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In this article, we first explicitly argue that disability associated with poor eyesight was a socially constructed category dependent on the needs of the Post Office as an employer and its ability to construct workplaces which ameliorated the impact of vision impairment. The second part of the article addresses the institutional responses and technological landscapes of work which comprised the contexts within which visual impairment needs to be interpreted. This involves examining the importance of medical inspection by Post Office doctors which worked to exclude those with significant sight loss from postal employment. However, what was understood to constitute significant or irreparable sight loss varied across different government agencies, and different definitions of what constituted significant sight loss served as a point of contention between Post Office management and the Civil Service Commission. .
Shorter, warmer winters linked to climate change are inviting the northwards expansion of mosquito species (Diptera: Culicidae) and the pathogens they vector. Monitoring can play an important role in helping to mitigate the health impacts of mosquito-borne disease due to changes in regional mosquito species composition. To update the inventory of mosquito species currently residing in Nova Scotia, we sampled adult mosquitoes from 60 locations using Centers for Disease Control and Prevention light traps and collected mosquito larvae from 232 water sources across nine ecozones from May to October in 2021 and 2022. Of the 12 652 mosquitoes collected, we identified 35 species, including eight species not previously recorded in the province: Aedes aurifer (Coquillett), Aedes decticus Howard et al., Aedes pionips Dyar, Aedes hendersoni Cockerell, Aedes sticticus (Meigen), Culiseta minnesotae Barr, Culiseta melanura (Coquillett), and Culex salinarius Coquillett. We have also observed the province-wide expansion of Aedes japonicus (Theobald) since the species’ first detection in Nova Scotia in 2007. Overall, vector species are being detected more frequently in Nova Scotia, highlighting potential changes in disease dynamics as climate change progresses and furthering the need for continued monitoring.
Eating disorders are severe psychiatric conditions associated with high mortality rates, particularly among young people. These disorders often co-occur with self-harm and suicidal ideation, yet the temporal dynamics between these variables remain poorly understood.
Aims
This study aims to elucidate the longitudinal associations between symptoms of body dissatisfaction and disordered eating, self-harm and suicidal ideation using structural equation modelling.
Method
Repeated measures of these phenotypes were used to construct a hypothetical model that includes cross-path analyses within and between the variables in two cohorts: the Twins Early Development Study (TEDS; ages 16, 21 and 26 years; N = 5196), representing a general population sample, and the COVID-19 Psychiatry and Neurological Genetics study (COPING; data collected between June 2020 and July 2021; N = 490), which focused on individuals with a history of anxiety or depression. In the TEDS cohort, symptoms of disordered eating, self-harm and suicidal ideation showed limited continuity across adolescence and young adulthood, with peak symptom severity at age 21 years.
Results
Cross-domain associations revealed that both self-harm and suicidal ideation at age 21 years were more strongly associated with disordered eating at 26 years than the reverse. In contrast, the COPING cohort exhibited greater stability in symptoms over time but showed minimal cross-domain effects.
Conclusions
The effects of self-harm and suicidal ideation on disordered eating in early adulthood are stronger than the influence of disordered eating on suicidality.
The effects of Reynolds number across ${\textit{Re}}=1000$, $2500$, $5000$ and $10\,000$ on separated flow over a two-dimensional NACA0012 airfoil at an angle of attack of $\alpha =14^\circ$ are investigated through biglobal resolvent analysis. We identify modal structures and energy amplifications over a range of frequencies, spanwise wavenumbers, and values of the discount parameter, providing insights across various time scales. Using temporal discounting, we find that the shear-layer dynamics dominates over short time horizons, while the wake dynamics becomes the primary amplification mechanism over long time horizons. Spanwise effects also appear over long time horizons, sustained by low frequencies. The low-frequency and high-wavenumber structures are found to be dominated by elliptic mechanisms within the recirculation region. At a fixed angle of attack and across the Reynolds numbers, the response modes shift from wake-dominated structures at low frequencies to shear-layer-dominated structures at higher frequencies. The frequency at which the dominant mechanism changes is independent of the Reynolds number. Comparisons at a different angle of attack ($\alpha =9^\circ$) show that the transition from wake to shear-layer dynamics with increasing frequency only occurs if the unsteady flow is three-dimensional. We also study the dominant frequencies associated with wake and shear-layer dynamics across the angles of attack and Reynolds numbers, and confirm characteristic scaling laws from the literature.
