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I offer an interpretation of Kant’s doctrine of cognitive spontaneity that explains how the understanding can function outside of the efficient-causal structure of nature, without being part of what McDowell calls ‘the domain of responsible freedom’. Contemporary literature is dominated by the ‘cognitive agency’ approach, which identifies cognitive spontaneity with a kind of freedom. Against this view, the ‘cognitive processing view’ banishes agential notions from its account but also reduces the understanding to mere mechanism. I argue that neither of these interpretations is obligatory, motivating a teleological but non-agential account that resists assimilation into either of the current approaches.
This chapter looks at ways of building personal resilience as a foundation for compassion. The chapter starts by presenting relevant learnings about resilience from the Covid-19 pandemic; outlines positive behaviours that promote individual physical health, mental health, and resilience; presents a guided imaginative practice focusing on resilience and inner solidity, and, finally, draws together key themes of resilience, equanimity, and compassion towards the end of the chapter. The overall message is that self-care is (a) an act of radical self-compassion, (b) the basis of compassion for other people, and (c) a vital foundation for resilience, among other qualities. We cannot care for others, or become more resilient, unless we care for ourselves, so it is essential that healthcare workers pay attention to their physical and mental health. This includes optimising levels of physical exercise, sleep patterns, and dietary habits, as best as possible. It also includes specific steps to improve mental health, both in our own lives and in relationship with other people. Physical and mental health are intimately related with each other. Both are vital foundations for learning greater resilience and cultivating deeper compassion for ourselves, our patients, their families, and our colleagues in the healthcare professions.
This chapter investigates the relationship between wealth and officeholding in Pompeii. It presents a new reconstruction of the wealth distribution among the Pompeian elite, combining an economic model with archaeological evidence from the local housing stock. The findings suggest that there were significantly more households in Pompeii with curial and senatorial wealth than there were Pompeian decurions and senators.
Few studies have investigated stapedotomy using 1470 nm diode laser, and the present article contributes with clinical experience.
Methods
A retrospective analysis was conducted to investigate hearing performance of 22 patients undergoing 1470 nm diode laser-assisted primary stapedotomy.
Results
In 8/22 cases, accidental breaches to the inner ear by the laser and in 14/22 cases the stapedotomy was performed as planned only by drill. Air–bone gap and loss of sensorineural hearing were low and with no significant differences for groups at follow-up. No patients with breaches by laser reported new or worse tinnitus.
Conclusion
Accidental breaches in the stapes footplate using this diode laser did not appear to equate with inner ear damage within this limited cohort. Hearing outcomes were not significantly affected. These findings should be interpreted with caution. Further studies evaluating this laser wavelength in stapedotomy is required.
As we cultivate mindfulness, we can develop and deepen our compassion skills, both for ourselves and for others. Without self-compassion, we will struggle to look after other people compassionately. This chapter explores ways to build self-compassion and how to extend this compassion to other people in our lives. This includes our patients, their families, and our colleagues, as well as our own families and circles of friends. These are important tasks that find their roots in the theoretical and research foundations of compassion, and build on the awareness skills that we develop through mindfulness practice. This chapter presents exercises for deepening self-compassion, growing compassion for other people in our lives, and extending that compassion to everyone. By focusing on common humanity, we move towards a more stable, engaged response to other people, less informed by our own situation and more informed by theirs, less shaped by our judgements about them and more shaped by what we can achieve together. Developing compassion for everyone can be challenging, especially for people whom we anticipate will be difficult, but, with awareness, we can move in the right direction. This chapter concludes with an exercise that focuses on generating feelings of compassion towards other people by encouraging mindfulness of our connection with all beings and the planet as a whole.
Shifting Landscapes is a rich, multidimensional exploration of urban education in the multiverse of India, adding value to the growing scholarship on broader connections between urbanisation and education. As cities have continued to develop, their spatial, social and cultural landscapes have also evolved to adapt to the global capitalist needs. Education has been an integral part of these transformations, and the upheavals within the education sector have given rise to privilege and exclusion in schooling and growing marginality of the poor. The volume takes on an interdisciplinary approach to examine how the idea of the urban and that of urban education are co-constituted and, more specifically, how spatial and educational inequalities in cities intersect. The chapters bring together diverse contexts to address the heterogeneity of urban social reality in India and similarly document the changes in educational access, provision, aspirations and politics in several parts of the country. This title is available as Open Access on Cambridge Core.
