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Cognitive behavioural therapy (CBT) including exposure and response prevention (ERP) is an effective treatment for preadolescent children with obsessive compulsive disorder (OCD); however, there is a need to increase access to this treatment for affected children.
Aims:
This study is a preliminary evaluation of the efficacy and acceptability of a brief therapist-guided, parent-led CBT intervention for pre-adolescent children (5–12 years old) with OCD using a non-concurrent multiple baseline approach.
Method:
Parents of 10 children with OCD were randomly allocated to no-treatment baselines of 3, 4 or 5 weeks before receiving six to eight individual treatment sessions with a Psychological Wellbeing Practitioner. Diagnostic measures were completed prior to the baseline, 1-week post-treatment, and at a 1-month follow-up, and parents completed weekly measures of children’s OCD symptoms/impairment.
Results:
Seventy percent of children were ‘responders’ and/or ‘remitters’ on diagnostic measures at post-treatment, and 60% at the 1-month follow-up. At least 50% of children showed reliable improvements on parent-reported OCD symptoms/impairment from pre- to post-treatment, and from pre-treatment to 1-month follow-up. Crucially, the intervention was acceptable to parents.
Conclusions:
Brief therapist-guided, parent-led CBT has the potential to be an effective, acceptable and accessible first-line treatment for pre-adolescent children with OCD, subject to the findings of further evaluations.
The law concerning limitation periods has long been recognised to be unsatisfactory. One area which poses particular problems concerns whether a limitation period can apply to equitable claims “by analogy” under section 36 of the Limitation Act 1980. This article considers three relatively recent decisions of the Court of Appeal – P & O Nedlloyd BV v Arab Metals Co. (The UB Tiger) [2006] EWCA Civ 1717, [2007] 1 W.L.R. 2288, The Commissioners for Her Majesty’s Revenue and Customs v IGE USA Investments Ltd. [2021] EWCA Civ 534, [2021] Ch. 423 and The Claimants in the Royal Mail Group Litigation v Royal Mail Group Limited [2021] EWCA Civ 1173 – which illustrate that very different approaches have been taken. It is argued that The UB Tiger was wrongly decided, or at least should be limited to specific performance, and revives calls for legislative reform.
This paper examines the contest between Canadian American industrialist Cyrus Eaton and the Pugwash scientists’ leadership for influence over the early Pugwash scientists’ conferences. Eaton's activism has generally been dismissed in the historical literature as ineffective, naive and too uncritical of the Soviet Union. This paper argues that he was genuinely committed to international peace and security, that Eaton shared with Pugwash scientists a belief in the importance of intellectuals to global unity, and that he worked to bring about greater international peace and understanding through both his personal activism and his own conferences held in the town of Pugwash. Eaton, however, favoured a broader push for peace, which included participation by a wider range of intellectuals and a call for rapprochement with the Soviet Union. These differences between Eaton and the Pugwash scientists, I argue, were more than simply about approach: they represented different internationalist visions and manifested in different conceptualizations for the Pugwash scientists’ conferences. Eaton hoped to incorporate non-scientists and humanism into the conferences, and integrate them into his own broader conference programme at his Thinkers’ Lodge at Pugwash. The scientists, however, wanted to keep their conferences as distinctly scientists’ events, tied to science and its authority.
The heritage of World War II left an indelible mark on the relations between Italy and Yugoslavia. During the détente period, however, these two countries were able to overcome many historical resentments and established a fruitful co-operation in Cold War Europe. This article questions the engagement on state, regional and municipal levels and analyses the role of twin cities in this multilayered process. With the help of primary sources, we learn how the heritage of World War II played an important role in building new forms of post-war co-operation. In fact, post-war twinning is often the result of shared anti-fascist activities from the war years. However, this is not confined to communist municipalities or ‘red’ regions in Italy on one side, and socialist Yugoslavia on the other, but is a more fluid and flexible practice which involves historical ties, geographical positions, personal capacities and economic needs.
Astigmatism and myopia are two common ocular refractive errors that can impact daily life, including learning and productivity. Current knowledge suggests that the etiology of these conditions is the result of a complex interplay between genetic and environmental factors. Studies in populations of European ancestry have demonstrated a higher concordance of refractive errors in monozygotic (MZ) twins compared to dizygotic (DZ) twins. However, there is a lack of studies on genetically informative samples of multi-ethnic ancestry. This study aimed to estimate the genetic contribution to astigmatism and myopia in the Mexican population. A sample of 1399 families, including 243 twin pairs and 1156 single twins, completed a medical questionnaire about their own and their co-twin’s diagnosis of astigmatism and myopia. Concordance rates for astigmatism and myopia were estimated, and heritability and genetic correlations were determined using a bivariate ACE Cholesky decomposition method, decomposed into A (additive genetic), C (shared environmental) and E (unique environmental) components. The results showed a higher concordance rate for astigmatism and myopia for MZ twins (.74 and .74, respectively) than for DZ twins (.50 and .55). The AE model, instead of the ACE model, best fitted the data. Based on this, heritability estimates were .81 for astigmatism and .81 for myopia, with a cross-trait genetic correlation of rA = .80, nonshared environmental correlation rE = .89, and a phenotypic correlation of rP = .80. These results are consistent with previous findings in other populations, providing evidence for a similar genetic architecture of these conditions in the multi-ethnic Mexican population.
