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This study evaluated the effectiveness of a one-year smoking cessation intervention for people with severe mental illness compared with treatment as usual (TAU) in outpatient mental healthcare.
Methods
The KISMET study is a pragmatic cluster-randomized controlled trial conducted in 21 outpatient mental healthcare teams in the Netherlands. Eleven teams delivered the KISMET intervention comprising cognitive-behavioral and peer support, combined with optional pharmacological reatment. Ten teams participated in the TAU condition. We collected data between October 2022 and July 2024. The primary outcome was self-reported smoking cessation at 12 months, verified through exhaled carbon monoxide levels below 10 parts per million. Secondary outcomes included depression and anxiety (HADS), severity of psychotic symptoms (PANSS-6), quality of life (SF-12), disease self-management (PAM-13), lipid profile, blood pressure, body mass index, glucose level, and physical fitness. Crude and adjusted linear and multivariable logistic regression and mixed model analyses were performed.
Results
Eighty-nine participants were included in the KISMET intervention and 44 in TAU. Smoking cessation rates were significantly higher in the KISMET group at 3 months (OR 12.1, 95% CI 1.4 to 103.7) and at 12 months (OR 4.2, 95% CI 1.0 to 17.2) but not at 6 months (OR 1.9, 95% CI 0.5 to 6.9). No significant differences between groups were found for secondary outcomes. Dropout rates were 58% in the intervention and 32% in the TAU group.
Conclusions
The KISMET intervention shows potential without signs of physical or psychopathological complications. However, results must be interpreted with the high dropout rates in mind.
The nosological status and psychopathology of delusional disorder have been a subject of debate since Kraepelin distinguished it from schizophrenia and affective psychoses. Contemporary diagnostic manuals define delusional disorder primarily by the presence of delusions, offering limited guidance for its differentiation from schizophrenia. Notably, DSM-5 introduced a major, seemingly unexplained change by allowing bizarre delusions in delusional disorder, contrary to ICD-11, prior DSM editions, and classical descriptions. This narrative review revisits the seminal works of six classical authors (Kraepelin, Jaspers, Kretschmer, Sérieux and Capgras, and De Clérambault), who shaped the concept of delusional disorder (paranoia), and their detailed clinical cases of the disorder. All considered delusional disorder to be an independent psychotic disorder, characterized by chronic, systematized, nonbizarre delusions, preservation of personality, and minimal hallucinations, with a largely intact experiential framework outside of the delusional theme. Additional features such as delusional misinterpretations, illusions, and false memories were also emphasized in the classical literature. We examined these authors’ clinical cases of delusional disorder for the presence of delusional features characteristic of schizophrenia (delusional mood, first-rank symptoms, autistic-solipsistic delusions, and double bookkeeping), which index alterations in the structure of experience rather than mere delusional content. Such delusions were rarely found in the classical clinical cases of delusional disorder. Our findings highlight psychopathological distinctions between delusional disorder and schizophrenia, suggesting that schizophrenia involves a qualitative alteration of the experiential framework that is absent in delusional disorder. These findings raise concerns about the validity of the DSM-5 change, allowing bizarre delusions in delusional disorder.
Depression in cancer patients is a common condition that poses significant challenges for prognosis, treatment adherence, and quality of life. Its onset reflects the interplay of diverse biological, psychological, and social factors, which has been the focus of numerous studies.
Methods
We identified both systematic and non-systematic reviews examining cross-sectional or prospective studies reporting associations between DAFs and depression. We extracted data relative to DAFs, as well as the direction and statistical significance of the reported association. Consistency of findings was assessed by estimating the proportion of concordant studies (PCS) for each DAF. Methodological quality and risk of bias were assessed using a standardized tool.
