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Understanding Modern Warfare has established itself as a leading text in professional military education and undergraduate teaching. This third edition has been revised throughout to reflect dramatic changes during the past decade. Introducing three brand new chapters, this updated volume provides in-depth analysis of the most pertinent issues of the 2020s and beyond, including cyber warfare, information activities, hybrid and grey zone warfare, multi-domain operations and recent conflicts in Ukraine, Gaza, and Syria. It also includes a range of features to maximise its value as a learning tool: a structure designed to guide students through key strategic principles; key questions and annotated reading guides for deeper understanding; text boxes highlighting critical thinkers and operational concepts; and a glossary explaining key terms. Providing debate driven analysis that encourages students to develop a balanced perspective, Understanding Modern Warfare remains essential reading both for officers and for students of international relations more broadly.
Functional impairment in daily activities, such as work and socializing, is part of the diagnostic criteria for major depressive disorder and most anxiety disorders. Despite evidence that symptom severity and functional impairment are partially distinct, functional impairment is often overlooked. To assess whether functional impairment captures diagnostically relevant genetic liability beyond that of symptoms, we aimed to estimate the heritability of, and genetic correlations between, key measures of current depression symptoms, anxiety symptoms, and functional impairment.
Methods
In 17,130 individuals with lifetime depression or anxiety from the Genetic Links to Anxiety and Depression (GLAD) Study, we analyzed total scores from the Patient Health Questionnaire-9 (depression symptoms), Generalized Anxiety Disorder-7 (anxiety symptoms), and Work and Social Adjustment Scale (functional impairment). Genome-wide association analyses were performed with REGENIE. Heritability was estimated using GCTA-GREML and genetic correlations with bivariate-GREML.
Results
The phenotypic correlations were moderate across the three measures (Pearson’s r = 0.50–0.69). All three scales were found to be under low but significant genetic influence (single-nucleotide polymorphism-based heritability [h2SNP] = 0.11–0.19) with high genetic correlations between them (rg = 0.79–0.87).
Conclusions
Among individuals with lifetime depression or anxiety from the GLAD Study, the genetic variants that underlie symptom severity largely overlap with those influencing functional impairment. This suggests that self-reported functional impairment, while clinically relevant for diagnosis and treatment outcomes, does not reflect substantial additional genetic liability beyond that captured by symptom-based measures of depression or anxiety.
Why, What, Who, When are a set of questions, sometimes referred to as the ‘WH calibration questions’ that help interrogate a concept in terms of its application and utility. In this article these questions are used to evaluate decisions made by footballers around their mental health (MH) and wellbeing. They allow us to examine the help-seeking behaviours of footballers, such as: Why seek help? What help is available? Who to go to? When’s the right time? The article examines the psychotherapies, mainly CBT, suitable for football players and offers practical examples of how clubs have supported their players. The roles of multi-disciplinary team members involved in promoting the wellbeing of players are discussed. The content of this paper is based on a review of the literature and personal knowledge of the authors’ experiences as MH clinicians in professional football clubs.
Key learning aims
(1) To show the extent to which professional footballers experience mental health difficulties, and the nature of these problems.
(2) To highlight the thought processes of footballers during their management of their mental health.
(3) To provide a description of the therapies available to footballers, and highlighting the forms of CBT in common use.
(4) To emphasise the need for a holistic approach to MH provision, and clarify the roles of people within football clubs who provide MH support.
(5) To reflect on the need for ‘in-house’ specialist mental health input within professional football clubs.
Despite the increased awareness and action towards Equality, Diversity and Inclusion (EDI), the glaciological community still experiences and perpetuates examples of exclusionary and discriminatory behavior. We here discuss the challenges and visions from a group predominantly composed of early-career researchers from the 2023 edition of the Karthaus Summer School on Ice Sheets and Glaciers in the Climate System. This paper presents the results of an EDI-focused workshop that the 36 students and 12 lecturers who attended the summer school actively participated in. We identify common threads from participant responses and distill them into collective visions for the future of the glaciological research community, built on actionable steps toward change. In this paper, we address the following questions that guided the workshop: What do we see as current EDI challenges in the glaciology research community and which improvements would we like to see in the next fifty years? Contributions have been sorted into three main challenges we want and need to face: making glaciology (1) more accessible, (2) more equitable and (3) more responsible.
