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By the early 1950s, Boulez became known for his controversial and outspoken statements, his notorious snipes at non-serial but otherwise progressive contemporaries, creating a rift that divided French composers into competing factions. Jolivet, Dutilleux and Ohana, as well as others represented not only at Darmstadt and Donaueschingen but also the Warsaw Autumn Festival as leading figures in French contemporary music, found themselves excluded from the Concerts du Domaine musical and subject to what has been called the Boulezian ‘aesthetic of refusal’. Contextualising these issues, this chapter considers Jolivet’s influence on the young Boulez, their subsequent rupture in the very public affaire de scandale that followed and Boulez’s later reconciliations. Compositional common denominators linking particular works of Ohana and Dutilleux with Boulez are also explored in relation to Debussy as well as non-serial dodecaphonic techniques and the style incantatoire to reveal closer aesthetic links than any may have wished to admit.
There is a tendency in academia to expect humanities graduates to have an innate understanding of the significance of their educational training, even in the midst of a diminishing regard for their chosen subjects within educational policy and public discourse. This pedagogical reflection explores the experience of two tutors and eight students on a final-year module called “The Public Role of the Humanities.” Grounded in the pedagogical principle that the Liberal Arts offers interdisciplinary education for engaged citizenship, its remit is to explore the ways in which arts and humanities perspectives play a vital role in all walks of public life. The module is designed to help students understand how they can bring their educational training to bear not just on future careers but also on the kinds of paid jobs and volunteering roles in which they are already engaged. The students each create a podcast reflecting on this topic. In this article, we discuss the shared experience of thinking about the public humanities, including situations where issues and disagreements arose. We draw conclusions about how to move beyond defensive discourse about value and instead integrate interdisciplinary insights and approaches with daily living and working practices.
A diagnostic label can have harms and benefits, particularly when provided following routine health screening tests. Whether these are discussed in clinical encounters is unknown.
Aims
To investigate whether potential impacts of diagnostic labelling are discussed before routine screening for non-cancer health conditions and explore the perceived value of such discussions by general practitioners (GPs) and healthcare consumers.
Method
Eleven semi-structured interviews with GPs and two focus groups with eight consumers were conducted. Interviews and focus groups were audio-recorded, transcribed and analysed using thematic analysis methods based on framework analysis.
Results
Prior to routine screening, most GPs did not discuss the potential consequences of diagnostic labelling, and no consumer recalled discussions of this nature. In contrast, many GPs provided information regarding the screening procedure and possible test limitations. Both GPs and consumers identified that it would be valuable to discuss the potential impacts of a diagnostic label; however, preferences varied as to the content and timing (i.e. before or after screening) of this discussion. Six themes that examine the utility of discussing the consequences of diagnostic labelling were identified: patient empowerment, patient variability, condition-specific information, GP and patient interactions and relationship, GP role and responsibilities, and characteristics of screening.
Conclusions
The practice and perceived value of discussing diagnostic labelling consequences were recognised as important by both GPs and consumers. However, preferences regarding the content of discussions and whether these occurred in clinical encounters before or after screening varied.
The Republic of Korea's economy has been one of the economic marvels of the last few decades, growing rapidly and steadily, with few downturns. By 2010, the ROK had the world's 12th largest GDP, and ranked 10th among nations in electricity consumption and production, 10th in gas imports, 9th in oil consumption, and 4th in oil imports. The ROK has become an international force in several industries, including steel, automobiles, and electronics, and has experienced a large increase in the living standards of its people, as well as in urbanization. Much of the ROK's energy needs are supplied by imports, and the ROK has embraced nuclear power as a key source of electricity.
