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The acclaimed novelist Barbara Pym worked for the International African Institute from 1948 to 1974 contributing her editing and administrative skills to the Institute’s journal, Africa, and output of scholarly publications on Africa. This article explores that contribution, her working relationships with Cyril Daryll Forde and other anthropologists, and how all this is reflected and referenced in her novels, especially in points of contact between Forde’s ethnography and Pym’s Quartet in Autumn.
Lift and drag forces on moving intruders in flowing granular materials are of fundamental interest but have not yet been fully characterized. Drag on an intruder in granular shear flow has been studied almost exclusively for the intruder moving across flow streamlines, and the few studies of the lift explore a relatively limited range of parameters. Here, we use discrete element method simulations to measure the lift force, $F_{{L}}$, and the drag force on a spherical intruder in a uniformly sheared bed of smaller spheres for a range of streamwise intruder slip velocities, $u_{{s}}$. The streamwise drag matches the previously characterized Stokes-like cross-flow drag. However, $F_{{L}}$ in granular shear flow acts in the opposite direction to the Saffman lift in a sheared fluid at low $u_{{s}}$, reaches a maximum value and then decreases with increasing $u_{{s}}$, eventually reversing direction. This non-monotonic response holds over a range of flow conditions, and the $F_{{L}}$ versus $u_{{s}}$ data collapse when both quantities are scaled using the particle size, shear rate and overburden pressure. Analogous fluid simulations demonstrate that the flow around the intruder particle is similar in the granular and fluid cases. However, the shear stress on the granular intruder is notably less than that in a fluid shear flow. This difference, combined with a void behind the intruder in granular flow in which the stresses are zero, significantly changes the lift-force-inducing stresses acting on the intruder between the granular and fluid cases.
Maladaptive daydreaming is a distinct syndrome in which the main symptom is excessive vivid fantasising that causes clinically significant distress and functional impairment in academic, vocational and social domains. Unlike normal daydreaming, maladaptive daydreaming is persistent, compulsive and detrimental to one’s life. It involves detachment from reality in favour of intense emotional engagement with alternative realities and often includes specific features such as psychomotor stereotypies (e.g. pacing in circles, jumping or shaking one’s hands), mouthing dialogues, facial gestures or enacting fantasy events. Comorbidity is common, but existing disorders do not account for the phenomenology of the symptoms. Whereas non-specific therapy is ineffective, targeted treatment seems promising. Thus, we propose that maladaptive daydreaming be considered a formal syndrome in psychiatric taxonomies, positioned within the dissociative disorders category. Maladaptive daydreaming satisfactorily meets criteria for conceptualisation as a psychiatric syndrome, including reliable discrimination from other disorders and solid interrater agreement. It involves significant dissociative aspects, such as disconnection from perception, behaviour and sense of self, and has some commonalities with but is not subsumed under existing dissociative disorders. Formal recognition of maladaptive daydreaming as a dissociative disorder will encourage awareness of a growing problem and spur theoretical, research and clinical developments.
We conducted the first randomized controlled field experiment of an Internet reputation mechanism. A high-reputation, established eBay dealer sold matched pairs of lots— batches of vintage postcards—under his regular identity and under new seller identities (also operated by him). As predicted, the established identity fared better. The difference in buyers’ willingness-to-pay was 8.1% of the selling price. A subsidiary experiment followed the same format, but compared sales by relatively new sellers with and without negative feedback. Surprisingly, one or two negative feedbacks for our new sellers did not affect buyers’ willingness-to-pay.
The COVID-19 pandemic has had a negative impact on the population’s mental health, particularly for individuals with health anxiety (HA) and obsessive compulsive disorder (OCD). This is in conjunction with a significant change in accessibility of face-to-face psychological services which have had to rapidly adapt to the remote delivery of therapy.
Aims:
Using a single-arm open trial design, the study aimed to evaluate the effectiveness of evidence-based CBT interventions for HA and OCD delivered via a blend of online therapist consultations interspersed with self-study reading materials. A secondary aim was to evaluate remote training workshops provided to therapists.
