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To examine whether negative symptoms, psychosis, hostility, excitation, and mannerism (PHEM symptoms), formal thought disorders (FTD) and psychomotor retardation (PMR) are interrelated phenomena in major neurocognitive psychosis (MNP) or deficit schizophrenia and whether those domains belong to an underlying latent vector reflecting general psychopathology.
In this study, we recruited 120 patients with MNP or deficit schizophrenia and 54 healthy subjects and measured the above-mentioned symptom domains.
In MNP, there were significant associations between negative and PHEM symptoms, FTD and PMR. A single latent trait, which is essentially unidimensional, underlies these key domains of schizophrenia and MNP and additionally shows excellent internal consistency reliability, convergent validity, and predictive relevance. Confirmatory Tedrad Analysis indicates that this latent vector fits a reflective model. The lack of discriminant validity shows that positive (and PHEM or psychotic) and negative symptoms greatly overlap and probably measure the same latent construct. Soft independent modeling of class analogy (SIMCA) shows that MNP (diagnosis based on negative symptoms) is better modeled using PHEM symptoms, FTD, and PMR than negative symptoms.
In stable phase MNP, which is a restricted sample of the schizophrenia population, negative and PHEM symptoms, FTD and PMR belong to one underlying latent vector reflecting overall severity of schizophrenia (OSOS). The bi-dimensional concept of “positive” and “negative” symptoms cannot be validated and, therefore, future research in stable phase schizophrenia should consider that the latent phenomenon OSOS as well as its reflective manifestations are the key factors of schizophrenia phenomenology.
Consanguineous marriage is a deeply rooted tradition in the Arab world. Such marriages are linked to higher rates of recessive genetic diseases. During the Syrian conflict, which started in 2011, around one million Syrian individuals became refugees in Lebanon. This study assessed the consanguinity rates among Syrian refugees living in Lebanon up to three successive consanguineous generations, and examined refugees’ awareness of the possible consequences of consanguineous marriage and their attitudes towards consanguinity. Their knowledge of, and access to, premarital screening was also assessed. The study was conducted between January and May 2018. Several study sites representing refugees’ distribution within the country were chosen. The study sample included 1008 interviewees from different families. Of those interviewed, 51.9% were in a consanguineous marriage. Interestingly, 23.9% were the product of consanguineous marriages themselves, and 17.9% were consanguineous for three successive generations. The interviewees generally knew about premarital screening, but the majority (61.9%) had not had the screening. The high rates of consanguinity in these Syrian refugees call for immediate action, including raising genetic awareness and providing appropriate genetic counselling. Despite the respondents’ familiarity with premarital screening, there was a low rate of uptake of the test, underscoring the importance of providing better education to these refugees.
There is no published evidence about the psychometric properties of the Cognitive Behavioral Avoidance Scale (CBAS) in Eastern cultures.
The current research evaluated the psychometric properties of a Persian version of the CBAS.
The research consisted of two studies. In Study 1, a university student sample (n = 702) completed the CBAS, the Beck Depression Inventory-II, the Thought Control Questionnaire and the Anxious Thoughts Inventory. In Study 2, a general population sample (n = 384) and a clinical sample (n = 152) completed the CBAS, the Young Compensation Inventory and the Depression, Anxiety, Stress Scale-21.
Exploratory factor analysis of the data from Study 1 suggested a four-factor solution for CBAS. The CBAS had acceptable internal consistency and test–re-test reliability, and showed significant correlations with depression symptoms and anxious thoughts. Confirmatory factor analysis of the data from Study 2 indicated good fit between the four-factor model and data. The CBAS had a significant relationship with depression, anxiety and stress symptoms, but no associations with schema compensatory behaviour strategy. Finally, the CBAS and its subscales successfully distinguished a clinical sample from a general population sample.
The findings provide preliminary evidence for reliability and validity of the CBAS among Iranian student, general population and clinical samples.