Results
We identified 73 reviews (26 systematic and/or meta-analyses, 47 narrative) encompassing 514 unique primary studies, reporting the associations between depression and 198 distinct DAFs. DAFs were grouped into six domains (sociodemographic, cancer-related, somatic, psychological, biological-genetic, and other). The strongest associations (PCS ≥ 75% and ≥5 studies) were observed for sociodemographic factors (e.g., high social support, being unmarried), inflammatory markers (IL-6, TNF-α, CRP), psychological factors (e.g., history of depression, distress, anxiety), and somatic factors (e.g., fatigue, low functional status, malnutrition). When restricting analyses to prospective studies, consistent associations emerged for cancer-related physical symptoms and time dedicated to patient communication.
Conclusions
Depression in cancer is multifactorial, with physical and psychosocial factors likely iteracting dynamically. Prospective studies are still greatly needed. Further research on risk and protective factors may facilitate risk stratification, early diagnosis and patient management.
As Lucy Grace writes, “Our lives are a bundle of stories.”1 In fact, even the self, that seemingly solid and continuous “I” we carry through the world, is a story, a narrative we construct and reconstruct by piecing together memories and experiences into what feels like, as Guy Saunders writes, “a single unified self.”2 We are thus all storytellers at heart, and the story we are most often telling, retelling, and revising is ourselves. As cognitive scientist Daniel Dennett argues in Consciousness Explained, our selves are “magnificent fictions,” not “independently existing soul-pearls” but “artifacts of the social processes that create us.”3 We do not discover who we are; we narrate ourselves into being.
The present study addresses the question of whether an individual who does not understand a sentence might still be able to repeat it verbatim. To answer this question, we examined paraphrasing and repetition data from two previous studies: Pavlenko et al. (2019), which analyzed L1 and L2 participants’ paraphrasing of seven Miranda warning sentences, and Akbary et al. (2023), which compared L1 and L2 participants’ paraphrasing and elicited imitation (EI) performance on 30 commonly used EI sentences. We formulated our questions into four predictions, two of which directly addressed whether rote repetition without comprehension occurs at all. Our results confirmed both predictions, identifying 36 (5.6%) of the 646 instances of verbatim sentence repetition in the data as potential cases of repetition without comprehension. However, a broader analysis showed that the evidence for a lack of comprehension was relatively weak and ambiguous. We conclude with recommendations for overcoming the limitations of the present study and resolving the ambiguity of our findings.
Participants in NIH-funded multicenter clinical trial received the compound opposite to the randomization intention. We report the problem, subsequent root cause analysis (RCA) and corrective and preventative action (CAPA).
Methods:
The RCA was independently facilitated to identify study-level causes of the problem. Results were reviewed by institutional research administration leaders to identify institution-level causes and formulate corresponding CAPA. Both culminated in consensus.
Results:
The resulting causal chain consisted of two physical causes, two study-level system causes, and two institution-level system causes for which two institution-level CAPAs were formulated by institutional leadership. The CAPAs established institutional procedures for independent verification of critical processes, their specification, and their planned control on high-risk studies.
Conclusions:
Lack of study-level procedural infrastructure jeopardized a multicenter study led by our institution. Lack of institutional infrastructure supporting identification of critical study processes, risks to them, and appropriate controls enabled the problem to occur. Studies conducted in settings lacking institutional or study-level procedural infrastructure are susceptible to similar problems. Adding the needed institutional processes to support identification of critical study processes, risks to them, and appropriate controls required reprioritizing existing resources.
This research article examines the role of immigrant labour and micro-innovations in transferring glass-making knowledge in early modern Britain. It argues that immigrants played a crucial role in adapting European products to local conditions by providing new recipes and access to trade routes. Furthermore, it emphasises the significance of mobility and secrecy in knowledge transfer. Immigrants created innovations through mobility by tailoring their roles to encourage movement and maintaining the confidentiality of their skills. The article also examines the demands of local settings and conditions for integrating new technology.
