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.
This chapter examines the challenges in measuring long-term care needs to determine eligibility and the impact of eligibility rules on access to care and wellbeing, focusing on European countries with established long-term care systems. Eligibility rules are crucial for identifying individuals with the greatest need and ensuring equitable resource distribution, yet defining these rules is challenging due to the lack of a universal approach to measuring health and social needs. Consequently, some individuals with functional or cognitive limitations may be inadequately supported or face high out-of-pocket costs, leading to reliance on informal care or unmet needs. This can reduce their independence and increase the risk of costly hospitalizations. The chapter advocates for expanding eligibility rules to improve coverage, equity, and efficiency, highlighting their role in increasing access to care, reducing poverty due to care costs, and enhancing wellbeing.
During the COVID-19 pandemic, governments worldwide invoked the ‘precautionary principle’ to justify policies designed to protect public health. This principle holds that the state may act proactively to avert harm where there is factual uncertainty about that harm and the efficacy of policies proposed to mitigate it. Many of the policies introduced during the pandemic limited citizens’ constitutional rights. This article accordingly analyzes how the precautionary principle can be integrated into the proportionality doctrine courts use to assess the validity of rights limitations. As our case study, we take the jurisprudence of the Supreme Court of Canada and its globally influential Oakes proportionality test. When articulating the test in the past, the Court has grappled with the need to defer to laws that pursue important public objectives when the evidence underlying those policies is indeterminate. However, it has been criticized for not creating detailed guidelines for when judges should defer, which is said to breed arbitrary, results-oriented decision-making. We update this criticism by showing that it continues to apply to judgments of lower courts in Canada that have followed the Court’s proclamations to evaluate laws that limit constitutional rights to combat COVID-19. We then construct the requisite guidelines by drawing analogies with existing legal principles found in tort and criminal law. We argue that in contexts of factual uncertainty, the degree of judicial deference should vary according to the gravity and likelihood of the harm the government seeks to prevent. This risk-based framework restrains judicial subjectivity and illuminates how precaution should operate at each stage of the proportionality test. We further argue that it can assist courts across jurisdictions when incorporating precaution within proportionality because, unlike approaches to this problem offered by other comparative constitutional scholars, it is suitably modest and avoids excessive revision of accepted proportionality principles.
The accession of colonies to international organisations is no longer considered compatible with modern ideas of sovereignty. Yet the allure of membership to an international body such as the United Nations for states-in-waiting continues to this day. This conclusion of the book reflects on how colonial membership, once a product of British colonialism, can provide precedents for aspiring states from Palestine to Greenland in asserting their international personality.
It is generally accepted that the evolution of the deep-water surface gravity wave spectrum is governed by quartet resonant and quasi-resonant interactions. However, it has also been reported in both experimental and computational studies that non-resonant triad interactions can play a role, e.g. generation of bound waves. In this study, we investigate the effects of triad and quartet interactions on the spectral evolution, by numerically tracking the contributions from quadratic and cubic terms in the dynamical equation. In a finite time interval, we find that the contribution from triad interactions follows the trend of that from quartet resonances (with comparable magnitude) for most wavenumbers, except that it peaks at low wavenumbers with very low initial energy. This result reveals two effects of triad interactions. (1) The non-resonant triad interactions can be connected to form quartet resonant interactions (hence exhibiting the comparable trend), which is a reflection of the normal form transformation applied in wave turbulence theory of surface gravity waves. (2) The triad interactions can fill energy into the low-energy portion of the spectrum (low wavenumber part in this case) on a very fast time scale, with energy distributed in both bound and free modes at the same wavenumber. We further analyse the latter mechanism using a simple model with two initially active modes in the wavenumber domain. Analytical formulae describing the distribution of energy in free and bound modes are provided, along with numerical validations.
