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Japan's death penalty is cruel, secretive and out of step with much of the developed world say its opponents. As a record 97 men and 5 women await the hangman's noose, one man alive and free who knows its true horrors speaks.
After breakfast on Christmas Day, 2006, three Japanese pensioners and a middle-aged former taxi-driver were given an hour to live. The men were told to clean their cells, say their prayers and write a will. Fujinami Yoshio, 75, scribbled a note to his supporters before he was taken to the gallows of the Tokyo Detention Center in a wheelchair. “I cannot walk by myself, I am ill and yet you still kill such a person,” he wrote. “I should be the last person executed.”
Hospitals play a significant and important role in funding high-cost medicines so patients can access treatments they need. High-cost medicines are often specialty medicines, which contribute to a significant and increasing portion of the hospital budget. It is imperative that these expensive medicines are governed and managed with a fair, standardized evidence-based process. We aim to provide a framework for Drugs and Therapeutics Committees (DTCs).
Methods
During 2021, Guiding Principles were developed following a literature review and survey of current practices by DTCs in Australia. An Expert Advisory Group (EAG) was convened, comprising individuals with expertise in quality use of medicines, evidence-based medicine and medicines governance. The guiding principles were drafted by the EAG, in consultation with a range of stakeholders and relevant external organizations. All feedback was collated, reviewed and discussed to refine the content of the final Guiding Principles released in January 2022.
Results
Seven overarching principles provide key recommendations for the governance of high-cost medicines:
(i) A definition of high‑cost medicines should be determined and clearly articulated for use by each medicines governance committee.
(ii) Review of high-cost medicines requires members with relevant expertize to facilitate good and effective decision-making.
(iii) The committee should engage directly with the applicant prior to review to ensure a full understanding of the rationale for the request.
(iv) consistent, robust and transparent procedure for the assessment of high-cost medicine applications should be defined and implemented for use by each medicines governance committee to ensure fair process.
(v) Ethical considerations fundamentally underpin deliberations around high-cost medicines.
(vi) The decisions and outcomes of the decision making should be transparent and appropriately communicated to the various audiences.
(vii) The high-quality assessment of high-cost medicines requires appropriate training and resourcing.
Conclusions
These national Guiding Principles promote consistent, evidence-based use of high-cost medicines and provide a framework for DTCs to assess and achieve effective governance for the quality use of high‑cost medicines.
Folate and choline are methyl donor nutrients that may play a role in fetal brain development. Animal studies have reported that prenatal folate and choline supplementation are associated with better cognitive outcomes in offspring and that these nutrients may interact and affect brain development. Human studies that have investigated associations between maternal prenatal folate or choline levels and neurodevelopmental outcomes have reported contradictory findings and no human studies have examined the potential interactive effect of folate and choline on children’s neurodevelopment. During the second trimester of pregnancy, maternal red blood cell folate was measured from blood samples and choline intake was estimated using a 24-h dietary recall in 309 women in the APrON cohort. At 3–5 years of age, their children’s neurodevelopment was assessed using the Wechsler Preschool and Primary Scales of Intelligence – Fourth EditionCND, NEPSY-II language and memory subtests, four behavioral executive function tasks, and the Movement Assessment Battery for Children – Second Edition. Adjusted regressions revealed no associations between maternal folate and choline levels during pregnancy and most of the child outcomes. On the Dimensional Change Card Sort, an executive function task, there was an interaction effect; at high levels of choline intake (i.e., 1 SD above the mean; 223.03 mg/day), higher maternal folate status was associated with decreased odds of receiving a passing score (β = −0.44; 95%CI −0.81, −0.06). In conclusion, maternal folate status and choline intake during the second trimester of pregnancy were not associated with children’s intelligence, language, memory, or motor outcomes at 3–4 years of age; however, their interaction may have an influence children’s executive functions.
We present a theoretical explanation for why migrant workers in China should be less likely to participate in protests than other categories of workers. While grievance-based theories of protest would suggest that migrant workers have more incentive to protest than other categories of workers, resource mobilization theory suggests that their capacity to mobilize for collective action is impeded by the conditions of their work situation and their residence. Using survey data from CGSS 2010, we test propositions derived from this framework. We find that a greater sense of relative deprivation is associated with a greater likelihood of participating in protest across all categories of workers. However, we also find that migrant worker status functions as a moderator between grievances and protest participation: compared to urban registered workers, migrant workers are significantly less likely to take part in protest activities when both of them have high levels of perceived unfairness. These findings are robust across all models.
The burial of multiple individuals within a single funerary monument invites speculation about the relationships between the deceased: were they chosen on the basis of status, gender or relatedness, for example? Here, the authors present the results of aDNA and isotope analyses conducted on seven individuals from an Early Iron Age barrow at Dolge njive, south-eastern Slovenia. All seven individuals are close biological relatives. While the group composition suggests strict adherence to neither patrilineal nor matrilineal structures, the funerary tradition appears highly gendered, and family links through both the male and female lines seem important in structuring of the community. The results have implications for understanding of kinship and funerary practices in late prehistoric Europe.
