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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.
Minority ethnic and migrant groups face an elevated risk of compulsory admission for mental illness. There are overlapping cultural, socio-demographic, and structural explanations for this risk that require further investigation.
By linking Swedish national register data, we established a cohort of persons first diagnosed with a psychotic disorder between 2001 and 2016. We used multilevel mixed-effects logistic modelling to investigate variation in compulsory admission at first diagnosis of psychosis across migrant and Swedish-born groups with individual and neighbourhood-level covariates.
Our cohort included 12 000 individuals, with 1298 (10.8%) admitted compulsorily. In an unadjusted model, being a migrant [odds ratio (OR) 1.48; 95% confidence interval (CI) 1.26–1.73] or child of a migrant (OR 1.27; 95% CI 1.10–1.47) increased risk of compulsory admission. However after multivariable modelling, region-of-origin provided a better fit to the data than migrant status; excess risk of compulsory admission was elevated for individuals from sub-Saharan African (OR 1.94; 95% CI 1.51–2.49), Middle Eastern and North African (OR 1.46; 95% CI 1.17–1.81), non-Nordic European (OR 1.27; 95% CI 1.01–1.61), and mixed Swedish-Nordic backgrounds (OR 1.33; 95% CI 1.03–1.72). Risk of compulsory admission was greater in more densely populated neighbourhoods [OR per standard deviation (s.d.) increase in the exposure: 1.12, 95% CI 1.06–1.18], an effect that appeared to be driven by own-region migrant density (OR per s.d. increase in exposure: 1.12; 95% CI 1.02–1.24).
Inequalities in the risk of compulsory admission by migrant status, region-of-origin, urban living and own-region migrant density highlight discernible factors which raise barriers to equitable care and provide potential targets for intervention.
How do migrants decide when to leave? Conventional wisdom is that violence and economic deprivation force migrants to leave their homes. However, long-standing problems of violence and poverty often cannot explain sudden spikes in migration. We study the timing of migration decisions in the critical case of Syrian and Iraqi migration to Europe using an original survey and embedded experiment, as well as interviews, focus groups, and Internet search data. We find that violence and poverty lead individuals to invest in learning about the migration environment. Political shifts in receiving countries then can unleash migratory flows. The findings underscore the need for further research on what migrants know about law and politics, when policy changes create and end migrant waves, and whether politicians anticipate migratory responses when crafting policy.
Institutions that require the use of coercion to enforce create political headaches. In these settings, enforcement involves fines, jail sentences, and asset seizures that are unpopular with those affected. This chapter highlights how coercive sanctions can generate social and electoral reactions against institutions, even when there is broad support for the underlying institutional aims. Intentional decisions not to enforce the law, or what I call forbearance (Holland 2016, 2017), is an important source of the institutional weakness studied in this volume.
Applying coercive sanctions is a challenge in any democracy. But in highly unequal societies, such as those in Latin America, enforcement challenges are compounded by both the power and poverty of those affected by institutional rules. On the one hand, the wealthy often stand above the law, using their money and connections to bend formal rules in their favor and forgo sanctions.
Obsessive-compulsive disorder (OCD) is a highly disabling condition, with frequent early onset. Adult/adolescent OCD has been extensively investigated, but little is known about prevalence and clinical characterization of geriatric patients with OCD (G-OCD = 65 years). The present study aimed to assess prevalence of G-OCD and associated socio-demographic and clinical correlates in a large international sample.
Data from 416 outpatients, participating in the ICOCS network, were assessed and categorized into 2 groups, age < vs = 65 years, and then divided on the basis of the median age of the sample (age < vs = 42 years). Socio-demographic and clinical variables were compared between groups (Pearson Chi-squared and t tests).
G-OCD compared with younger patients represented a significant minority of the sample (6% vs 94%, P < .001), showing a significantly later age at onset (29.4 ± 15.1 vs 18.7 ± 9.2 years, P < .001), a more frequent adult onset (75% vs 41.1%, P < .001) and a less frequent use of cognitive-behavioural therapy (CBT) (20.8% vs 41.8%, P < .05). Female gender was more represented in G-OCD patients, though not at a statistically significant level (75% vs 56.4%, P = .07). When the whole sample was divided on the basis of the median age, previous results were confirmed for older patients, including a significantly higher presence of women (52.1% vs 63.1%, P < .05).
G-OCD compared with younger patients represented a small minority of the sample and showed later age at onset, more frequent adult onset and lower CBT use. Age at onset may influence course and overall management of OCD, with additional investigation needed.
