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 firstname.lastname@example.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 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.
There is strong evidence that foods containing dietary fibre protect against colorectal cancer, resulting at least in part from its anti-proliferative properties. This study aimed to investigate the effects of supplementation with two non-digestible carbohydrates, resistant starch (RS) and polydextrose (PD), on crypt cell proliferative state (CCPS) in the macroscopically normal rectal mucosa of healthy individuals. We also investigated relationships between expression of regulators of apoptosis and of the cell cycle on markers of CCPS. Seventy-five healthy participants were supplemented with RS and/or PD or placebo for 50 d in a 2 × 2 factorial design in a randomised, double-blind, placebo-controlled trial (the Dietary Intervention, Stem cells and Colorectal Cancer (DISC) Study). CCPS was assessed, and the expression of regulators of the cell cycle and of apoptosis was measured by quantitative PCR in rectal mucosal biopsies. SCFA concentrations were quantified in faecal samples collected pre- and post-intervention. Supplementation with RS increased the total number of mitotic cells within the crypt by 60 % (P = 0·001) compared with placebo. This effect was limited to older participants (aged ≥50 years). No other differences were observed for the treatments with PD or RS as compared with their respective controls. PD did not influence any of the measured variables. RS, however, increased cell proliferation in the crypts of the macroscopically-normal rectum of older adults. Our findings suggest that the effects of RS on CCPS are not only dose, type of RS and health status-specific but are also influenced by age.
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.
THE foundations for wide-ranging interest in and discussion of Oxford, BodL, MS Digby 86 in relation to its context of production and early use were laid in the researches of Brian Miller, who assiduously collected and collated contemporary documentary records of individuals and families represented in marginalia and other entries within the manuscript. Publishing a facsimile of the manuscript for the Early English Text Society in 1996, Judith Tschann and Malcolm Parkes were able to bring out more of the complex and fascinating codicological process by which the manuscript was compiled. A number of subsequent studies have approached and applied these data from more literary – interpretative and critical – viewpoints, while Peter Coss has complementarily evaluated these insights from the point of view of a social historian's interest in the culture of the gentry and, in this case, also the ‘sub-gentry’ of the late thirteenth and earlier fourteenth centuries. This chapter's consideration of the societal context of the manuscript builds on all of these observations, using Network Theory to explore the sociopolitical networks of the area and considering the archaeological and geographical context of this region of Worcestershire.
The background: settlement and society in Worcestershire west of the Severn
Tschann and Parkes were prepared to speculate that the principal scribe and compiler, who completed his work during or shortly after the period of November 1281 to November 1283, was Richard de Grimhill (d. 1307/8), whose daughter Amice married Simon (of) Underhill. Death notices for Alexander of Grimhill, possibly a son of Richard who died young, and for Amice and Simon themselves are included in a Calendar within the manuscript (art. 25; fols. 68v–74r), and autograph pen-trials in the hand of William, the son of Simon and Amice, appear on several leaves. Further marginal pen-trials on the leaves of the manuscript are in the hands of a Robert and a John of Pendock, while a large marginal addition is the will of one Robert (son of Robert) of Pendock, stipulating that he should be buried at Redmarley, and leaving a young horse to William of Underhill. These references locate the manuscript, by the early fourteenth century at least, very precisely.
Although federal regulation of vehicle fuel economy is often seen as environmental policy, over 70% of the estimated benefits of the 2017–2025 federal standards are savings in consumer expenditures on gasoline. Rational-choice economists question the counting of these benefits since studies show that the fuel efficiency of a car is reflected in its price at sale and resale. We contribute to this debate by exploring why most consumers in the United States do not purchase a proven fuel-saving innovation: the hybrid-electric vehicle (HEV). A database of 110 vehicle pairs is assembled where a consumer can choose a hybrid or gasoline version of virtually the same vehicle. Few choose the HEV. A total cost of ownership model is used to estimate payback periods for the price premiums associated with the HEV choice. In a majority of cases, a rational-choice explanation is sufficient to understand consumer disinterest in the HEV. However, in a significant minority of cases, a rational-choice explanation is not readily apparent, even when non-pecuniary attributes (e.g., performance and cargo space) are considered. Future research should examine, from a behavioral economics perspective, why consumers do not choose HEVs when pricing and payback periods appear to be favorable.
Treatment for hoarding disorder is typically performed by mental health professionals, potentially limiting access to care in underserved areas.
