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Despite its impressive evidence base, there is a widening access gap to receiving cognitive behavioural therapy (CBT). Video conferencing therapy (VCT) offers an effective solution for logistical barriers to treatment, which has been salient throughout the Coronavirus pandemic. However, research concerning the delivery of CBT via VCT for children and young people (CYP) is in its infancy, and clinical outcome data are limited. The aim of this service evaluation was to explore the effectiveness of a VCT CBT intervention for CYP referred from Child and Adolescent Mental Health Services (CAMHS) in the UK. A total of 989 records of CYP who had completed CBT via VCT in 2020 with Healios, a digital mental health company commissioned by the National Health Service (NHS), were examined to determine changes in anxiety, depression and progress towards personalised goals. Routine outcome measures (ROMs) were completed at baseline and endpoint, as well as session by session. Feedback was collected from CYP and their families at the end of treatment. There was a significant reduction in symptoms of anxiety and depression and significant progress towards goals, with pre- to post-effect sizes (Cohen’s d) demonstrating medium to large effects (d=.45 to d=−1.39). Reliable improvement ranged from 31 to 80%, clinical improvement ranged from 33 to 50%, and 25% clinically and reliably improved on at least one measure; 92% reported that they would recommend Healios. This service evaluation demonstrates that Healios’ CBT delivered via VCT is effective for CYP receiving it as part of routine mental health care.
Key learning aims
(1) To consider whether CBT can be effectively delivered in routine care via VCT.
(2) To explore whether CBT delivered in routine care via VCT is acceptable to children, young people and their families.
(3) To reflect on the benefits of VCT and the collection of a variety of ROMs via digital platforms.
Economic inequalities are among the greatest human rights challenges the world faces today due to the past four decades of neoliberal policy dominance. Globally, there are now over 2,000 billionaires, while 3.4 billion people live below the poverty line of US $5.50 per day. Many human rights scholars and practitioners read these statistics with alarm, asking what impact such extreme inequalities have on realizing human rights and what role, if any, should human rights have in challenging them? This edited volume examines these questions from multiple disciplinary perspectives, seeking to uncover the relationships between human rights and economic inequalities, and the barriers and pathways to greater economic equality and full enjoyment of human rights for all. The volume is a unique contribution to the emerging literature on human rights and economic inequality, as it is interdisciplinary, global in reach and extends to several under-researched areas in the field.
This chapter discusses the measurement of economic inequality with the aim of furthering the discussion and potential cooperation between economists and human rights scholars and practitioners. It discusses how to measure economic inequality in the most useful way for the purpose of monitoring progress towards the goal of ensuring dignity and human rights for all. This builds on the work of many other economists (see Atkinson 2015 for a comprehensive review) to seek common ground in understanding the measurement of economic inequality, to be relevant for purposes of policymaking, and discusses new work by economists that improves the measurement of income and wealth, including of the richest. Reddy (2011) argued that economics and human rights approaches can be complementary if sufficient dialogue can be created between the disciplines. In the context of the extreme and growing economic inequalities in the world today, such dialogue has become an urgent matter.
Economic inequalities are among the greatest human rights challenges the world faces today. Over the past four decades of neoliberal policy dominance, economic inequalities have risen drastically in the vast majority of countries in the world (Alvaredo et al. 2018, 9; Harvey 2005). Over the same period, international human rights have risen to the become the primary ethical language and legal framework for justice. This Upendra Baxi labels the “Age of Human Rights” (Baxi 2012, 1). The trend of rising economic inequalities in the age of human rights is not, however, inevitable. In 1948, when the Universal Declaration of Human Rights (UDHR) was adopted, the human rights agenda encompassed the ideal of equality, which coincided with the growing welfare state and the decolonization and “modernization” of low- and middle-income countries (Marshall 1992 Moyn 2018; Dehm 2019). Today, extreme economic inequalities and their myriad negative impacts on human wellbeing provide compelling reasons to consider the potential of human rights to once again contribute to bring about a more economically equal and just world. This volume takes up that challenge.
To assess the relationship between food insecurity, sleep quality, and days with mental and physical health issues among college students.
Design:
An online survey was administered. Food insecurity was assessed using the ten-item Adult Food Security Survey Module. Sleep was measured using the nineteen-item Pittsburgh Sleep Quality Index (PSQI). Mental health and physical health were measured using three items from the Healthy Days Core Module. Multivariate logistic regression was conducted to assess the relationship between food insecurity, sleep quality, and days with poor mental and physical health.
Setting:
Twenty-two higher education institutions.
Participants:
College students (n 17 686) enrolled at one of twenty-two participating universities.
Results:
Compared with food-secure students, those classified as food insecure (43·4 %) had higher PSQI scores indicating poorer sleep quality (P < 0·0001) and reported more days with poor mental (P < 0·0001) and physical (P < 0·0001) health as well as days when mental and physical health prevented them from completing daily activities (P < 0·0001). Food-insecure students had higher adjusted odds of having poor sleep quality (adjusted OR (AOR): 1·13; 95 % CI 1·12, 1·14), days with poor physical health (AOR: 1·01; 95 % CI 1·01, 1·02), days with poor mental health (AOR: 1·03; 95 % CI 1·02, 1·03) and days when poor mental or physical health prevented them from completing daily activities (AOR: 1·03; 95 % CI 1·02, 1·04).
Conclusions:
College students report high food insecurity which is associated with poor mental and physical health, and sleep quality. Multi-level policy changes and campus wellness programmes are needed to prevent food insecurity and improve student health-related outcomes.
Herbicides are the primary method used to control exotic, invasive plants. This study evaluated restoration efforts applied to grasslands dominated by an invasive plant, sulfur cinquefoil, 6 yr after treatments. Of the five herbicides we evaluated, picloram continued to provide the best control of sulfur cinquefoil over 6 yr. We found the timing of picloram applications to be important to the native forb community. Plots with picloram applied in the fall had greater native forb cover. However, without the addition of native perennial grass seeds, the sites became dominated by exotic grasses. Seeding resulted in a 20% decrease in exotic grass cover. Successful establishment of native perennial grasses was not apparent until 6 yr after seeding. Our study found integrating herbicide application and the addition of native grass seed to be an effective grassland restoration strategy, at least in the case where livestock are excluded.