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.
Trauma- and stressor-related disorders (TSRD) are debilitating mental health conditions. Given the barriers to traditional services, remote and online technologies are increasingly used in treating TSRD.
Aims
This mixed-methods systematic review aimed to identify remote technologies and assessed their feasibility and acceptability in treating adults with post-traumatic stress disorder (PTSD), acute stress disorder and adjustment disorder (AjD).
Method
The databases MEDLINE, CINAHL, Embase, PsycInfo, PubMed and the Cochrane Library were screened to identify studies investigating the feasibility and acceptability of remote interventions for PTSD, acute stress disorder and AjD in adults. Studies that obtained poor-quality ratings on critical appraisal tools were excluded. Results were synthesised using a narrative review approach.
Results
In total, there were 74 studies evaluating 27 remote interventions for TSRD: online interventions (k = 47, 63.51%), mobile applications (k = 17, 22.97%), video conferencing (k = 9, 12.16%) and message-based systems (k = 1, 1.35%). Findings from the review showed higher feasibility and acceptability for interventions with an interactive clinician–patient component. Among self-directed interventions, only two applications and eight online interventions provided a clinician component. Most studies targeted PTSD, with few targeting other diagnoses.
Conclusions
Recommendations related to remote interventions for TSRDs should be broadened to include AjD and other underrepresented diagnoses, and tailored to individual patients’ profiles, including their ability to sustain engagement and clinical needs, using a stepped-care approach.
The distinctive isolated elements of Cynopodius, characterised by their deep narrow base and spatulate crown, were first described (as spine-like elements) by Ramsay Heatley Traquair in the late 19th Century, based on specimens from the Burghlee Ironstone (Serpukhovian, Carboniferous) at Loanhead near Edinburgh, Scotland. The type species Cynopodius crenulatus is also known from older Calciferous Sandstone Measures (Viséan) of Fife. Here we provide evidence that the elements are teeth rather than spines or dermal claspers, as hypothesised elsewhere. Thin sections of the teeth, illustrated for the first time, show osteodentine and tubate dentine forming the crown, covered by a thin outer hypermineralised layer on the cusps, and trabecular osteodentine or acellular bone forming the base. In recent decades, teeth of Cynopodius have also been collected from the lower Carboniferous Sainte Genevieve Formation (Mississippian: Viséan) of Iowa, Kentucky, and West Virginia in the USA. We assign these teeth from Iowa to Cynopodius robustus n. sp. They are distinguished from the type species by their relative robustness, with a ratio of maximum crown length to root length of c. 2:3 for C. traquairi and c. 1:2 for C. crenulatus, and lack of longitudinal curvature. The Scottish and American occurrences, though widely separated in the early Carboniferous, are the only known localities for the genus. The similarity between these over 300-million-year-old teeth and those of Recent long-toothed teleost reef fishes like Ctenochaetus, for instance, suggests that the Cynopodius animals might also have been specialised detritivores.
This research paper investigated the potential application of essential oils nano-emulsion after characterization as natural preservatives in the dairy sector, by measuring the minimum inhibitory concentration of ginger and clove oil nano-emulsion along with their impact on the sensory properties, starter culture activity and survivability of some foodborne pathogenic and spoilage microorganisms in fortified laboratory-manufactured labneh. The characterized EOs nano-emulsions exhibited significant antimicrobial effect against the tested microorganisms (Escherichia coli, Salmonella Typhimurium, Staphylococcus aureus, Pseudomonas aeruginosa, and Aspergillus flavus). S. aureus was completely inhibited in labneh fortified with 0.1 µg/mL clove and ginger nano-emulsion in the first and second weeks of the storage period, respectively. While A. flavus count was reduced by 100 and 35% in labneh fortified with 1 µg/mL clove and ginger nano-emulsion, respectively. Nonetheless, the overall acceptability and flavour of the fortified samples revealed scores that were not significantly different from the control samples (P > 0.05). These results were obtained without interfering with the starter culture activity during processing and storage period. In conclusion, the obtained results open a promising avenue for the EOs nano-emulsions application as safe and natural alternative in the dairy industry.