Paleontology provides insights into the history of the planet, from the origins of life billions of years ago to the biotic changes of the Recent. The scope of paleontological research is as vast as it is varied, and the field is constantly evolving. In an effort to identify “Big Questions” in paleontology, experts from around the world came together to build a list of priority questions the field can address in the years ahead. The 89 questions presented herein (grouped within 11 themes) represent contributions from nearly 200 international scientists. These questions touch on common themes including biodiversity drivers and patterns, integrating data types across spatiotemporal scales, applying paleontological data to contemporary biodiversity and climate issues, and effectively utilizing innovative methods and technology for new paleontological insights. In addition to these theoretical questions, discussions touch upon structural concerns within the field, advocating for an increased valuation of specimen-based research, protection of natural heritage sites, and the importance of collections infrastructure, along with a stronger emphasis on human diversity, equity, and inclusion. These questions offer a starting point—an initial nucleus of consensus that paleontologists can expand on—for engaging in discussions, securing funding, advocating for museums, and fostering continued growth in shared research directions.
We present the Evolutionary Map of the Universe (EMU) survey conducted with the Australian Square Kilometre Array Pathfinder (ASKAP). EMU aims to deliver the touchstone radio atlas of the southern hemisphere. We introduce EMU and review its science drivers and key science goals, updated and tailored to the current ASKAP five-year survey plan. The development of the survey strategy and planned sky coverage is presented, along with the operational aspects of the survey and associated data analysis, together with a selection of diagnostics demonstrating the imaging quality and data characteristics. We give a general description of the value-added data pipeline and data products before concluding with a discussion of links to other surveys and projects and an outline of EMU’s legacy value.
Marine sedimentary rocks of the late Eocene Pagat Member of the Tanjung Formation in the Asem Asem Basin near Satui, Kalimantan, provide an important geological archive for understanding the paleontological evolution of southern Kalimantan (Indonesian Borneo) in the interval leading up the development of the Central Indo-Pacific marine biodiversity hotspot. In this paper, we describe a moderately diverse assemblage of marine invertebrates within a sedimentological and stratigraphical context. In the studied section, the Pagat Member of the Tanjung Formation records an interval of overall marine transgression and chronicles a transition from the marginal marine and continental siliciclastic succession in the underlying Tambak Member to the carbonate platform succession in the overlying Berai Formation.
The lower part of the Pagat Member contains heterolithic interbedded siliciclastic sandstone and glauconitic shale, with thin bioclastic floatstone and bioclastic rudstone beds. This segues into a calcareous shale succession with common foraminiferal packstone/rudstone lenses interpreted as low-relief biostromes. A diverse trace fossil assemblage occurs primarily in a muddy/glauconitic sandstone, sandy mudstone, and bioclastic packstone/rudstone succession, constraining the depositional setting to a mid-ramp/mid to distal continental shelf setting below fair-weather wave base but above storm wave base.
Each biostrome rests upon a storm-generated ravinement surface characterized by a low-diversity Glossifungites or Trypanites trace fossil assemblage. The erosional surfaces were colonized by organisms that preferred stable substrates, including larger benthic foraminifera, solitary corals, oysters, and serpulid annelid worms.
The biostromes comprised islands of high marine biodiversity on the mud-dominated Pagat coastline. Together, the biostromes analyzed in this study contained 13 genera of symbiont-bearing larger benthic foraminifera, ~40 mollusk taxa, at least 5 brachyuran decapod genera, and 6 coral genera (Anthemiphyllia, Balanophyllia, Caryophyllia, Cycloseris, Trachyphyllia, and Trochocyathus), as well as a variety of bryozoans, serpulids, echinoids, and asterozoans. High foraminiferal and molluscan diversity, coupled with modest coral diversity, supports the hypothesis that the origin of the diverse tropical invertebrate faunas that characterize the modern Indo-Australian region may have occurred in the latest Eocene/earliest Oligocene.