Let $R \to S$ be a cyclically pure map of Noetherian $\mathbb {Q}$-algebras. In this paper, we show that if S has Du Bois singularities, then R has Du Bois singularities. Our result is new even when $R \to S$ is faithfully flat. Our proof also yields interesting results in prime characteristic and in mixed characteristic. As a consequence, we show that if $R \to S$ is a cyclically pure map of rings essentially of finite type over the complex numbers $\mathbb {C}$, S has log canonical type singularities, and $K_R$ is Cartier, then R has log canonical singularities. Along the way, we prove a version of the key injectivity theorem of Kovács and Schwede for Noetherian schemes of equal characteristic zero that have isolated non-Du Bois points. Throughout the paper, we use the characterization of the complex $\underline {\Omega }^0_X$ and of Du Bois singularities in terms of sheafification with respect to Grothendieck topologies.
Boiling and bubble injection are effective strategies for enhancing heat transfer between solid boundaries and a working fluid in numerous industrial applications, including nuclear reactors and molten metal processing. Motivated by this, we conduct direct numerical simulations of a vertical, turbulent, differentially heated, bubble-laden channel flow. The Prandtl number $\textit{Pr}$, kept identical in both phases, is varied across three representative values – $0.07$ (liquid metals), $0.7$ (vapour) and $7$ (water) – to span thermal transport regimes across three orders of magnitude. The simulations are conducted at a friction Reynolds number $\textit{Re}_\tau =150$, void fraction $\alpha =5.4\,\%$ and a density ratio $\rho _r=0.1$ (defined as the bubble-to-carrier density). The bubbles substantially alter the hydrodynamic structure of the flow, amplifying turbulent fluctuations and mixing. Their interaction with the thermal boundary layers disrupts the characteristic streaky structures near the heated walls, fragmenting them into smaller and more chaotic patterns. To elucidate this mechanism, we examine the bubble-induced modifications to the temperature field and show that temperature becomes decorrelated from velocity. Consequently, the heat-transfer enhancement arises primarily from an increase in convective heat flux driven by intensified wall-normal velocity fluctuations. The thermal boundary layer is markedly thinned, and the Nusselt number nearly doubles across all examined cases.
The Early Growth and Development Study (EGDS) began in 2002 as a longitudinal prospective adoption study of birth parents, adoptive parents, and adopted children (n = 361 adoptees). It expanded in 2007 to include a second cohort of adoptees (n = 200), and a third cohort of siblings (siblings reared by the birth mother at age 7 [n = 217 siblings in 2013] and additional siblings in both birth and adoptive family homes [n = 881 siblings in 2016]). Data are available in a national repository within the Environmental influences on Child Health Outcomes (ECHO) study and have been integrated into analyses with national and international cohorts. Birth and adoptive families were originally enrolled through a systematic recruitment approach that began with efforts to partner with all domestic adoption agencies in specific regions of the United States following the birth of a child. Longitudinal assessments are ongoing and occurred in 9-month intervals until the adoptees turned 3 years of age, and in 1- to 2-year intervals thereafter to age 21. Data collection includes child temperament, cognition, behavior, and physical health; birth and adoptive parent personality, mental and physical health, context, parenting, and marital relations; the prenatal environment; genetic, hormonal, and cardiovascular data; and geocoding. A unique aspect of the adoption-sibling design is its ability to detect environmental influences on development and test complex interactions and correlations between genetic, prenatal, and postnatal environmental influences on a range of outcomes. The sample and procedures are described, followed by an overview of multicohort findings and opportunities for integration with other registries.
Food literacy is a multidimensional concept capturing interrelated factors driving individuals’ food behaviours. Conceptualisation to date has focused on adults without considering developmental limitations of childhood. This scoping review clarifies conceptualisation and measurement of food literacy in late childhood and adolescence.
Design:
We searched the literature in seven electronic databases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews for article screening and selection. We conducted an inductive content analysis to identify the primary dimensions and indicators of food literacy for children and adolescents and examined assessment of these dimensions in existing measurement tools.
Setting:
Articles covering late childhood and adolescent populations.
