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Bringing formalisation ‘to the people’: deceased estates as a post-apartheid legal field
Get PDFIn matters of inheritance, post-apartheid transformation has meant extending formal administrative arrangements previously for a privileged minority to all South Africans. That formalisation is hampered by the distance between popular ideas of proper inheritance and formal intestate succession rules, exacerbated by a confusing system. Yet a wide range of legal practitioners see the formalisation of inheritance as increasing popular access in the public good. Focusing on Johannesburg, this article explores deceased estates assistance for the historically marginalised. Legal assistance for marginalised people is often depicted as adversarial, positioned against an uncaring system. By contrast, this article argues that inheritance work reveals a distinctly post-apartheid field of collaboration. It traces how a common project unites legal practitioners ranging from state officials to attorneys, non-governmental organisation-based practitioners, and community advice officers. In the name of bringing formalisation ‘to the people’, they converge on exhorting South Africans to engage with legal administration by formalising and planning their affairs – in short, preparing them as citizens for the system. This is thrown into particular relief in wills advice. From public education by officials to workshops where lawyers and paralegals explain and draft wills, testation is presented as bringing the system closer to people’s own priorities
The asymptotic behaviour of information leakage metrics
Get PDFInformation leakage metrics quantify the amount of information about a private random variable X that is leaked through a correlated variable Y . They can be used to evaluate the privacy of a system in which an adversary, from whom X should be kept private, observes Y . Global information leakage metrics quantify the overall information leaked upon observing Y , whilst their pointwise counterparts define leakage as a function of the particular realisation Y = y, and thus can be viewed as random variables. We consider an adversary who observes many conditionally independent identically distributed realisations of Y . We formalise the essential asymptotic behaviour of an information leakage metric, considering in turn what this means for pointwise and global metrics. With these requirements in mind, we take an axiomatic approach to defining a set of pointwise leakage metrics, and a set of global leakage metrics constructed from them. The global set encompasses many known measures including mutual information, Sibson mutual information, Arimoto mutual information, maximal leakage, min entropy leakage, fdivergence metrics, and g-leakage. We prove that both sets follow the desired asymptotic behaviour. Finally, we derive composition theorems quantifying the rate of privacy degradation as an adversary is given access to many conditionally independent observations of Y . We find that, for pointwise and global metrics, privacy degrades exponentially with increasing observations, at a rate governed by the minimum Chernoff information. This extends the work of Wu et al. (2024), who derived this result for certain known metrics, including some from our global set
Assessing neurocognitive functioning among adults ageing with and without HIV at the Kenyan Coast: measurement issues and correlates
Get PDFBackground: Cognitive impairment is one of the most prevalent complications of HIV infection, with significant medical and functional impacts. However, valid, and reliable assessment tools are lacking for the newly emergent ageing population of people living with HIV (PLWH) in many parts of sub-Saharan Africa (SSA), including Kenya. Without these tools, critical intervention opportunities, e.g., psychoeducation, treatment and additional support, are missed. To bridge this gap in Kenya, we adapted the Oxford Cognitive Screen Plus (OCSPlus), a tablet-based cognitive assessment tool designed for low-literacy settings, with adults ageing with HIV ≥ 50 years and their uninfected peers. This study examines the acceptability, reliability, and validity of the OCSPlus tool among older Kenyan adults and provides an initial understanding of the cognitive performance of these adults (by HIV status) and the biopsychosocial factors associated with their cognitive performance. Methods: In a cross-sectional sample of 440 older adults (257 living with HIV), we administered the OCSPlus tool alongside the Raven’s Standard Progressive Matrices (RSPM), the International HIV Dementia Scale (IHDS), and health and sociodemographic assessments. Results: There was a high level of acceptability of OCSPlus by participants and test administrators. OCSPlus demonstrated good test–retest reliability. Acceptable correlations between individual OCSPlus sub-tasks and conventional tests (RSPM and IHDS) were also observed for convergent validity. Regarding cognitive performance, older adults living