Objectives/Goals: The Competency-Based All-Level Training (COBALT) curriculum standardizes learning for clinical research coordinators (CRCs) across multiple institutions within Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI), with flexible, topic-specific training at all experience levels, in both academic and industry-sponsored research. Methods/Study Population: The COBALT curriculum was developed in collaboration with subject matter experts, managers of CRCs, and other clinical research professionals from institutions across the WWAMI region. A thorough assessment of existing training programs within the region helped identify gaps and unmet needs. The curriculum was designed within a user-friendly learning management system that can be accessed across institutions. It has been piloted with diverse groups and committees of CRCs, professionals, and institutional leaders in clinical and translational science. Ongoing evaluation is being conducted qualitatively using built-in assessment surveys, demonstrations, and interviews. Results/Anticipated Results: The anticipated outcome is the creation of a highly standardized and efficient training program for clinical research professionals across multiple institutions in the WWAMI region. This program will be carefully tailored to each professional’s level of experience, ensuring personalized skill development. By aligning training with diverse expertise levels, the initiative aims to significantly elevate the quality, consistency, and overall performance of clinical research efforts across the regional research community. Discussion/Significance of Impact: The COBALT curriculum provides a vetted learning curriculum for CRCs, with a tailorable training plan that helps them collaborate with their supervisors to tailor training to their career goals. This ensures that the curriculum is not only comprehensive but also adaptable to individual needs.
There is mounting interest in the dual health and environmental benefits of plant-based diets. Such diets prioritise whole foods of plant origin and moderate (though occasionally exclude) animal-sourced foods. However, the evidence base on plant-based diets and health outcomes in Australasia is limited and diverse, making it unsuitable for systematic review. This review aimed to assess the current state of play, identify research gaps and suggest good practice recommendations. The consulted evidence base included key studies on plant-based diets and cardiometabolic health or mortality outcomes in Australian and New Zealand adults. Most studies were observational, conducted in Australia, published within the last decade, and relied on a single dietary assessment about 10–30 years ago. Plant-based diets were often examined using categories of vegetarianism, intake of plant or animal protein, or dietary indices. Health outcomes included mortality, type 2 diabetes and insulin resistance, obesity, CVD and metabolic syndrome. While Australia has an emerging and generally favourable evidence base on plant-based diets and health outcomes, New Zealand’s evidence base is still nascent. The lack of similar studies hinders the ability to judge the overall certainty of evidence, which could otherwise inform public health policies and strategies without relying on international studies with unconfirmed applicability. The proportional role of plant- and animal-sourced foods in healthy, sustainable diets in Australasia is an underexplored research area with potentially far-reaching implications, especially concerning nutrient adequacy and the combined health and environmental impacts.
Eating disorders, including anorexia nervosa, bulimia nervosa and binge eating disorder, are psychiatric conditions associated with high mortality rates, particularly due to suicide. Although eating disorders are strongly associated with suicidal ideation, attempts, and fatalities, the precise relationship between these conditions remains poorly understood. While substantial genetic influences have been identified for both eating disorders and suicidality, the shared genetics contributing to their co-occurrence remain unclear. In this study, we utilized a multivariate approach to examine the shared genetic architecture of eating disorder symptoms, suicidal thoughts and behaviors in ~20,000 participants from the COVID-19 Psychiatry and Neurological Genetics (COPING) study. We applied individual-level structural equation modeling to explore the factor structure underlying eating disorder symptoms and suicidal ideation, followed by genetic correlation analyses. We modeled the general factor of susceptibility to eating disorders and suicidal ideation that was as strongly genetically influenced as both conditions, with mean SNP heritability of 9%. Importantly, despite the frequent co-occurrence of eating disorders with other psychiatric conditions, our findings highlight the specificity of the relationship between eating disorders and suicidality, independent of other co-occurring psychopathology, such as depression and anxiety. This specificity highlights the need for targeted approaches in understanding the shared susceptibility factors.