We aimed to conduct a non-inferiority trial of group peer-facilitated therapy (G-PFT) and group psychologist-led cognitive–behavioural therapy (G-CBT).
We randomised 323 adults with hording disorder 15 weeks of G-PFT or 16 weeks of G-CBT and assessed at baseline, post-treatment and longitudinally (≥3 months post-treatment: mean 14.4 months, range 3–25). Predictors of treatment response were examined.
G-PFT (effect size 1.20) was as effective as G-CBT (effect size 1.21; between-group difference 1.82 points, t = −1.71, d.f. = 245, P = 0.04). More homework completion and ongoing help from family and friends resulted in lower severity scores at longitudinal follow-up (t = 2.79, d.f. = 175, P = 0.006; t = 2.89, d.f. = 175, P = 0.004).
Peer-led groups were as effective as psychologist-led groups, providing a novel treatment avenue for individuals without access to mental health professionals.
Declaration of interest
C.A.M. has received grant funding from the National Institutes of Health (NIH) and travel reimbursement and speakers’ honoraria from the Tourette Association of America (TAA), as well as honoraria and travel reimbursement from the NIH for serving as an NIH Study Section reviewer. K.D. receives research support from the NIH and honoraria and travel reimbursement from the NIH for serving as an NIH Study Section reviewer. R.S.M. receives research support from the National Institute of Mental Health, National Institute of Aging, the Hillblom Foundation, Janssen Pharmaceuticals (research grant) and the Alzheimer's Association. R.S.M. has also received travel support from the National Institute of Mental Health for Workshop participation. J.Y.T. receives research support from the NIH, Patient-Centered Outcomes Research Institute and the California Tobacco Related Research Program, and honoraria and travel reimbursement from the NIH for serving as an NIH Study Section reviewer. All other authors report no conflicts of interest.
A working group was held during the 2017 National Adaptation Forum to build collaborative capacity on issues related to Tribal agriculture and natural resource management in a changing climate. We developed three synthetic themes from these discussions and dialogue to highlight on-going opportunities, but also demonstrate areas for continued engagement with Tribes related to effective agricultural and natural resource management. We hope this forum demonstrates the critical importance of partnerships, and motivates further coordination and collaboration among Tribes, universities and Federal agencies.
Anyone over the age of 60 would be foolhardy not to be fearful of dementia in general and Alzheimer's disease (AD) in particular, because it is very common. About one-third of people in the developed world have a family member or friend who has succumbed to one form or another of dementia, and these numbers are expected to soar thanks to longer lifespans. What makes dementia so horrifying is that it comes with the annihilation of memory and personal identity, to the extent that you eventually are unable to recognize even your loved ones. You end up as an empty shell of your former self.
When thinking about AD it is important to appreciate that AD and dementia are not one and the same thing. AD, which accounts for about 60 percent of dementia cases, causes problems with memory, language, and reasoning. It is characterized by the accumulation of deposits made up of a protein amyloid-β between, and tangles of another protein known as tau both between and within, brain cells. In describing AD it is important to distinguish “characterized by” from “caused by” because, as we will see, there is still some doubt here.
We argue that although objectivist moral attitudes may facilitate cooperation, they are not necessary for the high levels of cooperation in humans. This is implied by evolutionary models that articulate a mechanism underlying Stanford's account, and is also suggested by the ability of merely conventional social norms to explain extreme human behaviors.
The San Francisco Fire Department’s (SFFD; San Francisco, California USA) Homeless Outreach and Medical Emergency (HOME) Team is the United States’ first Emergency Medical Services (EMS)-based outreach effort using a specially trained paramedic to redirect frequent users of EMS to other types of services. The effectiveness of this program at reducing repeat use of emergency services during the first seven months of the team’s existence was examined.
A retrospective analysis of EMS use frequency and demographic characteristics of frequent users was conducted. Clients that used emergency services at least four times per month from March 2004 through May 2005 were contacted for intervention. Patterns for each frequent user before and after intervention were analyzed. Changes in EMS use during the 15-month study interval was the primary outcome measurement.
A total of 59 clients were included. The target population had a median age of 55.1 years and was 68% male. Additionally, 38.0% of the target population was homeless, 43.4% had no primary care, 88.9% had a substance abuse disorder at time of contact, and 83.0% had a history of psychiatric disorder. The HOME Team undertook 320 distinct contacts with 65 frequent users during the study period. The average EMS use prior to HOME Team contact was 18.72 responses per month (SD=19.40), and after the first contact with the HOME Team, use dropped to 8.61 (SD=10.84), P<.001.
