We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save 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 saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.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 saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved 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.
Historical narratives can satisfy basic individual psychological needs. However, an over-reliance on a group's past can marginalize those who think differently – thus, homogenizing the culture and stifling creativity. By revising narratives to balance the power of collective narratives with the richness of individuality, we foster groups that encourage varied identities.
We contend that, contrary to mainstream understanding, the Australian Constitution provides a meaningful framework for ensuring economic justice, by virtue of its conferral upon the Commonwealth Parliament of particular legislative powers, namely the income justice and taxation powers. We draw on Rawlsian political theory, together with constitutional theory including recent work on constitutional directive principles, to explain how a constitution, and specifically the Australian Constitution, can impose requirements upon the political order independently of its operation as a legal instrument whose legal meaning is interpreted and applied by the courts. We use this novel account of the relationship between political and legal constitutionalism to establish the consequences, for each branch of government, of this constitutional requirement to secure economic justice. This includes a defence, from the perspective of political as well as legal constitutionalism, of the constitutionality of laws imposing retrospective taxation.
Stigma of mental health conditions hinders recovery and well-being. The Honest, Open, Proud (HOP) program shows promise in reducing stigma but there is uncertainty about the feasibility of a randomized trial to evaluate a peer-delivered, individual adaptation of HOP for psychosis (Let's Talk).
Methods
A multi-site, Prospective Randomized Open Blinded Evaluation (PROBE) design, feasibility randomised controlled trial (RCT) comparing the peer-delivered intervention (Let's Talk) to treatment as usual (TAU). Follow-up was 2.5 and 6 months. Randomization was via a web-based system, with permuted blocks of random size. Up to 10 sessions of the intervention over 10 weeks were offered. The primary outcome was feasibility data (recruitment, retention, intervention attendance). Primary outcomes were analyzed by intention to treat. Safety outcomes were reported by as treated status. The study was prospectively registered: https://doi.org/10.1186/ISRCTN17197043.
Results
149 patients were referred to the study and 70 were recruited. 35 were randomly assigned to intervention + TAU and 35 to TAU. Recruitment was 93% of the target sample size. Retention rate was high (81% at 2.5 months primary endpoint), and intervention attendance rate was high (83%). 21% of 33 patients in Let's talk + TAU had an adverse event and 16% of 37 patients in TAU. One serious adverse event (pre-randomization) was partially related and expected.
Conclusions
This is the first trial to show that it is feasible and safe to conduct a RCT of HOP adapted for people with psychosis and individual delivery. An adequately powered trial is required to provide robust evidence.
The unbridled positivity toward curiosity and creativity may be excessive. Both aid species survival through exploration and advancement. These beneficial effects are well documented. What remains is to understand their optimal levels and contexts for maximal achievement, health, and well-being. Every beneficial element to individuals and groups carries the potential for harm – curiosity and creativity included.
Brief intervention services provide rapid, mobile and flexible short-term delivery of interventions to resolve mental health crises. These interventions may provide an alternative pathway to the emergency department or in-patient psychiatric services for children and young people (CYP), presenting with an acute mental health condition.
Aims
To synthesise evidence on the effectiveness of brief interventions in improving mental health outcomes for CYP (0–17 years) presenting with an acute mental health condition.
Method
A systematic literature search was conducted, and the studies’ methodological quality was assessed. Five databases were searched for peer-reviewed articles between January 2000 and September 2022.
Results
We synthesised 30 articles on the effectiveness of brief interventions in the form of (a) crisis intervention, (b) integrated services, (c) group therapies, (d) individualised therapy, (e) parent–child dyadic therapy, (f) general services, (g) pharmacotherapy, (h) assessment services, (i) safety and risk planning and (j) in-hospital treatment, to improve outcomes for CYP with an acute mental health condition. Among included studies, one study was rated as providing a high level of evidence based on the National Health and Medical Research Council levels of evidence hierarchy scale, which was a crisis intervention showing a reduction in length of stay and return emergency department visits. Other studies, of moderate-quality evidence, described multimodal brief interventions that suggested beneficial effects.