Method:
Therapists attended three half-day remote workshops after which consecutive participants with HA or OCD were assigned to therapists for treatment. Monthly expert supervision was provided. Patients completed routine outcome measures at each session and an idiosyncratic measure of pre-occupation with COVID-19 at pre- and post-treatment.
Results:
Significant and comparable improvements were observed on measures of anxiety, depression and social adjustment from pre- to post-treatment in both the HA (n=14) and OCD (n=20) groups. Disorder-specific measures also showed significant improvements after treatment. The HA group showed greater levels of change on the COVID-19-specific questionnaire. The training workshops were well received by therapists, who valued the monthly supervision sessions.
Conclusions:
The study provides support for the effectiveness of the online delivery of CBT for HA and OCD supported by the inclusion of additional self-study booklets.
Bathing intensive care unit (ICU) patients with chlorhexidine gluconate (CHG) decreases healthcare-associated infections (HAIs). The optimal method of CHG bathing remains undefined.
Methods:
Prospective crossover study comparing CHG daily bathing with 2% CHG-impregnated cloths versus 4% CHG solution. In phase 1, from January 2020 through March 2020, 1 ICU utilized 2% cloths, while the other ICU utilized 4% solution. After an interruption caused by the coronavirus disease 2019 pandemic, in phase 2, from July 2020 through September 2020, the unit CHG bathing assignments were reversed. Swabs were performed 3 times weekly from patients’ arms and legs to measure skin microbial colonization and CHG concentration. Other outcomes included HAIs, adverse reactions, and skin tolerability.
Results:
411 assessments occurred after baths with 2% cloth, and 425 assessments occurred after baths with 4% solution. Average microbial colonization was 691 (interquartile range 0, 30) colony-forming units per square centimeter (CFU/cm2) for patients bathed with 2% cloths, 1,627 (0, 265) CFUs/cm2 for 4% solution, and 8,519 (10, 1130) CFUs/cm2 for patients who did not have a CHG bath (P < .001). Average CHG skin concentration (parts per million) was 1300.4 (100, 2000) for 2% cloths, 307.2 (30, 200) for 4% solution, and 32.8 (0, 20) for patients without a recorded CHG bath. Both CHG bathing methods were well tolerated. Although underpowered, no difference in HAI was noted between groups.
Conclusions:
Either CHG bathing method resulted in a significant decrease in microbial skin colonization with a greater CHG concentration and fewer organisms associated with 2% CHG cloths.
Obruchevodid petalodonts are rare small chondrichthyans known from nearly complete to partial skeletons from the Upper Mississippian (Serpukhovian) Bear Gulch Limestone of central Montana and isolated teeth from the Upper Mississippian Bangor Limestone of northern Alabama. New records of obruchevodid petalodonts are presented here from the Middle Mississippian (Viséan) Joppa Member of the Ste. Genevieve Formation at Mammoth Cave National Park, Kentucky. Obruchevodids are here represented by multiple teeth of a new taxon, Clavusodens mcginnisi n. gen. n. sp., and a single tooth referred to ?Netsepoye sp. Clavusodens mcginnisi n. gen. n. sp. is characterized by teeth with pointed mesiodistal and lingual margins and more robust chisel-like cusps on the anterolateral and distolateral teeth. The suggestion that obruchevodid petalodonts evolved to inhabit complex reef-like environments and other nearshore habitats with a feeding ecology analogous to extant triggerfish is explored and discussed.
The theory of signal detection is convenient for measuring mnemonic ability in recognition memory paradigms. In these paradigms, randomly selected participants are asked to study randomly selected items. In practice, researchers aggregate data across items or participants or both. The signal detection model is nonlinear; consequently, analysis with aggregated data is not consistent. In fact, mnemonic ability is underestimated, even in the large-sample limit. We present two hierarchical Bayesian models that simultaneously account for participant and item variability. We show how these models provide for accurate estimation of participants’ mnemonic ability as well as the memorability of items. The model is benchmarked with a simulation study and applied to a novel data set.
