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.
The importance of art and humanities in mental health is widely recognised, and consumption and creation of poetry, prose, drama and the plastic arts are now considered to be relevant knowledge-generating and therapeutic activities. However, literary and art criticism remain at the margins. By contrast, in his two ‘Logics of Discovery’ papers, psychiatrist, psychopathologist and psychotherapist Giovanni Stanghellini brings to bear on clinical discovery and the healing alliance cultural historian Aby Warburg's approach to images (specifically, his Atlas of Mnemosyne) and philosopher Giorgio Agamben's analysis of the linguistic phenomenon of parataxis in Friedrich Hölderlin's poetry. Both Warburg and Hölderlin experienced severe mental disorders, and Stanghellini's analysis is notable for its potential to contribute to co-creation in a wide range of clinical settings. We suggest that this work may help to address some key sources of dissatisfaction among mental health patients and thus improve patient experience and clinical outcomes. We also comment on issues regarding implementation of Stanghellini's proposals and conclude with discussion of an example of the severe loosening of associations originally reported by Eugen Bleuler.
We present the second data release for the GaLactic and Extragalactic All-sky Murchison Widefield Array eXtended (GLEAM-X) survey. This data release is an area of 12 892-deg$^2$ around the South Galactic Pole region covering 20 h40 m$\leq$RA$\leq$6 h40 m, -90$^\circ$$\leq$Dec$\leq$+30$^\circ$. Observations were taken in 2020 using the Phase-II configuration of the Murchison Widefield Array (MWA) and covering a frequency range of 72–231 MHz with twenty frequency bands. We produce a wideband source finding mosaic over 170–231 MHz with a median root-mean-squared noise of $1.5^{+1.5}_{-0.5}$ mJy beam$^{-1}$. We present a catalogue of 624 866 components, including 562 302 components which are spectrally fit. This catalogue is 98% complete at 50 mJy, and a reliability of 98.7% at a 5 $\sigma$ level, consistent with expectations for this survey. The catalogue is made available via Vizier, and the PASA datastore and accompanying mosaics for this data release are made available via AAO Data Central and SkyView.
The subjective experience of employment insecurity may be more contradictory than discourses of ‘fragmentation’ and ‘flexploitation’ suggest. For young people seeking careers in creative occupations, the expectation of insecure employment conditions has become normalised. This may be the combined effect of intergenerational changes in the youth labour market generally, and the nature of employment in creative industries at all career stages. The article draws from 80 life history interviews conducted in Western Sydney, Australia, a region with high concentrations of unemployment and low socio-economic status. Their perspectives problematise the common assumption that young creative workers seek to resist insecure patterns of work or long for the stable jobs of the past. Partly, they have accepted the injunction for ‘vocational restlessness’ in their industries. Both in their ‘day jobs’ and in their attempts to get into their chosen part of the creative industry, they feel that not staying in one position too long can be both liberating and adaptive. Union campaigns highlighting the perils of insecurity are unlikely to resonate with them.
Research suggests that there have been inequalities in the impact of the coronavirus disease 2019 (COVID-19) pandemic and related non-pharmaceutical interventions on population mental health. We explored generational, sex, and socioeconomic inequalities during the first year of the pandemic using nationally representative cohorts from the UK.
Methods
We analysed data from 26772 participants from five longitudinal cohorts representing generations born between 1946 and 2000, collected in May 2020, September–October 2020, and February–March 2021 across all five cohorts. We used a multilevel growth curve modelling approach to investigate generational, sex, and socioeconomic differences in levels of anxiety and depressive symptomatology, loneliness, and life satisfaction (LS) over time.
Results
Younger generations had worse levels of mental and social wellbeing throughout the first year of the pandemic. Whereas these generational inequalities narrowed between the first and last observation periods for LS [−0.33 (95% CI −0.51 to −0.15)], they became larger for anxiety [0.22 (0.10, 0.33)]. Generational inequalities in depression and loneliness did not change between the first and last observation periods, but initial depression levels of the youngest cohort were worse than expected if the generational inequalities had not accelerated. Women and those experiencing financial difficulties had worse initial mental and social wellbeing levels than men and those financially living comfortably, respectively, and these gaps did not substantially differ between the first and last observation periods.
Conclusions
By March 2021, mental and social wellbeing inequalities persisted in the UK adult population. Pre-existing generational inequalities may have been exacerbated with the pandemic onset. Policies aimed at protecting vulnerable groups are needed.
