We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
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.
Threat sensitivity, an individual difference construct reflecting variation in responsiveness to threats of various types, predicts physiological reactivity to aversive stimuli and shares heritable variance with anxiety disorders in adults. However, no research has been conducted yet with youth to examine the heritability of threat sensitivity or evaluate the role of genetic versus environmental influences in its relations with mental health problems. The current study addressed this gap by evaluating the psychometric properties of a measure of this construct, the 20-item Trait Fear scale (TF-20), and examining its phenotypic and genotypic correlations with different forms of psychopathology in a sample of 346 twin pairs (121 monozygotic), aged 9–14 years. Analyses revealed high internal consistency and test-retest reliability for the TF-20. Evidence was also found for its convergent and discriminant validity in terms of phenotypic and genotypic correlations with measures of fear-related psychopathology. By contrast, the TF-20’s associations with depressive conditions were largely attributable to environmental influences. Extending prior work with adults, current study findings provide support for threat sensitivity as a genetically-influenced liability for phobic fear disorders in youth.
Invasive group A Streptococcal (iGAS) outbreaks have been linked to Community Healthcare Services Delivered at Home (CHSDH). There is, however, very limited evidence describing the epidemiology and mortality of iGAS cases associated with CHSDH. We used routine data to describe iGAS cases in adults who had received CHSDH prior to onset and compare characteristics between CHSDH-outbreak and non-outbreak CHSDH cases, in South East England between December 2021 and December 2023. There were 80/898 (8.9%) iGAS case episodes with CHSDH prior to onset; cases were in elderly people (50% aged 85 and over), and had primarily received wound or ulcer care (93.8%), with almost all care delivered by community nurses (98.8%). The 30-day all-cause case fatality was 26.3%. Emm 1.0 was the most common type (17.5%). In this period, 5/11 iGAS outbreaks (45.4%) were CHSDH-associated, and 25 cases with receipt of CHSDH prior to onset (31.3%, Confidence Interval [CI] 21.3–42.6%) were linked to these outbreaks. On univariate analysis, CHSDH-outbreak case episodes were more likely to be associated with emm pattern genotype E (OR 6.1 95% CI 1.8–20.9), and skin or soft tissue infection clinical presentation (OR 3.6, 95% CI 1.1–12.0) than non-outbreak CHSDH cases. There may be an increased risk of propagation of iGAS outbreaks in patients receiving CHSDH, emphasizing the need for rigorous early infection prevention and control, and outbreak surveillance.
Patients and their families often ask clinicians to estimate when full-time care (FTC) will be needed after Alzheimer's Disease (AD) is diagnosed. Although a few algorithms predictive algorithms for duration to FTC have been created, these have not been widely adopted for clinical use due to questions regarding precision from limited sample sizes and lack of an easy, user friendly prediction model. Our objective was to develop a clinically relevant, data-driven predictive model using machine learning to estimate time to FTC in AD based on information gathered from a) clinical interview alone, and b) clinical interview plus neuropsychological data.
Participants and Methods:
The National Alzheimer's Coordinating Center dataset was used to examine 3,809 participants (M age at AD diagnosis = 76.05, SD = 9.76; 47.10% male; 87.20% Caucasian) with AD dementia who were aged >50 years, had no history of stroke, and not dependent on others for basic activities of daily living at time of diagnosis based on qualitative self or informant report. To develop a predictive model for time until FTC, supervised machine learning algorithms (e.g., gradient descent, gradient boosting) were implemented. In Model 1, 29 variables captured at the time of AD diagnosis and often gathered in a clinical interview, including sociodemographic factors, psychiatric conditions, medical history, and MMSE, were included. In Model 2, additional neuropsychological variables assessing episodic memory, language, attention, executive function, and processing speed were added. To train and test the algorithm(s), data were split into a 70:30 ratio. Prediction optimization was examined via cross validation using 1000 bootstrapped samples. Model evaluation included assessment of confusion matrices and calculation of accuracy and precision.
Results:
The average time to requiring FTC after AD diagnosis was 3.32 years (Range = 0.53-14.57 years). For the clinical interview only model (Model 1), younger age of onset, use of cholinesterase inhibitor medication, incontinence, and apathy were among the clinical variables that significantly predicted duration to FTC, with the largest effects shown for living alone, a positive family history of dementia, and lower MMSE score. In Model 2, the clinical predictors remained significant, and lower Boston Naming Test and Digit-Symbol Coding scores showed the largest effects in predicting duration to FTC among the neuropsychological measures. Final prediction models were further tested using five randomly selected cases. The average estimated time to FTC using the clinical interview model was within an average of 5.2 months of the recorded event and within an average of 5.8 months for the model with neuropsychological data.