Human abilities in perceptual domains have conventionally been described with reference to a threshold that may be defined as the maximum amount of stimulation which leads to baseline performance. Traditional psychometric links, such as the probit, logit, and t, are incompatible with a threshold as there are no true scores corresponding to baseline performance. We introduce a truncated probit link for modeling thresholds and develop a two-parameter IRT model based on this link. The model is Bayesian and analysis is performed with MCMC sampling. Through simulation, we show that the model provides for accurate measurement of performance with thresholds. The model is applied to a digit-classification experiment in which digits are briefly flashed and then subsequently masked. Using parameter estimates from the model, individuals’ thresholds for flashed-digit discrimination is estimated.
Optimising stellarators for quasisymmetry leads to strongly reduced collisional transport and energetic particle losses compared with unoptimised configurations. Although stellarators with precise quasisymmetry have been obtained in the past, it remains unclear how broad the parameter space is where good quasisymmetry may be achieved. We study the range of aspect ratios and rotational transform values for which stellarators with excellent quasisymmetry on the boundary can be obtained. A large number of Fourier harmonics is included in the boundary representation, which is made computationally tractable by the use of adjoint methods to enable fast gradient-based optimisation and by the direct optimisation of vacuum magnetic fields, which converge more robustly compared with solutions from magnetohydrostatics. Several novel configurations are presented, including stellarators with record levels of quasisymmetry on a surface, three field period quasiaxisymmetric stellarators with substantial magnetic shear, and compact quasisymmetric stellarators at low aspect ratios similar to tokamaks.
The association between cannabis and psychosis is established, but the role of underlying genetics is unclear. We used data from the EU-GEI case-control study and UK Biobank to examine the independent and combined effect of heavy cannabis use and schizophrenia polygenic risk score (PRS) on risk for psychosis.
Methods
Genome-wide association study summary statistics from the Psychiatric Genomics Consortium and the Genomic Psychiatry Cohort were used to calculate schizophrenia and cannabis use disorder (CUD) PRS for 1098 participants from the EU-GEI study and 143600 from the UK Biobank. Both datasets had information on cannabis use.
Results
In both samples, schizophrenia PRS and cannabis use independently increased risk of psychosis. Schizophrenia PRS was not associated with patterns of cannabis use in the EU-GEI cases or controls or UK Biobank cases. It was associated with lifetime and daily cannabis use among UK Biobank participants without psychosis, but the effect was substantially reduced when CUD PRS was included in the model. In the EU-GEI sample, regular users of high-potency cannabis had the highest odds of being a case independently of schizophrenia PRS (OR daily use high-potency cannabis adjusted for PRS = 5.09, 95% CI 3.08–8.43, p = 3.21 × 10−10). We found no evidence of interaction between schizophrenia PRS and patterns of cannabis use.
Conclusions
Regular use of high-potency cannabis remains a strong predictor of psychotic disorder independently of schizophrenia PRS, which does not seem to be associated with heavy cannabis use. These are important findings at a time of increasing use and potency of cannabis worldwide.
Early intervention in psychosis (EIP) services improve outcomes for young people, but approximately 30% disengage.
Aims
To test whether a new motivational engagement intervention would prolong engagement and whether it was cost-effective.
Method
We conducted a multicentre, single-blind, parallel-group, cluster randomised controlled trial involving 20 EIP teams at five UK National Health Service (NHS) sites. Teams were randomised using permuted blocks stratified by NHS trust. Participants were all young people (aged 14–35 years) presenting with a first episode of psychosis between May 2019 and July 2020 (N = 1027). We compared the novel Early Youth Engagement (EYE-2) intervention plus standardised EIP (sEIP) with sEIP alone. The primary outcome was time to disengagement over 12–26 months. Economic outcomes were mental health costs, societal costs and socio-occupational outcomes over 12 months. Assessors were masked to treatment allocation for primary disengagement and cost-effectiveness outcomes. Analysis followed intention-to-treat principles. The trial was registered at ISRCTN51629746.