Thermal Marangoni effects play important roles in bubble dynamics such as bubbles generated by water electrolysis or boiling. As macroscopic bubbles often originate from nucleated nanobubbles, it is crucial to understand how thermocapillarity operates at the nanoscale. In this study, the motion of transient bulk gas nanobubbles in water driven by a vertical temperature gradient between two solid plates is investigated using molecular dynamics simulations and analytical theory. The simulation results show that due to the thermal Marangoni force, nanobubbles move towards the hot plate at a constant velocity, similar to the behaviour of macroscale gas bubbles. However, unlike macroscale gas bubbles whose thermal conductivity and viscosity are negligible compared to those of water, the thermal conductivity and viscosity of nanoscale gas bubbles are significantly increased due to their large gas density. The thermal resistance and the slip length are also found to matter at the liquid–gas interface, though they decrease with increasing gas densities. The previous thermocapillary theory for macroscale bubbles is extended by considering all these nanoscopic effects. Expressions of the Marangoni force and the drag force are derived. By balancing the Marangoni force and the drag force, the theoretical velocity of the nanobubble migration in a thermal gradient is obtained. When using the measured transport properties of liquid, gas, and their interfaces, the theoretically obtained velocity is consistent with the result of the molecular simulations. We find that the slip length is too small to have considerable effects on nanobubble motions in the current liquid–gas system.
Suicide remains a major risk factor for individuals suffering from schizophrenia and its prodromal state (i.e., Ultra-High Risk for Psychosis). However, less is known about the prevalence of suicidal behaviour among the adolescent and youth UHR population, a demographic vulnerable to the psychosocial and environmental risk factors of suicide. This review aims to synthesise existing literature on the prevalence of suicidal ideation and behaviour in the adolescent and youth at Ultra-High Risk for Psychosis (UHR), and the associations between suicidal behaviour and its correlates.
Methods
The databases PsycINFO, PubMed, Embase, Cochrane Library, Web of Science, and Scopus were accessed up to July 2024. A meta-analysis of prevalence was subsequently performed for lifetime suicidal ideation, lifetime non-suicidal self-injury, lifetime suicidal attempt, and current suicidal ideation. A narrative review was also carried out for the correlates of suicidal behaviour amongst adolescents and youth in the UHR population.
Results
Studies were included in this meta-analysis. Meta-analysis revealed a high prevalence of lifetime suicidal ideation (58%), lifetime non-suicidal self-injury (37%), lifetime suicidal attempt (25%), and current (2 week) suicidal ideation (56%). The narrative review revealed that a personal transition to psychosis and a positive family history of psychosis were associated with suicidal attempts, while depression was associated with both suicidal attempts and suicidal ideation.
Conclusion
The prevalence of suicidal ideation and behaviour among UHR adolescents and youth is high and comparable to that of the general UHR population. Existing measures that mitigate suicide risk in the general UHR population should be adopted for the youth context.
This chapter concludes by summarizing the evidence presented in the book and considering the way forward by re-visiting the arguments in favour of investing in long-term care and the costs of inaction.
With global population ageing and shifting morbidity and disability patterns, the demand for long-term care is increasing. The chapter highlights the impact of demographic changes, particularly the rise in the older population and the growing need for dementia care, on long-term care demand. It advocates for a paradigm shift from institutionalized nursing homes to home-based care and stresses the need for policy support to enhance informal caregiving and develop a robust long-term care workforce. Additionally, it underscores the significance of recognizing long-term care as a social and human right and establishing a regulatory framework to ensure high-quality care.
An important feature of the dynamics of double-diffusive fluids is the spontaneous formation of thermohaline staircases, where wide regions of well-mixed fluid are separated by sharp density interfaces. Recent developments have produced a number of one-dimensional reduced models to describe the evolution of such staircases in the salt fingering regime relevant to mid-latitude oceans; however, there has been significantly less work done on layer formation in the diffusive convection regime. We aim to fill this gap by presenting a new model for staircases in diffusive convection based on a regularisation of the $\gamma$-instability (Radko 2003 J. Fluid Mech. vol. 805, 147–170), with a range of parameter values relevant to both polar oceans and astrophysical contexts. We use the results of numerical simulations to inform turbulence-closure parametrisations as a function of the horizontally averaged kinetic energy $e$, and ratio of the haline to thermal gradients $R_0^*$. These parametrisations result in a one-dimensional model that reproduces the critical value of $R_0^*$ for the layering instability, and the spatial scale of layers, for a wide range of parameter values, although there is a mismatch between the range of $R_0^*$ for layer formation in the model and observational values from polar oceans. Staircases form in the one-dimensional model, evolving gradually through layer merger events that closely resemble simulations.