In 1952 Sinclair Hood found a large deposit of pottery in front of the Great Poros Wall at Mycenae and published a brief account of its discovery the following year. In 1966 Elizabeth French published a paper discussing the pottery, assigning it an early Late Helladic IIIB1 date. From these accounts, we know that the deposit appeared in four trenches: Prehistoric Cemetery Central (PCC) III, where it sat on a surface of hard tramped earth; PCC IV, where it lay on bedrock; and PCC III Extension East and Area VII, where it rested on white clay plaster floors. But otherwise we learn little about the stratigraphy of these four trenches. Using Hood's unpublished excavation notebook, this paper examines the stratigraphy of the trenches associated with the deposit and uncovers the archaeological history of the area. In doing so, it reveals several omissions in the published accounts, most notably that there was another surface immediately below the white clay plaster floor in PCC III Extension East and a deposit of pottery associated with it. The pottery from this layer, designated Level 3, was mistakenly included by French in her paper. Fifty-four decorated sherds from Level 3 were kept, seven of which were illustrated by French. Most of the sherds come from small stirrup jars; kylikes, including the Zygouries type; Group A deep bowls; and stemmed bowls. The five most popular motifs on the sherds are the flower, whorl-shell, wavy line, parallel chevrons and panelled patterns. The shapes and motifs reflect those in the main pottery deposit and indicate a date of early Late Helladic IIIB1 for the group. The conclusion emphasises the importance of using excavation notebooks in research.
Reward processing has been proposed to underpin the atypical social feature of autism spectrum disorder (ASD). However, previous neuroimaging studies have yielded inconsistent results regarding the specificity of atypicalities for social reward processing in ASD.
Aims
Utilising a large sample, we aimed to assess reward processing in response to reward type (social, monetary) and reward phase (anticipation, delivery) in ASD.
Method
Functional magnetic resonance imaging during social and monetary reward anticipation and delivery was performed in 212 individuals with ASD (7.6–30.6 years of age) and 181 typically developing participants (7.6–30.8 years of age).
Results
Across social and monetary reward anticipation, whole-brain analyses showed hypoactivation of the right ventral striatum in participants with ASD compared with typically developing participants. Further, region of interest analysis across both reward types yielded ASD-related hypoactivation in both the left and right ventral striatum. Across delivery of social and monetary reward, hyperactivation of the ventral striatum in individuals with ASD did not survive correction for multiple comparisons. Dimensional analyses of autism and attention-deficit hyperactivity disorder (ADHD) scores were not significant. In categorical analyses, post hoc comparisons showed that ASD effects were most pronounced in participants with ASD without co-occurring ADHD.
Conclusions
Our results do not support current theories linking atypical social interaction in ASD to specific alterations in social reward processing. Instead, they point towards a generalised hypoactivity of ventral striatum in ASD during anticipation of both social and monetary rewards. We suggest this indicates attenuated reward seeking in ASD independent of social content and that elevated ADHD symptoms may attenuate altered reward seeking in ASD.
Cerebral radionecrosis, a subacute or late effect of radiotherapy, can be debilitating and difficult to treat. Steroids can reduce symptoms, but have significant long-term side effects. Bevacizumab has been shown to reduce edema and other radiologic features associated with radionecrosis and improve patient symptoms. We report our experience using bevacizumab for cerebral radionecrosis.
Methods:
We retrospectively reviewed the charts of all patients treated at our institution with bevacizumab for non-glioma-associated cerebral radionecrosis. We recorded change in symptoms, change in steroids, change in performance status, time to tumor progression, and time to death. We delineated the volume of necrosis pre- and post-bevacizumab on T1-post-gadolinium and fluid-attenuated inversion recovery (FLAIR) MRI scans.
Results:
We identified 15 patients, 8 with brain metastases, 6 with meningioma, and 1 with nasopharyngeal carcinoma. Most received four doses of bevacizumab, 7.5 mg/kg q 3 weeks × 4 doses. Neuroimaging demonstrated a reduced T1 gadolinium-enhancing volume and edema in 14/15 patients (the average reduction in T1-post-gadolinium volume was 3.0 cm3, and average reduction in FLAIR volume was 27.9 cm3). There was no appreciable change in patient performance status. Steroid doses decreased in five of nine patients. There was a high rate (26%) of adverse events, including pulmonary embolism, stroke, and wound dehiscence. The median progression-free survival was 6.5 months.
Conclusion:
Although bevacizumab is commonly prescribed for cerebral radionecrosis, in our retrospective cohort, the clinical benefits were modest and there was significant toxicity.