Asylum seekers are required to narrate past experiences to the UK Home Office, doctors, lawyers and psychologists as part of their claims for international protection. The Home Office often cites perceived inconsistencies in asylum interviews as grounds for refusal of their claims. A number of processes affect asylum seekers' abilities to narrate past experiences fully to the professionals interviewing them. The dilemmas around disclosure that asylum seekers face have received little attention to date. This work aims to explore the perspectives of UK-based medico-legal report-writing doctors, lawyers and psychologists whose work involves eliciting narratives from asylum seekers on the processes that affect asylum seekers' abilities to disclose sensitive personal information in interview settings. Eighteen professionals participated in semi-structured interviews in individual or focus group settings to discuss, from their perspectives of extensive collective professional experience, the narrative dilemmas experienced by asylum seekers with whom they have worked.
Professionals identified a number of processes that made disclosure of personal information difficult for asylum seekers. These included asylum seekers' lack of trust towards the professionals conducting the interview, unclear ideas around pertinence of information for interviewers, feelings of fear, shame and guilt related to suspicions around collusions between UK and their country-of-origin's authorities, sexual trauma and, occasionally, their own involvement or collusion in crimes against others.
Recommendations are made on how to improve the interview environment to encourage disclosure. These have important implications for future research and policy initiatives.
Non-alcoholic fatty liver disease (NAFLD) includes a range of disorders from simple steatosis to non-alcoholic steatohepatitis. There is no proven drug treatment for NAFLD, and diet modification is considered part of the main line of treatment for this disease. The aim of this study was to investigate the efficacy of garlic supplementation in NAFLD patients. The effect of garlic powder supplementation on hepatic steatosis, liver enzymes and lipid profile was investigated in NAFLD patients. Ninety NAFLD patients were randomly assigned to take either a garlic powder supplement or a placebo for 12 weeks. The treatment group received four tablets of garlic daily (each tablet contained 400 mg garlic powder). The control group received four tablets of placebo (each placebo contained 400 mg starch). At the end of the study, hepatic steatosis was significantly reduced in the treatment group compared with the control group (P = 0·001). In addition, a significant decrease was seen in the serum concentration of alanine transaminase (P < 0·001), aspartate transaminase (P = 0·002), γ-glutamyltransferase (P = 0·003) as well as total cholesterol (P = 0·009), TAG (P < 0·001), HDL-cholesterol (P < 0·001) and LDL-cholesterol (P = 0·01) in the treatment group compared with the control group. No significant difference was seen between the two groups in serum concentration of alkaline phosphatase. Overall, garlic powder supplementation improved hepatic features and lipid profile among NAFLD patients.
A reformulation of the Social Brain Theory of schizophrenia is proposed that contends that schizophrenia is a novel human phenomenon that arose following the establishment of large permanent human settlements and the abandonment of the hunter-gatherer way of life. It is contended that the blurring of the demarcation between ingroup and outgroup membership and living in close proximity to strangers is a stressor that leads to perturbation in the development of the social brain in vulnerable individuals leading to the syndrome of schizophrenia. Contrary to previous authors who have considered schizophrenia to be an inherently human condition that has existed throughout human history we suggest that schizophrenia is a relatively recent phenomenon and that the vulnerability to it remained hidden amongst hunter-gatherers. Hence, we contend that schizophrenia is the result of a mismatch between the post-Neolithic human social environment and the design of the social brain. The importance of the distinction between ingroup and outgroup membershipin human evolutionary history lies at the heart of inter-group conflict, violence and xenophobia. This formulation explains a range of epidemiological findings on schizophrenia related to the risk of migration and urbanisation. The present hypothesis can therefore, account for a range of disparate findings regarding schizophrenia that have thus far defied explanation by other extant theories. However, as this formulation claims to have identified the ultimate causation of schizophrenia the hypothesis does not specify the proximate mechanisms that lead to it. We conclude with a number of testable and refutable predictions.
Depression/anxiety disorders and smoking behavior often begin in adolescence as co-occurring phenomena. Epidemiologically, the relationship between them is bidirectional,
Objective and Aims.
To examine both adolescent smoking as a predictor of depression/anxiety disorders, and the effect of these disorders on adolescent smoking.