Background. Smoking cessation represents a significant opportunity to improve cancer survival rates, reduces the risk of cancer treatment complications, and improves quality of life. However, about half of cancer patients who smoke continue to smoke despite the availability of several treatments. Previous studies demonstrate that repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) decreases cue craving, reduces cigarette consumption, and increases the quit rate in tobacco use disorder. We investigated whether 5 sessions of rTMS can be safely and efficaciously used for smoking cessation in cancer patients. Methods. We enrolled 11 treatment-seeking smokers with cancer (>5 cigarettes per day) in a randomized, double-blind, sham-controlled proof-of-concept study. Participants received 5 daily sessions of active 10 Hz rTMS of the left DLPFC (3000 pulses per session) or sham rTMS and were followed up for 1 month via phone assessments. Main outcomes included reductions in the number of smoked-cigarettes per day (primary) and craving (secondary). Adverse effects were reported daily by participants. Results. Seven of 11 participants completed 5 sessions of rTMS over one week. Compared to sham treatment (n = 4), the active rTMS (n = 3) exhibited modest effects overtime on smoking (Cohen’s f2 effect size of 0.16) and large effects on cue craving (Cohen’s f2 = 0.40). No serious side effects related to rTMS were reported in the treatment. Conclusions. Five sessions of daily rTMS over the left DLPFC might benefit cancer patients who smoke cigarettes. However, further evidence is needed to determine with more certainty its therapeutic effect and adverse effects for cancer patients who smoke cigarettes.
To evaluate the role of procalcitonin (PCT) results in antibiotic decisions for COVID-19 patients at hospital presentation.
Design, setting, and participants:
Multicenter retrospective observational study of patients ≥18 years hospitalized due to COVID-19 at the Johns Hopkins Health system. Patients who were transferred from another facility with >24 hours stay and patients who died within 48 hours of hospitalization were excluded.
Methods:
Elevated PCT values were determined based on each hospital’s definition. Antibiotic therapy and PCT results were evaluated for patients with no evidence of bacterial community-acquired pneumonia (bCAP) and patients with confirmed, probable, or possible bCAP. The added value of PCT testing to clinical criteria in detecting bCAP was evaluated using receiving operating curve characteristics (ROC).
Results:
Of 962 patients, 611 (64%) received a PCT test. ROC curves for clinical criteria and clinical criteria plus PCT test were similar (at 0.5 ng/mL and 0.25 ng/mL). By bCAP group, median initial PCT values were 0.58 ng/mL (interquartile range [IQR], 0.24–1.14), 0.23 ng/mL (IQR, 0.1–0.63), and 0.15 ng/mL (IQR, 0.09–0.35) for proven/probable, possible, and no bCAP groups, respectively. Among patients without bCAP, an elevated PCT level was associated with 1.8 additional days of CAP therapy (95% CI, 1.01–2.75; P < .01) compared to patients with a negative PCT result after adjusting for potential confounders. Duration of CAP therapy was similar between patients without a PCT test ordered and a low PCT level for no bCAP and possible bCAP groups.
Conclusions:
PCT results may be abnormal in COVID-19 patients without bCAP and may result in receipt of unnecessary antibiotics.
Identify risk factors that could increase progression to severe disease and mortality in hospitalized SARS-CoV-2 patients in the Southeast region of the United States.
Design, setting, and participants:
Multicenter, retrospective cohort including 502 adults hospitalized with laboratory-confirmed COVID-19 between March 1, 2020, and May 8, 2020 within 1 of 15 participating hospitals in 5 health systems across 5 states in the Southeast United States.
Methods:
The study objectives were to identify risk factors that could increase progression to hospital mortality and severe disease (defined as a composite of intensive care unit admission or requirement of mechanical ventilation) in hospitalized SARS-CoV-2 patients in the Southeast United States.
Results:
In total, 502 patients were included, and 476 of 502 (95%) had clinically evaluable outcomes. The hospital mortality rate was 16% (76 of 476); 35% (177 of 502) required ICU admission and 18% (91 of 502) required mechanical ventilation. By both univariate and adjusted multivariate analyses, hospital mortality was independently associated with age (adjusted odds ratio [aOR], 2.03 for each decade increase; 95% confidence interval [CI], 1.56-–2.69), male sex (aOR, 2.44; 95% CI, 1.34–4.59), and cardiovascular disease (aOR, 2.16; 95% CI, 1.15–4.09). As with mortality, risk of severe disease was independently associated with age (aOR, 1.17 for each decade increase; 95% CI, 1.00–1.37), male sex (aOR, 2.34; 95% CI, 1.54–3.60), and cardiovascular disease (aOR, 1.77; 95% CI, 1.09–2.85).