In this article, we describe the results of the second phase of a randomized controlled trial of Minding the Baby (MTB), an interdisciplinary reflective parenting intervention for infants and their families. Young first-time mothers living in underserved, poor, urban communities received intensive home visiting services from a nurse and social worker team for 27 months, from pregnancy to the child's second birthday. Results indicate that MTB mothers' levels of reflective functioning was more likely to increase over the course of the intervention than were those of control group mothers. Likewise, infants in the MTB group were significantly more likely to be securely attached, and significantly less likely to be disorganized, than infants in the control group. We discuss our findings in terms of their contribution to understanding the impacts and import of intensive intervention with vulnerable families during the earliest stages of parenthood in preventing the intergenerational transmission of disrupted relationships and insecure attachment.
In Latin America, the relationship between income and support for redistribution is weak and variable despite the region's extreme income inequality. This article shows that this condition is rooted in the truncated structure of many Latin American welfare states. Heavy spending on contributory social insurance for formal-sector workers, flat or regressive subsidies, and informal access barriers mean that social spending does far less for the poor in Latin America than it does in advanced industrial economies. Using public opinion data from across Latin America and original survey data from Colombia, the author demonstrates that income is less predictive of attitudes in the countries and social policy areas in which the poor gain less from social expenditures. Social policy exclusion leads the poor to doubt that they will benefit from redistribution, thereby dampening their support for it. The article reverses an assumption in political economy models that welfare exclusion unleashes demands for greater redistribution. Instead, truncation reinforces skepticism about social policy helping the poor. Welfare state reforms to promote social inclusion are essential to strengthen redistributive coalitions.
Lateral memristors consisting of planar Ag electrodes (with sub-micrometer separation) supported on thin films of amorphous zinc-tin-oxide have been characterized. After an initial filament-forming process, each device exhibited volatile, resistive switching. In the low resistance state, the transport mechanism and conductance depended on prior activity and on the imposed current limit, mimicking biologic synaptic plasticity. Microscopic observations performed on each device revealed nanoscale filaments between the electrodes. These filaments were subject to Rayleigh instability and exhibited relaxation times determined by their effective radii. The relaxation times and on:off resistance ratios suggest suitability for threshold switching selector devices.
The longstanding association between the major histocompatibility complex (MHC) locus and schizophrenia (SZ) risk has recently been accounted for, partially, by structural variation at the complement component 4 (C4) gene. This structural variation generates varying levels of C4 RNA expression, and genetic information from the MHC region can now be used to predict C4 RNA expression in the brain. Increased predicted C4A RNA expression is associated with the risk of SZ, and C4 is reported to influence synaptic pruning in animal models.
Based on our previous studies associating MHC SZ risk variants with poorer memory performance, we tested whether increased predicted C4A RNA expression was associated with reduced memory function in a large (n = 1238) dataset of psychosis cases and healthy participants, and with altered task-dependent cortical activation in a subset of these samples.
We observed that increased predicted C4A RNA expression predicted poorer performance on measures of memory recall (p = 0.016, corrected). Furthermore, in healthy participants, we found that increased predicted C4A RNA expression was associated with a pattern of reduced cortical activity in middle temporal cortex during a measure of visual processing (p < 0.05, corrected).
These data suggest that the effects of C4 on cognition were observable at both a cortical and behavioural level, and may represent one mechanism by which illness risk is mediated. As such, deficits in learning and memory may represent a therapeutic target for new molecular developments aimed at altering C4’s developmental role.
Comparative research on Latin American welfare states recently has focused on the extension of non-contributory benefits to those outside the formal labor market. This extension of benefits constitutes a major break from past exclusionary welfare regimes. Yet there also are substantial areas of continuity, especially in the contributory social-insurance system that absorbs most of welfare budgets. We develop here a framework for studying changes in Latin American welfare states that reconciles these trends. We argue that Latin American governments enjoyed an “easy” stage of welfare expansions in the 2000s, characterized by distinct political coalitions. Bottom-targeted benefits could be layered on top of existing programs and provided to wide segments of the population. But many Latin American governments are nearing the exhaustion of this social-policy model. We explore policy and coalitional challenges that hinder moves to “hard” redistribution with case studies of unemployment insurance in Chile and housing in Colombia.
It is becoming increasingly evident that biological invasions result in altered disease dynamics in invaded ecosystems, with knock-on effects for native host communities. We investigated disease dynamics in an invaded ecosystem, using the helminth communities of the native wood mouse (Apodemus sylvaticus) in the presence and absence of the invasive bank vole (Myodes glareolus) in Ireland. Native wood mice were collected over 2 years from four sites to assess the impact of the presence of the bank vole on wood mouse helminth community dynamics both at the component and infracommunity level. We found evidence for dilution (Syphacia stroma), spill-back (Aonchotheca murissylvatici) and spill-over (Taenia martis) in native wood mice due to the presence of the bank vole. Site of capture was the most important factor affecting helminth community structure of wood mice, along with year of capture and host-age and the interactions between them.