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Diagnostic accuracy is an unmet need for major depressive disorder (MDD) and major depressive episode (MDE) in bipolar disorder. Very limited research has evaluated bipolar disorder/MDE and MDD using ecological momentary assessment (EMA) time-series data.
Aims
We aimed to examine differentiating phenomenological characteristics in positive affect dynamics, and temporal relationships with pleasure towards current activity and meaning in life (MIL), among MDD, MDE/bipolar disorder and healthy controls using EMA.
Method
Participants (N = 88, mean age 28.7 years, 69% female), including individuals with MDD (n = 29) and MDE/bipolar disorder (n = 29) and healthy controls (n = 30), were assessed for positive affect, pleasure and MIL 5 times daily over a 2-week period. Multilevel modelling analysis was conducted, with estimation of first-order autoregressive model structure and time-lagged relationship between pleasure and positive affect.
Results
From 4632 EMA observations, positive affect dynamics (inertia, variability and instability) did not differ significantly across groups (all P > 0.05). Although all groups demonstrated a bidirectional relationship between positive affect and pleasure, for MDE/bipolar disorder, both pleasuret − 1 (β = −0.11, t[51.09] = −2.31, P = 0.025) and positive affectt − 1 (β = −0.13, t[56.54] = −2.30, P = 0.025) predicted subsequent MIL less significantly than for MDD and healthy controls.
Conclusion
Individuals with MDE/bipolar disorder, but not MDD, had less self-reported MIL from positive affect and pleasure. There is little evidence that emotional experience alone characterises the pathophysiology between MDD and MDE/bipolar disorder; such investigation may be limited by within-group heterogeneity. Our findings provide a new perspective on using a time-series approach beyond bimodal measures in EMA to differentiate bipolar disorder/MDE and MDD.
In major depressive disorder (MDD), only ~35% achieve remission after first-line antidepressant therapy. Using UK Biobank data, we identify sociodemographic, clinical, and genetic predictors of antidepressant response through self-reported outcomes, aiming to inform personalized treatment strategies.
Methods
In UK Biobank Mental Health Questionnaire 2, participants with MDD reported whether specific antidepressants helped them. We tested whether retrospective lifetime response to four selective serotonin reuptake inhibitors (SSRIs) (N = 19,516) – citalopram (N = 8335), fluoxetine (N = 8476), paroxetine (N = 2297) and sertraline (N = 5883) – was associated with sociodemographic (e.g. age, gender) and clinical factors (e.g. episode duration). Genetic analyses evaluated the association between CYP2C19 variation and self-reported response, while polygenic score (PGS) analysis assessed whether genetic predisposition to psychiatric disorders and antidepressant response predicted self-reported SSRI outcomes.
Results
71%–77% of participants reported positive responses to SSRIs. Non-response was significantly associated with alcohol and illicit drug use (OR = 1.59, p = 2.23 × 10−20), male gender (OR = 1.25, p = 8.29 × 10−08), and lower-income (OR = 1.35, p = 4.22 × 10−07). The worst episode lasting over 2 years (OR = 1.93, p = 3.87 × 10−16) and no mood improvement from positive events (OR = 1.35, p = 2.37 × 10−07) were also associated with non-response. CYP2C19 poor metabolizers had nominally higher non-response rates (OR = 1.31, p = 1.77 × 10−02). Higher PGS for depression (OR = 1.08, p = 3.37 × 10−05) predicted negative SSRI outcomes after multiple testing corrections.
Conclusions
Self-reported antidepressant response in the UK Biobank is influenced by sociodemographic, clinical, and genetic factors, mirroring clinical response measures. While positive outcomes are more frequent than remission reported in clinical trials, these self-reports replicate known treatment associations, suggesting they capture meaningful aspects of antidepressant effectiveness from the patient’s perspective.