Results
Disengagement was low at 15.9% overall in standardised stand-alone services. The adjusted hazard ratio for EYE-2 + sEIP (n = 652) versus sEIP alone (n = 375) was 1.07 (95% CI 0.76–1.49; P = 0.713). The health economic evaluation indicated lower mental healthcare costs linked to reductions in unplanned mental healthcare with no compromise of clinical outcomes, as well as some evidence for lower societal costs and more days in education, training, employment and stable accommodation in the EYE-2 group.
Conclusions
We found no evidence that EYE-2 increased time to disengagement, but there was some evidence for its cost-effectiveness. This is the largest study to date reporting positive engagement, health and cost outcomes in a total EIP population sample. Limitations included high loss to follow-up for secondary outcomes and low completion of societal and socio-occupational data. COVID-19 affected fidelity and implementation. Future engagement research should target engagement to those in greatest need, including in-patients and those with socio-occupational goals.
Childhood bullying is a public health priority. We evaluated the effectiveness and costs of KiVa, a whole-school anti-bullying program that targets the peer context.
Methods
A two-arm pragmatic multicenter cluster randomized controlled trial with embedded economic evaluation. Schools were randomized to KiVa-intervention or usual practice (UP), stratified on school size and Free School Meals eligibility. KiVa was delivered by trained teachers across one school year. Follow-up was at 12 months post randomization. Primary outcome: student-reported bullying-victimization; secondary outcomes: self-reported bullying-perpetration, participant roles in bullying, empathy and teacher-reported Strengths and Difficulties Questionnaire. Outcomes were analyzed using multilevel linear and logistic regression models.
Findings
Between 8/11/2019–12/02/2021, 118 primary schools were recruited in four trial sites, 11 111 students in primary analysis (KiVa-intervention: n = 5944; 49.6% female; UP: n = 5167, 49.0% female). At baseline, 21.6% of students reported being bullied in the UP group and 20.3% in the KiVa-intervention group, reducing to 20.7% in the UP group and 17.7% in the KiVa-intervention group at follow-up (odds ratio 0.87; 95% confidence interval 0.78 to 0.97, p value = 0.009). Students in the KiVa group had significantly higher empathy and reduced peer problems. We found no differences in bullying perpetration, school wellbeing, emotional or behavioral problems. A priori subgroup analyses revealed no differences in effectiveness by socioeconomic gradient, or by gender. KiVa costs £20.78 more per pupil than usual practice in the first year, and £1.65 more per pupil in subsequent years.
Interpretation
The KiVa anti-bullying program is effective at reducing bullying victimization with small-moderate effects of public health importance.
Funding
The study was funded by the UK National Institute for Health and Care Research (NIHR) Public Health Research program (17-92-11). Intervention costs were funded by the Rayne Foundation, GwE North Wales Regional School Improvement Service, Children's Services, Devon County Council and HSBC Global Services (UK) Ltd.
Severe mental illness (SMI), which includes schizophrenia, schizoaffective disorder and bipolar disorder, has profound health impacts, even in the elderly.
Aims
To evaluate relative risk of hospital admission and length of hospital stay for physical illness in elders with SMI.
Method
To construct a population-based retrospective cohort observed from April 2007 to March 2016, data from a case registry with full but de-identified electronic health records were retrieved for patients of the South London and Maudsley NHS Foundation Trust, the single secondary mental healthcare service provider in south-east London. We compared participants with SMI aged >60 years old with the general population of the same age and residing in the same areas through data linkage by age-, sex- and fiscal-year-standardised admission ratios (SARs) for primary diagnoses at hospital discharge. Furthermore, we compared the duration of hospital stay with an age-, sex- and cause-of-admission-matched random group by linear regression for major causes of admission.
Results
In total, records for 4175 older people with SMI were obtained, relating to 10 342 admission episodes, showing an overall SAR for all physical illnesses of 5.15 (95% CI: 5.05, 5.25). Among the top causes of admission, SARs ranged from 3.87 for circulatory system disorders (ICD-10 codes: I00–I99) to 6.99 for genitourinary system or urinary conditions (N00–N39). Specifically, the diagnostic group of ‘symptoms, signs and findings, not elsewhere classified’ (R00–R99) had an elevated SAR of 6.56 (95% CI: 6.22, 6.90). Elders with SMI also had significantly longer hospital stays than their counterparts in the general population, especially for digestive system illnesses (K00–K93), after adjusting for confounding.