Conclusions:
Predicting when individuals diagnosed with AD will need FTC is important as the transition often carries significant financial costs related to caregiving. Duration to FTC was predicted by clinical and neuropsychological variables that are easily obtained during standard dementia evaluations. Implementation of the model for prediction of FTC in cases showed encouraging prognostic accuracy. The two models show promise as a first step towards creation of a user friendly prediction calculator that could help clinicians better counsel patients on when FTC after AD diagnosis may occur, though the development of separate models for use in more diverse populations will be essential.
The use of digital technologies as a method of delivering health behaviour change (HBC) interventions is rapidly increasing across the general population. However, the role in severe mental illness (SMI) remains overlooked. In this study, we aimed to systematically identify and evaluate all of the existing evidence around digital HBC interventions in people with an SMI. A systematic search of online electronic databases was conducted. Data on adherence, feasibility, and outcomes of studies on digital HBC interventions in SMI were extracted. Our combined search identified 2196 titles and abstracts, of which 1934 remained after removing duplicates. Full-text screening was performed for 107 articles, leaving 36 studies to be included. From these, 14 focused on physical activity and/or cardio-metabolic health, 19 focused on smoking cessation, and three concerned other health behaviours. The outcomes measured varied considerably across studies. Although over 90% of studies measuring behavioural changes reported positive changes in behaviour/attitudes, there were too few studies collecting data on mental health to determine effects on psychiatric outcomes. Digital HBC interventions are acceptable to people with an SMI, and could present a promising option for addressing behavioural health in these populations. Feedback indicated that additional human support may be useful for promoting adherence/engagement, and the content of such interventions may benefit from more tailoring to specific needs. While the literature does not yet allow for conclusions regarding efficacy for mental health, the available evidence to date does support their potential to change behaviour across various domains.
Tobacco smoking is highly prevalent among patients with serious mental illness (SMI), with known deleterious consequences. Smoking cessation is therefore a prioritary public health challenge in SMI. In recent years, several smoking cessation digital interventions have been developed for non-clinical populations. However, their impact in patients with SMI remains uncertain. We conducted a systematic review to describe and evaluate effectiveness, acceptability, adherence, usability and safety of digital interventions for smoking cessation in patients with SMI. PubMed/MEDLINE, EMBASE, CINAHL, Web of Science, PsychINFO and the Cochrane Tobacco Addiction Group Specialized Register were searched. Studies matching inclusion criteria were included and their information systematically extracted by independent investigators. Thirteen articles were included, which reported data on nine different digital interventions. Intervention theoretical approaches ranged from mobile contingency management to mindfulness. Outcome measures varied widely between studies. The highest abstinence rates were found for mSMART MIND (7-day point-prevalent abstinence: 16–40%). Let's Talk About Quitting Smoking reported greater acceptability ratings, although this was not evaluated with standardized measures. Regarding usability, Learn to Quit showed the highest System Usability Scale scores [mean (s.d.) 85.2 (15.5)]. Adverse events were rare and not systematically reported. Overall, the quality of the studies was fair to good. Digitally delivered health interventions for smoking cessation show promise for improving outcomes for patients with SMI, but lack of availability remains a concern. Larger trials with harmonized assessment measures are needed to generate more definitive evidence and specific recommendations.
In this chapter, we explore the similarities and differences between the learning sciences (LS) and cognitive psychology applied to education (CP), and the potential synergy created through further integrating them. We believe that their mutual strengths can result in a deeper understanding of how learning occurs, and how to design learning environments that maximally foster learning.
For industrial and organizational psychologists who are unfamiliar with the mindfulness literature, Hyland, Lee, and Mills (2015) nicely introduce the concept by highlighting key findings from prior studies. Although their review focuses on the many benefits of mindfulness, we believe that mindfulness research should address certain questions that will help us understand whether mindfulness interventions result in a cost-effective positive return on investment. In alignment with the perspective of evidence-based practice (Briner & Rousseau, 2011; Pfeffer & Sutton, 2006), we call for a holistic evaluation of mindfulness, including a consideration of when or how unintended side effects emerge. Importantly, we discuss the potential mechanisms by which mindfulness generates valued outcomes (e.g., performance and collective psychological climate) and the need for more sophisticated research to isolate these causal effects. We also consider how the judicious use of utility analytics (e.g., cost effectiveness and return on investment) might help demonstrate the value of mindfulness interventions while also acknowledging questions of causality that must be addressed for such value to be experienced. We close by clarifying that we have the intention of promoting research to further evidence-based practices. There are organizations that have already begun providing mindfulness meditation interventions, and it is our hope that our commentary will help practitioners in these settings to consider the evidence suggesting that there may be unknown nuances regarding mindfulness practice. Ultimately, we believe that mindfulness is an important burgeoning area of research deserving of more scholarly attention.