This article focuses on how the policy on same-sex marriage and a person’s social locations impact upon Chinese lesbians’ life chances and welfare. Bringing the familisation and defamilisation literature, which has predominantly focused on heterosexual populations and families, into dialogue with an intersectionality perspective, we map the ways in which gender, sexuality, and class intersect in shaping lesbians’ experiences of defamilisation and familisation risks. The findings, drawn from interviews conducted in Beijing, China, reveal that the absence of legalised same-sex marriage, coupled with a lack of familial and societal recognition of same-sex relationships, exposes lesbians to both defamilisation and familisation risks, leading to difficulties in choosing whether and how to participate in the family. The intersectionality lens guides us to move beyond the heterosexual/homosexual boundary and to rethink the possibility of welfare alliances that can improve the welfare of not only lesbians but also other groups of women and minorities.
This article builds a bridge between research on the queer economy and that on the mixed economy of welfare by developing the ‘queer economy of welfare mix’ framework. While the two fields are related, there is a lack of discussion about the queer dimensions of the mixed economy of welfare or the mixed strategies employed by lesbian, gay, bisexual, trans, and queer (LGBTQ+) individuals to explore the benefits and limitations of the queer economy. The purpose of our framework is to show how local and transnational goods provided by the mixed economy of welfare can enable LGBTQ+ individuals to organise their welfare through the mixed strategies – citizen strategy, consumer strategy, and consumer-citizen strategy. By examining Taiwan’s legalised same-sex marriage and its impact on Hong Kong and Mainland China, we demonstrate the empirical significance of the framework, which serves as an analytical tool for examining the government’s role in promoting LGBTQ+ individuals’ welfare and the challenges involved.
This study examines the individual and combined association of BMI and waist-to-hip ratio (WHR) with CVD risk using genetic scores of the obesity measurements as proxies.
Design:
A 2 × 2 factorial analysis approach was applied, with participants divided into four groups of lifetime exposure to low BMI and WHR, high BMI, high WHR, and high BMI and WHR based on weighted genetic risk scores. The difference in CVD risk across groups was evaluated using multivariable logistic regression.
Setting:
Cohort study.
Participants:
A total of 408 003 participants were included from the prospective observational UK Biobank study.
Results:
A total of 58 429 CVD events were recorded. Compared to the low BMI and WHR genetic scores group, higher BMI or higher WHR genetic scores were associated with an increase in CVD risk (high WHR: OR, 1·07; 95 % CI (1·04, 1·10)); high BMI: OR, 1·12; 95 % CI (1·09, 1·16). A weak additive effect on CVD risk was found between BMI and WHR (high BMI and WHR: OR, 1·16; 95 % CI (1·12, 1·19)). Subgroup analysis showed similar patterns between different sex, age (<65, ≥65 years old), smoking status, Townsend deprivation index, fasting glucose level and medication uses, but lower systolic blood pressure was associated with higher CVD risk in obese participants.
Conclusions:
High BMI and WHR were associated with increased CVD risk, and their effects are weakly additive. Even though there were overlapping of effect, both BMI and WHR are important in assessing the CVD risk in the general population.
Let u and $\varphi $ be two analytic functions on the unit disk D such that $\varphi (D) \subset D$. A weighted composition operator $uC_{\varphi }$ induced by u and $\varphi $ is defined on $A^2_{\alpha }$, the weighted Bergman space of D, by $uC_{\varphi }f := u \cdot f \circ \varphi $ for every $f \in A^2_{\alpha }$. We obtain sufficient conditions for the compactness of $uC_{\varphi }$ in terms of function-theoretic properties of u and $\varphi $. We also characterize when $uC_{\varphi }$ on $A^2_{\alpha }$ is Hilbert–Schmidt. In particular, the characterization is independent of $\alpha $ when $\varphi $ is an automorphism of D. Furthermore, we investigate the Hilbert–Schmidt difference of two weighted composition operators on $A^2_{\alpha }$.
We investigate the boundedness, compactness, invertibility and Fredholmness of weighted composition operators between Lorentz spaces. It is also shown that the classes of Fredholm and invertible weighted composition maps between Lorentz spaces coincide when the underlying measure space is nonatomic.
