure for western literature. With its guiding theme of an artistic vocation, its sensitive portrayal of a sentimental education from childhood to maturity and its quest for deeper metaphysical truths beyond the confines of the material world, the novel aligns itself with a tradition of foundational texts that have shaped European literature for almost a thousand years. Dante Alighieri's Divina Commedia with its allegory of a spiritual peregrination; the analytical novel in the tradition of Madame de Lafayette; the Bildungsroman in the style of Goethe's Wilhelm Meister – not to forget the great Russian novel with its complex narrative construction and epic portraits of society – are but some of the models that resonate in Proust's novel. The author's use of a first-person narrative, sharp characterization and satirical descriptions of upper-class society recall the Mémoires of Saint-Simon – a major influence on the Recherche – while his probing analysis of human nature and relationships evokes the nineteenth-century French personal novel of authors such as Benjamin Constant, Nerval and Chateaubriand. The novel's doubling up as a philosophical treatise and an aesthetic manifesto, finally, puts it in the lineage of essayistic works such as Montaigne's Essais and Pascal's Pensées while heralding the heightened self-reflexivity that characterizes modernist and postmodern fiction. Just how indebted the Recherche is to its literary predecessors and how readily its author engages in intertextual games and pastiches can be gleaned from the extensive literary references in the text, ranging from Homer, Saint-Simon and Racine to George Eliot, Balzac and Dostoyevsky. Proust's quasi-encyclopaedic knowledge of western literature across the ages and his subtlety and flair as a literary critic have enriched and nourished his novel, endowing it with an intertextual and generic complexity matched perhaps only by his fellow modernist James Joyce. As Jean-Yves Tadié comments, ‘À la recherche recapitulates the entire literary tradition, from the Bible to Flaubert and Tolstoy, and all literary genres.’
19 - Marcel Proust (1871–1922): A modernist novel of time
- Edited by Michael Bell, University of Warwick
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- Book:
- The Cambridge Companion to European Novelists
- Published online:
- 28 September 2012
- Print publication:
- 14 June 2012, pp 327-342
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Summary
Alongside ground-breaking works by Virginia Woolf, James Joyce and Thomas Mann, Marcel Proust's seven-volume À la recherche du temps perdu (In Search of Lost Time), published between 1913 and 1927, is universally recognised as one of the masterpieces of European modernism, a milestone in the study of human consciousness and a revolution in the history of prose writing. Written over more than a decade and brought to a close only by the author's death (the last three volumes were published posthumously), it is a work of formidable complexity, not only in its meandering, sinuous style and digressive, often chronology-defying narrative, but, above all, in the radically new vision it proposes of individuals in time and its quasi encyclopedic engagement with the most diverse forms of human experience and knowledge. Characteristically ‘in-between centuries’ in terms of the culture and the literary imaginary that have shaped it, À la recherche serves as a bridge between the nascent forms of modernism found in the work of predecessors such as Gustave Flaubert and Charles Baudelaire and the high modernism that was to challenge traditional genre conventions in the period between the two world wars. Though anchored in the nineteenth century, Proust is also a contemporary of Albert Einstein, Sigmund Freud, Igor Stravinsky and Pablo Picasso, a writer whose thinking was indelibly shaped by the artistic and technological revolutions of modernity and who, in turn, contributed to the new understanding of the world and the self that emerged in the early decades of the twentieth century.
Chapter Four - À bas Wagner!: The French Press Campaign against Wagner during World War I
- Edited by Barbara L. Kelly, Keele University
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- Book:
- French Music, Culture, and National Identity, 1870-1939
- Published by:
- Boydell & Brewer
- Published online:
- 11 March 2023
- Print publication:
- 01 May 2008, pp 77-92
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Summary
In the career of Richard Wagner, artistic and ideological issues have always been closely interconnected, and, up to the present day, his work continues to be discussed on political rather than on purely musical grounds. In France, the most famous examples of the ideological controversies surrounding Wagner are, first of all, the Tannhäuser crisis of 1861, which led to the opera's withdrawal after only three performances, and, second, the nationalist revulsion against his work after the Franco-Prussian War, which resulted in a temporary ban of his operas in the 1870s and ‘80s. Wagnerism in France began to wane at the turn of the century. This was partly due to internal divisions among Wagner's followers and partly to Wagner's growing popularity among the general public which detracted from the avant-garde élan and “radical chic” that had surrounded him. The demise of Wagnerism as an avant-garde cultural movement did not, however, make the figure of Wagner any less controversial either ideologically or politically. Rather predictably, just as he had during the Franco-Prussian War, Wagner was once again at the center of a heated debate during World War I. As early as September 1914, that is, very shortly after general mobilization, Camille Saint-Saëns, the seventy-eight-year-old doyen of French music, published a series of articles in the nationalistic L’Écho de Paris in which he requested that Wagner be banned from French Opera houses. His articles caused outrage among the more liberally minded but also enlisted considerable support from the side of French conservative and nationalist forces. Though initially revolving around Wagner and his work, the polemic soon spread to a wider campaign directed against all Germanic influences in French art and culture, especially those of an avant-garde nature. It is in the context of this wider anti-German, antimodernist reaction that the Wagner campaign during World War I will be presented in this article. After a brief outline of the controversy, I shall move on to the different political and cultural agendas of Wagner's opponents, to representations of him by wartime caricaturists, to the reaction of Wagner's defenders, and finally to the role played by Wagner in the wider antimodernist reaction.
4 - The birth and development of A la recherche du temps perdu
- Edited by Richard Bales, Queen's University Belfast
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- Book:
- The Cambridge Companion to Proust
- Published online:
- 28 May 2006
- Print publication:
- 14 June 2001, pp 58-73
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Summary
Of the many areas of Proust scholarship, the one that has probably most enriched our knowledge of A la recherche du temps perdu consists of the wealth of genetic and textual studies on the novel carried out over the past thirty years. It now seems generally agreed that the long history of the novel's conception, elaboration and publication is not only fascinating and rewarding in its own right, but also enlightens our understanding and appreciation of Proust's work, giving a glimpse into the mind of one of the great masters of modern writing. In this chapter, I will outline the various compositional stages the novel underwent in the fourteen years of its development between January 1908, when Proust began to jot down ideas for a new fictional project, and November 1922, when - already terminally ill - he envisaged a highly controversial reorganisation of the novel's penultimate volume, Albertine disparue.
From ‘Contre Sainte-Beuve’ to the novel of remembrance (1908–1909)
The year 1908 is generally considered as the starting point for the Recherche. Proust is thirty-six years old and virtually unknown as a writer. He has published a collection of short stories, portraits and poems, Les Plaisirs et les jours (1896), two annotated translations of Ruskin, La Bible d’Amiens (1904) and Sésame et les lys (1906), as well as a series of articles and reviews, but has produced no fiction since 1899, when he abandoned his novel Jean Santeuil. We do not know precisely what made him return to novelistic writing in the early months of 1908.