To send 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 sending content to .
To send content items to your Kindle, first ensure email@example.com
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 sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent 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.
Behavioral determinants with the largest effects are often those related to the environments in which behaviors occur. This suggests the merits of a shift in focus of changing behavior at scale away from interventions based on deliberation and decision-making and toward interventions that involve changing cues – physical, digital, social, and economic – in environments. This chapter focuses on changing cues in small-scale physical environments – sometimes known as choice architecture or nudge interventions. Despite attracting much interest, these interventions have been little explored from a theoretical perspective. Exploring the mechanisms by which some of these interventions exert their effects provides a starting point. Examining evidence of three interventions – increasing availability of healthier food options, reducing glass size, and putting warning labels on food and alcohol products – suggests no single theory explains their effects. The mechanisms by which these interventions affect behavior change also necessitate different levels of explanation and demand a theoretical framework that applies at different levels. Recognizing the distinction between model-free and model-based learning and behavior may be central to this. Advancing knowledge on changing behavior by changing environments requires robustly designed field studies to estimate effect sizes, complemented by laboratory studies testing mechanisms to optimize interventions and develop theoretical understanding.
Affect and emotions play a key role in motivational processes, working together to make sense of one’s experience and to guide behavior. Until recently, however, research on motivation in the workplace has advanced largely independently from research exploring the role of emotions and affect at work. To better understand the human experience of work, we must explore the connections between these aspects as they influence thoughts, feelings, and behaviors related to work. In this chapter we describe theory and research that supports the ultimate development of a unified perspective; namely, an approach that takes into account how emotional experiences affect and interact with motivational forces to influence work behavior and its outcomes.
Anorexia nervosa (AN) and bulimia nervosa (BN) are complex psychiatric conditions, in which both psychological and metabolic factors have been implicated. Critically, the experience of stress can precipitate loss-of-control eating in both conditions, suggesting an interplay between mental state and metabolic signaling. However, associations between psychological states, symptoms and metabolic processes in AN and BN have not been examined.
Eighty-five women (n = 22 AN binge/purge subtype, n = 33 BN, n = 30 controls) underwent remote salivary cortisol sampling and a 2-day, inpatient study session to examine the effect of stress on cortisol, gut hormones [acyl-ghrelin, peptide tyrosine tyrosine (PYY) and glucagon-like peptide-1] and food consumption. Participants were randomized to either an acute stress induction or control task on each day, and plasma hormones were serially measured before a naturalistic, ad libitum meal.
Cortisol-awakening response was augmented in AN but not in BN relative to controls, with body mass index explaining the most variance in post-awakening cortisol (36%). Acute stress increased acyl-ghrelin and PYY in AN compared to controls; however, stress did not alter gut hormone profiles in BN. Instead, a group-by-stress interaction showed nominally reduced cortisol reactivity in BN, but not in AN, compared to controls. Ad libitum consumption was lower in both patient groups and unaffected by stress.
Findings extend previous reports of metabolic dysfunction in binge-eating disorders, identifying unique associations across disorders and under stress. Moreover, we observed disrupted homeostatic signaling in AN following psychological stress, which may explain, in part, the maintenance of dysregulated eating in this serious illness.
The rat model of prenatal restraint stress (PRS) is particularly valuable to study the mechanisms involved in the pathophysiology of anxiety/depression since adult PRS rats show endocrine and behavioral abnormalities that are corrected by antidepressant medication. We have previously shown that agomelatine chronic treatment reversed the anxiety behaviour and decreased hippocampal neurogenesis observed in PRS. Here, we investigated the mechanisms that may contribute to the antidepressant activity of agomelatine, by assessing the effects of a chronic treatment with agomelatine on neurobiological markers of neuroplasticity in the rat hippocampus such as BDNF and its receptor, TrkB, the transcription factor pCREB and metabotrophic glutamate receptors (mGluRs). Adult SD control and PRS rats were treated chronically with agomelatine (40mg/kg ip) or vehicle. 16h after last drug administration, animals were sacrificed and hippocampus dissected for biochemical analysis.
PRS animals showed reduced levels of pCREB in the hippocampus and increased hippocampal BDNF, and TrkB receptor levels. Agomelatine reversed changes in pCREB and BDNF/TrkB levels in PRS rats, had no effect on pCREB in control rats, and, interestingly, increased BDNF and TrkB receptor levels in control rats. Moreover, agomelatine reversed the reduced expression (for mGluR5 and mGluR2/3 receptors) and function (for mgluR5 receptor) observed in the hippocampus of PRS rats.
