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As refugees and asylum seekers are at high risk of developing mental disorders, we assessed the effectiveness of Self-Help Plus (SH + ), a psychological intervention developed by the World Health Organization, in reducing the risk of developing any mental disorders at 12-month follow-up in refugees and asylum seekers resettled in Western Europe.
Methods
Refugees and asylum seekers with psychological distress (General Health Questionnaire-12 ⩾ 3) but without a mental disorder according to the Mini International Neuropsychiatric Interview (M.I.N.I.) were randomised to either SH + or enhanced treatment as usual (ETAU). The frequency of mental disorders at 12 months was measured with the M.I.N.I., while secondary outcomes included self-identified problems, psychological symptoms and other outcomes.
Results
Of 459 participants randomly assigned to SH + or ETAU, 246 accepted to be interviewed at 12 months. No difference in the frequency of any mental disorders was found (relative risk [RR] = 0.841; 95% confidence interval [CI] 0.389–1.819; p-value = 0.659). In the per protocol (PP) population, that is in participants attending at least three group-based sessions, SH + almost halved the frequency of mental disorders at 12 months compared to ETAU, however so few participants and events contributed to this analysis that it yielded a non-significant result (RR = 0.528; 95% CI 0.180–1.544; p-value = 0.230). SH + was associated with improvements at 12 months in psychological distress (p-value = 0.004), depressive symptoms (p-value = 0.011) and wellbeing (p-value = 0.001).
Conclusions
The present study failed to show any long-term preventative effect of SH + in refugees and asylum seekers resettled in Western European countries. Analysis of the PP population and of secondary outcomes provided signals of a potential effect of SH + in the long-term, which would suggest the value of exploring the effects of booster sessions and strategies to increase SH + adherence.
To achieve high-precision and reproducible results from radiocarbon (14C) dating of carbonate samples in paleoclimate research, a new CO2 extraction line was designed, constructed, and characterized at the Heidelberg Radiocarbon Lab of the Institute of Environmental Physics, Heidelberg. The setup includes a circular glass-tube design, which is operated at vacuum pressure levels of the order of 10–5 mbar. The efficiency of the extraction process was assessed, showing significantly favorable conditions for solid piece samples (99.58 ± 4.69)% over powdered samples (88.28 ± 10.03)%. Process blank values are below 0.2 pMC apparent 14C activity. Repeated measurements of IAEA C2 standards with an average value of (41.09 ± 0.23) pMC attest high accuracy and reproducibility of the instrument. Six consecutive samples of 6 to 12 mg carbonate mass can be processed in one run of roughly 2.5 hours. Thus, the new setup contributes to time-efficient and reproducible radiocarbon dating results for paleoclimate research at the Institute of Environmental Physics. In a first application, Dead Carbon Fraction (DCF) values of a Holocene alpine stalagmite from Schratten Cave are presented, revealing extraordinarily high offsets between atmospheric and stalagmite 14C with DCF values between (49.4 ± 0.4)% and (61.6 ± 0.4)%.
The radiocarbon (14C) calibration curve so far contains annually resolved data only for a short period of time. With accelerator mass spectrometry (AMS) matching the precision of decay counting, it is now possible to efficiently produce large datasets of annual resolution for calibration purposes using small amounts of wood. The radiocarbon intercomparison on single-year tree-ring samples presented here is the first to investigate specifically possible offsets between AMS laboratories at high precision. The results show that AMS laboratories are capable of measuring samples of Holocene age with an accuracy and precision that is comparable or even goes beyond what is possible with decay counting, even though they require a thousand times less wood. It also shows that not all AMS laboratories always produce results that are consistent with their stated uncertainties. The long-term benefits of studies of this kind are more accurate radiocarbon measurements with, in the future, better quantified uncertainties.
Radiocarbon (14C) ages cannot provide absolutely dated chronologies for archaeological or paleoenvironmental studies directly but must be converted to calendar age equivalents using a calibration curve compensating for fluctuations in atmospheric 14C concentration. Although calibration curves are constructed from independently dated archives, they invariably require revision as new data become available and our understanding of the Earth system improves. In this volume the international 14C calibration curves for both the Northern and Southern Hemispheres, as well as for the ocean surface layer, have been updated to include a wealth of new data and extended to 55,000 cal BP. Based on tree rings, IntCal20 now extends as a fully atmospheric record to ca. 13,900 cal BP. For the older part of the timescale, IntCal20 comprises statistically integrated evidence from floating tree-ring chronologies, lacustrine and marine sediments, speleothems, and corals. We utilized improved evaluation of the timescales and location variable 14C offsets from the atmosphere (reservoir age, dead carbon fraction) for each dataset. New statistical methods have refined the structure of the calibration curves while maintaining a robust treatment of uncertainties in the 14C ages, the calendar ages and other corrections. The inclusion of modeled marine reservoir ages derived from a three-dimensional ocean circulation model has allowed us to apply more appropriate reservoir corrections to the marine 14C data rather than the previous use of constant regional offsets from the atmosphere. Here we provide an overview of the new and revised datasets and the associated methods used for the construction of the IntCal20 curve and explore potential regional offsets for tree-ring data. We discuss the main differences with respect to the previous calibration curve, IntCal13, and some of the implications for archaeology and geosciences ranging from the recent past to the time of the extinction of the Neanderthals.