While psychiatric disorders (e.g., depression, anxiety) are well-established predictors of suicidal ideation (SI) in individuals with traumatic brain injury (TBI), the roles of other psychological and cognitive factors remain underexplored. This study examined associations between SI and emotion-processing difficulties, coping strategies, psychological resilience, and cognitive functioning after moderate–severe TBI.
Method:
This was a secondary analysis of data from 106 individuals with moderate–severe TBI. SI and emotional distress were assessed using the Inventory of Depression and Anxiety Symptoms and Hospital Anxiety and Depression Scale, respectively. Participants also completed measures of emotional lability and detachment (Comprehensive Assessment of Traits Relevant to Personality Disorders [CAT-PD]), coping (Coping Scale for Adults), psychological resilience (Connor–Davidson Resilience Scale), and cognitive functioning, including subjective (CAT-PD, Brief Rating of Executive Function) and objective measures (Brief Test of Adult Cognition by Telephone). Spearman’s correlations and path models were used to examine psychological and cognitive correlates of SI.
Results:
SI was positively associated with emotional lability, emotional detachment, non-productive coping, and self-reported cognitive problems, and negatively associated with resilience. Path models indicated that emotional distress accounted for 76–100% of these associations. Conversely, SI was not significantly associated with adaptive coping or objective cognitive performance.
Conclusions:
Emotion-processing difficulties, non-productive coping strategies, low resilience, and self-reported cognitive problems are linked to SI in individuals with moderate–severe TBI, primarily through their associations with emotional distress. Findings underscore the importance of addressing emotional distress, including depression and anxiety, and its underlying contributors in suicide prevention for this population.
Population ageing, increased immigration and strained public resources will challenge the future provision of formal older-age care. Despite growing diversity in older populations across Western countries, evidence on health-care utilization among older immigrants remains limited. Using full-population registry data from Norway (2011–2016) for individuals aged 60+, we examined transitions into home health care (HHC) and intensity of use (hours/day) by immigrant background. Across all country-of-origin groups, immigrants had lower odds of transitioning into HHC than natives, with differences narrowing as duration of residence increased. A broad socio-demographic patterning to HHC transitions generally held across the country background groupings. Higher transition likelihoods were observed for individuals with lower education, lower income, living alone, and residing in less urban areas. Childlessness was linked to higher relative transition propensities among natives and Nordic immigrants, but lower relative propensities among Western-origin and Eastern European immigrants. Among non-Western immigrants, childlessness appeared to have little influence on transition propensities. For HHC intensity, only non-Western immigrants received significantly fewer hours of care than natives. Subsequent analysis indicated that this difference was entirely contingent on living alone: Only non-Western immigrants living alone had significantly fewer hours of care than natives (living alone or otherwise). These findings highlight clear variation in HHC utilization by immigrant background and socio-demographic characteristics. Future research should investigate whether lower HHC use among older immigrants reflects reduced need or barriers to access. It will also be important to assess how compositional changes in the immigrant population may influence future patterns of HHC utilization.
The ROBINS-I tool is a commonly used tool to assess risk of bias in non-randomised studies of interventions (NRSI) included in systematic reviews. The reporting of ROBINS-I results is important for decision-makers using systematic reviews to understand the weaknesses of the evidence. In particular, systematic review authors should apply the tool according to the guidance provided. This study aims to describe how ROBINS-I guidance is currently applied by review authors. In January 2023, we undertook a citation search and screened titles and abstracts of records published in the previous 6 months. We included systematic reviews of non-randomised studies of intervention where ROBINS-I had been used for risk-of-bias assessment. Based on 10 criteria, we summarised the diverse ways in which reviews deviated from or reported the use of ROBINS-I. In total, 492 reviews met our inclusion criteria. Only one review met all the expectations of the ROBINS-I guidance. A small proportion of reviews deviated from the seven standard domains (3%), judgements (13%), or in other ways (1%). Of the 476 (97%) reviews that reported some ROBINS-I results, only 57 (12%) reviews reported ROBINS-I results at the outcome level compared with 203 reviews that reported ROBINS-I results at the study level alone. Most systematic reviews of NRSIs do not fully apply the ROBINS-I guidance. This raises concerns around the validity of the ROBINS-I results reported and the use of the evidence from these reviews in decision-making.
