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For the 11th version of the International Classification of Diseases, the WHO recommended to rename transgender transidentity as “gender incongruence”, to remove it from the chapter of mental and behavioral disorders, and to put it in a new category titled “Conditions related to sexual health”. This should contribute to reduce stigmatisation while maintaining access to medical care. One argument in favor of depsychiatrisation is to demonstrate that essential features of gender identity disorders, namely psychological distress and functional impairment, are not necessarily reported by every transgender person, and may result from social rejection and violence rather than dysphoria itself. Initially confirmed in Mexico, these hypotheses were tested in a specific French medical context, where access to care does not require any prior mental health evaluation or diagnosis.
In 2017, 72 transgender persons completed retrospective interviews which focused on the period when they became aware that they might be transgender and perhaps would need to do something about it.
Results showed that psychological distress and functional impairment were not reported by every participant, that they may result from rejection and violence, and especially from rejection and violence coming from coworkers and schoolmates. Additional data showed that the use of health services for body transformation did not depend on distress and dysfunction. Finally, participants preferred ICD 11 to employ “transgender” or “transidentity” rather than “gender incongruence”.
Results support depsychiatrisation. They are discussed in terms of medical, ethical, legal, and social, added values and implications of depsychiatrisation.
In this investigation the factor structure of the Adult Attachment Interview was studied in a partially at-risk sample of 120 young adults. More specifically, 60 participants had engaged in nonsuicidal self-injury (NSSI; 53 females, M age = 20.38 years), and 60 were non-self-injuring controls matched by age and sex. Theoretically anticipated differential associations between preoccupied (but not dismissing) states of mind and NSSI were then examined. Exploratory factor analyses identified evidence for two weakly correlated state of mind dimensions (i.e., dismissing and preoccupied) consistently identified in factor analyses of normative-risk samples. As hypothesized, results further showed that preoccupied (but not dismissing) states of mind were associated with NSSI behavior. Findings support existing arguments suggesting that the regulatory strategy adults adopt when discussing attachment-related experiences with primary caregivers, particularly passive, angry, or unresolved discourse patterns, is uniquely correlated with NSSI.
RÉSUMÉ. Pêche et salines sont exploitées par les Normands et donnent lieu à un commerce intense entre la Sicile et la Calabre, tandis que les ports des Pouilles sont en relations avec la rive orientale de l'Adriatique et avec Constantinople. Par nature expansionnistes, les Normands ont constitué des flottes de guerre pour mener des raids vers la côte africaine où est constitué un éphémère royaume normand, vers Corinthe et Thèbes au milieu du XIIe siècle, vers Thessalonique en 1185, sans plan d'ensemble.
ABSTRACT. Fishing and salt pans were exploited by the Normans and gave rise to intense trade between Sicily and Calabria while the ports of Apulia were in contact with the eastern Adriatic coast and Constantinople. Expansionist by nature, the Normans formed war fleets to launch raids on the African coast, where a Norman kingdom briefly existed, Corinth and Thebes in the mid-12th century, and Thessalonica in 1185 – with no overall plan.
Les Normands ne sont pas arrivés en Italie du Sud par la mer. On ne sait à peu près rien de leurs voyages : certains sont sans doute passés par Rome. Ils sont venus, par petits groupes, presque tout au long du XIe siècle, certains encore au XIIe. L'immigration française en Italie, qui n'est d'ailleurs qu'en majorité normande, est essentiellement militaire : membres de familles seigneuriales et chevaleresques, parfois condamnés par le pouvoir ducal, et surtout cadets de familles cherchant fortune en s'engageant comme mercenaires auprès des autorités locales, avant d'y prendre le pouvoir.
Si la mer joue un rôle important dans l'histoire de ces régions, ce n'est donc pas le fait des Normands. Mais l'Italie normande – qui devient en 1130 le royaume de Sicile – est constituée d'une péninsule allongée et de la Sicile insulaire avec les petits archipels qui l'entourent : le pays est, par nature, marin. En outre, avant l'arrivée des Normands, la plupart des côtes de la péninsule étaient sous domination byzantine, ou de tradition byzantine : le seul port important des principautés lombardes était Salerne.