Intracrystalline distribution of ferrous and ferric iron within pumpellyites (VIIW8VIX4VIY8IVZ12O56–n(OH)n, Z = 1) from low-grade metamorphic green rocks of the Kanogawa unit in the Northern Chichibu Belt, Hijikawa district, western Shikoku, Japan, was investigated using electron microprobe analysis, X-ray Rietveld refinement, and 57Fe Mössbauer spectroscopic analysis to verify the regularity of the distribution of Fe within the octahedral X and Y sites in pumpellyite and its effect on the pumpellyite structure. Two Fe-rich pumpellyite samples, labelled CLW and CHG, with average total Fe2O3 of 10.01±1.69 and 16.07±1.08 wt.%, respectively, were separated from the rock samples. The site occupancies at the X and Y sites in the CLW and CHG pumpellyites, refined using powder X-ray diffraction data, are X[Mg0.298Fe0.298(5)Al0.405]Y[Fe0.191Al0.809] and X[Mg0.244Fe0.42(1)Al0.34]Y[Fe0.32Al0.68], respectively. The Fe2+:Fe3+ ratio of the CLW pumpellyite, determined using Mössbauer spectroscopy, is 12(1):88(3). By combining the average chemical composition data, the site occupancies at the X and Y sites, and the Fe2+:Fe3+ ratio of the CLW pumpellyite, the chemical formulae of CLW and CHG pumpellyites are constructed as (Ca7.96K0.02Na0.01)Σ7.99(Mg1.19Mn2+0.09Fe2+0.39Fe3+0.71Al1.62)Σ4.00(Al6.47Fe3+1.50V0.02Ti0.01)Σ8.00Si12.26O43.33(OH)12.67 and (Ca8.01K0.01)Σ8.02(Mg0.97Mn2+0.02Fe2+0.63Fe3+1.03Al1.19)Σ4.01(Al5.44Fe3+2.55V0.01)Σ8.00Si12.02O42.69OH)13.31, respectively, implying that the proper name of both pumpellyites is pumpellyite-(Al). The intracrystalline distribution coefficients of Fe3+ versus Al between the X and Y sites, KD = (Fe3+/Al)X/(Fe3+/Al)Y, are 1.62 and 1.90 for the CLW and CHG pumpellyites, respectively, implying stronger X-site preference of Fe3+ than Al3+. In the CHG pumpellyite, where the Fe contents at the X and Y sites are higher than in the CLW pumpellyite, the mean <X–O> and <Y–O> distances are 2.06 and 1.98 Å, respectively, which are larger than <X–O> = 2.040 and <Y–O> = 1.944 Å in the CLW pumpellyite. The unit-cell parameters of the CHG pumpellyite are a = 8.8672(3), b = 5.9562(2), c = 19.1899(6) Å, β = 97.473(2)° with V = 1004.9(2) Å3 and are larger than those of the CLW pumpellyite, a = 8.8456(4), b = 5.9393(2), c = 19.1613(8) Å, β = 97.461(3)° with V = 998.14(7) Å3.
The increased threat of natural disasters makes understanding the relationship between community resources and children’s mental health critical. Mental health care efficacy and access are crucial to assessing the quality of community mental health care availability.
Objectives:
The primary objective of this scoping review is to investigate the relationship between children’s mental health and community mental health resource efficacy and accessibility after a major disaster
Methods:
Conducted a systematic search to identify epidemiologic and health service utilization studies assessing the relationship between disasters and subsequent health service utilization amongst children and adolescents.
Results:
The research returned 1682 potentially relevant studies and 31 articles were selected based on identified criteria from pre-selected databases.
Conclusion:
The studies conclude a gender and age-based disparity in access and efficiency of children’s mental health services. The studies also identify the need for greater resource distribution and organizational structure.
In recent years, China has expanded its national weather modification programme to exploit climatic resources and adapt to climate change. The unprecedented scale of China's weather modification programmes has raised concerns over potential environmental impacts, including transboundary impacts. This article analyzes the domestic governance of weather modification in China and the extent to which this legal framework satisfies China's obligations under customary international law to minimize risks of significant transboundary harm. We find that existing arrangements do not satisfy procedural obligations under customary international law; nor do they adequately address the risks of environmental impacts associated with the increased use of weather modification. Procedures for transboundary environmental impact assessment (EIA) and engagement with regional neighbours are needed for China to comply with international law and promote stability in the region.
To examine trends in rates of self-harm among emergency department (ED) presenting older adults in Ireland over a 13-year period.
Design:
Population-based study using data from the National Self-Harm Registry Ireland.
Setting:
National hospital EDs.