The dominant view in proliferation research holds that security guarantees from nuclear patrons reduce client states’ incentives to pursue nuclear armament. Yet in South Korea, public support for indigenous nuclear capabilities remains high despite strong trust in US extended deterrence. Drawing on the “better-now-than-later” logic from preventive war theory, we argue that this support reflects public forward-looking pessimism about the security environment, shaped by perceptions of the relative decline of the US and North Korea’s advancing nuclear capabilities. Analysis of the 2023 EAI Public Opinion Poll shows that concerns about systemic power shifts and pessimism about future inter-Korean relations are significantly associated with support for nuclear armament. South Korean public assessments of US extended deterrence and North Korea’s military threat do not align with conventional alliance theory expectations that high trust in extended deterrence should reduce support for nuclear armament. These findings underscore the need for reassurance strategies that address enduring alliance credibility.
It has been over a decade since the conceptual foundation of collective psychological ownership (CPO) was first built in the organizational behavior and management literature. A significant body of empirical studies has been conducted to examine CPO at either the team level or the individual level, providing divergent views of CPO and its application in different contexts. This article offers insights into the genesis and emergence of CPO as an outgrowth of prior scholarship on psychological ownership at the individual level to the team level. It also includes a systematic literature review of 96 studies that cited the seminal study of collective psychological ownership and had CPO as a major construct in its conceptualization and empirical setting. We conclude with directions for future scholarship that would enhance the theory of CPO, as well as methodological recommendations for testing the role of CPO in different applied contexts.
This article examines the geographical distribution of tuberculosis mortality in Italy from 1891 to 1951 and its relationship with industrialisation. During this period, industrialisation brought about profound changes, although it affected the north and south of the country unequally. During the same period, the incidence of pulmonary tuberculosis increased, and the disease became a major health problem. Tuberculosis spread mainly among industrial workers and in densely populated urban areas, where living and working conditions were often precarious. Overall, the incidence of pulmonary tuberculosis was significantly higher in the more industrialised provinces of the North than in the backward provinces of the South. This article shows a positive correlation between pulmonary tuberculosis mortality and the levels of provincial industrialisation.
Intrusive re-experiencing of traumatic events is a cornerstone of post-traumatic stress disorder (PTSD). Clinicians notice that clients also experience intrusive mental images of what they think might happen during a traumatic event. As mental imagery has a powerful impact on emotion, imagination-based imagery may be implicated in the peaks of distress (‘hotspots’) during a trauma.
Aims:
A data-only study was undertaken of cognitive therapy for PTSD ‘hotspot’ charts used by Grenfell Health and Wellbeing Service clinicians after the Grenfell fire disaster. The aim was to establish the prevalence and nature of peri-traumatic ‘imagination-based hotspots’ in this sample.
Method:
Hotspots are described as the worst moments within a trauma. Two clinicians independently rated anonymised hotspot charts (N=26) for the presence and content of ‘imagination-based hotspots’, defined as ‘a peak of emotion during a traumatic event that is related to something imagined “in the mind’s eye” as opposed to directly perceived with the senses’.
Results:
81% (N=21) of individuals reported an imagination-based hotspot; 38% of all hotspots (n=159) contained an imagination-based component. The most common was an image in which the person watching the fire imagined themselves in the ‘shoes’ of a tower resident.
Conclusions:
Imagination-based mental imagery appears to be linked to the ‘hotspots’ of a high proportion of people experiencing PTSD in this sample. Results underline the importance of enquiring about the presence of mental imagery during PTSD treatment. The presence of peri-traumatic mental images has implications for effective updating of ‘hotspots’ in PTSD treatment.
Fulton’s matrix Schubert varieties are affine varieties that arise in the study of Schubert calculus in the complete flag variety. Weigandt showed that arbitrary intersections of matrix Schubert varieties, now called ASM varieties, are indexed by alternating sign matrices (ASMs), objects with a long history in enumerative combinatorics. It is very difficult to assess Cohen–Macaulayness of ASM varieties or to compute their codimension, though these properties are well understood for matrix Schubert varieties due to work of Fulton. In this paper, we study these properties of ASM varieties with a focus on the relationship between a pair of ASMs and their direct sum. We also consider ASM pattern avoidance from an algebro-geometric perspective.