Conclusions
This review provides evidence to substantiate the benefits of brief interventions, in different settings, to reduce the burden of in-patient hospital and readmission rates to the emergency department.
To investigate the symptoms of SARS-CoV-2 infection, their dynamics and their discriminatory power for the disease using longitudinally, prospectively collected information reported at the time of their occurrence. We have analysed data from a large phase 3 clinical UK COVID-19 vaccine trial. The alpha variant was the predominant strain. Participants were assessed for SARS-CoV-2 infection via nasal/throat PCR at recruitment, vaccination appointments, and when symptomatic. Statistical techniques were implemented to infer estimates representative of the UK population, accounting for multiple symptomatic episodes associated with one individual. An optimal diagnostic model for SARS-CoV-2 infection was derived. The 4-month prevalence of SARS-CoV-2 was 2.1%; increasing to 19.4% (16.0%–22.7%) in participants reporting loss of appetite and 31.9% (27.1%–36.8%) in those with anosmia/ageusia. The model identified anosmia and/or ageusia, fever, congestion, and cough to be significantly associated with SARS-CoV-2 infection. Symptoms’ dynamics were vastly different in the two groups; after a slow start peaking later and lasting longer in PCR+ participants, whilst exhibiting a consistent decline in PCR- participants, with, on average, fewer than 3 days of symptoms reported. Anosmia/ageusia peaked late in confirmed SARS-CoV-2 infection (day 12), indicating a low discrimination power for early disease diagnosis.
Pursuant to the Universal Health Care Act of 2019, the Health Technology Assessment Council (HTAC) in the Philippines was mandated to make recommendations for government financing of health technologies, including medical devices. The development of a Philippine Essential Medical Device List (PEMDL) will serve as a guide for the procurement of medical devices and supplies in government health facilities and as the basis for creating a price reference index.
Methods
The HTAC and a team of medical device experts (the Expert Advisory Committee) developed a streamlined pathway and guidelines using a Delphi technique with the Philippine Food and Drug Administration (FDA) and the Department of Health (DOH) to determine the necessary criteria for fast tracking the inclusion of medical devices. The pathway was also revised throughout a pilot processing of commonly procured medical devices (e.g., consumables) that were either already covered by existing national health insurance packages or funded by DOH programs, among others.
Results
The final pathway consisted of validating whether the device was already approved by the Philippine FDA and whether it was already part of standard of care. Similar to the usual HTA nomination requirement, the local FDA approval attested to the safety and quality of the device. Meanwhile, the inclusion of the device in the standard of care guaranteed that it was essential in the healthcare setting. This can be written in the World Health Organization technical documents and databases such as the Medical Devices Information System, health facility listing requirements, or locally adopted clinical practice guidelines. The initial PEMDL for release contained a total of 307 medical devices across 16 categories.
Conclusions
Unlike the mandate for the Philippine National Formulary, government health facilities are not yet required to base their procurement on the PEMDL because the list is still in its infancy. Moving forward, the list will include big ticket items and will be updated through consultations with specialty centers and hospitals.
In pasture-based grazing systems, farm roadways are a pivotal link to connect paddocks on the grazing platform to the milking parlour. However, their effectiveness in the efficient movement of the dairy herd between the grazing paddocks and the milking parlour has yet to be fully quantified. A validation experiment was conducted on a research farm to analyse characteristics on farm roadways that may affect cow throughput, which was observed as the number of cows per minute (CPM) passing a specified location. Roadway width (R2 = 0.96) and surface condition score (SC) (R2 = 0.78, respectively) were both positively associated with CPM. Public road crossings imposed a 32.7% reduction in CPM in this study. CPM increased from 12.4 CPM on a one-metre-wide roadway with a SC of Index 1 to 107.6 CPM on a five-metre roadway with a SC of Index 5. This exercise allowed for CPM on commercial farms to be predicted. Farm roadways were examined across 55 Irish dairy farms. Greater roadway width, reduced verge width and greater water run-off were each associated with higher SC on commercial farms. Larger herd sizes had a lower CPM relative to herd size in contrast to smaller herd sizes, resulting in a significantly longer total time to move the dairy herd through any specific point on the farm roadway network. The findings from this study have quantified the parameters which affect both CPM on commercial farm roadways and parameters which may be associated with SC on commercial farm roadways.
