Please note, due to essential maintenance online transactions will not be possible between 02:30 and 04:00 BST, on Tuesday 17th September 2019 (22:30-00:00 EDT, 17 Sep, 2019). We apologise for any inconvenience.
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.
On October 7, 2016, Hurricane Matthew traveled along the coasts of Florida, Georgia, and South Carolina causing flooding and power outages. The Georgia Department of Public Health (DPH) developed the Web-based Responder Safety, Tracking, and Resilience (R-STaR) system to monitor the health and safety of public health responders and to inform disaster response planning for Hurricane Matthew. Using R-STaR, responders (n = 126) were e-mailed a daily survey while deployed to document injuries or harmful exposures and a post-deployment survey on their post-deployment health and satisfaction with using R-STaR. DPH epidemiologists contacted responders reporting injuries or exposures to determine the need for medical care. Frequencies were tabulated for quantitative survey responses, and qualitative data were summarized into key themes. Five percent (6/126) of responders reported injuries, and 81% (43/53) found R-STaR easy to use. Suggestions for R-STaR improvement included improving accessibility using mobile platforms and conducting pre-event training of responders on R-STaR. Lessons learned from R-STaR development and evaluation can inform the development and improvement of responder health surveillance systems at other local and state health departments and disaster and emergency response agencies. (Disaster Med Public Health Preparedness. 2019;13:74–81).
Older adults represent the highest proportion of gamblers (Ontario Lottery and Gaming Corporation [OLG], 2012). Unpartnered older adults may be more socially isolated and lonely (Dykstra & de Jong Gierveld, 2004), thus more likely to be at risk for problem gambling (McQuade & Gill, 2012). We examined whether gambling to socialize or from loneliness and going to the casino with friends/family mediate the relation between marital status and problem gambling. Data from a random sample of older adults at gambling venues across Southwestern Ontario indicated that gambling with family/friends and gambling due to loneliness mediated the relationship between marital status and problem gambling. Relative to those married, unpartnered older adults were less likely to gamble with family/friends, more likely to gamble due to loneliness, and had higher problem gambling. Prevention and treatment initiatives should examine ways to decrease loneliness and social isolation among older adults and offer alternative social activities.
Research in our time offers a welcome flood tide of investigation into how cognitively modern human beings use their basic mental operations to think and act. With luck, it will not ebb. It could become standard, in the way that calculus, once it arose, abided. This tide offers special emphasis, crucial for this issue, on the cognitive origins and operations of language and literature, and in particular on the ways in which systems of multimodal forms can be deployed to prompt for mental operation.
Objectives: Treatments for childhood brain tumors (BT) confer substantial risks to neurological development and contribute to neuropsychological deficits in young adulthood. Evidence suggests that individuals who experience more significant neurological insult may lack insight into their neurocognitive limitations. The present study compared survivor, mother, and performance-based estimates of executive functioning (EF), and their associations with treatment intensity history in a subsample of young adult survivors of childhood BTs. Methods: Thirty-four survivors (52.9% female), aged 18 to 30 years (M=23.5; SD=3.4), 16.1 years post-diagnosis (SD=5.9), were administered self-report and performance-based EF measures. Mothers also rated survivor EF skills. Survivors were classified by treatment intensity history into Minimal, Average/Moderate, or Intensive/Most-Intensive groups. Discrepancies among survivor, mother, and performance-based EF estimates were compared. Results: Survivor-reported and performance-based measures were not correlated, although significant associations were found between mother-reported and performance measures. Survivors in the Intensive/Most-Intensive treatment group evidenced the greatest score discrepancies, reporting less executive dysfunction relative to mother-reported F(2,31)=7.81, p<.01, and performance-based measures F(14,50)=2.54, p<.05. Conversely, survivors in the Minimal treatment group reported greater EF difficulties relative to mothers t(8)=2.82, p<.05, but not performance-based estimates (ps>.05). Conclusions: There may be a lack of agreement among survivor, mother, and performance-based estimates of EF skills in young adult survivors of childhood BT, and these discrepancies may be associated with treatment intensity history. Neuropsychologists should use a multi-method, multi-reporter approach to assessment of EF in this population. Providers also should be aware of these discrepancies as they may be a barrier to intervention efforts. (JINS, 2016, 22, 900–910)
Autism spectrum disorders (ASD) including high-functioning types such as Asperger's syndrome (AS) are diagnosed when there is evidence of a triad of qualitative impairments in social interaction, communication, and stereotyped/repetitive behaviours. It is not uncommon for these impairments to be accompanied by social anxiety. The present single-case study investigates the use of cognitive behavioural therapy (CBT) to treat a 47-year-old man who was assessed as having difficulties with social skills and social phobia in the context of a late diagnosis of AS. He received 20 h of CBT adapted for his AS in 15 sessions including a 1-month follow-up. Following a highly individualized formulation, treatment included modelling, role-playing, reinforcement, thought challenging, and behavioural experimentation. Results from five self-report measures showed continued improvements from the start of therapy to follow-up in social anxiety, global distress, depression and self-esteem. The client gave positive feedback about his experience of treatment. The case study is discussed with reference to limitations and some reflections for CBT in ASD.