Despite being outlawed, attacks on cultural heritage remain a pervasive feature in atrocity contexts, the effects of which are compounded by a relative deficit of accountability at the international level. To remedy this gap, the Office of the Prosecutor (OTP) of the International Criminal Court (ICC) issued Policy on Cultural Heritage. However, crimes against cultural heritage are not fully articulated in the Court’s governing instruments. To leverage the protective scope of the Court, the Policy adopts a human rights understanding of cultural heritage which I frame in terms of distinctive relationships between heritage and atrocity crimes. The Policy fertilises a second argument shorthanded as world-building. Against world-destruction, the Policy erects an accountability architecture. Conceptually, it foregrounds an understanding of the world as a cultural construct around which social relations are organised. Crimes against heritage undercut the very notion of what it means to be human; disrupt cultural identification, transmission, and development processes; and deny present and future generations the ability to be specific kinds of cultural human beings. In those regards, this article adds to the world society research agenda of English School theory by examining how the Policy more fully develops the Court’s role as an agent for humanity.
We explore strategic betting in competitive environments with multiple participants and potential winners. We examine two scenarios: an ‘inclusive’ low-competition scenario with many winners and an ‘exclusive’ high-competition scenario with few winners. Using a simple model, we illustrate the strategic insights in these scenarios and present experimental results that align with our predictions. In the experiment, participants made repeated bets with feedback on past results and their payoffs. In the inclusive scenario, all but the worst guessers were rewarded, while in the exclusive scenario, only the top guessers received rewards. Our findings show that in the inclusive scenario, participants exhibit herding behavior by coordinating their bets, while in the exclusive scenario, they diversify their bets across multiple options. The main general insight of our findings is that in moderate competitions, one tends to join the majority to avoid standing out in case of failure, whereas in intense competitions, one tends to differentiate oneself from one’s peers to ensure that success stands out. This insight is relevant for a broad domain of strategic interactions.
Spontaneous mentalizing refers to the capacity to attribute mental states to oneself and others without explicit prompts or conscious deliberation. This process enables individuals to comprehend and anticipate social behaviors in a more intuitive manner. Individuals diagnosed with schizophrenia frequently demonstrate deficits in this domain, which contribute to impaired social functioning. The present meta-analysis aims to assess the extent of spontaneous mentalizing impairments in schizophrenia.
Methods
A comprehensive search was conducted in four prominent databases: MEDLINE, EMBASE, CENTRAL, and Web of Science. Following the review of the retrieved records and subsequent citation searching, a total of 15 studies were selected for inclusion in the quantitative synthesis. The data of 526 patients diagnosed with schizophrenia and 536 controls were subjected to analysis. Effect sizes for intentionality and appropriateness were computed utilizing weighted or standardized mean differences, and heterogeneity was evaluated.
Results
Patients with schizophrenia exhibited substantial impairments in intentionality and appropriateness during mentalizing tasks, with large effect sizes. No significant differences were observed in random movement tasks, although patients also demonstrated deficits in interpreting goal-directed movements. Furthermore, high heterogeneity in some outcomes and variability in study methodologies were also noted.
Conclusions
This analysis corroborates substantial spontaneous mentalizing deficits in schizophrenia, underscoring their potential role in impaired social functioning. In conjunction with previous analyses, the present findings emphasize the pervasive nature of mentalizing deficits in schizophrenia, encompassing explicit, implicit, and spontaneous dimensions. These results hold significant implications for therapeutic strategies designed to augment social cognition in individuals with schizophrenia.
This paper describes challenges and opportunities for data collection during a disaster, focusing on how young adults in the United States navigated the initial period of the COVID-19 pandemic--a disaster which introduced significant uncertainty and precarity both for individuals and the research process.