We consider spline-based additive models for estimation of conditional treatment effects. To handle the uncertainty due to variable selection, we propose a method of model averaging with weights obtained by minimizing a J-fold cross-validation criterion, in which a nearest neighbor matching is used to approximate the unobserved potential outcomes. We show that the proposed method is asymptotically optimal in the sense of achieving the lowest possible squared loss in some settings and assigning all weight to the correctly specified models if such models exist in the candidate set. Moreover, consistency properties of the optimal weights and model averaging estimators are established. A simulation study and an empirical example demonstrate the superiority of the proposed estimator over other methods.
Research suggests that there may be an association between prescribed opioid use and suicide-related behaviours.
Aims
This 15-year retrospective population-based cohort study examines the relationship between opioid use, self-harm and suicide.
Method
The study was based on the POPPY II study, a population-based cohort of 3 268 282 adults who initiated a prescription opioid between 1 July 2003 and 31 December 2018, in Australia. Prescription dispensing data were linked to hospitalisation, death and other data collections. Opioid use was defined as current opioid exposure, cumulative duration of exposure and estimated daily dose. Outcomes were self-harm hospitalisation and suicide mortality, categorised as overall and according to the method (opioid poisoning, non-opioid substance poisoning and other methods). Time-varying generalised estimating equations were used to assess the relationship with self-harm hospitalisation, and Cox proportional hazard models were used to assess the relationship with suicide mortality, controlling for known suicide-related risk factors.
Results
There were 49 215 self-harm hospitalisations at a crude rate of 262 per 100 000 person-years and 3087 suicide deaths at a crude rate of 16.5 per 100 000 person-years. Intentional opioid poisoning was the least common method for both self-harm hospitalisation and suicide. Following multivariable adjustment, current opioid exposure, longer cumulative duration and higher doses were significantly associated with a greater risk of opioid-related self-harm or suicide. In adjusted models, associations for other methods of self-harm and suicide were not as strong or consistent.
Conclusions
Opioid poisoning was the least common method of self-harm and suicide. Despite this, for the minority of people prescribed high doses and/or a long duration of prescription opioids, there is an increased risk for opioid-related self-harm and suicide after controlling for known covariates. Suicide-related behaviours should be screened and monitored in people prescribed opioids, particularly among those on long-term and/or high-dose opioids.
Impaired insight is a regularly documented clinical observation in patients undergoing involuntary care, but is easily misunderstood since it refers to different phenomena depending on the context. Within the context of psychotic illness, which comprises the majority of involuntary care, it is more accurately portrayed as unawareness of illness which intersects with the element of capacity related to the ability to appreciate information and weigh it up to make a judgement. Psychotic disorders associated with persistent unawareness of illness are negatively associated with illness outcome and attitudes towards clinical services. There is some evidence that metacognitive therapy can improve insight, but compassionate care which seeks to enhance therapeutic alliance more commonly engages such patients in successful recovery. When insight is substantially impaired, the apparent will and the stated preferences of patients often diverge, in which case involuntary care should not be considered “against the will,” but more accurately “without the consent” of the patient.
Censoring language in medical science enforces ideological conformity and political repression of marginalised groups through self-censorship. This editorial urges the scientific community to resist language control as a grave threat – not only to research freedom, but ultimately to human diversity and life itself.
The rules of international law gently transcend the physical boundaries of our world and extend their influence into the mysterious realm of cyberspace. State practice confirms digital sovereignty, yet rival camps offer divergent approaches. Non-Western states, such as Russia and China, advocate for strict national control, asserting cyber sovereignty to safeguard their digital infrastructures. In contrast, Western countries like the USA and EU Member States support an open, global internet governed by cooperative principles. Further, this article examines the challenges of applying the traditional notion of territorial sovereignty in cyberspace, where clear borders are absent, and evaluates potential solutions. Among these, the competence/function theory and the Functional Equivalent of the Border are explored as means to reconcile competing interests and advance a balanced framework for regulating digital activities while protecting national sovereignty and individual rights.