with HIV (OALWH) presented with significantly lower scores on language (picture naming task), executive function, and the IHDS overall score compared to their uninfected peers. However, OALWH performed significantly better on memory domain (orientation, word encoding and word recall tasks), non-verbal intelligence and processing speed. There were no differences in attention domain. Cognitive performance as assessed by OCSPlus was significantly associated with behavioural and lifestyle factors (physical activity, sleeping difficulties, obesity, and sexual activity), sociodemographic factors (age, sex, educational status, household income, household size and asset index), medical or treatment factors (self-reported urinary incontinence, hearing problems, history of TB, seeking services of traditional healers, antiretroviral therapy (ART) regimen change, being on 3rd line ART treatment) and psychosocial factors including ageism and food insecurity. Conclusion: We demonstrated the feasibility of OCSPlus administration by trained lay persons, its acceptability, and preliminary reliability and validity among low-literacy older adults on the Kenyan coast. Mean cognitive scores were mixed across the two groups. Cognitive performance was associated with several biopsychosocial factors spanning behavioural/lifestyle, sociodemographic, psychosocial, medical and treatment factors. Further validation studies and epidemiological research are needed to understand better the utility of OCSPlus and the cognitive function of these adults
Synthetic transmembrane transporters for catalytic ions
No full textThe thesis describes the design and synthesis of photo-activated intra-vesicle catalysis systems. By regulating the transmembrane delivery process of catalytic species in response to light, photoresponsive catalysis within lipid bilayer membrane-bound systems can be achieved. This concept is demonstrated by two intra-vesicle catalysis systems: a photoresponsive transmembrane transport system for Pd(II) in combination with encapsulated water-soluble phosphine ligands, and a photo-activated delivery system for catalytic Ru complexes.
Chapter 1 introduces the field of synthetic supramolecular membrane systems and their applications in biological relevant contexts. Current progress in intracellular catalysis and the potential of synthetic supramolecular membrane systems in this area are also discussed.
Chapter 2 details a novel Pd(II) transport system and demonstrates its application in mediating catalysis within vesicles, in combination with water-soluble phosphine ligands encapsulated in the lumen.
Chapter 3 demonstrates that the Pd-induced catalysis within vesicles can be controlled by light through photocaging of the transporter introduced in Chapter 2.
Chapter 4 establishes a photoresponsive Ru catalyst capable of mediating catalysis in lipid bilayer vesicles, where the catalytic activity is initiated via light-activated transmembrane delivery.
Chapter 5 outlines the experimental procedures employed throughout the work.
Chapter 6 concludes the thesis and discusses potential topics for future investigation
P12 An audit of the psychological morbidity of children and young people on systemic medications for atopic eczema or psoriasis
Get PDFChildren and young people (CYP) living with skin conditions, experience significant psychological burden, which has been well-documented. Guidance has been produced to help support clinicians address this (McPherson T, Ravenscroft J, Ali R et al. British Society for Paediatric and Adolescent Dermatology assessment and support of mental health in children and young people with skin conditions: a multidisciplinary expert consensus statement and recommendations. Br J Dermatol 2023;189:459–66). The guidance stresses the importance of routinely asking about impact on psychosocial health and documenting this in communications. We audited clinic letters at our tertiary Dermatology Centre from 2013–2025 in CYP who have been prescribed systemic medications for eczema or psoriasis to assess if this is addressed and documented in clinic correspondence. 540 clinic letters from 47 CYP (age range 5 months–22 years) with eczema (n = 37) or psoriasis (n = 10), were examined. 80.2% of clinic letters had mental health impact and/ or quality of life (QoL) impact documented in some form. This was most commonly recorded using Patient Reported Outcome Measures (PROMs) and a comment (58.0%), followed by a comment only (27.5%) and PROM only (14.8%). Examples of mental health impact comments included decreased self-confidence, isolation, decreased mood during flares and sleep disturbance frequently due to pruritus. 18/47 patients were documented to be under CAMHS and 14 were referred to Psychological Medicine Service for skin condition related psychological support. Improvement in disease specific scores (EASI, POEM, PASI) did relate to improvement in QOL scores (CDLQI and TQoL) and reported psychological benefits such as improved sleep and mood. This data confirms that severe inflammatory skin conditions have a high mental health burden. Reassuringly this is generally being discussed in clinic and recorded in communications as part of ongoing assessment