Diamondback moth, Plutella xylostella (Linnaeus) (Lepidoptera: Plutellidae), a globally important pest of Brassicaceae crops, migrates into all provinces of Canada annually. Life tables were used to determine the mortality levels contributed by the parasitoid complexes associated with diamondback moth in British Columbia, Ontario, Prince Edward Island, and insular Newfoundland. Overall, diamondback moth populations showed high generational mortality (> 90%) in all provinces, although parasitism levels were generally low. The net reproductive rate of increase in diamondback moth was less than 1.0 (populations declined) in both years in British Columbia and in each of two years in Newfoundland and Ontario, but it was greater than 1.0 in all three years in Prince Edward Island. Lower parasitism levels were found in Prince Edward Island (3.0–6.3%) compared with other provinces (8.4–17.6%, except one year in British Columbia). Diadegma insulare was the main larval parasitoid found; it was present in all provinces. Microplitis plutellae was present in all provinces except British Columbia. Oomyzus sokolowskii was found in British Columbia and Ontario. The parasitoid community documented from sentinel sampling was less diverse than that found through destructive sampling. Hypotheses are provided to explain the presence of major parasitoids. Increasing larval parasitism would have the largest effect on diamondback moth population growth in Canada.
Recent urban disturbances, concerns about the fate of asylum seekers and renewed debates about the nature of ethnic identity and citizenship have all combined to give ethnic differences a high public and policy profile. This book explores the diverse experiences of ethnic disadvantage and challenges common assumptions.
We present a theory on how trust in the central government to remedy grievances combined with a lack of trust in local government to act motivates people to participate in local protests in China. Low trust in local government combined with high trust in the central government gives people expectation that protest will not be an exercise in futility. People protest to redress injustices when they believe that such protests have a chance of producing a favorable resolution of their grievances. Utilizing individual level data from the Asian Barometer Survey Wave 4, our analysis suggests that, in contemporary China, people who have greater trust in the central government than the local government are more likely than others to report having participated in protests. In a society without meaningful elections, participating in protest is an effective strategy for attracting the attention from the upper-level authorities in hope of redressing unfavorable situations.
Implementation of clinically useful research discoveries in the academic environment is challenged by limited funding for early phase proof-of-concept studies and inadequate expertise in product development and commercialization. To address these limitations, the National Institutes of Health (NIH) established the National Centers for Accelerated Innovations (NCAI) program in 2013. Three centers competed successfully for awards through this mechanism. Here, we present the experience of one such center, the Boston Biomedical Innovation Center (B-BIC), and demonstrate its remarkable success at the translation of innovations to clinical application and commercialization, as well as skills development and education.
Literary history offers many stories of writers being ‘discovered’: Ford Madox Ford discovering ‘another genius’ in D. H. Lawrence, Ezra Pound fostering his fellow American T. S. Eliot, Teddy Roosevelt saving the career of E. A. Robinson by reviewing his book and finding him a sinecure in the New York Custom House. In a sense, discoveries of writers are no more real than discoveries of continents, since the writers and continents were already in place, fully alive by themselves. Discovery in this sense is that primal experience of reading on one's own, falling in love with a writer before that writer has been approved by others. We become fascinated by the hopefulness of careers rescued from obscurity, amazed that any writing of value survives beyond its original composition.
W. H. Davies is one of those writers requiring rescue and rediscovery. A minor poet and the author of an extraordinary memoir, The Autobiography of a Super-Tramp (1908), Davies can seem trapped in the amber of another age, Britain before the First World War, a time of innocence or delusion, depending on your point of view. Whether Davies's poetry ever really transcended that intolerable innocence is not easily determined. His first self-published collection of verse, The Soul's Destroyer (1905), contains work of derivative enthusiasm alongside poems that touch reality freshly and acutely. However, one can learn a great deal about aesthetic values of our own and other generations by reading his work, and not least this first volume.
What is it that makes a modern poet like Eliot seem perennially fresh, if compromised by his prejudices, while a generous figure like Davies may have lost some of his bloom? Surely Davies wrote several poems with truth in them. But saying something true is not alone the stuff of literature that lasts – ‘news that stays news’, in Pound's words. The best poetry can be read both in and out of the context of its period, a form of expression that dawns on us like reality renewed. When read in extenso, Davies's verse, unlike his best prose, more often than not seems old news.
In rapidly changing work environments, individuals need a willingness and ability to learn new skills and knowledge to contribute to their organization's goals and their own employability. As the baby-boomer generation begins to exit the workplace, organizations need to pay attention to developing the capability of younger, novice workers who will increasingly comprise the core workforce of the future. The present study, grounded in social cognitive theory, develops and examines a model of learning and development for younger workers. In total, 1,732 employees in New Zealand aged 16–24 years completed a survey relating to their perceptions, beliefs, and intentions regarding learning and development. The results from structural equation modeling show that individual and work-environment factors both influence younger workers' developmental intentions but affect this through different pathways. The study contributes to a better understanding of the development process for younger workers and offers implications for management based on these findings.