Conclusions:
In an adjusted multivariate analysis, advanced age, male sex, and cardiovascular disease increased risk of severe disease and mortality in patients with COVID-19 in the Southeast United States. In-hospital mortality risk doubled with each subsequent decade of life.
Close double neutron stars (DNSs) have been observed as Galactic radio pulsars, while their mergers have been detected as gamma-ray bursts and gravitational wave sources. They are believed to have experienced at least one common envelope episode (CEE) during their evolution prior to DNS formation. In the last decades, there have been numerous efforts to understand the details of the common envelope (CE) phase, but its computational modelling remains challenging. We present and discuss the properties of the donor and the binary at the onset of the Roche lobe overflow (RLOF) leading to these CEEs as predicted by rapid binary population synthesis models. These properties can be used as initial conditions for detailed simulations of the CE phase. There are three distinctive populations, classified by the evolutionary stage of the donor at the moment of the onset of the RLOF: giant donors with fully convective envelopes, cool donors with partially convective envelopes, and hot donors with radiative envelopes. We also estimate that, for standard assumptions, tides would not circularise a large fraction of these systems by the onset of RLOF. This makes the study and understanding of eccentric mass-transferring systems relevant for DNS populations.
Helminth infections have large negative impacts on production efficiency in ruminant farming systems worldwide, and their effective management is essential if livestock production is to increase to meet future human needs for dietary protein. The control of helminths relies heavily on routine use of chemotherapeutics, but this approach is unsustainable as resistance to anthelmintic drugs is widespread and increasing. At the same time, infection patterns are being altered by changes in climate, land-use and farming practices. Future farms will need to adopt more efficient, robust and sustainable control methods, integrating ongoing scientific advances. Here, we present a vision of helminth control in farmed ruminants by 2030, bringing to bear progress in: (1) diagnostic tools, (2) innovative control approaches based on vaccines and selective breeding, (3) anthelmintics, by sustainable use of existing products and potentially new compounds, and (4) rational integration of future control practices. In this review, we identify the technical advances that we believe will place new tools in the hands of animal health decision makers in 2030, to enhance their options for control and allow them to achieve a more integrated and sustainable approach to helminth control in support of animal welfare and production.
Politicians, educators and business leaders often tell young people they will need to develop their creative skills to be ready for the new economy. Vast numbers of school leavers enrol in courses in media, communications, creative and performing arts, yet few will ever achieve the creative careers they aspire to. The big cities are filled with performers, designers, producers and writers who cannot make a living from their art/craft. They are told their creative skills are transferable but there is little available work outside retail, service and hospitality jobs. Actors can use their skills selling phone plans, insurance or advertising space from call centres, but usually do so reluctantly. Most people in the 'creative industries' work as low-paid employees or freelancers, or as unpaid interns. They put up with exploitation so that they can do what they love. The Creativity Hoax argues that in this individualistic and competitive environment, creative aspirants from poor and minority backgrounds are most vulnerable and precarious. Although governments in the West stress the importance of culture and knowledge in economic renewal, few invest in the support and infrastructure that would allow creative aspirants to make best use of their skills.
Policies promoting labour flexibility erode processes of relational and peer-group interaction that are vital for reproducing skills and constructive attitudes to work. If you expect to change what you are doing at almost any time, to change ‘employer’ at short notice, to change colleagues and above all to change what you call yourself, work ethics become constantly contestable and opportunistic.
Guy Standing The Precariat
At this point, it is worth recapping the argument with which we opened this book. Economic change in the West has made the directions of working life more difficult to fathom. Jobs and careers that once appeared stable seem more and more precarious, as do skills, both those acquired on the job and through education. In societies where communal and social supports have eroded, people are increasingly made responsible for their own fate. Policymakers and educators have encouraged workers to develop their creative skills, arguing that the West's future prosperity depends on symbolic and intellectual innovation. Such an injunction strikes a popular chord at two levels. Firstly, it accords with a radical critique of soul-destroying, Taylorised work that has its roots in both the 1960s counterculture (a largely middle-class movement) and in working-class resistance to alienated labour. The creativity injunction appears to offer an alternative to moral conformity, mass production and consumption and the conventional scripts of working life. It finds expression in popular culture, particularly televised talent shows (now a subgenre of ‘reality television’), where contestants can find fame in a variety of creative endeavours – singing, dancing, cooking, modelling. Secondly, the creativity injunction appeals to youth, particularly those who resist or don't fit in at school. Such people can easily become lost in the fog in the journey to adulthood and the idea of a creative career suggests the possibility of bridging subculture/ youth culture and adult life. Where once such cultures seemed hermetically sealed against the workaday world – forming a parallel universe where only imaginary solutions to alienated adult life were possible – now youthful symbolic play receives pedagogical and technocratic encouragement. Most of our interviewees related their vocational aspirations to those freewheeling youth cultural practices. In the creative economy even resistant subculture can provide a foundation for life.