Frequent users of EMS suffer from disproportionate comorbidities, particularly substance abuse and psychiatric disorders. This population responds well to the intervention of a specially trained paramedic as measured by EMS usage.
TangherliniN, VillarJ, BrownJ, RodriguezRM, YehC, FriedmanBT, WadaP. The HOME Team: Evaluating the Effect of an EMS-based Outreach Team to Decrease the Frequency of 911 Use Among High Utilizers of EMS. Prehosp Disaster Med. 2016;31(6):603–607.
Operation of the six 13.7 m antennas of the Fleurs synthesis telescope as a sub-array has provided a new and surprisingly versatile astronomical tool. With enhanced reliability and fully automated operation, unattended observing over several days is possible. Interleaved ‘multiple-snapshot’ observations of many fields per day can be made.
The array has shown itself to be particularly suitable for the measurement of precision (a few arcsecond) positions for the optical identification of a large number of radio sources, a survey of compact sources and the monitoring of the activity of several radio stars over periods of weeks. At present a program of recalibration is under way to improve the positional accuracy and dynamic range of the instrument.
Properties of the microwave emission from HR1099 are examined in an attempt to determine whether the emission arises as gyro-synchrotron radiation from mildly relativistic electrons trapped in magnetic fields above starspots on the active K subgiant component. It is shown that radio curves do not exhibit a systematic variation in phase with the rotation rate, as one might expect for emission from a source situated above a long-lived starspot. However, there is some evidence that the radio flaring occurs at two preferred longitude zones. Whether these zones agree with starspot locations remains to be determined by light curve modelling. What we can say with confidence is that the measured spectral index of the microwave emission does not fit a simple gyro-synchrotron source model, such as that proposed to explain the observed reversal with frequency of the sense of circular polarization.
A program to determine accurate radio positions and optical identifications of southern flat-spectrum radio sources has been undertaken with the six-dish array of the Fleurs synthesis telescope at 1.4 GHz and using the SERC J sky survey. This sample covers the declination range −80° to −50° and comprises all 198 sources from the Parkes catalogue with α of > −0.5 and flux density of 0.25 Jy.
The radio astrometric phase of the program is complete. We conclude that by comparison with accurate VLBI positions the FST positions have r.m.s. uncertainties of ∼0″.9. There is no global bias in the FST positions at the 0″.2 to 0″.3 level relative to the JPL VLBI extragalactic reference frame. A comparison with positions from the Parkes catalogue shows that in the southern regions the Parkes catalogue has rms position errors of about 9″. There is no significant bias between the FST and Parkes positions.
One of the more significant weaknesses in the search for extraterrestrial intelligence (SETI) research has been the limited contribution from scholars working outside of the Western cultural context including North America and Europe. While there has been interest among astronomers in countries like Japan and South Korea in the search, involvement has been limited particularly when it comes to more speculative research and writing about communication with extraterrestrial intelligence and the possible nature of civilizations inhabiting exoplanets. As argued in Chapter 8 of this volume, there is an ethnocentric bias in much writing about extraterrestrial life that is shaped by both the Western intellectual and religious traditions of Social Darwinism and Christianity, and this ethnocentrism significantly shapes the ways we think about what constitutes a civilization and how cultures and civilizations evolve over time.
In this chapter, we are interested in giving some thought to the potential influence contributions from a non-Western perspective might make in expanding our thinking about extraterrestrial intelligence. This has both pragmatic and theoretical consequences. From a theoretical perspective, alternative worldviews (from the Christian perspective) – such as what we see in Buddhism or Taoism – have the potential to shape our thinking about the nature of progress and change. Pragmatically, this should widen our scope of imagination as we contemplate the possibilities and difficulties we may encounter should contact occur.
Before moving on, we want to emphasize that this chapter is quite speculative. Our perspective here is intended only as an example of how a non-Western perspective might influence our thinking about SETI. In many respects, this chapter is a call for SETI scholars to work on finding new ways to draw non-Western scholars into the discourse. It was interesting that during the Library of Congress symposium that formed the basis for this volume, there were participants from the Vatican and those who worked in areas of Western theology and ethics, but there were no thinkers involved who work from a Buddhist, Muslim, or Hindu perspective (just to name a few possibilities). Indeed, as McAdamis (2011: 339) has argued, “[w]hether a result of ethnocentrism, or of the global influence of Western philosophy, most research engaging astrobiology's relationship with religion has tended to disproportionately focus on Christian theology.”