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.
Ethnic minority groups often have more complex and aversive pathways to mental health care. However, large population-based studies are lacking, particularly regarding involuntary hospitalisation. We sought to examine the risk of involuntary admission among first-generation ethnic minority groups with early psychosis in Ontario, Canada.
Using health administrative data, we constructed a retrospective cohort (2009–2013) of people with first-onset non-affective psychotic disorder aged 16–35 years. This cohort was linked to immigration data to ascertain migrant status and country of birth. We identified the first involuntary admission within 2 years and compared the risk of involuntary admission for first-generation migrant groups to the general population. To control for the role of migrant status, we restricted the sample to first-generation migrants and examined differences by country of birth, comparing risk of involuntary admission among ethnic minority groups to a European reference. We further explored the role of migrant class by adjusting for immigrant vs refugee status within the migrant cohort. We also explored effect modification of migrant class by ethnic minority group.
We identified 15 844 incident cases of psychotic disorder, of whom 19% (n = 3049) were first-generation migrants. Risk of involuntary admission was higher than the general population in five of seven ethnic minority groups. African and Caribbean migrants had the highest risk of involuntary admission (African: risk ratio (RR) = 1.52, 95% CI = 1.34–1.73; Caribbean: RR = 1.58, 95% CI = 1.37–1.82), and were the only groups where the elevated risk persisted when compared to the European reference group within the migrant cohort (African: RR = 1.24, 95% CI = 1.04–1.48; Caribbean: RR = 1.29, 95% CI = 1.07–1.56). Refugee status was independently associated with involuntary admission (RR = 1.16, 95% CI = 1.02–1.32); however, this risk varied by ethnic minority group, with Caribbean refugees having an elevated risk of involuntary admission compared with Caribbean immigrants (RR = 1.72, 95% CI = 1.15–2.58).
Our findings are consistent with the international literature showing increased rates of involuntary admission among some ethnic minority groups with early psychosis. Interventions aimed at improving pathways to care could be targeted at these groups to reduce disparities.
Heyes’ book is an important contribution that rightly integrates cognitive development and cultural evolution. However, understanding the cultural evolution of cognitive gadgets requires a deeper appreciation of complexity, feedback, and self-organization than her book exhibits.
To update current estimates of non–device-associated urinary tract infection (ND-UTI) rates and their frequency relative to catheter-associated UTIs (CA-UTIs) and to identify risk factors for ND-UTIs.
Academic teaching hospital.
All adult hospitalizations between 2013 and 2017 were included. UTIs (device and non-device associated) were captured through comprehensive, hospital-wide active surveillance using Centers for Disease Control and Prevention case definitions and methodology.
From 2013 to 2017 there were 163,386 hospitalizations (97,485 unique patients) and 1,273 UTIs (715 ND-UTIs and 558 CA-UTIs). The rate of ND-UTIs remained stable, decreasing slightly from 6.14 to 5.57 ND-UTIs per 10,000 hospitalization days during the study period (P = .15). However, the proportion of UTIs that were non–device related increased from 52% to 72% (P < .0001). Female sex (hazard ratio [HR], 1.94; 95% confidence interval [CI], 1.50–2.50) and increasing age were associated with increased ND-UTI risk. Additionally, the following conditions were associated with increased risk: peptic ulcer disease (HR, 2.25; 95% CI, 1.04–4.86), immunosuppression (HR, 1.48; 95% CI, 1.15–1.91), trauma admissions (HR, 1.36; 95% CI, 1.02–1.81), total parenteral nutrition (HR, 1.99; 95% CI, 1.35–2.94) and opioid use (HR, 1.62; 95% CI, 1.10–2.32). Urinary retention (HR, 1.41; 95% CI, 0.96–2.07), suprapubic catheterization (HR, 2.28; 95% CI, 0.88–5.91), and nephrostomy tubes (HR, 2.02; 95% CI, 0.83–4.93) may also increase risk, but estimates were imprecise.
