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.
Chronic pain activates the HPA axis stress response resulting in the release of cortisol, although empirical associations are often contradictory. Quantile regression models of hair cortisol may help us measure HPA-axis dysregulation more accurately and establish more robust associations with chronic pain. We also examined whether people with chronic pain characterised by HPA-axis dysregulation are at risk of future mental ill-health.
Methods
This study examined data from the English Longitudinal Study of Ageing (ELSA, n = 4,560) and the UK Household Longitudinal Survey-Innovation Panel (UKHLS-IP, n = 473) to assess whether quantile regression methods enable us to assess more robust associations between hair cortisol and chronic pain, and whether older adults with chronic pain characterised by HPA-axis dysregulation are at risk of future mental ill-health.
Results
In ELSA, chronic pain was associated with a 15% (CI: 6%–23%) increase in cortisol at the 10th percentile of the hair cortisol distribution among older adults and a 19% (CI: 2%–37%) increase at the 80th percentile, but no association was found at the 30th or 40th percentiles. Having a low cortisol response to chronic pain protected against the recurrence of depression. These patterns of association were replicated in the UKHLS-IP sample.
Conclusions
The associations demonstrated across two longitudinal population surveys from the UK indicate that quantile regression analysis of hair cortisol may be useful in identifying individuals resilient to chronic pain. Hair cortisol is a promising biomarker that can be measured in population studies to quantify the stress response and resilience to future mental ill-health.
A bottlenose dolphin, Tursiops sp., stranded on the coast of South Carolina, USA was found to be heavily infected in its intestine by tapeworms, which we identified molecularly. Sequencing of portions of the mitochondrial cytochrome c oxidase I (COI) and nuclear large subunit ribosomal RNA (28S rRNA) genes showed the cestodes to be Diphyllobothrium stemmacephalum, commonly known as a broad tapeworm. Infections of marine mammals by Diphyllobothrium have been previously reported in the Northwestern Atlantic Ocean, but only to genus level. Infection by tapeworms may be rare in dolphins in South Carolina, but because this species is zoonotic, its presence indicates the potential for an emerging public health concern.
When traditional measures for material conditions are scarce or unreliable, body mass, height, and weight are complements to standard income and wealth measures. A persistent question in welfare studies is the 19th century’s 2nd and 3rd quarter’s stature diminution, a pattern known as the antebellum paradox. However, the question may not be well stated nor experienced equally by women and non-white male samples. The late 19th century’s political Granger, Greenback, and Populist movements may have affected farmer and non-farmer’s net nutrition. Despite 19th and early 20th century US political movements, farmers had greater BMIs, taller statures, and heavier weights than non-farmers. From the 1870s through 1890s, women’s body mass, height, and weight increased relative to men. Individuals of African or mixed European-African descent had heavier weights and greater BMIs than their taller, European-white counterparts, indicating that the traditional antebellum paradox needs to include women and non-European males and weight measures.
Moralising language is a powerful rhetorical tool for signaling political identity, persuading audiences, and mobilising voters. The valid and reliable classification of moral language is therefore a critical objective for political scientists. Recent advances in automated text analysis have introduced myriad new strategies for measuring morality in language, but have often produced conflicting, inconclusive findings. We investigate whether this diversity of moral content analyses might partially explain inconclusive findings, using a large corpus of political manifestos in four different languages (N=810 manifestos). Our results show that, despite starting from the same framework of Moral Foundations Theory (MFT), different instruments and underlying methodologies lead to remarkably different results for extracting moral foundations. Reproducing a previous study on political parties’ ideology and their use of moral foundations, we find that different measurements can lead to opposite effect directions. We discuss the relevance of our findings for research at the intersection of politics and moral rhetoric using automated text analysis.
While individuals are expected to perceive similarly identical quantities, regardless of the used units (e.g., 1 ton or 1000 kg), several scholars suggest that consumers over-infer quantities when they are presented in bigger and phonetically longer numbers. In two experimental studies, we examine this numerosity bias in the context of household food waste. Unlike previous scholars, manipulating numerosity revealed no effect: perceptions of food waste volume and likelihood to reduce it are not influenced by the used numeric value (2500 g vs. 2.5 kg; Study 1) nor the number of syllables (two kilos eight hundred seventy-five grams vs. three kilograms; Study 2).
