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The ability to manage emotions is an important social-cognitive domain impaired in schizophrenia and linked to functional outcome. The goal of our study was to examine the impact of cognitive enhancement therapy (CET) on the ability to manage emotions and brain functional connectivity in early-course schizophrenia.
Participants were randomly assigned to CET (n = 55) or an enriched supportive therapy (EST) control group (n = 45). The resting-state functional magnetic resonance imaging scans and measures of emotion management performances were collected at baseline, 9, and 18 months follow-up. The final sample consisted of 37 CET and 25 EST participants, including 19 CET and 12 EST participants with imaging data. Linear mixed-effects models investigated the impact of treatment on emotion management and functional connectivity from the amygdala to ventrolateral and dorsolateral prefrontal cortex (dlPFC).
The CET group showed significant improvement over time in emotion management compared to EST. Neither functional connectivity changes nor main group differences were observed following treatment. However, a significant between-group interaction showed that improved emotion management ability was associated with increased functional connectivity between the left amygdala and the left dlPFC in the CET group exclusively.
Our results replicate the previous work demonstrating that CET is effective at improving some aspects of social cognition in schizophrenia. We found evidence that improvement in emotion management may be associated with a change in amygdala-dlPFC connectivity. This fronto-limbic circuit may provide a mechanistic link between the biology of emotion management processes that can be enhanced in individuals with schizophrenia.
This study describes a procedural blank assessment of the ultraviolet photochemical oxidation (UV oxidation) method that is used to measure carbon isotopes of dissolved organic carbon (DOC) at the National Ocean Sciences Accelerator Mass Spectrometry Facility (NOSAMS). A retrospective compilation of Fm and δ13C results for secondary standards (OX-II, glycine) between 2009 and 2018 indicated that a revised blank correction was required to bring results in line with accepted values. The application of a best-fit mass-balance correction yielded a procedural blank of 22.0 ± 6.0 µg C with Fm of 0.30 ± 0.20 and δ13C of –32.0 ± 3.0‰ for this period, which was notably higher and more variable than previously reported. Changes to the procedure, specifically elimination of higher organic carbon reagents and improved sample and reactor handling, reduced the blank to 11.0 ± 2.75 µg C, with Fm of 0.14 ± 0.10 and δ13C of –31.0 ± 5.5‰. A thorough determination of the entire sample processing blank is required to ensure accurate isotopic compositions of seawater DOC using the UV oxidation method. Additional efforts are needed to further reduce the procedural blank so that smaller DOC samples can be analyzed, and to increase sample throughput.
Since 2009, mid-upper arm circumference (MUAC) has become an accepted measure for screening children for acute malnutrition and determining eligibility for services to manage acute malnutrition. Use of MUAC has increased the reach and enhanced the quality of community-based management of acute malnutrition services. Increasingly, MUAC is also used to assess nutritional status and eligibility for nutrition support among adolescents and adults, including pregnant and lactating women and HIV and TB clients. However, globally recognised cut-offs have not been established to classify malnutrition among adults using MUAC. Therefore, different countries and programmes use different MUAC cut-offs to determine eligibility for programme services. Patient monitoring guidelines provided by WHO for country adaptation to support the integrated management of adult illness do not include MUAC, in part because guidance does not exist about what MUAC cut-off should trigger further action.
Depression, anxiety, and apathy are the most commonly reported neuropsychiatric symptoms (NPS) in Alzheimer’s disease (AD). Understanding their prevalence in rarer dementias such as frontotemporal dementia (FTD), primary progressive aphasia (PPA), posterior cortical atrophy (PCA), young-onset AD (YOAD), and inherited dementias has implications for both clinical practice and research. In this study, we aimed to examine the current state of knowledge of the prevalence of these three NPS in less prevalent dementias.
We conducted a systematic review based on searches of EMBASE, PsycINFO, and PubMed up to September 2019.
47 articles meeting inclusion criteria were identified. Depression, anxiety, and apathy were commonly reported across the phenotypes studied but their prevalence showed large variation between studies. Apathy showed the highest reported frequency in FTD (50–100% across studies), behavioral variant frontotemporal dementia (bvFTD) (73–100%), and YOAD (44–100%). Anxiety was frequently reported in FTD (0–100%) and bvFTD (19–63%). Depression showed the highest prevalence in FTD (7–69%) and YOAD (11–55%). Among the three variants of PPA, sv-PPA is the one most investigated (seven articles). Three or fewer articles were identified examining NPS in the remaining PPA variants, PCA, familial AD, and familial FTD. Inconsistency in the tools used to measure symptoms and small sample sizes were common methodological limitations.