In the last decade new psychotropic agents have been licensed for the treatment of bipolar depression and mania. We wanted to evaluate if this led to changes in psychotropic prescriptions for bipolar-inpatients over the time-period from 2000 to 2007.
On two reference-days per hospital and per year, the following data are recorded for all patients on the wards under AMSP surveillance: all drugs applied on that day with the daily dosage for psychotropic drugs, ICD-diagnosis, age, and sex. In our analysis we evaluated data from 2000 (N = 210) and 2007 (N = 383).
We found a decrease of psychotropic monotherapy from 13.8% in 2000 to 4.7% in 2007. The percentage of inpatients receiving 5 or more psychotropics increased significantly from 10.95% in 2000 to 22.19% in 2007 (chi2: 11.199, df:1, p < 0.001). Furthermore we found a significant decrease of prescriptions for one or two psychotropics (38.89% to 16.38%) in bipolar-depressed-inpatients, but not in bipolar-hypo/manic-inpatients (chi2: 17.929, df:1, p < 0.001). The most frequently prescribed psychotropic in bipolar depression in 2000 was lithium-carbonate (median-dosage: 675 mg/day) and in 2007 valproic-acid (median-dosage: 1000 mg/day). In bipolar hypo-/mania the most commonly prescribed psychotropic in 2000 was again lithium-carbonate (median-dosage: 675 mg/day) and in 2007 valproic-acid (median-dosage: 1500 mg/day). The most frequently prescribed combinations were those of cbamazepine with lithium-carbonate (4.76%) in 2000 and of valproic-acid with quetiapine (8.88%) in 2007.
In our bipolar sample polypharmacy increased over the years. Further studies evaluating the safety of this polypharmacy, as well as putative effects of psychotropic combination-treatment in bipolar disorder are needed.
To investigate caregiving and its consequences among fathers and mothers of the same patients suffering from schizophrenia.
Methods:
101 patients as well as both parents were investigated using the “Carers' Needs Assessment for Schizophrenia”, the “Beck Depression Inventory”, the “Involvement Evaluation Questionnaire” and the “Family Problem Questionnaire”.
Results:
The mean number of days fathers lived together with the patients was not significant from that of the mothers, but the average duration (hours per week) of contact with the patient was significantly higher for mothers than for fathers. Among 40% of the sample, fathers and mothers spend an equal amount of time caring for the patient. Mothers reported significantly more often problems than fathers concerning stress due to earlier life events and burn-out. Mothers needed some interventions such as individual psychoeducation or family counselling more than twice as often as fathers. Mothers reported overall higher numbers of problems and needs for intervention than fathers. The overall score of caregivers' involvement did not differ significantly between fathers and mothers. The mothers' objective burden was significantly higher than the fathers' objective burden, but parents did not show differences concerning subjective burden. Using the “Beck Depression Inventory”, mothers were more often depressed than fathers.
Conclusions:
This study shows that often fathers and mothers spend an equal amount of time caring for the patient. The differences found between mothers and fathers should be considered when planning services for family caregivers.
Originally, the General Health Questionnaire (= GHQ) was designed to detect mental disorders among general medical outpatients and in community. The aim of the present survey is to compare the criterion validity indices of three different GHQ versions among general hospital inpatients when using different scoring methods.
Method
The GHQ-30 was filled in by inpatients prior to the research interview. For psychiatric case-identifiation the Clinical Interview Schedule was performed by three research psychiatrists.
Results
The final sample consisted of 993 inpatients. When comparing the three different GHQ-versions, no significant differences were found in OMR and ROC-AUC as well as in sensitivity (0,612–0,701) and specificity (0,601–0759). When comparing the four scoring methods no significant differences were found in sensitivity. By contrast, OMR and specificity showed better indices for the 20 item and 12 item GHQ versions when using the bimodal and modified Lickert scoring method. Further, the Lickert scoring method showed no significant differences to the other scoring methods for the GHQ-30, where as the modified Lickert and the bimodal method showed lower OMR and higher specificity compared to the chronic method.