On the Singaporean resort island of Sentosa, two waxworks depict the British surrender to the Japanese in Singapore in 1942, and the Japanese surrender to the Allies in 1945. This essay focuses on the Japanese surrender waxworks, first displayed in 1974. Consideration of what the waxworks represent, how the display came about, and the experience the exhibit offers provides a perhaps unexpected opportunity to examine questions concerning the nature of diplomacy as refracted through post-war Japan-Singapore relations. In both representational and material terms, the waxworks mark a liminal condition. Representing a surrender grants them an ambivalent relation to post-war diplomacy, something crystallised by fraught public debate over their creation in the 1970s as independent Singapore struggled to reconcile its wartime past and commercial present. The chapter then goes on to consider the contemporary experience of the waxworks, which today represent historical curiosities in their own right and present the visitor with a strange and uncanny embodied experience of a moment frozen in time. In light of the events the waxworks depict, and the debates they triggered, the chapter seeks to answer the question of what embodied ‘work’ of history they continue to perform.
Anxiety symptoms are elevated among people with joint hypermobility. The underlying neural mechanisms are attributed theoretically to effects of variant connective tissue on the precision of interoceptive representations contributing to emotions.
Aim
To investigate the neural correlates of anxiety and hypermobility using functional neuroimaging.
Method
We used functional magnetic resonance neuroimaging to quantify regional brain responses to emotional stimuli (facial expressions) in people with generalised anxiety disorder (GAD) (N = 30) and a non-anxious comparison group (N = 33). All participants were assessed for joint laxity and were classified (using Brighton Criteria) for the presence and absence of hypermobility syndrome (HMS: now considered hypermobility spectrum disorder).
Results
Participants with HMS showed attenuated neural reactivity to emotional faces in specific frontal (inferior frontal gyrus, pre-supplementary motor area), midline (anterior mid and posterior cingulate cortices) and parietal (precuneus and supramarginal gyrus) regions. Notably, interaction between HMS and anxiety was expressed in reactivity of the left amygdala (a region implicated in threat processing) and mid insula (primary interoceptive cortex) where activity was amplified in people with HMS with GAD. Severity of hypermobility in anxious, compared with non-anxious, individuals correlated with activity within the anterior insula (implicated as the neural substrate linking anxious feelings to physiological state). Amygdala-precuneus functional connectivity was stronger in participants with HMS, compared with non-HMS participants.
Conclusions
The predisposition to anxiety in people with variant connective tissue reflects dynamic interactions between neural centres processing threat (amygdala) and representing bodily state (insular and parietal cortices). Correspondingly, interventions to regulate amygdala reactivity while enhancing interoceptive precision may have therapeutic benefit for symptomatic hypermobile individuals.
Although the framers of the Commonwealth Constitution, steeped in the study of American federalism, found the United States Constitution a valuable model which they could copy or adapt to the requirements of the six federating Australian colonies, they deliberately departed from the judicial provisions of that model in two major respects: first by creating the High Court of Australia as a general court of appeal from the Supreme Courts of the States; and, secondly, by empowering the Parliament to invest State courts with jurisdiction in all matters which might be brought before the High Court in its original jurisdiction.
Treatment-resistant depression (TRD) affects 10–30% of patients with major depressive disorder, leading to increased comorbidities, higher mortality, and significant economic and social burdens. This study aimed to compare the efficacy and safety of bupropion and aripiprazole as augmentation therapies for TRD.
Methods
This population-based, retrospective cohort study included adults aged ≥18 years with a diagnosis of depressive disorder who met the criteria for TRD. Data were collected from a nationwide claims database in South Korea. Patients prescribed bupropion were matched 1:1 with those prescribed aripiprazole. Subgroup analyses were performed according to age. An as-treated analysis was performed as the primary analysis, and an intention-to-treat analysis was performed to identify different risk windows. The primary outcome was depression-related hospitalization, and the secondary outcomes were first-time diagnoses of movement disorder and seizure.
Results
A total of 5,619 patients (bupropion: n = 1,568; aripiprazole: n = 4,051) were included in this study. Bupropion was associated with lower risks of hospitalization (hazard ratio [HR]: 0.51; 95% confidence interval [CI] 0.29–0.86) and movement disorders (HR: 0.56; 95% CI 0.36–0.85) than aripiprazole. No significant difference in seizure risk (HR: 0.65; 95% CI 0.30–1.31) was observed between the two treatments. The subgroup analysis of participants aged ≥60 years revealed no significant differences in the three outcomes between the two medications.