Since the 1978 discovery of an islet “Oodaaq Island” north of Greenland, then considered to be the northernmost island in the world, multiple islets have been reported and apparently disappeared with regular intervals in the permanent sea ice-covered area offshore the northernmost part of Greenland. In this paper, we report results of comprehensive investigations at all quoted positions of reported islets, with bathymetry measurements, as well as supplementary lidar, ice thickness and gravity measurements during a helicopter reconnaissance. The bathymetry measurements confirm the non-existence of all the reported islets, and the northernmost land in the world is thus confirmed to be the moraine island “Inuit Qeqertaat” (Kaffeklubben Island) at latitude 83°39′54″ N, 30°37′45 ″ W. All reported islet positions are found at ocean depths from 26 m to 47 m, with no indications of shallow banks or submarine rocks at the reported positions. It is therefore concluded that all reported islets or new islands since 1978 have been stranded icebergs, likely originating from marine-terminating glaciers near Cape Morris Jesup, and stranded for up to several years in the relatively shallow and nearly permanently sea ice-covered areas around Inuit Qeqertaat.
The accession of British colonies to the League was drafted so as not to set a precedent, yet by 1923, another British Dominion had acceded to the League. Chapter Four covers the unanticipated accession of Ireland to the League, and how Britain attempted to use League membership to manage more active anti-colonial struggles within its Empire. This chapter examines how Irish nationalists perceived the League, both as a promising vehicle of international recognition and liberation, but also as a tool of British imperialism. Furthermore, it explores the role the League played in the negotiations around the Anglo-Irish ‘Treaty’ that created the Irish Free State, and how the League acted as a guarantor of the agreement. Finally, this chapter observes how the Free State approached League membership, and how the entry of the so called ‘restless Dominion’ would test the doctrine of inter se.
Having secured a seat at the Paris Peace Conference at the end of the First World War, British and Dominion officials pushed for the accession of British colonies to the new League of Nations. Chapter Two probes the legal bases, as well as the political arguments employed to convince United States’ President Woodrow Wilson, why the Dominions and India should be separate member states from Britain at the League. As Britain and the Dominions pushed Wilson for colonial accession to the League, this chapter also examines political pressures, both within the United States, as well as from anti-colonial nationalists from within British colonies, who wanted their own membership of the League, separate from the one proposed by Britain. In doing so, this chapter answers whether colonial membership came about through British imperial design, or through anti-colonial pressures of the ‘Wilsonian Moment’.
As the Irish Free State came into being, Egypt too was declared independent. Whilst in Ireland, League membership was rapidly forthcoming, negotiations for Egypt’s accession were protracted, with Egypt acceding in 1937, the last member state to join the League. Chapter Five investigates why Egypt, which was never formally a colony of the British Empire and from 1922 deemed an independent state, was obstructed by Britain from joining the League for fifteen years. This chapter examines the contested relationship between the Egyptian nationalist Wafd party, that sought Egyptian independence, and Britain, that sought Egyptian acquiescence to a treaty of alliance. Egypt’s contested accession to the League reveals the risks that colonial membership to the League posed to British imperial policy, and how Britian could act as a gatekeeper for the accession of their colonies to the League. Finally, this chapter reveals how the actions of another imperial party, Italy, and its growing encroachment into North-East Africa would ultimately lead to a compromise that would see Egypt’s accession to the League.