Conclusion
Due to the results of this survey, the future use of the chronic scoring method for the GHQ has to be questioned when used for general hospital inpatients.
As part of the ongoing effort to improve the Northern Hemisphere radiocarbon (14C) calibration curve, this study investigates the period of 856 BC to 626 BC (2805–2575 yr BP) with a total of 403 single-year 14C measurements. In this age range, IntCal13 was constructed largely from German and Irish oak as well as Californian bristlecone pine 14C dates, with most samples measured with a 10-yr resolution. The new data presented here is the first atmospheric 14C single-year record of the older end of the Hallstatt plateau based on an absolutely dated tree-ring chronology. The data helped reveal a major solar proton event (SPE) which caused a spike in the production rate of cosmogenic radionuclides around 2610/2609 BP. This production event is thought to have reached a magnitude similar to the 774/775 AD production event but has remained undetected due to averaging effects in the decadal calibration data. The record leading up to the 2610/2609 BP event reveals a 11-yr solar cycle with varying cyclicity. Features of the new data and the benefits of higher resolution calibration are discussed.
Combining atmospheric Δ14CO2 data sets from different networks or laboratories requires secure knowledge on their compatibility. In the present study, we compare Δ14CO2 results from the Heidelberg low-level counting (LLC) laboratory to 12 international accelerator mass spectrometry (AMS) laboratories using distributed aliquots of five pure CO2 samples. The averaged result of the LLC laboratory has a measurement bias of –0.3±0.5‰ with respect to the consensus value of the AMS laboratories for the investigated atmospheric Δ14C range of 9.6 to 40.4‰. Thus, the LLC measurements on average are not significantly different from the AMS laboratories, and the most likely measurement bias is smaller than the World Meteorological Organization (WMO) interlaboratory compatibility goal for Δ14CO2 of 0.5‰. The number of intercomparison samples was, however, too small to determine whether the measurement biases of the individual AMS laboratories fulfilled the WMO goal.
Vitamin D has an important role in calcium homeostasis and is known to have various health-promoting effects. Moreover, potential interactions between vitamin D and physical activity have been suggested. This study aims to investigate the relationship between 25-hydroxyvitamin D (25(OH)D) and exercise capacity quantified by cardiopulmonary exercise testing (CPET). For this, 1377 participants from the Study of Health in Pomerania (SHIP-1) and 750 participants from the independent SHIP-TREND cohort were investigated. Standardised incremental exercise tests on a cycle ergometer were performed to assess exercise capacity by VO2 at anaerobic threshold, peakVO2, O2 pulse and peak power output. Serum 25(OH)D levels were measured by an automated chemiluminescence immunoassay. In SHIP-1, 25(OH)D levels were positively associated with all considered parameters of cardiopulmonary exercise capacity. Subjects with high 25(OH)D levels (4th quartile) showed an up to 25 % higher exercise capacity compared with subjects with low 25(OH)D levels (1st quartile). All associations were replicated in the independent SHIP-TREND cohort and were independent of age, sex, season and other interfering factors. In conclusion, significant positive associations between 25(OH)D and parameters of CPET were detected in two large cohorts of healthy adults.
We have loved this book for more than forty years. Age cannot wither its intellectual charms, nor custom stale its endless teachability, especially in graduate seminars. As in any long relationship, there have been moments of vexation and irritation, but we return to this book over and over to be nourished anew by its originality, its insights, and its capacity not just to evoke a certain kind of German community but also to convince us that the values of such communities shaped much of German history right into the nineteenth and twentieth centuries.
The IntCal09 and Marine09 radiocarbon calibration curves have been revised utilizing newly available and updated data sets from 14C measurements on tree rings, plant macrofossils, speleothems, corals, and foraminifera. The calibration curves were derived from the data using the random walk model (RWM) used to generate IntCal09 and Marine09, which has been revised to account for additional uncertainties and error structures. The new curves were ratified at the 21st International Radiocarbon conference in July 2012 and are available as Supplemental Material at www.radiocarbon.org. The database can be accessed at http://intcal.qub.ac.uk/intcal13/.
High-quality data from appropriate archives are needed for the continuing improvement of radiocarbon calibration curves. We discuss here the basic assumptions behind 14C dating that necessitate calibration and the relative strengths and weaknesses of archives from which calibration data are obtained. We also highlight the procedures, problems, and uncertainties involved in determining atmospheric and surface ocean 14C/12C in these archives, including a discussion of the various methods used to derive an independent absolute timescale and uncertainty. The types of data required for the current IntCal database and calibration curve model are tabulated with examples.