The Arctic is at the forefront of climate change, undergoing some of the most rapid environmental transformations globally. Here, we examine the impacts of climate change on the livelihoods in the coastal Inuit community of Hopedale, Nunatsiavut, Canada. The study examines recently evolved adaptation strategies employed by Inuit and the challenges to these adaptations. We document changing sea ice patterns, changing weather patterns and the impact of invasive species on food resources and the environment. Utilising knowledge co-production and drawing upon Indigenous knowledge, we monitor the changes and multiple stresses through direct observations, engagement with rights holders and community experiences to characterise climate risks and associated changes affecting livelihoods. We use both decolonising research and participatory methodologies to develop collaboration and partnership, ensuring that monitoring reflects local priorities and realities while also fostering trust and collaboration. We showcase that monitoring environmental trends involves more than data collection; it includes observing and analysing how environmental changes affect community well-being, particularly in terms of food security, cultural practices, economic activities, mental health, sea ice changes and weather patterns. The paper contributes to a nuanced understanding of Inuit resilience and experiences in confronting climate risks and the broader implications for Indigenous communities confronting climate challenges.
The problem of evil is an ideal topic for experimental philosophy. Suffering – which is at the heart of most prominent formulations of the problem of evil – is a universal human experience and has been the topic of careful reflection for millennia. However, interpretations of suffering and how it bears on the existence of God are tremendously diverse and nuanced. Why does suffering push some people toward atheism while pushing others toward deeper faith? What cultural, psychological, or sociological differences account for this diversity of responses? And, importantly, what light might this diversity of responses shed on the problem of evil and how it has been formulated by philosophers in recent years? The aim of this article is to highlight how the tools and resources of experimental philosophy might be fruitfully applied to the problem of evil. In the first section, we review some recent work in this area and describe the current state of this emergent body of literature. In the second section, we review the broader and more recent theoretical developments on the problem of evil. In the final section, we outline some potential areas of future empirical research that we see as especially promising given those developments.
Edited by
James Ip, Great Ormond Street Hospital for Children, London,Grant Stuart, Great Ormond Street Hospital for Children, London,Isabeau Walker, Great Ormond Street Hospital for Children, London,Ian James, Great Ormond Street Hospital for Children, London
Edited by
James Ip, Great Ormond Street Hospital for Children, London,Grant Stuart, Great Ormond Street Hospital for Children, London,Isabeau Walker, Great Ormond Street Hospital for Children, London,Ian James, Great Ormond Street Hospital for Children, London
Edited by
James Ip, Great Ormond Street Hospital for Children, London,Grant Stuart, Great Ormond Street Hospital for Children, London,Isabeau Walker, Great Ormond Street Hospital for Children, London,Ian James, Great Ormond Street Hospital for Children, London
Edited by
James Ip, Great Ormond Street Hospital for Children, London,Grant Stuart, Great Ormond Street Hospital for Children, London,Isabeau Walker, Great Ormond Street Hospital for Children, London,Ian James, Great Ormond Street Hospital for Children, London
Edited by
James Ip, Great Ormond Street Hospital for Children, London,Grant Stuart, Great Ormond Street Hospital for Children, London,Isabeau Walker, Great Ormond Street Hospital for Children, London,Ian James, Great Ormond Street Hospital for Children, London
Ophthalmic surgery takes place in children of all ages, from premature neonates to teenagers, the majority of whom are ASA 1 or 2. In some cases, the ocular pathology may be part of a wider congenital or metabolic abnormality and anaesthesia is not so straightforward. Nearly all will require general anaesthesia. Anxiety can be common in children returning for repeated procedures, and premedication may be necessary. Surgery can be extraocular or intraocular. Simple day-case procedures can usually be managed with an inhalational spontaneous breathing technique and supraglottic airway device (SAD). Certain more complex cases necessitate a completely still eye, and muscle relaxation is therefore usually required. Special anaesthetic considerations are management of the oculocardiac reflex (OCR), commonly elicited by traction on the recti muscles and prevention of postoperative nausea and vomiting (PONV); strabismus surgery is particularly emetogenic. The majority of ophthalmic surgery is not particularly painful, and simple analgesia with paracetamol and NSAIDs is sufficient. Regional ophthalmic blocks, such as sub-Tenons, can supplement or offer an alternative to opiates when additional analgesia is required. This has the added advantage of producing akinesis of the globe and a beneficial reduction in PONV and the OCR.