Conclusions
Bupropion augmentation is associated with a significantly lower risk of depression-related re-hospitalization and movement disorders in patients with TRD. Therefore, bupropion augmentation can be a comprehensive treatment strategy for TRD.
Crowd crush disasters result in psychological risks such as anxiety, depression, and post-traumatic stress disorder (PTSD). This descriptive research study identified the mental health status of Koreans after the Itaewon crowd crush disaster and explored related factors.
Methods
Data were collected May 2-9, 2023 using an online survey. Participants included 205 adults aged 19-69 years recruited through South Korean local and online university communities. Their mental health and related factors were measured at 6 months post-disaster. Data were analyzed using IBM® SPSS® Statistics 26.0. and R 3.4.2.
Results
Significant differences in anxiety, depression, and PTSD among participants who experienced the disaster as victims; changes in drinking frequency and alcohol consumption; and differences in anxiety and PTSD according to family type were observed. Comparing the 3 and 6 month surveys, there were no significant changes in anxiety, depression, PTSD, general mental health, or mental well-being. When mental health severity was divided according to victimization, a significant difference in the severity of anxiety, depression, and PTSD was observed.
Conclusions
Participants’ levels of anxiety, depression, and PTSD varied according to their direct and indirect experience of the disaster, with higher levels of PTSD even without direct experience with the disaster.
Much has been made about the impact of new technologies on the organisation of work in the professions. However, the gendered effect of technological change has rarely been a focus of investigation, even though these transformations are occurring in a context of persistent and pervasive gendered inequality. This paper aims to address this gap, using the case of the legal profession to understand the gendered impact of technological change. Drawing on insights developed through interviews with 33 senior legal stakeholders, the paper finds that technological change plays out in contradictory ways, offering both promise and peril for gender equality within the legal profession. We identify four key concepts – bifurcation, democratisation, humanisation, and flexibilisation – to elucidate the intricate interplay between technology and gendered legal careers, acknowledging the dual potential that technology holds for advancement and adversity. We argue for proactive measures and strategies to be adopted by legal institutions, professional associations, and employers, to harness the benefits of new technologies while mitigating the very real risks such technologies pose to a more gender-equitable future of work.
Background: Neonatal intensive care units (NICU) outbreaks caused by methicillin-susceptible Staphylococcus aureus (MSSA) are less commonly reported than outbreaks caused by methicillin-resistant S. aureus. We report an unusual outbreak of MSSA skin and soft tissue infections (SSTIs) in a level IV NICU investigated by whole genome sequencing (WGS) and molecular typing. Methods: An investigation was initiated in a 56-single-bed NICU after four patients developed MSSA SSTIs in Week 1. Case-patients had positive MSSA cultures identified by clinical cultures or surveillance sampling (bilateral nares, axillae, umbilicus, and groin), and antibiotic susceptibility testing was performed. WGS and assessment of isolate relatedness through mutation event analysis and multi-locus sequence typing (MLST) was performed by the NYS DOH. Demographic and isolate characteristics were compared using Wilcoxon rank sum test, Fisher’s exact test and Pearson’s Chi-squared test, as appropriate. Results: From Week 2 to Week 32, 9 rounds of surveillance for MSSA colonization were conducted. In all, 30 case-patients had MSSA colonization and 16 infants developed infections including impetigo (n=7), pustules (n=5), staphylococcal scalded skin syndrome (SSSS, n=2), abscess (n=1), and bacteremia (n=1). All SSTI cases presented on infants’ faces, all of whom were on non-invasive respiratory support. MLST identified 4 distinct types including MLST 121 (n=12), MLST 398 (n=10), MLST 30 (n=6), and MLST 15 (n=6). Eight isolates were unrelated to other isolates. MLST 398 and MLST 30 included isolates not closely related (>9 mutation events). The 12 MLST 121 isolates were closely related (≤9 mutational events between all isolates), harbored the mupA gene, and were mupirocin-resistant (MIC>1024 ug/ml). Clinical infection and mupirocin resistance were associated with MLST 121 (Table 1). Multiple infection control measures were implemented, including increased availability of alcohol-based hand sanitizers, introducing bare-below-the-elbows practice for staff, contact precautions for case-patients, decolonization with mupirocin and chlorhexidine baths, environmental cleaning/disinfection, and removing excess equipment and supplies. No new cases of mupirocin-resistant or MLST 121 SSTIs occurred after Week 25. Conclusion: We report a MSSA outbreak associated with multiple MLST types and a predominant mupirocin-resistant strain. This report highlights the ability of molecular typing to characterize strains causing infections versus colonization and the potential loss of mupirocin as a control measure when outbreaks are caused by mupirocin-resistant strains. WGS analysis allows for increased discrimination of mutation events allowing for improved resolution of case relatedness compared to other typing methods. Successful control of this outbreak was achieved with a multitude of infection prevention and control.