Future studies should consider the inclusion of larger sample sizes (e.g. through multicenter collaborations) and the use of harmonized protocols that include the combination of caregiver and patient-derived measures and symptom-specific questionnaires. More research is needed on the phenotype-specific barriers and facilitators for people living with dementia to successfully engage in self-reports of NPS.
Chapter 1 gives the historical context for Burke’s commentary on political economy. I first provide a sketch of Burke’s biography, with particular stress on the events and activities in his life that related to questions of commerce, property, and markets. For instance, I discuss Burke’s early interest in political economy as a member of his college debating club; and I explain how his activities as a farmer on his landed estate informed his views on the British agricultural economy. This chapter also marshals evidence showing that Burke earned a strong reputation in public and private life as an authoritative thinker on commercial policy, indicating that we should study his economic thought with heightened seriousness.
I conclude that Burke was one of the most prominent advocates of economic liberty in eighteenth-century England. I then summarize Burke’s principles of political economy, placing heavy emphasis on his defense of a free internal trade, his prudential advocacy of free trade in the foreign arena, and his endorsement of private property rights. I contend that Burke’s economic thought retains a meaningful consistency with his political thought – and thus, that Burke did not perceive an inherent tension between liberty and tradition. Therefore, there was no “Burke-Smith” problem or “Das Edmund Burke Problem” to begin with. In Burke’s judgment, a careful integration of market dynamism and the moderating presences of traditional virtue and landed property was essential for commercial prosperity. The most important lesson Burke’s economic thought teaches, however, is that civil society cannot endure on transactional exchange and voluntary contracts alone. Market economies are important instruments for the commercial enrichment of a people, but the deeper chords of friendship and trust, religion and virtue, are the ultimate bedrocks of social order and progress. I end by suggesting that our temptation for gain in the modern commercial economy should not make us forget our deeper obligations to our fellow man.
Chapter 12 includes the deeper normative arguments of Burke’s economic theory that come alive in the Reflections. Burke argued that among the real rights of men were the right to industry and the right to acquisition. He further contended that abstract theory overlooked the complexity of circumstance in social life, and that rigid government edicts intended to establish equality in civil society bred social chaos. Social engineering crushed the human soul. More important, I discuss Burke’s emphasis on the limits of transactional exchange in sustaining the growth of civilization. In his view, contracts could produce commercial opulence, but civilizations required pre-transactional bonds of religion, friendship, and manners in order to endure. Man’s moral obligations thus preceded the requirements of voluntary contracts; civilization might persist without commercial vitality, but it could not survive without virtue and chivalry. I also examine Burke’s commentary in Third Letter on a Regicide Peace, in which he provides remarks on the healthy state of the English economy, an Invisible Hand-type phenomenon, and the virtues of limited government, all of which complement his thoughts in Thoughts and Details and the Reflections.
The Introduction begins by presenting the problem of Burke’s conception of political economy: while Burke is known as the most celebrated critic of the abstract theory of the French Revolution, his defense of economic freedom rested in many ways on principles some French revolutionaries also endorsed, such as individual liberty, the right to property, a free grain trade. Framed differently, although Burke has acquired a powerful reputation for defending tradition, he also championed a human activity, market exchange, which was perceived by contemporaries as a disruptive force to settled social conventions. Therefore, was there an ineradicable tension in Burke’s thought between his praise of tradition and his embrace of commercial dynamism? Did he fully champion Adam Smith’s system of natural liberty? Did Burke offer a convincing way to overcome the “Burke-Smith” problem?, or “Das Edmund Burke Problem,” that of reconciling political stability with economic change? Answering these questions, I argue, can help us comprehend Burke’s own beliefs about the relation between political economy and ethics, and offer timely lessons on the compatibility between liberty and virtue in modernity.