Conclusions
Poorer overall physical health and specific patterns were identified in elders with SMI.
American and European adults prefer natural products and often pay premiums to purchase natural products. They may do this because they believe natural products are better, either functionally or inherently. We present a measure that assesses belief in the ‘benevolence of nature’ across a range of products and a range of situations, including safety, sensory appeal, and effectiveness. American adults show a substantial belief in the benevolence of nature. This belief is sometimes erroneous, with participants attributing higher quality to some natural products that are in fact inferior to their artificial counterparts. In support of the belief that natural products are inherently better, many participants express a preference for a natural as opposed to an artificial product when both are stipulated to be chemically identical or to have identical effects. An original set of 24 items to measure belief in the benevolence of nature is refined into a more useful 10-item scale, and correlations with related scales are assessed. Belief in the benevolence of nature is not lower in participants who have experienced at least one natural disaster.
Declining labor force participation of older men throughout the 20th century and recent increases in participation have generated substantial interest in understanding the effect of public pensions on retirement. The National Bureau of Economic Research's International Social Security (ISS) Project, a long-term collaboration among researchers in a dozen developed countries, has explored this and related questions. The project employs a harmonized approach to conduct within-country analyses that are combined for meaningful cross-country comparisons. The key lesson is that the choices of policy makers affect the incentive to work at older ages and these incentives have important effects on retirement behavior.
Particle segregation in dense flowing size-disperse granular mixtures is driven by gravity and shear, but predicting the associated segregation force due to both effects has remained an unresolved challenge. Here, a model of the combined gravity- and kinematics-induced segregation force on a single intruder particle is integrated with a model of the concentration dependence of the gravity-induced segregation force. The result is a general model of the net particle segregation force in flowing size-bidisperse granular mixtures. Using discrete element method simulations for comparison, the model correctly predicts the segregation force for a variety of mixture concentrations and flow conditions in both idealized and natural shear flows.
The contributors to this book represent a wide breadth of scholarly approaches, including law, social and environmental science, engineering, as well as from the arts and humanities. The chapters explore what environmental violence is and does, and the variety of ways in which it affects different communities. The authors draw on empirical data from around the globe, including Ukraine, French Polynesia, Latin America, and the Arctic. The variety of responses to environmental violence by different communities, whether through active resistance or the creative arts, are also discussed, providing the foundation on which to build alternatives to the potentially damaging trajectory on which humans currently find themselves. This book is indispensable for researchers and policymakers in environmental policy and peacebuilding. This title is also available as Open Access on Cambridge Core.
This paper compares community responses to Ebola and Covid-19 in two regions of southern and eastern Sierra Leone with reference to the theory of institutional dynamics proposed by the anthropologist Mary Douglas. Institutions, Douglas argued, are conveyed by styles of thought, shaped by the ways human communities, through everyday practices, reinforce systems of classification and denotation. Pandemic advice to ‘follow the science’ proved problematic, since there is no single institution of science, and institutions never stand alone but are bundled with other institutions, reflecting the manifold and intertwined practices of human social life. The paper explores some of the ways a traumatic epidemic of Ebola Virus Disease in Sierra Leone shaped a distinctive local response to this deadly infectious disease in the absence of an effective vaccine. This local approach emphasised social rules based on ideas about sequestration and testing. Communities then proposed to continue this rules-based approach to the pandemic of Covid-19 and showed little initial enthusiasm for vaccination. With Ebola, the adoption of rules resulted in dramatic drops in infection rates. But Covid-19 spreads in different ways, and good results from the application of social rules were much less apparent. The paper shows how communities began to grapple with this new situation. In some cases, vaccine hesitation was overcome by treating the requirement for vaccination as a new form of social discipline. More generally, it is concluded that epidemiologists need to pay specific attention to institutions and institutional dynamics in order to better understand and anticipate public reactions to new disease threats.