The U.S. Department of Agriculture–Agricultural Research Service (USDA-ARS) has been a leader in weed science research covering topics ranging from the development and use of integrated weed management (IWM) tactics to basic mechanistic studies, including biotic resistance of desirable plant communities and herbicide resistance. ARS weed scientists have worked in agricultural and natural ecosystems, including agronomic and horticultural crops, pastures, forests, wild lands, aquatic habitats, wetlands, and riparian areas. Through strong partnerships with academia, state agencies, private industry, and numerous federal programs, ARS weed scientists have made contributions to discoveries in the newest fields of robotics and genetics, as well as the traditional and fundamental subjects of weed–crop competition and physiology and integration of weed control tactics and practices. Weed science at ARS is often overshadowed by other research topics; thus, few are aware of the long history of ARS weed science and its important contributions. This review is the result of a symposium held at the Weed Science Society of America’s 62nd Annual Meeting in 2022 that included 10 separate presentations in a virtual Weed Science Webinar Series. The overarching themes of management tactics (IWM, biological control, and automation), basic mechanisms (competition, invasive plant genetics, and herbicide resistance), and ecosystem impacts (invasive plant spread, climate change, conservation, and restoration) represent core ARS weed science research that is dynamic and efficacious and has been a significant component of the agency’s national and international efforts. This review highlights current studies and future directions that exemplify the science and collaborative relationships both within and outside ARS. Given the constraints of weeds and invasive plants on all aspects of food, feed, and fiber systems, there is an acknowledged need to face new challenges, including agriculture and natural resources sustainability, economic resilience and reliability, and societal health and well-being.
The ability to accurately identify human gait intent is a challenge relevant to the success of many applications in robotics, including, but not limited to, assistive devices. Most existing intent identification approaches, however, are either sensor-specific or use a pattern-recognition approach that requires large amounts of training data. This paper introduces a real-time walking speed intent identification algorithm based on the Mahalanobis distance that requires minimal training data. This data efficiency is enabled by making the simplifying assumption that each time step of walking data is independent of all other time steps. The accuracy of the algorithm was analyzed through human-subject experiments that were conducted using controlled walking speed changes on a treadmill. Experimental results confirm that the model used for intent identification converges quickly (within 5 min of training data). On average, the algorithm successfully detected the change in desired walking speed within one gait cycle and had a maximum of 87% accuracy at responding with the correct intent category of speed up, slow down, or no change. The findings also show that the accuracy of the algorithm improves with the magnitude of the speed change, while speed increases were more easily detected than speed decreases.
This chapter compares and contrasts the thought of three philosophers – Bernard Williams, Charles Taylor, and Martha Nussbaum – who developed influential and idiosyncratic ways of reforming Anglo-American moral philosophy. Their positions substantially overlap inasmuch as they hold that the goods of human life are necessarily multiple and persistently in conflict, which has implications for the structure and content of ethical life everywhere. All three are of interest to anthropology because they hold that history, culture, social relations, and biographical experience make a difference to the goods and values that inform human life, and therefore that moral philosophy needs to be, to at least a very large degree, an empirical, descriptive, and comparative discipline. The different, sometimes even rival, ways in which they pursue that project offer anthropologists of ethics the chance to reflect on how and why they might develop an anthropology that would fulfil these authors’ different visions of moral philosophy.
This co-authored book examines the implications of the global ascent of China on cross-Strait relations and the identity of Taiwan as a democratic state, offering insights into policies for peaceful relations and prosperity across the Taiwan Strait.