Participants:
Older children and adolescents (9–18 years).
Results:
The initial search in November 2023 yielded 1319 articles with thirteen meeting inclusion criteria, and a search update in February 2026 yielded four additional recently published articles for inclusion. We identified four dimensions and twenty-three reflective indicators of child and adolescent food literacy. Conceptualisation and measurement of food literacy in children to date have heavily emphasised dimensions pertaining to food systems and nutrition knowledge and confidence in everyday food skills relative to valuing shared food experiences and purposeful engagement with food.
Conclusions:
Valuing shared food experiences and purposeful engagement with food are understudied dimensions of food literacy, despite evidence that they are important determinants of food behaviours. Future research should focus on further conceptual development and validation of age-appropriate indicators for these dimensions.
Emotion dysregulation is a transdiagnostic construct associated with multiple mental health conditions and shown to be an amenable target for treatment. The original Emotion Dysregulation Inventory (EDI) was created as a proxy-report measure validated in autistic and nonautistic youth. The goal of the current study was to develop a self-report version, the EDI-Self-Report (EDI-SR), that captures a first-person perspective and creates the option of multi-reporter measurement from adolescence through adulthood.
Methods
Using methods developed by the Patient-Reported Outcomes Measurement Information System (PROMIS), potential items and response options were written and tested in cognitive interviews. Two samples (996 participants who are autistic or have other intellectual and developmental disabilities and 1,000 participants selected to be representative of the US census as a nonclinical comparison group) completed the initial item pool. Items were assessed using exploratory and confirmatory factor analyses, item response theory analyses, concurrent calibrations, convergent correlations with comparable legacy measures, internal consistency reliability, and test–retest reliability.
Results
Exploratory factor analyses suggested splitting Reactivity and Dysphoria items for confirmatory factor analyses and subsequent analyses. Following analyses, a 25-item Reactivity scale, a 7-item Dysphoria scale, and a 6-item Reactivity short-form scale were finalized. EDI-SR subscales showed convergent validity and superior total information when compared with similar measures, strong internal consistency reliability, and good test–retest reliability.
Conclusions
The EDI-SR provides an efficient, precise measure of ED in autistic individuals, individuals with other intellectual and developmental disabilities, and a US census-matched representative sample, and allows for multi-reporter assessment in clinical and research contexts.
This article examines the endurance of timbering and rafting along the upper Yellow River in the late nineteenth and early twentieth centuries as a case study of Fernand Braudel’s ‘social time’ of that critical section of the waterway, marked by intensified commerce and shifting political dynamics. The Muslim consolidation of midstream Ningxia, anchored in upstream Linxia, exemplified how Hui economic dominance intertwined with territorial control. These networks, later repurposed to support China’s resistance against Japanese imperialism, were abruptly disrupted by mid–twentieth-century dam construction and socialist collectivisation. Beyond economic history, the article interrogates historiographical silences surrounding Hui economic territorialisation. While external observers, including Republican officials and Japanese strategists, acknowledged Hui commercial monopolies, state historiography under the People’s Republic of China has often downplayed them to maintain narratives of ethnic harmony. Analysing cinematic representations across different eras of the twentieth century, the article further argues that film serves as a counterpoint to official narratives, offering an alternative medium where Hui agency and economic territoriality are articulated and contested. By bridging economic history, historiography, and visual culture, this study highlights the political stakes of ethnic commerce and the ways in which Hui identity has been shaped and reshaped across different political regimes.
This paper examines how incorporating theoretical virtues in belief updating affects the long-term success of epistemic communities. Drawing on NK landscape models of the type used by Lazer and Friedman (2007), simulation results are used to show that when epistemic agents in a connected community factor in virtues like conservatism, modesty, and familiarity in theory selection, agents hold differing beliefs for longer periods of time. This increase in transient diversity typically leads to greater long-term communal epistemic success, a benefit that becomes more pronounced as interconnectedness between community members increases.