In conclusion, we have shown that agomelatine treatment reversed all biochemical and cellular changes induced by PRS in rats. These changes, independently of their direction, are the expression of an enduring maladaptive form of neuroplasticity that may contribute to the depressive/anxious phenotype of PRS rats.
A very low cost treatment system for alcohol dependence is possible with new technology.
To maintain abstinence from alcohol with affordable remote intensive therapeutic support and long term follow up.
To describe the use of new technology and its application in a treatment system to promote abstinence from alcohol.
A new breathalyser uses a photo-ionisation device and a fuel cell to remotely monitor disulfiram metabolites and alcohol on a sample of breath. A small sample (n=10) of post-detoxified patients with severe alcohol dependence were provided with a breathalyser. Patients sent daily readings from various locations (e.g. UK, Australia, Germany). The clinical team required 2-3 minutes to read the results and email the patient each day. Patients were telephoned if readings dropped (missed tablet), or no sample was sent.
The mean duration of follow up was 11.3 months. Of 10 patients using the breathalyser 90% remained totally abstinent from alcohol. One patient had two brief lapses during an 8 month period, both of which were detected in advance.
There was no requirement for routine clinic follow up appointments. Daily emails and monthly summaries of progress were reported to be of great motivational value.
New technology has the potential to provide daily remote therapeutic support and monitoring to alcohol dependent patients prescribed disulfiram. Early observations indicate that it is possible to maintain disulfiram adherence at very low cost. The sample size was small, and further trials are required, but early indications are promising.
A new breathalyser can remotely monitor disulfiram compliance and breath alcohol levels, and can predict relapse before it occurs.
Improve compliance with disulfiram and post-detoxification abstinence rates from alcohol.
To describe technology that provides remote support and monitoring to patients prescribed disulfiram and its clinical application.
Disulfiram produces volatile organic compounds (VOCs) during its metabolism. These VOCs are detectable on a sample of breath using a photo-ionisation device. By adding a fuel cell it is possible to produce a hand-held breathalyser that determines disulfiram compliance and monitors alcohol levels. With appropriate software the instrument can be used remotely, and the encrypted readings can be sent to the clinical team from anywhere in the world with internet access.
This instrument, called a Zenalyser, has been constructed and used on a small sample (n=12) of severely alcohol dependent patients after in-patient detoxification.
Patients sent daily Zenalyser readings from various locations (e.g. UK, Australia, Germany). Equipment costs were below 2 euros per day.
It required less than 45 seconds of patient time per day. The clinical team required 2-3 minutes to read the results and email the patient. Patients were telephoned if Zenalyser readings dropped (missed tablet) or no sample sent. One patient had two lapses during an 8 month period which were detected in advance. All other patients abstained for periods between 3-36 months. Compliance and user satisfaction were high.
The Zenalyser can improve disulfiram compliance and reduce out-patient costs. It may improve post-detoxification abstinence rates.
Prevalence estimates of childhood and adolescent mental health disorders appear to vary between 20 to 30% worldwide. It is therefore unsurprising that studies have yielded inconsistent findings in regards to the trends of prevalence of mental health disorders. Some reasons for the discrepancy in findings include use of survey data and its associated attrition and selection bias.
Objectives and aims
First, to determine and compare the prevalence of mental health disorders derived from a survey and a population cohort. Second, to evaluate trends of mental health prevalence over time.
As population data (i.e., linked health records) may be used to overcome the issues presented by survey data, we compared the prevalence estimated from a prospective survey cohort (the Western Australian Pregnancy Cohort (Raine study) to another estimate from a prospective population cohort (linked population data; data from the Hospital Morbidity Records and Mental Health Registration).
As expected, the Raine cohort yielded a larger estimate of prevalence when compared to the linked population data. However each cohort also revealed opposite trends of prevalence, where the Raine cohort showed the prevalence of mental health disorders to decrease as children age.
We therefore recommend that estimates of prevalence be interpreted with the type of cohort in mind, as estimates from survey cohorts will provide different information to that from population cohorts.