Initially prescribed for schizophrenia and psychosis, antipsychotics are increasingly prescribed for other indications. Since the late 1990s, prescribing shifted from first-generation to second-generation antipsychotics.
Aims
To examine overall initiation and prevalence of antipsychotic drug prescribing in UK primary care from 1995 to 2018, stratified by gender.
Method
Cohort studies using UK anonymised electronic primary care data from IQVIA Medical Research Data, including over 790 general practices and registered individuals aged 18–99 years.
Results
Antipsychotic drug initiation was stable in the late 1990s, at 6–7/1000 person-years at risk (PYAR) in men and 9–11/1000 PYAR in women. From 2001, initiation declined, stabilising from 2005 onward at 4/1000 PYAR in men and 4–5/1000 PYAR in women. Prevalence remained consistent from 1995 to 2018: 12/1000 in men and 14/1000 in women by 2018. Initiation and prevalence were higher in women than men, but increased with age in both genders: (18–39 v. 80–99 years; incidence rate ratio (IRR) 4.85, 95% CI 4.75–4.95 in men; IRR 5.90, 95% CI 5.78–6.02 in women; prevalence rate ratio (PRR) 2.22, 95% CI 2.19–2.25 in men; PRR 4.28, 95% CI 4.24–4.33 in women). Initiation and prevalence were greater in individuals with greater socioeconomic deprivation (Townsend score of 5 v. 1; IRR 2.69, 95% CI 2.64–2.75 in men; IRR 2.19, 95% CI 2.15–2.24 in women; PRR 3.87, 95% CI 3.82–3.92 in men; PRR 2.80, 95% CI 2.77–2.83 in women).
Conclusions
Antipsychotic drug initiation decreased after 2001, stabilising from 2005 onward. Prevalence remained relatively consistent throughout the study period. Women had higher initiation and prevalence than men. However, both genders showed increased prescribing with age and socioeconomic deprivation.
With trade and the environment becoming increasingly interconnected, environmental impact assessments (EIAs) of trade negotiations help to integrate environmental considerations into trade-related treaty making by evaluating potential risks and opportunities, addressing public concerns, and facilitating the introduction of response measures. Despite international efforts, such ‘trade EIAs’ have not yet been universally adopted. At the domestic level, the United States, Canada, and the European Union have pioneered the use of EIAs through their institutionalized procedures for over 20 years. This article examines and compares the relevant practices of these three jurisdictions to identify major patterns and to discuss the pros and cons of existing differences in this area. It argues that the time-tested experience of these jurisdictions could provide benchmarks for consideration in promoting the widespread implementation of trade EIAs through global and regional trade regimes.
We propose and present evidence for a conjectural global-local phenomenon concerning the p-rationality of height-zero characters. Specifically, if $\chi $ is a height-zero character of a finite group G and D is a defect group of the p-block of G containing $\chi $, then the p-rationality of $\chi $ can be captured inside the normalizer ${\mathbf {N}}_G(D)$.
We investigate whether, in Swedish national registers, social and psychiatric outcomes for six major psychiatric and substance disorders – drug use disorder (DUD), alcohol use disorder (AUD), major depression (MD), bipolar disorder (BD), anxiety disorder (AD), and schizophrenia (SZ) – reflect the primary genetic risk for each disorder and the level of genetic heterogeneity.
Methods
We utilize Genetic Risk Ratios – defined as the ratio of the genetic risk for secondary disorders to the genetic risk for the primary disorder – derived from Family Genetic Risk Scores. Poor social outcome was defined by a common factor of four variables: receipt of social welfare, sick leave, early retirement pension, and residence in a socially deprived area. Psychiatric outcome was defined as days of inpatient psychiatric hospitalization.