A representative sample of Catalan adolescents (N = 3008) participating in (PFI) a longitudinal study were interviewed about smoking behavior at baseline (T1) and at two follow-up assessments (T2 and T3). In interviews at baseline (T1) and at T4, the parents were asked whether their daughters/sons had a diagnosis of depression or anxiety. Smoking behavior was defined as smoking at least once a week. Age, sex and household income were included.
Depression/anxiety at T1 increases the risk of smoking behavior at T3 [odds ratio (OR), 1.97, 95% confidence interval (CI) 1.24-3.14] compared with undiagnosed adolescents. After adjusting for age and sex, the risk remains, but after adjusting for sex, age and income, the risk of smoking behavior decreases as household income increases [OR 1.6, 95% CI 0.9-2.85]. Alternatively, smoking behavior at T3 increases the risk of depression/anxiety at T4 [OR 1.7, 95% CI 1.1-2.5] compared with non-smokers. After adjusting for age and sex, the risk remains, but after adjusting for sex, age and income, the risk of depression/anxiety decreases as household income increases [OR 1.48, 95% CI 0.93-2.36].
Our findings provide the first evidence of a two-way relationship between adolescent smoking and depression/anxiety disorders in a community sample in Spain.
TEACCH program (Treatment and Education of Autistic and related Communication Handicapped Children) represents a model for management of five major autistic behavioral problems:
(1) Self abuse,
(3) Disruptive behaviors,
(4) Repetitive Behaviors,
(5) Other behavioral deficits.
Present study introduces TEACCH based model for behavioral intervention of autistic preschoolers in school setting.
Studying effectiveness of usage of (TEACCH) program in decreasing commonly experienced behavioral disorders among autistic preschool children according to Parent/Teacher assessment and follow up.
5 autistic children aged (2-6) years (4 boys and 1 girl) were selected according to the study inclusion criteria and legal guardian consent. They were subjected to psychiatric assessment (psychiatric interview sheet and DSM IV criteria for autistic disorder), psychological assessment using:
(2) Vineland Adaptive Behavior Scale(2004)(Arabic version), as well as
(3) Autistic Behavioral Checklist for preschool children and
(4) Disordered Behavior Intervention Program (3 and 4 were made by researchers).
Study subjects were assessed by their mothers and teachers for their behavioral problems. Pre- intervention assessment were arranged for each child and commonly experienced behaviors both at home and school as regard both severity and frequency were listed for intervention. Mother/Teacher Post-intervention and follow up assessment were also arranged for each child.
Both Pre/post and Post /follow up assessment and comparison were statistically significant both for mother and teacher ratings. Behavioral problems were significantly decreased using TEACCH model for behavioral intervention of disordered behaviors among study subjects.
Early identification, Individualized intervention and follow up of significant behavioral problems using study model helps reducing them.
The motion of a neutrally buoyant spherical particle along the axis of an axisymmetric stagnation point flow at a rigid and smooth flat wall (Hiemenz–Homann flow) is investigated in the presence of low-to-moderate inertia effects. The particle dynamics is elucidated using numerical simulation. At distances large compared to the characteristic thickness of the boundary layer
the kinematic viscosity and
the strain rate of the carrying flow, the particle decelerates as it approaches the wall, due to the ambient pressure increase toward the stagnation point. In this part of the path, its velocity is nearly identical to that of the local undisturbed fluid at the position of its centre. Relative motion between the particle and fluid increases as the wall–particle gap reduces, due to wall-induced hydrodynamic interaction forces. Two distinct evolutions of the net force on the particle are observed, depending on the relative particle size,
is the particle radius and
is the Reynolds number. For
, the force decays monotonically to zero, while it undergoes a sharp rise before returning to zero for larger particles. In the latter case, the particle retains a sufficient velocity even for very small gap widths such that, under usual roughness levels, a rebounding collision would occur. The stress profiles at the particle surface are investigated to separate the various contributions to the hydrodynamic force. Theoretical predictions for near-wall viscous and inertial forces available in the creeping-flow and low-but-finite Reynolds-number limits, respectively, are used to pinpoint the origin of the dominant inertia effect that controls the particle dynamics when the particle gets very close to the wall.