Surface gravity waves induce a drift on objects floating on the water’s surface. This study presents laboratory experiments investigating the drift of large two-dimensional floating objects on deep-water, unidirectional, regular waves, with wave steepness ranging from 0.04 to 0.31 (0.04 $\lt k{a_w}\lt$ 0.31, where $k$ is the wavenumber and $a_w$ the wave amplitude). The objects were carefully designed to have a rectangular cross-section with a constant aspect ratio; their size varied from 2.6 $\%$ to 27 $\%$ of the incident wavelength. We observed Lagrangian behaviour for small objects. Small and large objects exhibited fundamentally different drift behaviour at high compared with low wave steepness, with a regime shift observed at a certain size and wave steepness. The scaling of object drift with steepness depends on the relative size of the object. For small objects, drift scales with steepness squared, whereas drift becomes a linear function of steepness as the object size increases. For objects that are relatively large but smaller than 13–16% of a wavelength (low to high steepness), we provide experimental evidence supporting the mechanisms of drift enhancement recently identified by Xiao et al. (J. Fluid Mech., vol. 980, 2024, p. A27) and termed the ‘diffraction-modified Stokes drift’. This enhanced drift behaviour, compared with the theoretical Stokes drift for infinitely small fluid parcels, is attributed to changes in the objects’ oscillatory motion and local wave amplitude distribution (standing wave pattern) due to the presence of the object. In the case of larger objects, similar to Harms (J. Waterw. Port Coast. Ocean Eng., vol. 113(6), 1987, pp. 606–622), we relate the critical size at which drift is maximised to their vertical bobbing motion. We determine the domain of validity for both Stokes drift and the diffraction-modified Stokes drift model of Xiao et al. (J. Fluid Mech., vol. 980, 2024, A27) in terms of relative size and wave steepness and propose an empirical parametrisation based on our experimental data.
We develop a model to perform a cost–benefit analysis of bus fare subsidies under financial constraints that preclude the purchase of additional buses. Our model considers users’ costs in the provision of bus services and the lack of road pricing to internalize urban transport externalities in a context where financial constraints severely limit the institutional ability to plan and design the bus system. Because of financial constraints, the bus system can hardly accommodate demand during peak times: buses travel overcrowded, passengers cannot board the first bus to arrive at the bus stop, and they cannot arrive at their destination at their desired time. Another salient aspect of our model is the inclusion of motorcycles as a second private transport mode. Motorcycles are typical in many urban agglomerations in the emerging world and engender many negative transport externalities. According to our results, fare subsidies provide social benefits in Metropolitan Asunción. During peak hours, a higher subsidy is justified as the reduction of the unpriced external costs of substitute modes compensates for the increased cost created by an additional bus passenger. In the off-peak, a higher subsidy is justified (i) as the higher frequencies induced by the new bus ridership reduce waiting times and (ii) because of the reduction of the unpriced external costs of substitute modes. Although our model does not explicitly include inequality aversion, we discuss the distributional aspects of subsidies in the context of middle-income countries.
Individuals with a psychiatric inpatient admission in adolescence have a high risk of schizophrenia-spectrum disorders (SSDs) when followed to adulthood. Whether psychotic symptoms predict subsequent SSDs in inpatient cohorts, however, is an important unanswered question.
Methods
The sample consisted of adolescents (aged 13–17) admitted to psychiatric inpatient care (Oulu, Finland) from April 2001 to March 2006. Psychotic symptoms were assessed with the Schedule for Affective Disorders and Schizophrenia. Specialized health care use and diagnoses were followed up in national health care registers until June 2023. Cox regression was used to predict SSDs by the presence of baseline psychotic symptoms.
Results
Of 404 adolescent inpatients admitted with non-psychotic mental disorders, 28% (n = 113) reported psychotic symptoms: 17% (n = 68) subthreshold and 11% (n = 45) full threshold. By the end of follow-up, 23% of the total cohort went on to be diagnosed with an SSD. Subthreshold psychotic symptoms did not differentiate patients who would subsequently develop SSDs (cumulative incidence 24%; HR = 1.42, 95%CI = 0.81–2.50). Full-threshold psychotic symptoms, on the other hand, were associated with an increased risk of subsequent SSDs (cumulative incidence 33%; HR = 2.00, 95%CI = 1.12–3.56). Most subsequent SSDs (83%), however, occurred in individuals who had not reported threshold psychotic symptoms during inpatient admission.
Conclusions
There was a high risk of subsequent SSDs among adolescent psychiatry inpatients when followed over time. SSDs were not predicted by subthreshold psychotic symptoms. Full-threshold psychotic symptoms were associated with an increased risk of subsequent SSDs, though with low sensitivity.