Decorated ostrich eggs were traded around the Mediterranean during the Bronze and Iron Ages. Research on their origins has focused primarily on decorative techniques and iconography to characterise the producers, workshops and trade routes, thereby equating decorative styles with cultural identities and geographic locations. This is problematic, as craftspeople were mobile and worked in the service of foreign royal patrons. The present study investigates the provenance of ancient ostrich eggs, reconsiders trade patterns via isotopic indicators and characterises decorative techniques in order to assist in the identification of culturally distinct decorative styles or regional preferences.
Who is more likely to be isolated from society in terms of political beliefs? To answer this question, we measure whether individuals’ beliefs are “out of sync”—the extent to which their views differ with their contemporaries—and examine how the level of synchronization is associated with the size of important-matter and political-matter discussion networks. The results show that people with weaker belief synchronization are more likely to have smaller important-matter discussion networks. However, additional analyses of political-matter discussion networks show that weaker belief synchronization is associated with smaller networks only among those without a high school diploma and even provides some advantage in maintaining larger networks for the college-educated. Overall, the results imply that political beliefs that are “out of sync” correspond to the individual being “out of society,” whereas the aspects of “out of society” are quite different among educational groups.
Situated within the larger context of Canadian pipeline decisions, it is argued that pipeline proposals in a geography without pre-existing pipelines are unsuccessful in contrast to proposals repurposing and expanding existing pipelines. The Chippewas of the Thames (the ‘Chippewas’) unsuccessfully opposed Enbridge's expansion, reversal and repurposing to crude oil of the Line 9 pipeline in Ontario, Canada. Analysing the Chippewas’ case within the context of recent oil- and gas-pipeline developments, using a lens of intersectionality focused on identity markers of indigeneity, socio-economic status and geographical location, exposes the naturalised power structures of Canadian law. These structures include the legal institutions of real-property law, Crown ownership of wildlife and fish, implicit ‘standing’ of the economy and assimilation of indigenous rights. Exposing this dichotomy of indigenous rights on paper vs. in practice deepens the consideration of indigenous rights, potentially allowing intersecting oppressions to be addressed.
The Everyday Cognition (ECog) scales measure cognitively based across domains of everyday abilities that are affected early in the course of neurodegenerative disorders such as Alzheimer’s disease. However, the degree to which the ECog may be differentially influenced by ethnic/racial background is unknown. This study evaluates measurement invariance of the ECog across non-Hispanic White (NHW), Black, and Hispanic individuals.
Participants included 1177 NHW, 243 Black, and 216 Hispanic older adults from the UC Davis Alzheimer’s Disease Center Cohort who had an ECog. Differential item functioning (DIF) for each ECog domain was evaluated separately for Black and Hispanic participants compared to NHW participants. An iterative multiple group confirmatory factor analysis approach for ordinal scores was used to identify items whose measurement properties differed across groups and to adjust scores for DIF. Adjusted scores were then evaluated to test whether they were more strongly associated with cognitive function (concurrent and longitudinal change in cognition) and brain volumes (measured by brain imaging).
Varying levels, patterns, and impacts of DIF were found across domains and groups. However, the impact of DIF was relatively small, and DIF effects on scores generally were less than one-half standard error of measurement. There were no meaningful differences in associations with cognition and brain injury between DIF adjusted and unadjusted scores.
Varying patterns of DIF were observed across the Black and Hispanic participants across select ECog domains. Overall, DIF effects were relatively small and did not change the relationship between the ECog and other indicators of disease.
Postoperative cognitive impairment is among the most common medical complications associated with surgical interventions – particularly in elderly patients. In our aging society, it is an urgent medical need to determine preoperative individual risk prediction to allow more accurate cost–benefit decisions prior to elective surgeries. So far, risk prediction is mainly based on clinical parameters. However, these parameters only give a rough estimate of the individual risk. At present, there are no molecular or neuroimaging biomarkers available to improve risk prediction and little is known about the etiology and pathophysiology of this clinical condition. In this short review, we summarize the current state of knowledge and briefly present the recently started BioCog project (Biomarker Development for Postoperative Cognitive Impairment in the Elderly), which is funded by the European Union. It is the goal of this research and development (R&D) project, which involves academic and industry partners throughout Europe, to deliver a multivariate algorithm based on clinical assessments as well as molecular and neuroimaging biomarkers to overcome the currently unsatisfying situation.