The consumption of alcohol within the Australian community continues to rise, impacting care delivery in already over-burdened emergency departments (EDs).
Study Objective:
This study aimed to examine the impact of alcohol-related presentations (ARPs) to EDs on days with a public holiday or sporting event.
Methods:
A retrospective cohort study was undertaken using routinely collected health data pertaining to patient presentations diagnosed with an alcohol-related disorder (ICD-10-AM code F10) to two EDs in Queensland, Australia from January 1, 2016 – December 31, 2020. Descriptive and inferential statistics were used to describe and compare ARPs on event days versus non-event days and uncomplicated versus other ARPs on event days only.
Results:
Of all 5,792 ARPs, nine percent (n = 529) occurred on public holidays or sporting event days. When compared by day type, type of presentation, mode of arrival, and day of week differed between event and non-event days. On event days, uncomplicated ARPs differed to other ARPs, with uncomplicated ARPs being younger, having shorter median length-of-stay (LOS), and less likely to be admitted to hospital.
Conclusions:
In this multi-site study, public holidays and sporting events had a noteworthy impact on ARPs to EDs. Focused refinement on the clinical management of uncomplicated ARPs is warranted to inform future resource allocation, including on event days.
OBJECTIVES/GOALS: Women are twice as susceptible to ailments like anxiety, PTSD, and Alzheimer’s disease compared to men. The locus coeruleus (LC), the primary source of noradrenaline for the brain is implicated in these disorders, however physiological sex differences have never been assessed in the LC. METHODS/STUDY POPULATION: To address this gap, In vivo electrophysiology under anesthesia was used to measure single unit activity of noradrenergic LC firing patterns in 4-month-old wild-type Fischer male and female rats. Recordings measured neuronal activity under basal conditions and in response to a footshock stimulation which elicits burst firing in LC neurons. Single unit activity is sorted via automatic valley seeking scan PCA, additional manual sorting is done via line and template method. Analysis is done extracting interspike interval (ISI) and firing rate of single units, additional analysis is done to quantify properties of bursting patterns (burst duration, spikes per burst, interburst interval, etc…). RESULTS/ANTICIPATED RESULTS: This data shows that during LC burst firing, females have longer interspike intervals compared to males, supporting the inhibitory effect of E2 on LC firing. Additionally, females have significantly different waveform patterns than males, indicating possible differences in intrinsic properties, but further supporting sexually distinct physiology of the LC . Because female rats have been estrous cycle tracked via vaginal lavage, stratification into estrus groups and further analysis may uncover differences within females. These data suggest that estrogen acts as a potent neuromodulator of noradrenergic LC neurons, providing valuable insights into the physiology of this brain region. DISCUSSION/SIGNIFICANCE: This study is the first exploration of LC physiological sex differences. This work offers insights into a critical brain region implicated in many diseases, and may pave the way for future therapeutic approaches, particularly for women, who are at a higher risk of neurological disease developing.