Methods
This paper draws on lessons from a small exploratory study which used journaling techniques as a data collection tool.
Results
Journaling addressed 3 key challenges to collecting data during a public health crisis: 1) accessing respondents when preparation time and resources are limited; 2) ensuring protection for both participants and researchers in a context when human interaction is severely constrained; and 3) needing both rapid response and flexibility in research design and data collection.
Conclusions
Journaling techniques are a feasible, efficient and effective tool that can be adapted and utilized in various disaster contexts, including other pandemics and extreme climate events.
We investigate enstrophy variations by collapse of point vortices in an inviscid flow and, in particular, focus on the enstrophy dissipation that is a significant property characterising two-dimensional (2-D) turbulent flows. To reveal the vortex dynamics causing the enstrophy dissipation, we consider the dynamics of point vortices, whose vorticity is concentrated on points and dynamics on the inviscid flow, governed by the point-vortex system. The point-vortex system has self-similar collapsing solutions, which are expected to be a key to understand the enstrophy dissipation, but the collapsing process cannot be described by solutions to the 2-D Euler equations. We thus consider the 2-D filtered-Euler equations, which are a regularised model of the 2-D Euler equations, and their point-vortex solutions. The preceding studies (Gotoda and Sakajo, J. Nonlinear Sci. 2016, vol. 26, pp. 1525–1570, Gotoda and Sakajo, SIAM J. Appl. Math. 2018, vol. 78, 2105–2128) have proven that there exist three point-vortex solutions to the filtered model such that they converge to self-similar collapsing orbits in the three point-vortex system and dissipate the enstrophy at the event of collapse in the zero limit of the filter parameter. In this study, we numerically show that the enstrophy dissipation by the collapse of point vortices could occur for the four and five vortex problems in a filtered model. Moreover, we show the detailed convergence process of the point vortices for gradually decreasing filter parameters, which provides a new insight for the three vortex problem. In addition, numerical computations suggest that the enstrophy dissipation is caused by collapse of separated point vortices with the negative interactive energy.
Three decades after the Good Friday Agreement, repositories such as the Linen Hall Library in Belfast have built collections that explore the impact of sectarian violence and the path to peace. While the Northern Ireland Political Collection is a must for any scholar of The Troubles, the library is also filled with resources for British scholars in a number of areas. One such innovative resource – the ExtraORDINARY Women collection – helps scholars answer questions of how gender history interacts with contemporary and local political history. The collection documents the history of a range of women's political and civil rights in holdings that range from 1965 to the present.
Antipsychotics are primarily indicated for psychotic disorders. There is increasing concern regarding their potential overuse for other conditions.
Aims
To examine the change in the number of community prescriptions and corresponding costs for antipsychotics per head of population over 25 years (1998–2022) in England.
Method
The data for 1998–2022 were obtained from two separate resources from the OpenPrescribing database: from 1998 to 2016 from their long-term trends data-set; and for 2017–2022 from the monthly medication prescribing data. The relevant British National Formulary subcategories 4.2.1 ‘antipsychotic drugs’ and 4.2.2 ‘antipsychotic depot injections’ were selected. The annual differences in prescriptions and the mean average annual increase were calculated. Scatter plots to visualise the yearly trend and Spearman testing to assess the strength of the correlations were done. The total annual costs of these medications were calculated for this time period.
Results
The annual mean increase in the number of prescriptions was 287 548 in raw numbers and 4.27 per 1000 population. There is a statistically significant and strong positive relationship between time and the prescriptions of antipsychotics per 1000 population (Spearman correlation coefficient 0.995, P ≤ 0.001). This increasing trend is driven by the increase in oral antipsychotic drug prescriptions over time (Spearman correlation coefficient 0.995, P ≤ 0.001). Antipsychotic drug costs increased until 2011, reduced until 2016 and rose again during 2020–2022.
Conclusions
This analysis suggests a worrying increasing trend in antipsychotic medication prescribing. Potential causal factors include off-licence use. Clinical practice and research implications are discussed.