Young people with childhood adversity (CA) were at increased risk to experience mental health problems during the COVID-19 pandemic. Pre-pandemic research identified high-quality friendship support as a protective factor that can buffer against the emergence of mental health problems in young people with CA. This longitudinal study investigated friendship buffering effects on mental health symptoms before and at three timepoints during the pandemic in 102 young people (aged 16–26) with low to moderate CA. Multilevel analyses revealed a continuous increase in depression symptoms following the outbreak. Friendship quality was perceived as elevated during lockdowns and returned to pre-pandemic baseline levels during reopening. A stress-sensitizing effect of CA on social functioning was evident, as social thinning occurred following the outbreak. Bivariate latent change score modeling revealed that before and during the pandemic, young people with greater friendship quality self-reported lower depression symptoms and vice versa. Furthermore, sequential mediation analysis showed that high-quality friendships before the pandemic buffered depression symptoms during the pandemic through reducing perceived stress. These findings highlight the importance of fostering stable and supportive friendships in young people with CA and suggest that through reducing stress perceptions high-quality friendships can mitigate mental health problems during times of multidimensional stress.
Salmonella enterica is a Gram-negative bacterium responsible approximately for 155,000 deaths annually. S. enterica is one of the most important foodborne pathogens, affecting mainly people in developed countries. The human immune system produces antibacterial peptides and proteins like lactoferrin (LF). This work addresses the hypothesis that bovine lactoferrin (bLF) and its derivative peptides bLactoferricin17-30, bD-Lactoferricin17-30, bLactoferrampin265-284, bD-Lactoferrampin265-284 and bLF-chimera have antimicrobial activity on planktonic cells and pre-formed biofilms of S. enterica. Planktonic Salmonella enterica ATCC 14028 were treated with bLF and bLF-peptides for two hours, and bacterial viability was determined by counting colony-forming units/ml. In addition, S. enterica biofilms were pre-formed or established on an abiotic surface, and viability or disruption was assessed in the presence of bLF and bLF-peptides by counting colony-forming units/ml or using the live/dead viability kit. We observed that bLF and bLF-peptides were bactericidal against planktonic S. enterica, killing more than 80% of cultures after two hours of treatment. The bactericidal effect was concentration and time-dependent. In addition, bLF, bLFampin165-284, and bLF-chimera showed an anti-biofilm effect against Salmonella biofilms pre-formed during 8 and 12 hours on the abiotic surface, disorganizing more than 50% of the biofilms after 4 or 6 hours of treatment. We conclude that bLF and its peptides show antimicrobial activity against planktonic cells and pre-formed biofilms of S. enterica on abiotic surfaces and could potentially be a therapeutic solution to combat Salmonella infections.
Accurate diagnosis of bipolar disorder (BPD) is difficult in clinical practice, with an average delay between symptom onset and diagnosis of about 7 years. A depressive episode often precedes the first manic episode, making it difficult to distinguish BPD from unipolar major depressive disorder (MDD).
Aims
We use genome-wide association analyses (GWAS) to identify differential genetic factors and to develop predictors based on polygenic risk scores (PRS) that may aid early differential diagnosis.
Method
Based on individual genotypes from case–control cohorts of BPD and MDD shared through the Psychiatric Genomics Consortium, we compile case–case–control cohorts, applying a careful quality control procedure. In a resulting cohort of 51 149 individuals (15 532 BPD patients, 12 920 MDD patients and 22 697 controls), we perform a variety of GWAS and PRS analyses.
Results
Although our GWAS is not well powered to identify genome-wide significant loci, we find significant chip heritability and demonstrate the ability of the resulting PRS to distinguish BPD from MDD, including BPD cases with depressive onset (BPD-D). We replicate our PRS findings in an independent Danish cohort (iPSYCH 2015, N = 25 966). We observe strong genetic correlation between our case–case GWAS and that of case–control BPD.