Division XI, the predecessor to Division D until 2012, was formed in 1994 at the IAU General Assembly in The Hague by merging Commission 44 Astronomy from Space and Commission 48 High Energy Astrophysics. Historically, space astrophysics started with the high energy wavelengths (far UV, X-ray, and gamma-ray astronomy) which are only accessible from space. However, in modern astronomy, to study high energy astrophysical processes, almost all wavelengths are used (including gamma-ray, X-ray, UV, optical, infrared, submillimeter and radio). In addition other ground-based facilities, including gravitational wave antennas, neutrino detectors and high-energy cosmic ray arrays are joining in this era of multi-messenger astrophysics, as well as space missions with the primary goals to discover and study exoplanets, are under the umbrella of Division XI.
This paper presents an original characterization method of trapping phenomena in gallium nitride high electron mobility transistors (GaN HEMTs). This method is based on the frequency dispersion of the output-admittance that is characterized by low-frequency S-parameter measurements. As microwave performances of GaN HEMTs are significantly affected by trapping effects, trap characterization is essential for this power technology. The proposed measurement setup and the trap characterization method allow us to determine the activation energy Ea and the capture cross-section σn of the identified traps. Three original characterizations are presented here to investigate the particular effects of bias, ageing, and light, respectively. These measurements are illustrated through different technologies such as AlGaN/GaN and InAlN/GaN HEMTs with non-intentionally doped or carbon doped GaN buffer layers. The extracted trap signatures are intended to provide an efficient feedback to the technology developments
Background: Atrial fibrillation (AF) is a cause of ischemic stroke and is associated with recurrence and with acute multi-vessel territory non lacunar stroke. Many cryptogenic strokes could be secondary to undiagnosed paroxystic AF. As left atrium (LA) dilatation is a risk factor of AF, we sought to determine if moderate or severe LA dilatation was associated with multiple vascular territory infarcts on magnetic resonance imaging (MRI) in patients with acute ischemic stroke without known AF. Normal LA diameter values are ≤4.0 cm for men and ≤3.8 for women. Methods: Patients who presented at our center between 2006 and 2011 with a diagnosis of acute ischemic stroke (AIS) or transient ischemick attack (TIA) who had a transthoracic echocardiography and a brain MRI were included. Patients with known or de novo AF diagnosed within 3 months of the event were excluded. The main outcome was the presence of acute multi-vessel territory infarct(s) on MRI.Results: 356 patients were included. The mean LA diameter was 37 mm in the control group (normal or mildly dilated LA) and 49 mm in those with moderately to severely enlarged LA (p<0.001). More patients in the LA dilatation group met the main outcome (20% vs 6%; OR 3.89; 95% CI 1.32-11.43; p=0.0014). Conclusions: LA dilatation (at least moderate) is associated with acute non lacunar multiple vascular territory infarcts on MRI in patients with AIS or TIA without known AF or a confirmed diagnosis of AF. Further studies are necessary to determine if this population might benefit from anticoagulation therapy.
The silicon/porous silicon (PS) hybrid substrate is an interesting candidate for the monolithic integration of radiofrequency (RF) circuits. Thus, passive components can be integrated on the insulating PS regions close to the active devices integrated on silicon. Regarding silicon, hybrid substrates allow the improvement of RF circuits performances. To demonstrate it, coplanar waveguides have been integrated on glass, silicon, and localized PS substrates. The characterization results show that the substrate losses are reduced with PS.
To examine the use of vitamin D supplements during infancy among the participants in an international infant feeding trial.
Information about vitamin D supplementation was collected through a validated FFQ at the age of 2 weeks and monthly between the ages of 1 month and 6 months.
Infants (n 2159) with a biological family member affected by type 1 diabetes and with increased human leucocyte antigen-conferred susceptibility to type 1 diabetes from twelve European countries, the USA, Canada and Australia.
Daily use of vitamin D supplements was common during the first 6 months of life in Northern and Central Europe (>80 % of the infants), with somewhat lower rates observed in Southern Europe (>60 %). In Canada, vitamin D supplementation was more common among exclusively breast-fed than other infants (e.g. 71 % v. 44 % at 6 months of age). Less than 2 % of infants in the USA and Australia received any vitamin D supplementation. Higher gestational age, older maternal age and longer maternal education were study-wide associated with greater use of vitamin D supplements.
Most of the infants received vitamin D supplements during the first 6 months of life in the European countries, whereas in Canada only half and in the USA and Australia very few were given supplementation.