To recap, we have argued that behind the rhetoric of the creative economy is a neo- liberal project to transform labour. This has several elements: to habituate workers to new capitalism's churn and upheaval; to encourage them to be optimistic despite their experience of precarity, underemployment and professional/ career abeyance; and to persuade them to be ready to transfer their creative skills, passions and ambitions towards the opportunities the market presents. In the creative economy, workers should give up on any expectation of a steady, long- term job, and instead look at working life as a series of gigs. The increasing influence of globalization and digitization over economic processes, and the weakening of industrial rights, have undermined job stability. So companies expect workers to be flexible and biddable. In one sense they must live like artists – hand- to- mouth – and be ready to bring the same creative energies to work that they apply to their art, even when performing routinized and low- skilled tasks. But in another sense, they must relinquish the artist's suspicion of commercialization. This chapter will consider how capitalism meets this latter challenge – how it brings creativity to market. Following Boltanski and Chiapello (2006), we argue that the system's remarkable durability is in part based on its capacity to absorb critique. Modern capitalism's alienated labour, mass production and consumption provoked various forms of popular resistance, including from artistic, subcultural and countercultural communities. The popularity of the idea of creative work rests in its implicit promise to remedy these ills, and free us from lives of rigid industrial direction.
However, as we have seen, the task of yoking art to enterprise is not straightforward. In this chapter we look at the idea of the social factory in more detail and how it challenges the work/ play binary. In one sense, immaterial labour is everywhere, but, from a neoclassical economic perspective, it is not productive labour until it is harnessed for profit. So how to make it productive? Immaterial labour rarely complies with the rigid directions and techniques of scientific management.
Life can only be understood backwards; but it must be lived forwards.
Soren Kierkegaard (1843, p. 306)
In opening this book we argued that capitalism now flies the banner of creativity, in part because of the increasing importance of intellectual property to corporate prosperity. Companies can no longer rely exclusively on scientific managers to drive innovation, but must look elsewhere for the symbolic and intellectual labour required to make them competitive. In narrow utilitarian terms, the ‘creative economy’ is simply a project to persuade artists to transfer their skills in commercially viable directions – to abandon the garret for the graphic designer's studio or the copywriter's office. But creativity is more than simply a set of skills. From a romantic perspective, it involves expressing the inner self in symbolic form – through, for example, the quest to produce the masterpiece or the virtuoso performance. In this deeper sense, the creative economy is a bid to conscript workers’ cultural, emotional and intellectual energies for post- Fordist work. New capitalism needs more from labour (whether as wage labourers or subcontractors) than ‘skill’ and obedience.
For workers, long denied any semblance of vocational fulfillment, the idea of creative work appears to hold the promise that they might (a) salvage a modicum of craft satisfaction from the ruins of Taylorism (b) participate in the traditional arts from which they were long excluded or (c) make a living from their cultural/ subcultural enthusiasms even where these involve protest and resistance. It is not easy for capitalism to conscript energies that originate in the private, communal and recreational spheres, especially because most available ‘creative work’ does not satisfy these ludic/ craft/ bohemian/ subcultural ideals. The jobs do not match the passions, nor even the training and skills.
To overcome this reticence, capital must shift the definition of the term ‘creativity’ – to extend its lexical range – so as to encourage workers to reassign their ambitions, skills and energies in new and unanticipated directions. This relies on the idea that creativity is not simply an intrinsic quality of a task but a product of the discourse surrounding the labour.
In September 1979 I returned to live with my parents after a gap year in Europe, and needed to make some quick money before starting university the following February. Newcastle, New South Wales, was a smokestack city built around the Broken Hill Proprietary Steelworks, now long closed, but which at that time employed many thousands of men, including some of those I had finished high school with the year before. Production had slowed after the world recession five years earlier but there was still plenty of unskilled work. It was dirty and hard, but the pay was good.