Conclusions
We find that MDD and BPD, including BPD-D are genetically distinct. Our findings support that controls, MDD and BPD patients primarily lie on a continuum of genetic risk. Future studies with larger and richer samples will likely yield a better understanding of these findings and enable the development of better genetic predictors distinguishing BPD and, importantly, BPD-D from MDD.
Following a health technology assessment, the Health Service Executive (HSE) supported reimbursement of dupilumab subject to a managed access protocol (MAP) being implemented. Reimbursement is restricted to a subgroup of the fully licensed indication, that is, moderate-to-severe refractory atopic dermatitis (AD) in adults and adolescents 12 years and older. This study provides an overview of the first year of the MAP.
Methods
All reimbursement applications submitted to the HSE Medicines Management Programme between 1 April 2021 and 31 March 2022 were reviewed. Key demographic and clinical characteristics of the approved population were analyzed. Reimbursement claims data within the specified period were extracted from the HSE Primary Care Reimbursement Services national pharmacy claims database. All data were compiled and analyzed using SPSS Statistics 27. Expenditure estimates were based on wholesale prices and were exclusive of value-added tax, fees, and confidential rebates.
Results
During the study period, 382 applications were submitted, 96 percent (n=365) of which were approved. Among approved patients, the mean age was 35 years (range 12 to 79 years), the mean number of years between AD diagnosis and approval was 22.65 years (range 1 to 78 years), and 65 percent (n=238) were men. The mean Eczema Area and Severity Index score was 28.72 and the mean (Children’s) Dermatology Life Quality Index score was 19.72. Approved patients who had unsuccessfully tried other systemic immunosuppressants had trialed up to five different medicines (mean=1.6). Year one expenditure was EUR2.4million, with 70 percent of approved patients accessing treatment.
Conclusions
Most applications submitted through the MAP were approved. These patients met the predefined evidence-based eligibility criteria for treatment. Patient numbers were higher than estimated, suggesting that the MAP did not hinder access. Utilizing health technology management by way of a MAP has facilitated access to expensive medicines for patients with the greatest need, while controlling expenditure for the payer.
Clozapine is the antipsychotic medication with the greatest efficacy in treatment-resistant schizophrenia (TRS). Unfortunately, clozapine is ceased in approximately 0.2% to 8.5% of people due to concerns about clozapine-associated myocarditis (CAM). The opportunity for clozapine rechallenge is important for people with TRS and CAM, due to limited alternative treatments. However, there is a lack of consensus regarding the optimal process, monitoring, and dose titration to achieve successful clozapine rechallenge. The study aimed to review the process, monitoring, and dose titration within cases of clozapine rechallenge after CAM, to identify features associated with successful rechallenge.
Methods
A systematic review of clozapine rechallenge cases following CAM was conducted. PubMed, EMBASE, Cinahl, and PsycINFO were searched for cases. Reference lists of retrieved articles and field experts were consulted to identify additional studies.
Results
Forty-five cases were identified that described clozapine rechallenge, 31 of which were successful. Successful rechallenge cases generally used a slower dose titration regime with more frequent monitoring than standard clozapine initiation protocols; however, this data was not always completely recorded within cases. Six cases referred to published rechallenge protocols to guide their rechallenge.
Conclusions
The process, monitoring, and dose titration of clozapine rechallenge are inconsistently reported in the literature. Despite this, 69% of case reports detailed a successful rechallenge post CAM; noting limitations associated with reliance on case data. Ensuring published clozapine rechallenge cases report standardised data, including titration speed and monitoring frequencies, is required to guide the development and validation of guidelines for clozapine rechallenge.
Tape rolls are often used for multiple patients despite recommendations by manufacturers for single-patient use. We developed a survey to query Health Care Personnel about their tape use practices and beliefs and uncovered behaviors that put patients at risk for hospital-acquired infections due to tape use.