Following the Xynthia storm of February 2010 in France, an outreach program was initiated by the regional health authorities during the post-emergency phase to improve access to mental health care for the population exposed to the floods. The program was designed to complement routine health and social care services. It relied on a special telephone service and outreach consultations located in the town halls of the five most affected cities. The objective of this outreach service was to provide initial psychological counseling free of charge and without appointment. Another objective was to refer persons for appropriate treatment and follow-up by routine health care services. A surveillance program was developed to monitor the use of mental health services by first-time users, describe outreach service users with psychological manifestations, and provide timely information to decision makers.
Health providers working in affected towns were asked to complete an individual record sheet for each person who displayed psychological manifestations directly or indirectly linked with the storm on their first visit, and to send it to the regional health office. Participation was voluntary. Data analysis was performed monthly during the six-month surveillance period.
Only mental health providers participated in the surveillance. A total of 227 individual files were sent from April 7 through September 19, 2010. New cases were mainly female adults, and one fifth had a past history of psychiatric illness. Depressive signs and anxiety were the most commonly reported symptoms, followed by signs of post-traumatic stress disorder. A total of five feedback reports were produced for surveillance participants (informants) and authorities.
With initiation in the post-emergency phase of a disaster and timely regular feedback, the surveillance program enabled the authors to describe the occurrence of psychological distress, monitor mental health service use by first-time users, and provide guidance to health authorities. This research showed the advantages of integrating epidemiology in the development of strategy for mental health and psychosocial support in the aftermath of natural catastrophes.
RaguenaudM-E, GermonneauP, LeseigneurJ, ChavagnatJJ, MotreffY, Vivier-DarrigolM, PirardP. Epidemiological Surveillance Linked to an Outreach Psychological Support Program after the Xynthia Storm in Charente-Maritime, France, 2010. Prehosp Disaster Med.2012;27(5):1-6.
Healthy diet and physical activity are associated with a lower cardiometabolic risk (CMR). Little is known about whether they interact to improve CMR. The purpose of the present study was to determine the synergistic associations of diet quality and physical activity energy expenditure (PAEE) on CMR factors. The present study was an a posteriori analysis of two cross-sectional studies on 124 inactive non-diabetic postmenopausal women with a BMI ≥ 27 kg/m2. The following factors were measured: diet quality (assessed by the Canadian Healthy Eating Index (C-HEI) from a 3 d food record); PAEE (doubly labelled water); body composition (dual-energy X-ray absorptiometry, computed tomography scan); lipoprotein profile (total, HDL- and LDL-cholesterol (HDL-C and LDL-C), non-HDL-C, total cholesterol:HDL-C, TAG, apoA1, apoB, apoA1:apoB and LDL-C:apoB); insulin sensitivity (homeostasis model assessment of insulin resistance and hyperinsulinaemic–euglycaemic clamp); inflammatory markers (high-sensitivity C-reactive protein (hs-CRP), haptoglobin, orosomucoid, IL-6 and leucocyte count). The association of the interaction PAEE × C-HEI and CMR factors was evaluated by hierarchical regressions. Fat mass-adjusted ANCOVA determined the interaction between PAEE and the C-HEI. In hierarchical regressions, the interaction PAEE × C-HEI was a correlate of more favourable values of HDL-C, apoB, apoA1:apoB and LDL-C:apoB ratios, and hs-CRP, while only PAEE was a negative correlate of haptoglobin. Compared with those in the low-PAEE/low-C-HEI group, women in the high-PAEE/high-C-HEI group had 10 % higher HDL-C, 13 % lower apoB, 11 % larger LDL particles and 28 % lower hs-CRP concentrations (P< 0·05). PAEE and the C-HEI have a synergistic association with the CMR profile. These results support the integration of both diet quality and physical activity in the management of CMR.
Originally, Division XI concerned itself only with high-energy astrophysics (in particular UV, X-ray and gamma rays), to which was later added the domain of lower-energy astrophysics where observations are generally performed from space (optical, infrared, submillimeter and parts of the radio spectrum). The Division also includes ground-based high energy gamma ray and cosmic ray experiments, gravitational wave, and Moon-based astronomical observations. The individual expertise of the present OC reflects primarily the UV and higher energy domains. However, since there are plans within the IAU to restructure divisions, we propose that, following the changes in the Divisional structure and renewal of the OC, the new members will be recruited to broaden the spectral range of research covered by the Division.