Meaningful engagement with young adults (YAs) with a lived experience of cancer is important for conducting impactful research on issues that matter to them, and ensures their voices are central to shaping cancer research outcomes. This preliminary study explored barriers and facilitators to participation in research to identify strategies for making cancer research more inclusive and responsive to the needs of YAs.
Methods:
This qualitative study involved twelve YAs (aged 21–43 years at time of interview) with a lived experience of cancer, who participated in a focus group or interview. Participants were recruited via multiple cancer charities/organizations and social media platforms. Data were analyzed using thematic analysis.
Results:
Barriers to research participation were Person Specific (health and wellbeing, logistical and practical challenges, knowledge, understanding and confidence) and Systemic (lack of advocacy, social and cultural influences). A multi-pronged approach to engage YAs in cancer research should include framing research to make it more relatable, using accessible language, and showcasing its potential value and impact. Incentivising participation and offering flexible engagement formats, (e.g., online surveys and videos), to meet individuals where they are, can aid participation. Collaboration with trusted organizations, ensuring diverse representation in recruitment materials, and using social media platforms were recognized as effective ways to reach a broader audience and ensure inclusivity.
Conclusions:
We provide practical strategies on how to implement these approaches. From a researcher perspective, early consideration of funding allocation (e.g., dedicated person for social media engagement, time of Patient and Public Involvement) is key to support these strategies and enhance engagement.
This systematic review aimed to explore the impact of food voucher schemes during pregnancy and early life on fruit and vegetable (F&V) consumption and explore experiences of schemes.
Design:
Six electronic databases and grey literature sources were searched. Interventional, observational, qualitative and mixed methods studies published from January 2000 to April 2024 in English were included.
Setting:
Food voucher interventions targeting F&V intake.
Participants:
Low-income pregnant women and families with young children (aged under 5 years).
Results:
7344 peer reviewed records and 103 grey literature documents were screened. Sixteen peer reviewed studies (across eighteen reports) and eight grey literature documents met the inclusion criteria. All studies took place in the UK or the USA. There was a lack of consistency across primary quantitative outcomes. Overall, F&V voucher schemes did appear to increase fruit and/or vegetable consumption, but confidence in this finding was low. Qualitative data were more consistent. F&V vouchers were used in three main ways; as a financial benefit to subsidise food already being purchased, to increase the quantity or variety of F&V purchased, or as a safety net, to be used to ensure that the family had something to eat.
Conclusions:
F&V vouchers may increase F&V intake and are positively received by recipients. This review also highlights some of the difficulties that researchers face in evaluating the impact of public health measures to improve population health. It is clear that more high-quality research is required to better understand the impacts of F&V vouchers on individual outcomes.
Completed suicide (CS) is among the leading causes of death. Suicide attempts (SAs) are more frequent and are a significant contributor to overall morbidity. However, there is only few data on community-based suicide prevention using systemic approaches. We have implemented a communal suicide prevention program and tested whether it reduced the number of SA and CS.
Methods
“FraPPE” comprised measures proposed by previous studies: low-threshold outpatient services, a SA postvention, a hotline targeting individuals with suicidal intent, qualification of gatekeepers and general practitioners, and a campaign to refer SA cases to psychiatric services and antistigma campaigns. The intervention lasted for 25 months.
Results
For CS, 7.7 cases per month were recorded during baseline, compared to 9 cases per month in the intervention phase. For SA, the numbers were 39.2 and 40.7, respectively. These numbers did not differ significantly. The most frequent diagnostic group was affective disorders, followed by substance use disorders. The average age was lower in the SA group. More males committed suicide (p < 0.001), whereas the sex ratio was balanced in SA.
Conclusions
The communal suicide prevention measures implemented in FraPPE did not reduce the number of suicides and SAs. This should be interpreted with caution, as a number of prevention measures were already executed in the region. Also, data were confounded by the COVID-19 pandemic. Our awareness campaign may also have reduced the dark field, leading to increased reporting. We thus propose to enact registries on suicidal behaviors, to obtain better data and develop new preventive measures.