Advances in artificial intelligence (AI) have great potential to help address societal challenges that are both collective in nature and present at national or transnational scale. Pressing challenges in healthcare, finance, infrastructure and sustainability, for instance, might all be productively addressed by leveraging and amplifying AI for national-scale collective intelligence. The development and deployment of this kind of AI faces distinctive challenges, both technical and socio-technical. Here, a research strategy for mobilising inter-disciplinary research to address these challenges is detailed and some of the key issues that must be faced are outlined.
In this chapter, we discuss the relationship of individual personal thriving to fairness and worthiness by exploring the concept of epistemic injustice. Epistemic injustice refers to the rejection of people’s capacity as knowers, such that these individuals are treated as being less knowledgeable and less believable than other people, frequently on the basis of their social identities. In the first half of the chapter, we will explain how epistemic injustices take place and how they interrupt human thriving. In the second half of the chapter, we will profile the ways that psychologists and others can work to prevent epistemic injustice.
Disease-modifying therapies (DMTs) for Alzheimer’s disease (AD) are emerging following successful clinical trials of therapies targeting amyloid beta (Aβ) protofibrils or plaques. Determining patient eligibility and monitoring treatment efficacy and adverse events, such as Aβ-related imaging abnormalities, necessitates imaging with MRI and PET. The Canadian Consortium on Neurodegeneration in Aging (CCNA) Imaging Workgroup aimed to synthesize evidence and provide recommendations on implementing imaging protocols for AD DMTs in Canada.
Methods:
The workgroup employed a Delphi process to develop these recommendations. Experts from radiology, neurology, biomedical engineering, nuclear medicine, MRI and medical physics were recruited. Surveys and meetings were conducted to achieve consensus on key issues, including protocol standardization, scanner strength, monitoring protocols based on risk profiles and optimal protocol lengths. Draft recommendations were refined through multiple iterations and expert discussions.
Results:
The recommendations emphasize standardized acquisition imaging protocols across manufacturers and scanner strengths to ensure consistency and reliability of clinical treatment decisions, tailored monitoring protocols based on DMTs’ safety and efficacy profiles, consistent monitoring regardless of perceived treatment efficacy and MRI screening on 1.5T or 3T scanners with adapted protocols. An optimal protocol length of 20–30 minutes was deemed feasible; specific sequences are suggested.
Conclusion:
The guidelines aim to enhance imaging data quality and consistency, facilitating better clinical decision-making and improving patient outcomes. Further research is needed to refine these protocols and address evolving challenges with new DMTs. It is recognized that administrative, financial and logistical capacity to deliver additional MRI and positron emission tomography scans require careful planning.
This chapter will present a composite method of analysis for embodied movement data, developed in the first author's doctoral project (in progress at time of writing), which considered attitudes towards the body in English primary schools. This project sought to understand embodied experiences and their pedagogical implications, suggesting that heightened embodied awareness might support a more perceptive and responsive pedagogy. It drew heavily on the first author's career as a dancer and aerialist specialising in creative movement. Residencies in three schools over the course of nine months consisted of weekly, one- hour sessions of creative movement play with at least two classes in each school, over the course of six weeks in the pilot school and the first enquiry school, and ten weeks in the second enquiry school.
Children were mainly aged 7 to 11 and attended in whole- class groups. Class teachers supported, sometimes joining in and sometimes observing the movement. Data generated included: interviews with staff, video of the children moving using both high- quality video and infrared cameras, and drawings and voice- recorded comments made by the children at the end of the sessions. These different data types were used to triangulate and cross reference during later stages of analysis, which are not discussed in this chapter.
Theoretical foundations
Extending and adapting Rhythmanalysis (Lefebvre, 2004), we used creative dance practice for non- verbal interpretation of the intangible experience of the learner. Analysing primary, embodied, movement data through a series of dance- led lenses avoids immediately grappling with the limitations of translating movement into language, focusing instead on the perceptual level of these experiences and opening the possibility of deeper understanding. However, this approach does then consider what is entailed in the move to reflect and define through words, mindful that this translation will necessarily be occurring in research on embodiment, but also that words can usefully enrich and then invoke as data the movement language that is generated. The question is not then whether reflection and analysis through words should happen at all, but rather how and at what stage.