Increased demand for corn for ethanol production has helped push grain prices to record levels. This has increased livestock production costs, and producers have responded with changes to production systems. This paper explores the degree to which costs can be mitigated with alternative feeds, the effect this might have on physical performance, and the impact of alternative feeds on the competitive position of different species.
Several studies demonstrating that central line–associated bloodstream infections (CLABSIs) are preventable prompted a national initiative to reduce the incidence of these infections.
Methods.
We conducted a collaborative cohort study to evaluate the impact of the national “On the CUSP: Stop BSI” program on CLABSI rates among participating adult intensive care units (ICUs). The program goal was to achieve a unit-level mean CLABSI rate of less than 1 case per 1,000 catheter-days using standardized definitions from the National Healthcare Safety Network. Multilevel Poisson regression modeling compared infection rates before, during, and up to 18 months after the intervention was implemented.
Results.
A total of 1,071 ICUs from 44 states, the District of Columbia, and Puerto Rico, reporting 27,153 ICU-months and 4,454,324 catheter-days of data, were included in the analysis. The overall mean CLABSI rate significantly decreased from 1.96 cases per 1,000 catheter-days at baseline to 1.15 at 16–18 months after implementation. CLABSI rates decreased during all observation periods compared with baseline, with adjusted incidence rate ratios steadily decreasing to 0.57 (95% confidence intervals, 0.50–0.65) at 16–18 months after implementation.
Conclusion.
Coincident with the implementation of the national “On the CUSP: Stop BSI” program was a significant and sustained decrease in CLABSIs among a large and diverse cohort of ICUs, demonstrating an overall 43% decrease and suggesting the majority of ICUs in the United States can achieve additional reductions in CLABSI rates.
1. The formation and translocation of the sugars in the mangold have been studied under actual conditions of growth, in which translocation was normal.
2. Starch is entirely absent from the leaf after the very earliest stages of growth. As soon as the root begins to develop so that the sugars formed in the leaf can be translocated to it, starch disappears almost entirely from the leaf. Maltose is entirely absent from leaf, mid-ribs and stalks at all stages of growth and at all times of night and day.
3. During the early stages of growth of the mangold, when leaf formation is the principal function, saccharose is present in the leaf tissue in excess of the hexoses. Later in the season, when sugar is being stored in the root, the reverse is true, hexoses largely predominating in the leaf.
4. In the mid-ribs and stalks the hexoses always predominate greatly over the saccharose and vary widely in amount during the day and night, and throughout the season, whilst the saccharose remains practically constant. In passing from leaves to mid-ribs, from mid-ribs to the tops of stalks and from the tops of stalks to the bottoms, the ratio of hexoses to saccharose steadily and rapidly increases. As the season advances the predominance of the hexoses in leaf, mid-ribs and stalks becomes more and more marked.
Partial syndromes of eating disorder are common in adolescents but the health significance of these syndromes remains uncertain.
Aims
To document the health and social adjustment in young adulthood of females assessed as having a partial syndrome of eating disorder in adolescence.
Method
A community sample of 1943 participants was tracked over 10 years in an eight-wave cohort study. A partial syndrome was defined as the fulfilment of at least two DSM-IV criteria for either anorexia or bulimia nervosa at one assessment or more between the ages of 15 years and 17 years.
Results
Partial syndromes were found in 9.4% of 15- to 17-year-old female participants and 1.4% of males. There were few instances of progression of partial syndromes to fully fledged anorexia and bulimia nervosa. However, among those with partial syndromes depressive and anxiety symptoms were two to three times higher in young adulthood, substance misuse was common, and a majority of those with a partial syndrome of anorexia nervosa were still underweight in their mid-20s.
Conclusions
Given the level of subsequent psychopathology and social role impairment, there may be justification for initiating trials of preventive and early clinical intervention strategies for adolescent partial syndromes.
In this article, we report a simple and inexpensive approach to micromolding of complex, three-dimensional, high aspect ratio structures (with non-line-of-sight features) out of a high-strength amorphous metal. Inexpensive sacrificial silicon molds were created using lithography and etching techniques originally developed for integrated circuit production by the microelectronics industry and later adopted for microelectromechanical (MEMS) manufacturing. Multiple silicon layers were stacked, and the metallic glass was forced into the cavities under heat and pressure in an open air environment. Following cooling, the metallic structures were released by etching the silicon away in a potassium hydroxide (KOH) bath. Process studies showed that temperature is the most significant variable governing mold-filling. Transmission electron microscopy (TEM) sections of the mold/glass interface showed successful replication of features with characteristic dimensions on the order of 10 nanometers and no discernible gap between the silicon and the metallic glass. This scalable micromolding process leverages the inexpensive and readily available aspects of silicon lithography to economically support the mass customization (low volume production) of metal microcomponents without elaborate infrastructure needs.