Edited by
James Ip, Great Ormond Street Hospital for Children, London,Grant Stuart, Great Ormond Street Hospital for Children, London,Isabeau Walker, Great Ormond Street Hospital for Children, London,Ian James, Great Ormond Street Hospital for Children, London
Edited by
James Ip, Great Ormond Street Hospital for Children, London,Grant Stuart, Great Ormond Street Hospital for Children, London,Isabeau Walker, Great Ormond Street Hospital for Children, London,Ian James, Great Ormond Street Hospital for Children, London
Edited by
James Ip, Great Ormond Street Hospital for Children, London,Grant Stuart, Great Ormond Street Hospital for Children, London,Isabeau Walker, Great Ormond Street Hospital for Children, London,Ian James, Great Ormond Street Hospital for Children, London
Edited by
James Ip, Great Ormond Street Hospital for Children, London,Grant Stuart, Great Ormond Street Hospital for Children, London,Isabeau Walker, Great Ormond Street Hospital for Children, London,Ian James, Great Ormond Street Hospital for Children, London
Fully revised and updated, the second edition of this important book covers the key topics in paediatric anaesthesia in a concise and structured format, providing key management principles for practitioners. Incorporating the latest advances in clinical practice and anaesthesia, it guides readers through the complications and complexities of the field, from the premature infant to the teenager. It covers the common surgical conditions encountered in daily practice alongside a comprehensive discussion of consent and the law, safeguarding children and the complexity of drug dosing in the paediatric population. Additional topics include trauma, burns, resuscitation, principles of intensive care, transporting a sick child and information on the paediatric-specific areas of ethics and medicolegal concerns. Established experts in the field share a wealth of practical experience, providing all the essential information required for advanced paediatric anaesthesia training. This book is an essential reading for trainee and practising paediatric anaesthetists and general anaesthetists managing children.
The Flexible Farrington Algorithm (FFA) is widely used to detect infectious disease outbreaks at national/regional levels on a weekly basis. The rapid spread of SARS-CoV-2 alongside the speed at which diagnostic and public health interventions were introduced made the FFA of limited use. We describe how the methodology was adapted to provide a daily alert system to support local health protection teams (HPTs) working in the 316 English lower-tier local authorities. To minimize the impact of a rapidly changing epidemiological situation, the FFA was altered to use 8 weeks of data. The adapted algorithm was based on reported positive counts using total tests as an offset. Performance was assessed using the root mean square error (RMSE) over a period. Graphical reports were sent to local teams enabling targeted public health action. From 1 July 2020, results were routinely reported. Adaptions accommodated the impact on reporting because of changes in diagnostic strategy (introduction of lateral flow devices). RMSE values were relatively small compared to observed counts, increased during periods of increased reporting, and were relatively higher in the northern and western areas of the country. The exceedance reports were well received. This presentation should be considered as a successful proof-of-concept.
The relationship between clinical examination findings and objective nasal patency measures in structural nasal obstruction remains uncertain. This review aims to explore the relationship between clinical nasal examination findings and objective nasal patency measures using acoustic rhinometry, peak nasal inspiratory flow, rhinomanometry and rhinospirometry.
Methods
Qualitative systematic review using the Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 statement.
Results
A total of 17 articles were included in the systematic review. Several studies showed a positive relationship between objective nasal patency measures and clinical nasal examination findings, however evidence in the literature is limited and confined to cohort studies. Objective nasal patency measures using acoustic rhinometry, rhinomanometry and rhinospirometry assessment correlate positively in severe anterior septal deviation but its role in assessing middle/posterior and mild/moderate septal deviation in isolation remains uncertain. There is limited evidence in the literature to assess the relationship between peak nasal inspiratory flow and clinical examination findings.
Conclusion
Objective nasal patency measures has a limited role in supporting clinical examination findings in severe structural nasal obstruction.