Wild sheep and many primitive domesticated breeds have two coats: coarse hairs covering shorter, finer fibres. Both are shed annually. Exploitation of wool for apparel in the Bronze Age encouraged breeding for denser fleeces and continuously growing white fibres. The Merino is regarded as the culmination of this process. Archaeological discoveries, ancient images and parchment records portray this as an evolutionary progression, spanning millennia. However, examination of the fleeces from feral, two-coated and woolled sheep has revealed a ready facility of the follicle population to change from shedding to continuous growth and to revert from domesticated to primitive states. Modifications to coat structure, colour and composition have occurred in timeframes and to sheep population sizes that exclude the likelihood of variations arising from mutations and natural selection. The features are characteristic of the domestication phenotype: an assemblage of developmental, physiological, skeletal and hormonal modifications common to a wide variety of species under human control. The phenotypic similarities appeared to result from an accumulation of cryptic genetic changes early during vertebrate evolution. Because they did not affect fitness in the wild, the mutations were protected from adverse selection, becoming apparent only after exposure to a domestic environment. The neural crest, a transient embryonic cell population unique to vertebrates, has been implicated in the manifestations of the domesticated phenotype. This hypothesis is discussed with reference to the development of the wool follicle population and the particular roles of Notch pathway genes, culminating in the specific cell interactions that typify follicle initiation.
The Tlahuica, a Nahua ethnic group, arrived in what is now western Morelos and conquered several preexisting towns circa a.d. 1100. Members of Tlahuica elite lineages took control of irrigable land and founded altepeme (small city-states). As population increased, segmentation occurred until there were 32 altepeme. The elite's control of the irrigable land was the basis for collecting tribute consisting of cotton cloth. The 32 altepeme in western Morelos became part of three señoríos (regional centers) comprised of multiple altepeme by a.d. 1400: Cuauhnahuac, Tlaquiltenango, and Xiutepec. Coatlan, located in the southwestern part of western Morelos, remained an independent polity separate from the three señoríos. The 32 altepeme were conquered by the Triple Alliance in the 1430s and 1450s, putting a halt to further conquests by these señoríos and leaving Coatlan as an independent buffer state between the Tlahuica señoríos and Chontal polities to the southwest. The Triple Alliance did not displace the local population in western Morelos or send colonists from the Basin of Mexico, as they did in non-Nahua provinces of the empire.
On August 24, 2016, the Colombian government of President Juan Manuel Santos and leaders of the FARC rebel movement (Revolutionary Armed Forces of Colombia) signed a peace agreement designed to bring to an end the FARC insurgency that had lasted since 1964. One provision of the agreement was that it would be put to a vote in a plebiscite for Colombian citizens to ratify or reject. On October 2, 2016, the plebiscite was held and, surprisingly, 50.2 percent of voters rejected the agreement. Shortly thereafter, the Colombian government and FARC negotiated and signed a revised agreement and sent it directly to the Colombian legislature for ratification, bypassing a second referendum. Both houses of the Congress ratified the agreement, marking a formal end to the war between FARC and the government of Colombia.
Crisis resolution teams (CRTs) offer brief, intensive home treatment for people experiencing mental health crisis. CRT implementation is highly variable; positive trial outcomes have not been reproduced in scaled-up CRT care.
Aims
To evaluate a 1-year programme to improve CRTs’ model fidelity in a non-masked, cluster-randomised trial (part of the Crisis team Optimisation and RElapse prevention (CORE) research programme, trial registration number: ISRCTN47185233).
Method
Fifteen CRTs in England received an intervention, informed by the US Implementing Evidence-Based Practice project, involving support from a CRT facilitator, online implementation resources and regular team fidelity reviews. Ten control CRTs received no additional support. The primary outcome was patient satisfaction, measured by the Client Satisfaction Questionnaire (CSQ-8), completed by 15 patients per team at CRT discharge (n = 375). Secondary outcomes: CRT model fidelity, continuity of care, staff well-being, in-patient admissions and bed use and CRT readmissions were also evaluated.
Results
All CRTs were retained in the trial. Median follow-up CSQ-8 score was 28 in each group: the adjusted average in the intervention group was higher than in the control group by 0.97 (95% CI −1.02 to 2.97) but this was not significant (P = 0.34). There were fewer in-patient admissions, lower in-patient bed use and better staff psychological health in intervention teams. Model fidelity rose in most intervention teams and was significantly higher than in control teams at follow-up. There were no significant effects for other outcomes.
Conclusions
The CRT service improvement programme did not achieve its primary aim of improving patient satisfaction. It showed some promise in improving CRT model fidelity and reducing acute in-patient admissions.