We are interested in the stability of the localized stationary solutions of a three-component reaction-diffusion system with one activator and two inhibitors. We show that depending on control parameters, solutions in form of moving and breathing localized structures can be observed in the vicinity of the codimension-two bifurcation point. We analyze this situation performing multiple scale perturbation expansion in the vicinity of the bifurcation point and derive a set of order parameter equations, explicitly describing the dynamics of the single localized structure. Numerical simulations are carried out, showing good agreement with the analytical predictions.
Due to the collapse of the socialist systems in 1989, Cuba's government promoted a series of structural changes to deal with resource scarcity and to enhance agricultural productivity. The upcoming crisis triggered adaptation strategies and led to a large-scale transition process towards a more sustainable model of agriculture. Farmers' experiments have been an implicit part of this process. Nowadays, farmers' capacity to experiment is widely accepted among the scientific community. However, detailed descriptions of farmers' approaches to experimentation are scarce. In this study, we examine the topics, resources, sources, motives, methods and outcomes of farmers' experiments in Cuba. The research methods comprised semi-structured interviews with 72 Cuban farmers, field notes, participant observation and a research diary. Key informants and 34 expert interviews added important insights into analysis. The results reveal that farmers' experiments are an integral part of farming in Cuba. Most farmers reported realizing their own experiments on their farms. The use of locally available resources was a crucial element for farmers' experiments. The topics were related to the introduction of new plant species or varieties, plant production, mechanization, fertilization, plant protection and the introduction of new animal species. The farmers' own idea was the most important source for experimenting, followed by ideas offered by colleagues and family members. Increasing production, independence from external resources and improving farm management were the main motives for experimenting. More than half of the farmers started to experiment without detailed written or mental planning, but made some considerations about the experiment before starting. Some planned more in detail and a few farmers devised a written plan, draft or model. Starting on a small scale was a way to minimize risks. The experiments were mainly evaluated by observation and comparison. Only a few farmers took records of their experiments. The most important outcomes were higher production, food self-sufficiency, work easement, improved plant health, increased knowledge, higher working efficiency and better taste of products. Farmers' experiments are a means of learning and they enhance farmers' capacity to adapt to changing conditions.
Innovations are the driving force for agricultural development under present diverse situations of uncertainty. The innovation system perspective acknowledges the contributions made by all stakeholders involved in knowledge development, dissemination and appropriation. According to the specific agricultural production system, farmers adopt innovations, modify them or innovate on their own. This paper examines the role of farmers' experiments and innovations in Cuba's agricultural innovation system (AIS), identifies knowledge exchange encounters and describes some strategies implemented to institutionalize farmers' experiments and innovations. The research methods comprised 34 semi-structured interviews with agricultural experts from the science, administration and advisory system, and 31 free list questionnaires to assess the institutional influence on farmers' experiments and innovations. In addition, three case studies of outstanding farmers' experiments are presented. The results suggest that the government's commitment to social participation in knowledge development provides the basic prerequisite for an effective integration of farmers' experiments and innovation in Cuba. The historically conditioned vertical structure of knowledge development and dissemination is gradually changing toward more horizontal procedures. The dynamic exchange of ideas at all kinds of interactive meetings, such as workshops or farmers' field schools, have favored farmer to farmer learning as well as knowledge sharing with research, academic and extension officials. This multi-stakeholders' approach contributes to institutionalize farmers' knowledge. Farmers' experiments and innovations play a major role in improving farm management and thereby can contribute to build resilience at the farming system level as well as for the national agricultural system.
We argue that detonations of sub-Chandrasekhar mass white dwarfs can lead to bright explosions with light curves and spectra similar to those of observed Type Ia supernovae. Given that binary systems containing accreting sub-Chandrasekhar mass white dwarfs should be common, this suggests that a non-negligible fraction of the observed Type Ia supernova rate may arise from sub-Chandrasekhar mass explosions, if they can be ignited. We discuss aspects of how such explosions might be realized in nature and both merits and challenges associated with invoking sub-Chandrasekhar mass explosion models to account for observed Type Ia supernovae.
The interaction between turbulence in a minimal supersonic channel and radiative heat transfer is studied using large-eddy simulation. The working fluid is pure water vapour with temperature-dependent specific heats and molecular transport coefficients. Its line spectra properties are represented with a statistical narrow-band correlated-k model. A grey gas model is also tested. The parallel no-slip channel walls are treated as black surfaces concerning thermal radiation and are kept at a constant temperature of 1000 K. Simulations have been performed for different optical thicknesses (based on the Planck mean absorption coefficient) and different Mach numbers. Results for the mean flow variables, Reynolds stresses and certain terms of their transport equations indicate that thermal radiation effects counteract compressibility (Mach number) effects. An analysis of the total energy balance reveals the importance of radiative heat transfer, compared to the turbulent and mean molecular heat transport.