Results
With poorer social outcomes, the primary genetic risks rose robustly for all disorders except SZ, as did the secondary genetic risks for DUD, AUD, and attention-deficit hyperactivity disorder. With poorer psychiatric outcomes, available only for BD and SZ, the primary genetic risks increased sharply. Overall, MD, AD, and BD became substantially more genetically heterogenous as their social outcomes became poorer, while for AUD, DUD, and SZ, the increase in heterogeneity was more modest. By contrast, with poorer psychiatric outcome, genetic risks for SZ became substantially more genetically homogeneous, with a similar but less robust trend seen for BD.
Conclusions
Despite important differences between our primary disorders, social and psychiatric outcomes are often robust indices of genetic risk and can reflect the levels of genetic heterogeneity.
We present and test a model of reciprocity in which people are more likely to repay good treatment to the extent they judge it as motivated by true caring rather than tactical self-interest. The model’s key contributions stem from how it handles ambiguously motivated behavior. It allows people to maintain divergent hypotheses: They can view behavior as driven by caring, self-interest, or a mix thereof. In contrast, previous analyses resolve rather than maintain ambiguity. They treat caring and self-interest as mutually exclusive hypotheses, and require that people commit to one and dismiss the other. By more realistically handling ambiguity, our model yields three benefits. First, it accommodates intuitive patterns of play that existing analyses do not and which we experimentally corroborate. These patterns reflect intermediate inclinations to reciprocate ambiguously motivated positive behavior. Second, it challenges conventional interpretations of long-studied phenomena, including unraveling in finitely iterated prisoners’ dilemmas, substantial offers in ultimatum games, and gift exchange. Third, it highlights how diversity in perceptions – the same action can appear generous to one person and miserly to another – is empirically consequential. Under conventional interpretations and without accounting for diverse perceptions, the aforementioned phenomena have been viewed as inconsistent with a taste for repaying good treatment. Our model shows that they are entirely consistent with a nuanced form of this taste: a desire to repay good treatment that seems to largely reflect genuine caring.
This longitudinal study investigates the changes in bilingual oral language proficiency and home language and literacy practices of young Chinese American and Mexican American dual language learners (DLLs) before and during the COVID-19 pandemic. Given that DLLs represent a significant portion of young children in the U.S., often facing socioeconomic challenges, understanding their language development is crucial. The pandemic’s considerable impact on the educational trajectories of low-income immigrant communities is of particular concern. The sample comprised 132 DLLs (41 Mexican Americans and 91 Chinese Americans) from low-income immigrant families. Data on oral language proficiency in English and the home language and home literacy practices were collected before the pandemic and again 1.5 years later. Despite school closures, both groups showed improved oral language proficiency and shifts in home literacy practices over time. This study reveals distinct relationships between home literacy practices and oral language proficiency in the two immigrant groups.
Let k be a field finitely generated over its prime subfield. We prove that the quotient of the Brauer group of a product of varieties over k by the sum of the images of the Brauer groups of factors has finite exponent. The bulk of the proof concerns p-primary torsion in characteristic p. Our approach gives a more direct proof of the boundedness of the p-primary torsion of the Brauer group of an abelian variety, as recently proved by D’Addezio. We show that the transcendental Brauer group of a Kummer surface over k has finite exponent but can be infinite when k is an infinite field of positive characteristic. This answers a question of Zarhin and the author.
Pelvic radiotherapy can be an important management option for people diagnosed with colorectal or anal cancer, who often experience a wide range of adverse effects that can be detrimental to Quality-of-Life (QoL) due to the radiotherapy. Clinical nurse specialists (CNS) are valuable multi-disciplinary members who provide a range of practical and holistic support to these patients, via on-treatment review appointments. A lack of evidence exists relating to colorectal and anal cancer patients’ perceptions of on-treatment CNS review appointments.
Methods:
A service evaluation of the nurse-led on-treatment appointments using a questionnaire was undertaken. Yes/No, Likert Scale and free-text questions were asked, allowing for quantitative and qualitative data collection. Ethical approval was obtained. Standard quantitative data analysis and thematic analysis (TA) methods were used.
Results:
Twelve [12] colorectal and anal cancer patients participated. The data showed that patients had positive experiences with their appointments, but had fears regarding the unknown and the future.