Effects of anticoagulation in patients with device-detected atrial fibrillation and multiple stroke risk factors: a win ratio analysis of the NOAH-AFNET 6 trial
Get PDFAims: Patients with device-detected atrial fibrillation (DDAF) have a lower stroke risk than those with ECG-diagnosed AF, requiring careful evaluation of oral anticoagulation benefits vs. its inherent bleeding risk. Methods and results: An unmatched win ratio analysis was performed of the NOAH-AFNET 6 trial dataset, using components of the primary efficacy and safety outcomes of the trial. The primary analysis used this hierarchical order: (1) all-cause death, (2) stroke, (3) systemic or pulmonary embolism/myocardial infarction, and (4) major bleeding. Two additional analyses replaced all-cause death with cardiovascular death or included patient-reported outcomes. Win odds were calculated to account for undecided comparisons. Among 2534 patients 77 ± 7 years old, 947 (37%) women, median CHA2DS2-VA score 3 [interquartile range (IQR), 3–4], median follow-up 21 months (IQR, 10–38) 1 605 280 win ratio pairs were analyzed. The win ratio comparing edoxaban to no anticoagulation was 0.87 (95% CI: 0.68–1.10; P = 0.23). Most comparisons resulted in no clear winner (undecided pairs 84.9%). In the remaining comparisons, edoxaban won in 46% of the cases, placebo in 54%. Death and major bleeding were the most common events. The win odds was 0.98 (95% CI: 0.94–1.01; P = 0.23). Conclusions: This hypothesis-generating win ratio analysis, integrating death, thrombotic events, and major bleeds with and without quality of life, did not find an advantage of anticoagulation with edoxaban over no anticoagulation in patients with DDAF. The most common events were death and major bleeding
When does inflation become too high? Thresholds in the inflation–happiness relationship
Get PDFThis paper documents a threshold relationship between inflation and national happiness using annual data from 81 countries between 2006 and 2024. I show that inflation negatively impacts happiness but only when inflation exceeds 5%. Below this level, I find no effect of inflation on a country’s overall wellbeing. This null result is primarily driven by inflation observations in the range of 2% to 5% which appear to have no impact on happiness. This finding departs from the existing literature, which typically assumes a linear effect of inflation on happiness. I estimate a dynamic panel threshold model that controls for unobserved heterogeneity across countries as well as time-varying macroeconomic indicators. I also show that national happiness scores display high levels of persistence in the dynamic model, a fact which previous panel studies of happiness have ignored. I argue that the lag of happiness, which is correlated with contemporaneous happiness and inflation, is thus an essential control variable. The threshold relationship between inflation and happiness is robust across alternative specifications, well-being measures, control sets and estimation methods, and it can be considered causal under strong but plausible assumptions
Lecanemab appropriate use recommendations for clinical practice in the UK
Get PDFLecanemab is an anti-amyloid monoclonal antibody, recently approved in the UK as a treatment for mild cognitive impairment (MCI) and mild dementia due to Alzheimer's disease (AD) in adults who are apolipoprotein E ε4 gene (APOE4) heterozygotes or non-carriers.A group of UK neurologists, old age psychiatrists and geriatricians with expertise in AD convened to agree appropriate use recommendations for lecanemab in UK clinical practice. The primary focus of these recommendations is safety.Eligibility criteria for lecanemab in the UK include (a) a clinical diagnosis of MCI or mild dementia due to AD, (b) the presence of amyloid-β pathology, confirmed using approved methods (ie, an amyloid positron emission tomography scan or cerebrospinal fluid assay) and (c) APOE4 heterozygous or non-carrier status. Eligibility screening should be conducted in secondary care and those identified as being potentially eligible for lecanemab should be referred to a specialist centre for confirmation of the likely pathological diagnosis, APOE4 counselling and testing and a multidisciplinary consensus decision regarding treatment eligibility. Lecanemab is administered as an intravenous infusion every 2 weeks, and those eligible for treatment should have brain magnetic resonance imaging (MRI) scans prior to the 1st, 5th, 7th and 14th infusions. Specific guidance is provided for safety monitoring and management of potential adverse reactions, including amyloid-related imaging abnormalities and infusion-related reactions.The introduction of lecanemab into UK clinical practice provides an important opportunity to improve services for all people living with dementia, not just those eligible for lecanemab treatment