Participants:
Older adults aged 60 years and over presenting with self-harm to hospital EDs in Ireland between January 1, 2007 and December 31, 2019.
Measurements:
ED self-harm presentations.
Results:
Between 2007 and 2019, there were 6931 presentations of self-harm in older adults. The average annual self-harm rate was 57.8 per 100,000 among older adults aged 60 years and over. Female rates were 1.1 times higher compared to their male counterparts (61.4 vs 53.9 per 100,000). Throughout the study time frame, females aged 60–69 years had the highest rates (88.1 per 100,000), while females aged 80 years and over had the lowest rates (18.7 per 100,000). Intentional drug overdose was the most commonly used method (75.5%), and alcohol was involved in 30.3% of presentations. Between the austerity and recession years (2007–2012), self-harm presentations were 7% higher compared to 2013–2019 (incidence rate ratio (IRR): 1.07 95% CI 1.02–1.13, p = 0.01).
Conclusions:
Findings indicate that self-harm in older adults remains a concern with approximately 533 presentations per year in Ireland. While in younger age groups, females report higher rates of self-harm, this gender difference was reversed in the oldest age group (80 years and over), with higher rates of self-harm among males. Austerity/recession years (2007–2012) had significantly higher rates of self-harm compared to subsequent years.
Modern Chinese diplomatic histories rarely discuss the marriages of diplomats, leaving the impression that women made little impact on their husbands' careers. The extraordinary performance of Oei Hui-lan (1889–1992), wife of celebrated diplomat Wellington Koo (1888–1985), challenges this view. Hui-lan's contributions to diplomacy call our attention to the role played by Chinese diplomatic wives: as reception hostesses and embassy managers, they cultivated social relationships to facilitate diplomatic exchange. Hui-lan's story reminds us that to study modern diplomatic history solely through the lens of professionalization and institutionalization – while forgoing perspectives of gender and family – is insufficient to explain China's success in this period. Hui-lan's Peranakan family background in the Dutch East Indies (now Indonesia) equipped her with the financial assets and cosmopolitan upbringing to shine as a diplomatic wife. And yet, though she benefited from her overseas origins, Hui-lan had an uneasy relationship to her Chinese identity. Concealing the tension in her two autobiographies, Hui-lan later reconstructed her past, emphasizing her patriotism and ethnic Chineseness to befit her established position. Thus, her case also shows how the complicated process of identity rebuilding and selective adaptation played out for elite overseas Chinese women through their engagement with modern China.
We present a learner corpus-based study of English article use (“a”/“the”/Ø) by L2 learners with four typologically distinct first languages (L1s): German and Brazilian Portuguese (both have articles), Chinese and Russian (no articles). We investigate several semantic and morphosyntactic factors—for example, specificity, prenominal modification that can affect article use. Our analysis of 660 written scripts from the Education First Cambridge Open Database confirms the lower overall accuracy of learners with no-article L1s. Our main finding is the differential effect of specificity on definite and indefinite articles: learners tend to associate specificity with “a,” which implies article omission with nonspecific indefinite singulars and overuse of “a” with specific indefinite mass nouns. Prenominal modifiers further contribute to perceived specificity, leading to article overuse with modified indefinite mass nouns. However, in definite contexts, prenominal modifiers are associated with increased article omission.
The focus of nutritionists is on improvement of the health impact of current diets. Therefore, it is important to ask the question whether healthy diets are more sustainable. This review provides an overview on the research on synergies between health and sustainability. Synergies are found from shifts from animal-based to plant-based diets, from ultra-processed foods to fresh and whole foods and from reduction of food waste. The importance of looking at sustainability of the present diets has led to steps made in Europe to incorporate sustainability into food-based dietary guidelines. Examples from UK, Nordics, Belgium and the Netherlands are given. World Wildlife Fund has summarised the insides in a future-proof diet: the planet-based diet within planetary boundaries.
A multi-agent deep reinforcement learning (DRL)-based model is presented in this study to reconstruct flow fields from noisy data. A combination of reinforcement learning with pixel-wise rewards, physical constraints represented by the momentum equation and the pressure Poisson equation, and the known boundary conditions is used to build a physics-constrained deep reinforcement learning (PCDRL) model that can be trained without the target training data. In the PCDRL model, each agent corresponds to a point in the flow field and learns an optimal strategy for choosing pre-defined actions. The proposed model is efficient considering the visualisation of the action map and the interpretation of the model operation. The performance of the model is tested by using direct numerical simulation-based synthetic noisy data and experimental data obtained by particle image velocimetry. Qualitative and quantitative results show that the model can reconstruct the flow fields and reproduce the statistics and the spectral content with commendable accuracy. Furthermore, the dominant coherent structures of the flow fields can be recovered by the flow fields obtained from the model when they are analysed using proper orthogonal decomposition and dynamic mode decomposition. This study demonstrates that the combination of DRL-based models and the known physics of the flow fields can potentially help solve complex flow reconstruction problems, which can result in a remarkable reduction in the experimental and computational costs.