Humanitarian and non-profit work places staff and volunteers in contexts of high moral responsibility and commitment to mission, which can simultaneously sustain and strain mental well-being. Drawing on literature from organizational psychology and studies of non-profit and voluntary organizations, this paper examines how workplace structure and dynamics shape psychological outcomes among humanitarian workers. It argues that distress is not solely a consequence of exposure to traumatic events but is significantly influenced by organizational factors, including hierarchical constraints, inequitable working conditions and limited autonomy in ethically complex environments. These conditions create a dual-edged experience: workers derive purpose and identity from their altruistic engagement, yet face structural and relational stressors that contribute to burn-out, moral distress and reduced well-being. By foregrounding organizational responsibility, this paper identifies key determinants of mental well-being and highlights the need for systemic approaches that move beyond individual resilience-focused interventions.
Contemporary scholarship rarely questions the expectation of gratitude in asymmetrical relationships, such as those between institutional structures and persons with disabilities, where refusal is difficult. This dynamic organises dependence and constrains choice in the Indian context, where access to education, welfare, and institutional accommodation is often contingent, negotiated, and unevenly realised. From the perspective of moral economy, affect theory, and disability studies, gratitude operates as a form of moral governance, not through overt coercion but through affective compliance. It is not simply expressed as a voluntary emotion but rather as a social performance, read as evidence of deservingness. This demand is not uniformly distributed; rather, its intensity flows through the faultlines of caste, class, gender, and religion such that the capacity to withhold gratitude is itself structured by power. This article argues that when gratitude lies not in its presence but in its necessity, and when appreciation becomes a condition of access, gratitude ceases to be a virtue and instead functions as the quiet consolidation of inequality.
Natural phonetic variability such as talker differences facilitates second language (L2) word learning. Whether accent variability enhances the talker variability benefit, particularly in the learning of words that differ only in lexical tones, has not yet been examined despite its potential applied value for L2 tone language learning. Two groups of monolingual English speakers completed six training sessions on four minimal-tone quadrads of Mandarin monosyllabic pseudowords, produced either by 12 talkers from Beijing (single accent) or by four talkers each from Beijing, Yantai, and Guangzhou (multiple accents). Bayesian mixed-effects modeling revealed strong learning improvement across sessions in both conditions, but the multiple-accent group improved faster than the single-accent group. In addition, the multiple-accent group demonstrated superior generalization to new talkers with a familiar and an unfamiliar accent, suggesting that natural L2-Mandarin accent variability facilitates English learners’ access to abstract tone-word lexical representations, beyond the benefits of talker variability alone.
In meta-analyses, effect size measures with bounded or non-normal sampling distributions are commonly analyzed on a transformed scale to justify normality assumptions. While point estimates and confidence intervals (CIs) are routinely back-transformed to the original scale for interpretation, this practice is nontrivial in random-effects models. In particular, standard inverse back-transformations yield estimates of the median rather than the mean effect size due to Jensen’s inequality. Integral back-transformations provide a principled solution for recovering the mean on the original scale, but their use entails practical issues. We study integral back-transformations for several effect size measures, including correlation coefficients, proportions, odds and risk ratios, and Cronbach’s alpha. We derive general formulations for integral back-transformations and corresponding CIs that are applicable across different transformation functions and provide a software implementation. Although required to obtain correct mean estimates, these approaches must be used with caution, as they are sensitive to heterogeneity estimation and can be unstable for unbounded transformations. Certain asymmetric transformations can also lead to inconsistent inference results. We illustrate these issues using analytical considerations and re-analyses of several meta-analyses. Importantly, we stress that the choice of back-transformation depends on the analyst’s goals. The standard inverse back-transformation remains well suited for descriptive purposes and is often preferable in practice, provided that it is correctly interpreted as a back-transformed median effect size. We recommend using the integral back-transformation only when a mean estimate is explicitly required, and restricting its use for CIs to cases where they are demanded, but not for hypothesis testing.