Basidiomes of Amanita alboverrucosa, A. ochrophylla, and A. pyramidifera were collected from native mixed sclerophyll forest sites and of A. conicoverrucosa and A. punctata from planted stands of Eucalyptus maculata in New South Wales, Australia. DNA was extracted from stipe tissue and subjected to inter-simple sequence repeat (ISSR) PCR analysis conducted using the primers (GTG)5 and (GACA)4 in order to determine genotype distribution at each site. Two to nine genotypes of one of the species were identified at each field site. Genotypes of A. ochrophylla, A. conicoverrucosa and A. punctata were spread over areas of ca 10–60 m diam, suggesting vegetative spread via large below-ground mycelial genets. In contrast, genotypes of A. alboverrucosa were more spatially restricted, suggesting recent establishment via basidiospores and more limited below-ground vegetative spread. Two groups of A. pyramidifera basidiomes that were separated by ca 600 m were found to be of the same genotype. While this might reflect long distance spread of below-ground mycelium in this taxon, the proximity of the basidiomes to a roadway makes movement of vegetative basidiome tissue via vehicular activity and subsequent establishment equally plausible.
Otoliths were obtained from Nezumia aequalis, a small macrourid that is widely distributed throughout the Atlantic and Mediterranean—two very different physical environments. Microchemical analysis of the otoliths was carried out using solution-based inductively coupled plasma mass spectrometry of whole otoliths. Significant differences between fish populations were found for concentrations of the elements Li and Sr. Only 54% of the samples were correctly classified by area using discriminant analysis. Otolith samples from the Reykjanes Ridge were most easily distinguished. The results are discussed in relation to trace element concentrations in the waters of the north-eastern Atlantic Ocean and the Mediterranean Sea.
What do peasants in eighteenth-century England, African Americans in Reconstruction-era Virginia, mothers in Nicaragua and Argentina, and contemporary transnational activists have to do with one another? They all illustrate instances where marginalized groups challenge a lack of democracy or the limitations of existing democracy. Democracy is both a process and a product of struggles against power. Both the social capital literature and literature that focuses on democracy as a product of institutions can undervalue the actions of regular people who imagine a democratic world beyond anything that actually exists. The four cases examined in this article demonstrate that marginalized groups use a variety of performative and subversive methods to uproot the public sphere from its exclusionary history as they imagine, on their own terms, democratic possibilities that did not previously exist. In so doing, they plant the seeds of a more egalitarian public politics in new times and places. This process is “contentious pluralism,” and we ask political scientists in all subfields to look to popular movements and changing political structures as they explore the promise of democracy and to rethink the gap between democracy as an ideal and the ways in which people actually experience it.The whole history of the progress of human liberty shows that all concessions yet made to her august claims have been born of earnest struggle. The conflict has been exciting, agitating, all-absorbing, and for the time being, putting all other tumults to silence. It must do this or it does nothing. If there is no struggle, there is no progress. Those who profess to favor freedom and yet deprecate agitation are men who want crops without plowing up the ground, they want rain without thunder and lightning. They want the ocean without the roar of its waters. The struggle may be a moral one, or it may be a physical one, and it may be moral and physical, but it must be a struggle. Power concedes nothing without demand. It never did and it never will.
—Frederick DouglassQuotation from Dawson 2001, 259.
The abilities of isolates of Amanita alboverrucosa, A. conicoverrucosa, A. fuscosquamosa, A. nauseosa, A. ochrophylla, A. pyramidifera, A. roseolamellata, A. xanthocephala and six unidentified Amanita species from eastern Australian temperate sclerophyll forests to utilise a range of inorganic and organic nitrogen sources for growth was examined in axenic liquid cultures. All taxa utilised NH4+ and at least some amino acids readily, while biomass yields on NO3− and histidine were generally low. All taxa were able to utilise bovine serum albumin, but for most taxa biomass yields on this substrate were significantly lower than on NH4+. Significant intraspecific variation in biomass yield was observed on all substrates for taxa for which multiple isolates were screened. As a group, eastern Australian Amanita species thus have the potential to utilise nitrogen from a broad range of organic substrates and this might be important in the nitrogen nutrition of their ectomycorrhizal tree hosts in sclerophyll forests.
Basidiomes of Amanita muscaria were collected from sites in three 30–36-yr-old Pinus radiata plantations in New South Wales, Australia. Following DNA extraction from basidiome stipes, inter-simple sequence repeat PCR using the degenerate primers 5′DHB(CGA)5 and 5′DDB(CCA)5, was used to identify the mycelial genotypes from which basidiomes arose. Each site was found to contain 8–10 A. muscaria genotypes, with six genotypes common to all three sites and one common to two sites. The presence of common genotypes at the three sites is taken to indicate that they were introduced as vegetative inocula when seedlings were planted and have persisted for < 36 yr.