Conclusion:
Patients were satisfied with the on-treatment review service, and the results suggest that the service is efficient and effective. Future research should evaluate this type of colorectal CNS service across a larger colorectal and anal cancer patient population.
Ireland has a long-standing voluntary private health insurance market (PHI) which is regulated to meet the public policy objective of achieving risk solidarity to promote affordability of PHI. Under the regulations underpinning the market, many features are common to those of universal mandatory health insurance markets, that have wider equity objectives of ensuring universal equitable access to care for everyone. The market acts a complete/partial alternative to the public health system, and has been criticised for leading to a two-tier system with consequent implications for equity. To improve equity, these criticisms led to the adoption of a new public health reform plan, called Sláintecare, which seeks to build towards equal access to services based on patient need and not their ability to pay. Given this context, this paper re-examines how might the current voluntary health insurance system be adapted to meet the central Sláintecare objective of increasing health coverage on an equitable basis. It does so by considering to what extent does Ireland meet the preconditions for equity and efficiency under the Enthoven managed competition model. It provides a roadmap for the use of health insurance as a tool for bring this equity.
Archaeogenetics, the study of ancient DNA, can reveal powerful insights into kinship and the movement of individuals in (pre)history. Here, the authors report on the identification of two individuals with genetic profiles consistent with recent sub-Saharan African ancestry, both of whom were buried in early-medieval cemeteries in southern Britain. Focusing primarily on a sub-adult female from Updown in Kent, the authors explore the societal and cultural contexts in which these individuals lived and died, and the widening geographic links indicated by their presence, pointing back to the Byzantine reconquest of North Africa in AD 533–534.
The increasing destruction of cultural heritage in conflict zones has exposed the shortcomings of current crisis response frameworks. Traditional, state-led mechanisms have struggled to address the complexities and rapid developments of modern warfare, leading to the emergence of more flexible, decentralized approaches. In this context, civil society organizations (CSOs) have emerged as key actors, stepping in to address the shortcomings of national governments and international heritage institutions. This article explores the evolving role of CSOs in emergency cultural heritage protection, focusing on Heritage for Peace (H4P) and its interventions in Syria, Sudan, and Gaza. Through case study analysis, this research examines the logistical, ethical, and operational challenges faced by H4P, and presents a model of its strategic interventions in emergency contexts. This model illustrates the opportunities and constraints inherent in crisis environments, including mobility and safety risks, alongside structural challenges in cultural heritage protection, such as limited funding and short-term project cycles that hinder sustainability. The research advocates placing the local population at the center of emergency strategies, strengthening local partnerships, implementing proactive preparedness measures, and strengthening international cooperation mechanisms.
This study examines the impact of a continuing medical education (CME) intervention on smoking cessation among primary-care professionals (PCPs) and explores the relationship between PCP smoking status and patient tobacco-treatment delivery.
Background:
High rates of tobacco use among PCPs have been reported in several European countries. PCPs who smoke are less motivated to provide cessation support to their patients.
Methods:
A before-after study was conducted with 228 PCPs from Greece and Cyprus. The intervention included a one-day CME training, a 2.5-hour seminar three months later, and practice tools. Expert faculty provided informal support to smoking PCPs. Changes in PCP smoking status and 5As (ask, advise, assess, assist, and arrange) tobacco treatment delivery were assessed before and six months after training. Analysis of variance (ANOVA) and analysis of covariance (ANCOVA) were used to evaluate the association between the training and PCP smoking status and 5As delivery.
Findings:
At baseline, 18% (n = 47) of PCPs were current smokers, and 39% (n = 66) were ex-smokers. At follow-up, 31.9% of current smokers reported quitting (n = 15/47; p < 0.001). Smoking cessation was higher among female PCPs (p = 0.02) and those in Cyprus and Thessaloniki (p < 0.01). PCPs reported increased 5As delivery at follow-up, with the highest rates among ex-smokers (>6 months) and never smokers. PCPs reported significant quitting rates following a comprehensive evidence-based training intervention. The findings suggest that addressing PCPs’ smoking status can improve both health-care provider and patient smoking outcomes.