It is proven that, for a wide range of integers s (2 < s < p − 2), the existence of a single wildly ramified odd prime l ≠ p leads to either the alternating group or the full symmetric group as Galois group of any irreducible trinomial Xp + aXs + b of prime degree p.
This paper follows up from a previous study on this topic and outlines the second part of a wider, two-part study on the information seeking behaviour (ISB) of law students. Exploratory work was outlined in a previous publication17 and there we found that although mobile technologies offered benefits to law students seeking information for their academic studies, there was concern from law librarians that the use of electronic resources via both non-mobile and mobile interfaces resulted in a loss of skills required for information retrieval due to the increasing capabilities of electronic resources’ search interfaces. To gain more insight into how law students were using mobile information resources, and better understand the advantages and disadvantages of such, we extended our study to a wider cohort and employed more research techniques including a focus group. This final phase of our study was conducted between 2015 to 2017. Here our cohort included another set of law librarians (13) and a further 54 law students. We expanded our research tools to include 2 thematic questionnaires and a focus group exercise. Our findings discovered that law librarians were concerned with the intangibility of digital formats. Law students remained indifferent to this aspect and valued the speed, multi-tasking and near-ubiquitous accessibility attributes that electronic format use via mobile technologies provided. These learnings and more, with conclusions, are reported in the course of this paper written by Zaki Abbas, Andrew MacFarlane and Lyn Robinson.
A de novo drug delivery nanosystem based on gold nanoparticles (GNPs), decorated poly(ethylene glycol) (PEG), and folate (FA)-conjugated graphene oxide (GO) was designed and developed successfully. Initially, the graphite (G) powder was oxidized to the GO, and then functionalized with chloroacetic acid to afford a carboxylated graphene oxide (GO–COOH). The obtained GO–COOH was functionalized with an amine end-caped PEG, FA, as well as 3-amino-1-propanethiol to produce a GO–PEG–FA–SH. In another experimental section, GNPs were synthesized through a citrate-mediated reduction approach, and subsequently decorated onto/into GO–PEG–FA–SH through the formation of Au–S bond to afford a GO–PEG–FA/GNP nanosystem. The resultant nanosystem was loaded with doxorubicin hydrochloride (DOX) as a model anticancer drug, and its drug-loading capacity as well as pH-dependent drug release behavior were investigated. The anticancer activity of the developed theranostic nanomedicine was extensively evaluated using MTT assay against human breast cancer cells (MCF7). The developed GO–PEG–FA/GNPs–DOX theranostic nanomedicine exhibited an excellent cancer chemotherapy feature. In addition, this nanomedicine can be used in chemo-photothermal therapy of solid tumors because of the presence of GO and GNPs in its structure.
This chapter reviews the most researched psychotherapeutic interventions for individuals with cognitive impairment (CI) and common symptoms targeted by these interventions. Elements of assessment and psychotherapy modifications to consider when working with individuals with dementia are also discussed. Assessment components might include clarification of medical symptom overlap, collateral information, assessment instruments developed for individuals with cognitive difficulties, and incorporating consultation with other specialties. In general, clinicians should consider using simplified skills, increasing the number and frequency of sessions, shortening sessions, reducing group size, and providing more guidance during skill instruction and practice when working with individuals with cognitive impairments. Despite their promise and recommendations for their use, nonpharmacological therapies for individuals with dementia have a small research base and warrant continued development and evaluation.
Current treatments for smoking cessation are not effective for most smokers. This study aims to examine the effectiveness of transcranial Direct Current Stimulation (tDCS) on smoking cessation.
In this randomized, sham-controlled trial study, tobacco-dependent (by DSM-5) male participants were recruited from the general public invitation. Participants were randomly allocated to 5 groups; (A), treatment with 300mg bupropion for 8 weeks; (B), active tDCS (20 sessions for 4 weeks); (C), sham for group B ; (D), active tDCS (20 sessions for 12 weeks), and (E), sham for group D. The electrode montage was anode F3 and cathode F4. Study outcomes include salivary cotinine, Fagerstrom test for nicotine dependence, and smoked cigarette per day, were examined on three time points. Repeated-measures analysis of variances and the generalized estimation equation (GEE) model were employed for data analysis.