This article uses data gathered from a survey that probed the career orientations and values of more than 1,000 law students in Beijing, Hong Kong and Taipei to examine the legal professionalism of future lawyers being trained under different legal education systems in Greater China. Our findings suggest that these future lawyers have a “materialistic” career orientation, although those studying in a system whose legal education goal is to train professional lawyers are more inclined to pursue professional legal ideals, and those trained in a system that emphasizes legal ethics are more likely to pursue public interest issues. On the basis of the findings, we argue that legal education systems in Greater China, while different in their traditions, share the same need to strengthen legal professionalism by according greater emphasis to legal ethics in their respective law school curricula.
We provide complete characterisations for the compactness of weighted composition operators between two distinct $L^{p}$-spaces, where $1\leq p\leq \infty$. As a corollary, when the underlying measure space is nonatomic, the only compact weighted composition map between $L^{p}$-spaces is the zero operator.
Individuals with bipolar disorder respond to affective symptoms with a range of coping behaviours, which may further maintain the symptoms.
Aims
To examine moment-to-moment dynamics between affective states and coping behaviours, and to evaluate the role of cognitive appraisals of internal states as moderators.
Method
Forty-six individuals with bipolar disorder completed a clinical interview and an experience sampling assessment over 6 days. Time-lagged analyses were conducted by multilevel regression modelling.
Results
A total of 1807 momentary entries were analysed. Negative affect predicted an increase in rumination at the subsequent time point (β = 0.21, s.e. = 0.08, P = 0.009, 95% CI 0.05–0.36), and vice versa (β = 0.03, s.e. = 0.01, P = 0.009, 95% CI 0.01–0.05). Positive affect predicted an increase in adaptive coping (β = 0.26, s.e. = 0.11, P = 0.018, 95% CI 0.04–0.47), and vice versa (β = 0.02, s.e. = 0.01, P = 0.019, 95% CI 0.00–0.03). Positive affect also predicted a decrease in rumination (β = −0.15, s.e. = 0.06, P = 0.014, 95% CI −0.26 to −0.03), and vice versa (β = −0.03, s.e. = 0.01, P = 0.016, 95% CI −0.06 to −0.01). Extreme cognitive appraisals predicted stronger associations between affective states and coping behaviours.
Conclusions
Feedback loops between affective states and coping behaviours were revealed in the daily life of individuals with bipolar disorder, which were moderated by extreme cognitive appraisals.
Let $u$ and $\unicode[STIX]{x1D711}$ be two analytic functions on the unit disc $D$ such that $\unicode[STIX]{x1D711}(D)\subset D$. A weighted composition operator $uC_{\unicode[STIX]{x1D711}}$ induced by $u$ and $\unicode[STIX]{x1D711}$ is defined by $uC_{\unicode[STIX]{x1D711}}f:=u\cdot f\circ \unicode[STIX]{x1D711}$ for every $f$ in $H^{p}$, the Hardy space of $D$. We investigate compactness of $uC_{\unicode[STIX]{x1D711}}$ on $H^{p}$ in terms of function-theoretic properties of $u$ and $\unicode[STIX]{x1D711}$.
In our previous study, the prevalence of childhood masked hypertension was 11%. This study aims to assess the left ventricular mass index of persistent masked hypertension and determine the factors of elevated left ventricular mass index in Hong Kong Chinese adolescents from a community cohort.
Design
Community prospective cohort study, follow-up of a case-control study in community.
Subjects
Patients with masked hypertension at baseline were invited to recheck ambulatory blood pressure for the persistence of masked hypertension.