Factbound and Splitless: recognizes the US Supreme Court’s preeminent role in announcing federal common law that governs the relationship between tribes, states, and the federal government. However, because the Supreme Court only hears cases that can earn four votes for certiorari, the direction of federal Indian law is controlled as much by the choice to hear a case as by the ultimate decision that is issued. Fletcher examines the Supreme Court’s behavior in Indian law cases at the certiorari stage in order to explain how modern Court behavior is changing the landscape of Indian law without even deciding some of the most important legal issues.
Lifespan outcomes of simultaneous versus sequential myelomeningocele repair and shunt placement or effects of repeated shunt revisions on specific domains of IQ or fine motor dexterity are largely unknown. The current study addressed these gaps in a large cohort of children and adults with spina bifida myelomeningocele (SBM).
Participants between 7 and 44 years of age with SBM and shunted hydrocephalus were recruited from international clinics at two time points. Each participant completed a standardized neuropsychological evaluation that included estimates of IQ and fine motor dexterity. Simultaneous versus sequential surgical repair and number of shunt revisions were examined in relation to long-term IQ and fine motor scores.
Simultaneous myelomeningocele repair and shunting were associated with more frequent shunt revisions, as well as to lower Full Scale and verbal IQ scores, controlling for number of shunt revisions. More shunt revisions across study time points were associated with higher nonverbal IQ (NVIQ) scores. No effects were observed on fine motor dexterity.
Findings indicate generally greater influence of surgery type over shunt revision history on outcomes in well-managed hydrocephalus. Findings supported apparent, domain-specific benefits of sequential compared to simultaneous surgery across the lifespan in SBM. Higher NVIQ scores with greater number of additional shunt revisions across surgery type supported positive outcomes with effective surgical management for hydrocephalus.
Some would argue there is a global movement afoot to study “biopolitics.” More and more scholarly reports that help shape our understanding of the political domain from this perspective are filling the pages of research journals. This is an important era of increasing scholarly interest in the intersection of the political and biological worlds and the rapidly evolving analytical innovations available to explore this still under-explored domain. With the arrival of these new opportunities comes a new editorial team at Politics and the Life Sciences (PLS). It is a team that extends its appreciation to the Council of the Association for Politics and the Life Sciences for the trust they put in it to steer the journal forward at this interesting and critical time. As well, it is a team that expresses its heartfelt gratitude to its immediate predecessors, Tony Wohlers, Maggie Kosal, and their editorial colleagues, for their determined leadership of the journal over the last three years and the easy transition they facilitated for the new team. They clearly laid a firm foundation for the next stage of the development of the journal.
Psychosocial interventions that mitigate psychosocial distress in cancer patients are important. The primary aim of this study was to examine the feasibility and acceptability of an adaptation of the Mindful Self-Compassion (MSC) program among adult cancer patients. A secondary aim was to examine pre–post-program changes in psychosocial wellbeing.
The research design was a feasibility and acceptability study, with an examination of pre- to post-intervention changes in psychosocial measures. A study information pack was posted to 173 adult cancer patients 6 months–5 years post-diagnosis, with an invitation to attend an eight-week group-based adaptation of the MSC program.
Thirty-two (19%) consented to the program, with 30 commencing. Twenty-seven completed the program (mean age: 62.93 years, SD 14.04; 17 [63%] female), attending a mean 6.93 (SD 1.11) group sessions. There were no significant differences in medico-demographic factors between program-completers and those who did not consent. However, there was a trend toward shorter time since diagnosis in the program-completers group. Program-completers rated the program highly regarding content, relevance to the concerns of cancer patients, and the likelihood of recommending the program to other cancer patients. Sixty-three percent perceived that their mental wellbeing had improved from pre- to post-program; none perceived a deterioration in mental wellbeing. Small-to-medium effects were observed for depressive symptoms, fear of cancer recurrence, stress, loneliness, body image satisfaction, mindfulness, and self-compassion.
Significance of results
The MSC program appears feasible and acceptable to adults diagnosed with non-advanced cancer. The preliminary estimates of effect sizes in this sample suggest that participation in the program was associated with improvements in psychosocial wellbeing. Collectively, these findings suggest that there may be value in conducting an adequately powered randomized controlled trial to determine the efficacy of the MSC program in enhancing the psychosocial wellbeing of cancer patients.