Among 210 volunteers, 170 participants completed the study. Mean age of participants was 42.9 years, ranging from 21 to 64 years. The 6-month point abstinence rates in groups A, B and D were 20%, 7% and 25.7%, and in C, D sham groups were 3.1% and 3% respectively. Results of the GEE model showed that although group D was not different from group A in abstinence rate, i.e., salivary cotinine >4 (p = 0.266), nicotine dependency by Fagerstrom test was lower in this group compared to group A (p = 0.019).
The 12-week tDCS had a clinically good therapeutic effect on smoking cessation and its dependency. It may be a substitute for bupropion treatment.
The chapter draws insights from the institutional theoretic model to investigate the role of courts and other formal adjudicative institutions in promoting sustainable development. Its tripartite institutions framework emphasises the knowledge and communicative elements of sustainable development flowing from key social actors such as adjudicative institutions to other segments of society. Using environmental protection as a case study and making references to national laws and judicial decisions, the chapter demonstrates that adjudicative institutions can manifest a commitment to sustainable development, affirm applicable global standards influence other actors in, and segments of, society. It is argued that the regulatory role of adjudicative institutions includes constitutionalisation of sustainable development, empowerment of individuals and stakeholder groups and addressing vulnerability of victims while the normative role ensures the internalisation and transmission of sustainable development values. The cognitive role includes reshaping local practices by promoting effective glocalisation and appropriate corporate governance and social responsibility for sustainable development. While it shows adjudicative institutions as a key champion for sustainable development in the public and private spheres, the chapter proposes solutions to overcoming impediments to such as lack of explicit provisions, narrowly focusing on compensatory remedies, locus standi, forum non conveniens and choice of law.
The epidemiology of ESBL-producing Enterobacteriaceae (ESBL-PE) has been extensively studied in hospitals, but data on community transmission are scarce. We investigated ESBL-PE cocarriage and acquisition in households using a systematic literature review.
We conducted a systematic literature search to retrieve cross-sectional or cohort studies published between 1990 and 2018 evaluating cocarriage proportions and/or acquisition rates of ESBL-PE among household members, without language restriction. We excluded studies focusing on animal-to-human transmission or conducted in nonhousehold settings. The main outcomes were ESBL-PE cocarriage proportions and acquisition rates, stratified according to phenotypic or genotypic assessment of strain relatedness. Cocarriage proportions of clonally related ESBL-PE were transformed using the double-arcsine method and were pooled using a random-effects model. Potential biases were assessed manually.
We included 13 studies. Among 863 household members of ESBL-PE positive index cases, prevalence of ESBL-PE cocarriage ranged from 8% to 37%. Overall, 12% (95% confidence interval [CI], 8%–16%) of subjects had a clonally related strain. Those proportions were higher for Klebsiella pneumoniae (20%–25%) than for Escherichia coli (10%–20%). Acquisition rates of clonally related ESBL-PE among 180 initially ESBL-PE–free household members of a previously identified carrier ranged between 1.56 and 2.03 events per 1,000 person weeks of follow-up. We identified multiple sources of bias and high heterogeneity (I2, 70%) between studies.
ESBL-PE household cocarriage is frequent, suggesting intrafamilial acquisition. Further research is needed to evaluate the risk and control of ESBL-PE household transmission.
As technology becomes more powerful, intelligent, and autonomous, its usage also creates unintended consequences and ethical challenges for a vast array of stakeholders. The ethical implications of technology on society, for example, range from job losses (such as potential loss of truck driver jobs due to automation) to lying and deception about a product that may occur within a technology firm or on user-generated content platforms. The challenges around ethical technology design are so multifaceted that there is an essential need for each stakeholder to accept responsibility. Even policymakers who are charged with providing the appropriate regulatory framework and legislation about technologies have an obligation to learn about the pros and cons of proposed options.