Results
A total of 144 out of 165 patients with masked hypertension in the 2011/2012 ambulatory blood pressure survey consented to participate in the study. In all, 48 patients were found to have persistent masked hypertension by ambulatory blood pressure rechecking and were matched with normotensive controls by sex, age, and body height. The left ventricular mass (117.3±39.9 g versus 87.0±28.2 g versus 102.0±28.2 g) and left ventricular mass index (30.1±8.4 g/m2.7 versus 23.9±6.3 g/m2.7 versus 25.1±5.7 g/m2.7) were significantly higher in the persistent masked hypertension group (p<0.0001) compared with the patients without persistent masked hypertension and controls. In multivariate linear regression analysis, left ventricular mass index was found to be higher in male gender (β=4.874, p<0.0001) and the patients with persistent masked hypertension (β=2.796, p=0.003). In addition, left ventricular mass index was positively associated with body mass index z-score (β=3.045, p<0.0001) and low-density lipoprotein cholesterol concentration (β=1.634, p=0.015).
Conclusions
Persistent masked hypertension in adolescents is associated with elevated left ventricular mass index.
Research suggests that an 8-week mindfulness-based cognitive therapy (MBCT) course may be effective for generalised anxiety disorder (GAD).
Aims
To compare changes in anxiety levels among participants with GAD randomly assigned to MBCT, cognitive–behavioural therapy-based psychoeducation and usual care.
Method
In total, 182 participants with GAD were recruited (trial registration number: CUHK_CCT00267) and assigned to the three groups and followed for 5 months after baseline assessment with the two intervention groups followed for an additional 6 months. Primary outcomes were anxiety and worry levels.
Results
Linear mixed models demonstrated significant group × time interaction(F(4,148) = 5.10, P = 0.001) effects for decreased anxiety for both the intervention groups relative to usual care. Significant group × time interaction effects were observed for worry and depressive symptoms and mental health-related quality of life for the psychoeducation group only.
Conclusions
These results suggest that both of the interventions appear to be superior to usual care for the reduction of anxiety symptoms.
Cantonese operatic singing, one of the regional opera forms in China, flourishes mainly in the southern province of Guangdong. By exploring the culture of Cantonese operatic singing, this study relates older people's music participation to a sense of collectivism, thereby contributing to the maintenance of interpersonal relationships and promoting successful ageing. The study also illustrates how the musical participation of older adults can be influenced by the lifecourse and ageing in terms of both vocal abilities and levels of participation. Data analysed through participation observation in two Cantonese operatic singing lessons identify the rituals and core values of Cantonese operatic singing lessons. The findings help to explain how this particular music genre interacts with ageing.
This paper compares the key arguments of ecological modernization theory (EMT) with the reality of recent environmental reform in China. Based on data gathered from a survey and in-depth interviews with executives from Hong Kong-based enterprises operating in Guangdong province, we examine the changing roles of government, market, and civil society actors in the reform process, focusing on various types of pressures these actors have exerted on business enterprises. Compatible with Mol's (2006) conjectures, ecological concerns have gradually gained a foothold in existing political, economic, and to a lesser extent, social institutions. Yet, the relevant actors and their patterns of interactions differ from what EMT generalizes from Western European experiences. Specifically, local governments are assuming a more formalized relationship with firms in regulatory enforcement. Among market actors, organizational buyers along the supply chain have exerted more noticeable pressures on manufacturing firms than industrial associations and individual consumers. Civil society, while remaining less of an institutionalized actor in the environmental policy process, appears to pose a perceptible threat to at least some firms.
The longitudinal predictive power of four important reading-related skills (phonological skills, rapid naming, orthographic skills, and morphological awareness) to Chinese word reading and writing to dictation (i.e., spelling) was examined in a 3-year longitudinal study among 251 Chinese elementary students. Rapid naming, orthographic skills, and morphological awareness assessed in Grade 1 were significant longitudinal predictors of Chinese word reading in Grades 1 to 4. As for word spelling, rapid naming was the only significant predictor across grades. Morphological awareness was a robust predictor of word spelling in Grade 1 only. Phonological skills and orthographic skills significantly predicted word spelling in Grades 2 and 4. After controlling for autoregressive effects, morphological awareness and orthographic skills were the significant longitudinal predictors of Chinese word reading and word spelling, respectively. These findings reflected the impacts of the Chinese orthography on children's reading and spelling development.