Chapter 3 investigates Burke’s thoughts on the Corn Laws and the enclosure movement. Burke’s support for the corn bounty was one of the rare exceptions in which he defended state intervention in the market. Burke believed that the bounty had made corn cheaper in the long run and empowered the landed interest to compete in the foreign market. I also examine how Burke generally viewed enclosure in a favorable light for encouraging productive agricultural activity; he maintained, however, that the practice should be carried out in a transparent and lawful manner. In addition, I explore broader themes of Burke’s views on the agricultural economy. He held that the rich were the trustees of the poor, and thus possessed the moral resonsibility to aid them in times of need. I further outline his discussion of the varieties of labor in Thoughts and Details, which he used to demonstrate the hazards in establishing a uniform wage regulation that overlooked such differences. I also investigate Burke’s antipathy to wealth redistribution in the grain market. In his judgment, schemes to take wealth from some to give to others would lead to universal poverty, not universal opulence, and would cause social disorder.
Chapter 11 unveils Burke’s understanding of the French Revolution through the lens of his principles of political economy. In Reflections on the Revolution in France, Burke attacked the Revolution for violating prescriptive property rights and subverting the market principles of supply and demand that he later defended in Thoughts and Details. In addition, I provide a thorough treatment of Burke’s criticism of the monied interest and the revolutionaries’ frenzied issuance of paper money called assignats. In his judgment, these two aspects of the Revolution shook the foundations of France’s system of revenue and discouraged commercial activity. The monied interest in particular exploited their position as state creditors to drive their pursuit of avaricious self-interest and wield a nefarious influence in the conduct of government affairs, which helped provoke the expansion of the French state. Such financiers, as well as the new middle class, were driven by ambition and speculation, supplanting the landed nobility and unsettling the social order of France. In Burke’s view, the landed interest was necessary to tame and channel such influences because their family pedigrees, ancestral estates, modern disposition, and commitment to the common good provided a stable foundation for market exchange and foreign investment to flourish.
Chapter 8 offers comprehensive treatment of Burke’s thoughts on Anglo-Irish commercial relations. Burke was Parliament’s leading proponent of the Irish trade bills in the late 1770s, which were intended to relax commercial restrictions between Ireland and England. In Two Letters of the Trade of Ireland, he argued that free trade granted advantages to the trading nations and produced collective prosperity. Burke’s legislative activities in support of the Irish trade bills also illustrated his famous trustee theory of representation: he was willing to jeopardize his seat in Parliament in pursuit if Irish free trade, a policy goal that upset many Bristol merchants apprehensive about foreign competition. Furthermore, I discuss instances in which Burke did not argue for the maximum amount of free trade, such as his opposition to William Pitt’s commercial propositions and the Anglo-French Treaty of 1786. These cases reveal that Burke took into account other considerations of the British Empire, such as national security, when reflecting on matters of commercial policy. I also challenge the interpretation that Burke was originally a committed adherent of mercantilism. Rather than being a mercantilist or free trade absolutist, he sought to balance a defense of commercial liberty with the imperatives of empire.
Chapter 10 begins with discussion of Burke’s critique of Warren Hastings’s rule in Eleventh Report of Select Committee. Under Hastings, the East India Company fueled bribery, extortion, and fraudulence, which eroded the bond of trust between England and Indian natives. I then discuss Speech on Fox’s India Bill, one of Burke’s most illustrious speeches in which he outlined his plan to reform the maladministration of the Company. I explain why Burke both defended the prescriptive legitimacy of the Company and argued that the corporation should return to being a commercial institution, rather than continue to operate in the capacity of a public administrator. I also explore the six mercantile principles Burke proffers in the speech that he believed were necessary maxims of ethical and effectual commercial activity. Additionally, I demonstrate that Burke’s rebuke of the Company’s violation of Indian property rights disclosed his broader belief in the importance of private property in establishing a strong landed aristocracy and vibrant commercial culture. I conclude that Burke’s attack on the Company underlined his steadfast opposition to the concentration of political and economic power.
Chapter 6 explores Burke’s early views and legislative activities on foreign trade by analyzing Account of the European Settlements in America, which he coauthored with Will Burke. I explain how the Account offered some of the earliest glimpses into Burke’s conception of imperial political economy: the British Empire possessed the right to rule its colonial possessions, but its governance should be selective in regulating their internal affairs. Furthermore, the Account criticized the idea that the accumulation of gold was the best means to opulence, thereby challenging a core tenet of mercantilism. More important, the Account stressed that the character and fortitude of the English people would enable Britain to counter the imperial threat of its rival, France. In addition, Chapter 6 explores Burke’s leading parliamentary role in orchestrating the passage of the Free Port Act of 1766, which created six new free trade ports in the West Indies. Such legislative efforts showed that he was a champion of merchants and commercial liberty early on in his career in the House of Commons.