Multilateral diplomacy is defined as the management of relations among three or more nation-states, both within and outside international organizations. The main value of multilateral diplomacy is its ability to reduce the complexity of international relations in everyday life, including traveling, sending mail and solving crimes across borders. It produces agreements that are much more practical and less costly than a web of bilateral arrangements between individual countries, and it sets common standards that enable collaboration among scientists, engineers and businesses around the world. In addition to formal international organizations, multilateral diplomacy is practiced in informal or ad hoc groups and coalitions. There are few things in multilateral diplomacy more important than who writes the rules, who sets the agenda, and who holds the pen during negotiations.
The Vestfold Hills are a 400 km2, isolated ice-free oasis in eastern Antarctica featuring large areas with translucent quartz rocks that provide habitat for hypolithic microbial communities underneath. We used high-throughput DNA sequencing of 16S and 18S ribosomal RNA amplicons to characterize bacterial and eukaryotic hypolithic communities across the Vestfold Hills. We found high-level, local heterogeneity in community structure consistent with limited dispersal between hypoliths. Hypolithic communities were dominated by heterotrophic Bacteroidetes (mean bacterial relative read abundance: 56%) as well as Cyanobacteria (35%), with the eukaryote component often dominated by Chlorophyta (43%). Small but significant proportions of the variation in microbial community composition and function were explained by soil salinity (5–7%) and water availability (8–11%), with distinct taxa associated with different salinities and water availabilities. Furthermore, many inferred bacterial metabolic pathways were enriched in hypolithic communities from either dry or high-salinity sites. Vestfold Hills hypolithic habitats are likely to be local refuges for bacterial and eukaryotic diversity. Gradients in soil salinity and water availability across the Vestfold Hills, in addition to the number and diversity of lake types and fjords as potential source populations, may contribute to the observed variation in the extremophile, hypolithic microbial community composition.
Population-wide restrictions during the COVID-19 pandemic may create barriers to mental health diagnosis. This study aims to examine changes in the number of incident cases and the incidence rates of mental health diagnoses during the COVID-19 pandemic.
Methods
By using electronic health records from France, Germany, Italy, South Korea and the UK and claims data from the US, this study conducted interrupted time-series analyses to compare the monthly incident cases and the incidence of depressive disorders, anxiety disorders, alcohol misuse or dependence, substance misuse or dependence, bipolar disorders, personality disorders and psychoses diagnoses before (January 2017 to February 2020) and after (April 2020 to the latest available date of each database [up to November 2021]) the introduction of COVID-related restrictions.
Results
A total of 629,712,954 individuals were enrolled across nine databases. Following the introduction of restrictions, an immediate decline was observed in the number of incident cases of all mental health diagnoses in the US (rate ratios (RRs) ranged from 0.005 to 0.677) and in the incidence of all conditions in France, Germany, Italy and the US (RRs ranged from 0.002 to 0.422). In the UK, significant reductions were only observed in common mental illnesses. The number of incident cases and the incidence began to return to or exceed pre-pandemic levels in most countries from mid-2020 through 2021.
Conclusions
Healthcare providers should be prepared to deliver service adaptations to mitigate burdens directly or indirectly caused by delays in the diagnosis and treatment of mental health conditions.
This chapter highlights the newly significant role of embodiment in the discourses of realist aesthetics and theory of mind across the 1860s. Developing conterminously (though not in lockstep), the discourses of aesthetic realism and psychology at this time endowed material reality – including the mind – with new relevance, insisting on the interdependence of body and mind and on the fundamental sameness of scientific and psychological inquiry, whose shared pursuit was advancing the “science of human nature.” More particularly, this chapter moves beyond a familiar emphasis on the role of visual aesthetics to feature other emergent or developing discourses important to realism, including theories of sound, psychology and perception, and motion, and even ital atomic theory and what E.S. Dallas, in The Gay Science (1866), described as “the science of the laws of pleasure.”