I applied for labouring work and promptly received a letter inviting me to an interview for a job in the ‘Number One Merchant Mill’. The problem was that I only intended to stay for five months before going off to study, and didn't want them to know this. As a skinny, nerdy 19-year-old, I bore little resemblance to anyone's idea of factory fodder. So I clearly needed a plan for the interview and decided (with a youthful arrogance I cringe to recall) that I would need to conceal my instinctive eagerness, intellect and all-round talent! It would be vital, I thought, to masquerade as an inarticulate, working-class youth, slightly perplexed by the situation in which I found myself. Otherwise, I reasoned, they would see me for who I was: a high-achieving, middle-class kid, with big plans for his future, likely to grow restless and leave.
Fronting the drab company offices a short walk from the blast furnaces on a sweltering afternoon, I was summoned before a fierce-looking man in his fifties who had probably served his time on the shop floor before graduating to a desk job. He quizzed me about my work experience – to that point restricted to minor retail and clerical jobs – and I responded with mumbles and fragments, avoiding eye contact. This seemed to furrow his brow. ‘So, where are you going with your life? Where do you see yourself in ten years’ time?’ he barked.
Most creative aspirants from working-class and minority backgrounds have grown up in places remote from the epicentres of the creative economy, and must undertake journeys if they are to fulfil their life plans. Such journeys are archetypal – the stuff of youthful fantasies – but they can provide both economic and social challenges. The journey forms part of the classic Bildungsroman narrative of the passage from adolescence to maturity. It is not just geographical, but also social and cultural. It can require aspirants to remake themselves, to change their image, in order to fit in with new urban scenes. The informal and improvised relations of the new economy mean that to be seen as cool or hip is not only important for accessing particular peer social groups, but also the networks through which vocational opportunities are allocated. In this chapter we argue that, far from being the egalitarian sphere that some have suggested, the new economy can actually accentuate existing power relations and sources of disadvantage. Those who are deemed not worthy rarely get far and the social and economic costs associated with ambition can be high. Our interviewees, most of whom grew up in Sydney's western suburbs, generally experience their neighbourhoods/ communities as places of comfort, but also of cultural sterility, as lacking the dynamism of the creative scenes and networks that operate in the inner city. The metropolitan journey therefore appears to be crucial if they are to break into those scenes and networks and access the opportunities that might lead from them. While to the greenhorn the journey appears to offer the chance for magical change, the experience can often be demoralizing. We will look at the cases of two young women, Nada and Tanja, who, after receiving lucky creative career breaks, experience a sharp sense of cultural vertigo, of being out of place and inadequate, in their new workplace settings. With the metropolitan journey comes the pressure to make unpalatable sacrifices.
The adjective ‘creative’ and the abstract noun ‘creativity’ have been on a wild ride just lately. Where once they referred almost exclusively to artistic practice, in recent times they have become the buzzwords of new capitalism. There is hardly a corporate vision statement, a ‘master plan for restructuring’, or job advertisement that does not refer to creativity. Additionally, it has become a lifestyle zeitgeist in an era of increasingly precarious employment. The shelves of bookshops in hipster neighbourhoods are littered with self-help and career-advice books with creativity in the title (Barton, 2016; de Bono, 2015; Ingeldew, 2016; Judkins, 2016): Liberate your creative instincts! Take control of your life! A word that once signified independent self-expression has now become both a motto of neo-liberalism and a panacea for its consequences.
In one sense, there is nothing remarkable about this semantic slippage. Language is never fixed; all words change meaning through use. But this particular transition is historically important: it is symptomatic of capitalism's epochal quest to reorganize relations of production and reconstruct labour power. However, as we argued, the brave new world of the creative economy is as yet more planned than realized. Its proponents point to digital renewal, and in particular the success of Silicon Valley ‘unicorns’ like Apple, Google, Amazon. But there is little evidence of widespread social benefits from the tech boom. The core creative workforces employed by such companies are very small when compared with the numbers employed by Fordist enterprises in the mid-twentieth century. So without widespread reasonably paid creative employment it is difficult to argue that the benefits of the sort of economic restructuring craved by policymakers will flow to workers.
The quest to marry art and economy is formidable. In bridging the void that separates the old and new economies, employers and policymakers face the problem of how to conscript cultural energies and practices that, as Bruno Gulli (2005) has argued, were traditionally situated outside the wage relation. Creativity is not easily summoned up by strict managerial direction. How does capitalism harness workers’ ludic and imaginative impulses, and their intellectual curiosity, to the project of building the new economy?