Here we describe a 14-year collaboration in New Ireland, Papua New Guinea, between an Indigenous NGO, Indigenous scientists and international researchers. New Ireland is a marine province in the Western Pacific region where most residents depend on fishing, marine gleaning and small-scale gardening for their livelihoods. Ailan Awareness is a locally founded and managed NGO that focuses on the strengthening of Indigenous sovereignty regarding biological, cultural and spiritual diversity as well as fostering Indigenous epistemology practices and strengthening biocultural diversity. In partnership with anthropological researchers, Ailan Awareness has designed an approach to marine conservation informed by the growing field of decolonial research practices. By working to empower coastal communities to make decisions about their marine and cultural resources using a mix of Indigenous, anthropological and scientific methods and giving primacy to strengthening Indigenous modes of knowledge production and the role of community Elders, Ailan Awareness addresses a major gap in the efforts of the national government and international NGOs: giving the people most directly affected by declining biodiversity and loss of tradition the support and tools required to design and carry out the strengthening of both biological diversity and traditional social practices. In this paper we describe the methodology used by Ailan Awareness and the history of collaboration that resulted in these methods.
This article presents texts recovered by post-processing of multispectral images from the fifth- or sixth-century underwriting of the palimpsest Codex Climaci Rescriptus. Texts identified include the Anonymous II Proemium to Aratus’ Phaenomena, parts of Eratosthenes’ Catasterisms, Aratus’ Phaenomena lines 71–4 and 282–99 and previously unknown text, including some of the earliest astronomical measurements to survive in any Greek manuscript. Codex Climaci Rescriptus also contains at least three astronomical drawings. These appear to form part of an illustrated manuscript, with considerable textual value not merely on the basis of its age but also of its readings. The manuscript undertexts show significant overlap with the Φ Edition, postulated as ancestor of the various Latin Aratea.
Research is an important aspect of many medical students’ training. However, many medical students are not required to complete a scholarly project, and formal research training is often fragmented across the medical school curriculum. Thus, we developed an online, structured, asynchronous set of modules to introduce trainees to multiple topics relevant to the conduct of research.
Methods:
Research 101 was piloted by 27 first-year medical students at the University of Cincinnati College of Medicine. Students’ knowledge, confidence, and satisfaction were assessed using a final quiz and pre- and post-module surveys with five-point Likert-scaled questions and open-ended text responses.
Results:
Pre-module survey results showed that learners felt most confident in Conducting a literature search and least confident in Submitting an Institutional Review Board (IRB) protocol at UC. Post-module mean scores were significantly increased compared to pre-module results for all modules and questions (P < 0.05). The response to “The content of this module met my needs” was high across all modules with 236 (84.0%) “yes” responses. Thematic analysis of open-ended text responses from post-module surveys identified several improvements to individual modules and to the overall structure of Research 101. A final quiz of 25 multiple choice questions covering content from all required modules was required. The median score was 21.
Conclusions:
Comparison of post-module to pre-module survey scores provided clear evidence of improved learning across all topics. The modules developed were responsive to the students’ needs, and students provided additional improvements for subsequent iterations of Research 101.
Pangolins are some of the most overexploited but least studied mammals. The giant pangolin Smutsia gigantea is the largest of the eight pangolin species, measuring up to 180 cm in length and weighing up to 40 kg. It is a nocturnal, solitary species that occurs at low densities and little is known regarding its biology and ecology. It is distributed widely across the rainforests and forest savannah mosaics of equatorial Africa but its exact range extent is unknown. Apart from a single record in Kenya predating 1971, the eastern limit of its range was thought only to extend to central Uganda and western Tanzania. Here we present three spatially separate records confirming the presence of this species in Kenyan Afromontane forests. The three records are c. 120 km apart and c. 500 km east of the nearest confirmed giant pangolin population in Uganda. These records represent a significant range extension for the species and highlight the biodiversity and conservation importance of the Afromontane forests of western Kenya.