To investigate the attitudes to health and work of general practitioners (GPs) with training in occupational medicine (OM) compared with non-OM trained GPs, since the introduction of the fit note.
Changes to the UK sickness certification system since 2010 and the introduction of the fit note required GPs to change their focus to what patients can do, rather than what they cannot do in relation to work. In an effort to reduce the UK sickness absence burden, GPs completion of the fit note should help to keep people in work, or assist patients to return to work as quickly as possible after a period of absence.
Questionnaire data were collected via the 7th National General Practitioner Worklife Survey.
Results indicate that responses from GPs who had undertaken training in OM, and GPs having received some form of work and health training in the 12-month period before the study were associated with significantly more positive attitudes to patients’ returning to work and to the fit note. This study reveals evidence of a difference between trained and non-trained GPs in their attitude to the fit note, and to work and health generally. Further work investigating the effect of specific training in OM on the management and recognition of ill-health by GPs is recommended.
Papers devoted to the subject of reserving for Permanent Health Insurance (PHI) are not exactly numerous. The author could not find one published in the U.K., although there were papers in the U.S.A., Australia and South Africa.
Most U.K. PHI papers have sought to cover the topic in its entirety and therefore do give views on reserving issues. Ironically, this paper in seeking to focus on reserving did, incidentally, find itself wandering over a large part of the PHI actuarial countryside. Perhaps this is unavoidable.
PHI reserving is not just a question of ensuring adequate solvency. The reserving basis we choose can aid or hinder our understanding of the business. After all, the recognition of profits is defined by the reserving basis. If management is going to track profits in order to assist decisions on marketing position, financial strength of the office, etc. then it needs to be concerned that the reserving basis is not distorting the emerging results. An equivalent argument can be put forward in respect of the capital requirements of the business.
Soprano Emma Juch (1860–1939), famous in the 1880s and 1890s, combined singing in concerts and festivals with a short English-language operatic career. Because Juch exemplifies a typical prima donna of the late nineteenth century, her life provides a perspective on the American cultural landscape that a focus on star performers cannot capture. Like all female singers, she had to negotiate between competing stereotypes about divas and the nineteenth-century distrust of women who led public lives. In response to these pressures, she constructed an image of a vigorous American singer who nevertheless understood her expected role in society. During the Gilded Age, opera's place in American culture was changing. Foreign-language opera became increasingly associated with wealth, the highest performance quality, and sometimes even cultural and moral uplift, whereas English-language opera suggested popular entertainment for the middle class and mediocre performance standards. The American Opera Company and Juch's own Emma Juch English Grand Opera Company attempted to fight against these assumptions and center opera in English performed by native singers as an important component of a distinctly American musical tradition. She was unsuccessful, however, and Juch's career, which began with great promise, lost momentum after her opera troupe folded and she slid into obscurity.
Conodont elements from Scottish Carboniferous rocks have been reviewed for Colour Alteration Index(CAI) data, and most values range between 1 and 1·5. Assuming a local average geothermal gradient similar to that of today, the observed and predicted CAI values generally fit well. Only a few of the samples analysed were influenced by local igneous intrusives. The CAI range shown lies within the immature (early dry gas) to mature (perhapsmid-oil window) stages of hydrocarbon generation, and this suggests that burial maturation (where CAI values are 1-5) could account for locally generated oil, where this occurred away from igneous intrusions. Alkali-dolerite and tholeiitic intrusives are, however, widespread in the Midland Valley of Scotland, and an understanding of their thermal effects has implications for both coal and petroleum exploration. The insensitivity of conodonts to low temperatures is noted, and the relevance, application and potential of various other palaeothermometers is discussed. Locally, the qualitative study of spore colour (SCI) appears useful.