Greater than 70% of UTIs are now non–device associated. Current targeted surveillance practices should be reconsidered in light of this changing landscape. We identified several modifiable risk factors for ND-UTIs, and future research should explore the impact of prevention strategies that target these factors.
The inherent difficulty of knowledge specification and the lack of trained specialists are some of the key obstacles on the way to making intelligent systems based on the knowledge representation and reasoning (KRR) paradigm commonplace. Knowledge and query authoring using natural language, especially controlled natural language (CNL), is one of the promising approaches that could enable domain experts, who are not trained logicians, to both create formal knowledge and query it. In previous work, we introduced the KALM system (Knowledge Authoring Logic Machine) that supports knowledge authoring (and simple querying) with very high accuracy that at present is unachievable via machine learning approaches. The present paper expands on the question answering aspect of KALM and introduces KALM-QA (KALM for Question Answering) that is capable of answering much more complex English questions. We show that KALM-QA achieves 100% accuracy on an extensive suite of movie-related questions, called MetaQA, which contains almost 29,000 test questions and over 260,000 training questions. We contrast this with a published machine learning approach, which falls far short of this high mark.
In this chapter, we discuss the evolution of the field of ‘ethics of nuclear energy’, regarding its past, present and future. We will first review the history of this field in the previous four decades, focusing on new and emerging challenges of nuclear energy production and waste disposal, in light of several important developments. Four of the most pressing ethical challenges will be further reviewed in the chapter. First, what is a morally ‘acceptable’ nuclear energy production method, if we consider the existing and possible new technologies? Second, provided a new tendency to consider nuclear waste disposal with several countries, what would be the new ethical and governance challenges of these multinational collaborations? Third, how should we deal with the (safety) challenges of the new geographic distribution of nuclear energy, tilting towards emerging economies with less experience with nuclear technology? Fourth, nuclear energy projects engender highly emotional controversies. Neither ignoring the emotions of the public nor taking them as a reason to prohibit or restrict a technology – we call them technocratic populist pitfalls respectively – seem to be able to guide responsible policy making.
Energy policy making is complex, and policy makers have traditionally relied on evidence and assessments dominated by a handful of disciplines from the natural and physical sciences. These assessments have often focused on technological solutions with the implicit message that the answer to policy needs lies in identifying and developing the right technology. Historically, however, problems arise in the implementation process of new technologies. These obstacles may be better understood, and either alleviated or avoided, through a more holistic analysis of energy policy requirements that includes multidisciplinary approaches from the social sciences and humanities. This chapter introduces the main ideas of the book, including an overview of each chapter and the most important arguments of the book.
The final chapter presents responses to the content of the entire book by policy practitioners who have dealt with the realities of constructing and implementing policies. They include essays by Emily Shuckburgh, OBE, deputy head of the Polar Oceans Team at the British Antarctic Survey; John Deutch, currently Institute Professor at the Massachusetts Institute of Technology and former Deputy Secretary of Energy in the United States; and Lord Ronald Oxburgh, who is a British parliamentarian, member of the House of Lords, a former chairman of Shell and himself a geologist and geophysicist. These ‘technologists’ offer three different perspectives on the topic of ‘good energy policy’. Finally the editors provide the main lessons learned from the book and offer suggestions for future directions of multidisciplinary research in energy policy.
The aim of this chapter is two-fold. First, the authors present a practical application of multidisciplinary research based on the experience of editing a book comprised of multidisciplinary cases and focusing on two chapter cases. There are many theoretical accounts of how one may approach multidisciplinary research, but here the authors aim to offer a practical account of how the theoretical goal of multidisciplinary research can play out in the ‘real world’. After addressing the current conceptual understanding of multidisciplinary versus interdisciplinary research, the authors will explain how useful these concepts, in fact, are when applied to the typical constraints that many academics face today in conducting joint research. The authors, who are both editors of the book, will provide lessons for future multidisciplinary collaboration and suggestions for developing methods of multidisciplinary research.