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The Developmental Origins of Health and Disease (DOHaD) framework aims to understand how environmental exposures in early life shape lifecycle health. Our understanding and the ability to prevent poor health outcomes and enrich for resiliency remain limited, in part, because exposure–outcome relationships are complex and poorly defined. We, therefore, aimed to determine the major DOHaD risk and resilience factors. A systematic approach with a 3-level screening process was used to conduct our Rapid Evidence Review following the established guidelines. Scientific databases using DOHaD-related keywords were searched to capture articles between January 1, 2009 and April 19, 2019. A final total of 56 systematic reviews/meta-analyses were obtained. Studies were categorized into domains based on primary exposures and outcomes investigated. Primary summary statistics and extracted data from the studies are presented in Graphical Overview for Evidence Reviews diagrams. There was substantial heterogeneity within and between studies. While global trends showed an increase in DOHaD publications over the last decade, the majority of data reported were from high-income countries. Articles were categorized under six exposure domains: Early Life Nutrition, Maternal/Paternal Health, Maternal/Paternal Psychological Exposure, Toxicants/Environment, Social Determinants, and Others. Studies examining social determinants of health and paternal influences were underrepresented. Only 23% of the articles explored resiliency factors. We synthesized major evidence on relationships between early life exposures and developmental and health outcomes, identifying risk and resiliency factors that influence later life health. Our findings provide insight into important trends and gaps in knowledge within many exposures and outcome domains.
Key to the distinctiveness of the burnout construct is the idea that burnout is etiologically anchored in the occupational context and mainly dependent on job-related factors. This idea, however, needs further empirical validation.
The aim of the present study was to examine whether burnout is more strongly associated with chronic occupational stress and workplace social support (job-related factors) than with global stress and life satisfaction (generic factors).
This study included 2124 French teachers (mean age: 41.36; 73% female). Participants were enrolled during the last trimester of the 2013-2014 school year. Burnout was assessed with the Maslach Burnout Inventory. Chronic occupational stress and workplace social support were measured with the Job Content Questionnaire. Global stress and life satisfaction were assessed with the Perceived Stress Scale (10-item version) and the Satisfaction with Life Scale, respectively. Multiple regression analyses were carried out.
Global stress was found to be the main predictor of burnout (β = .35), followed by chronic occupational stress (β = .22), life satisfaction (β = -.20), and workplace social support (β = -.12), all ps < .001. A model coupling global stress and life satisfaction as predictors accounted for 42% of the variance in burnout. A model coupling chronic occupational stress and workplace social support as predictors accounted for 31% of the variance in burnout.
Burnout may not be better predicted by job-related indicators than by generic indicators. Thereby, the dominant view of burnout is questioned. Longitudinal investigation should be conducted.
It has been assumed that a key difference between burnout and depression is that burnout is job-related and situation-specific whereas depression is context-free and pervasive. This view has recently been challenged at a theoretical level and additional empirical investigation has been called for.
The aim of this study was to examine whether chronic occupational stress—the putative cause of burnout—discriminated burnout from depression. Following a scope-based approach to the burnout-depression distinction, chronic occupational stress should be primarily related to burnout and only to a lesser degree to depression. This hypothesis was tested.
A total of 2124 French teachers took part in this study (mean age: 41.36; 73% female) during the last trimester of the 2013-2014 school year. Burnout was assessed with the Maslach Burnout Inventory and depression with the 9-item depression module of the Patient Health Questionnaire. The Effort-Reward Imbalance Questionnaire short form (ERIQ) was used for assessing chronic occupational stress.
Burnout and depression were almost identically correlated to effort-reward imbalance at work. Interestingly, the job over-commitment component of the ERIQ was slightly more correlated to depression than to burnout. Multiple regression analyses showed that effort-reward imbalance at work and job over-commitment predicted depression as much as burnout, controlling for gender, age, and length of employment.
Chronic occupational stress was not found to discriminate burnout from depression. These results further question the relevance of a scope-based distinction between burnout and depression and supports the idea that burnout overlaps with depression.
A multi-method approach is recommended for evaluatingalexithymia. Apart from the directmethods such as self-reported questionnaires, there are indirect approachesthat make use of projective tests. Of these tests, the quantitative version ofthe Objectively Scoring Archetypal Test 9 (SAT.9) of the 9 Element Anthropological Test(AT.9) has demonstrated an adequatelevel of reliability in the evaluation of alexithymia, notably symbolizationability deficiency (SAD). However, there has to our knowledge been no recent researchdone on the appropriateness of the SAT.9 for evaluating alexithymia.
The aim of the study undertakenwas to determine to what extent the Bermond-VorstAlexithymia Questionnaire (BVAQ) is correlated with the SAT.9, andparticularly the SAD.
The study was conducted withan experimental group composed of substance polyconsumers (N=25) and a controlgroup (N=25) of university-level students. All participants tookthe BVAQ and the SAT.9.
The results indicate thatthe experimental group participants’ scores were significantly superior to thecontrol group's scores on each of the sub-scales of the BVAQ as well as ontheir total score. The results also show that the experimental groupparticipants had a larger SAD than the control group members. Lastly, the results highlight significantcorrelations between the two groups’ BVAQ global scores and the SAD on the SAT.9.
This studyunderscores the appropriateness of using the SAT.9 for evaluating alexithymia aspart of a multi-method approach.
Whether burnout is anything other than a (job-related) depressive syndrome is unclear. A growing body of research suggests that the overlap of burnout with depression has been largely underestimated.
The aim of this longitudinal study was to examine whether burnout at baseline helped predict depression at follow-up when depression at baseline was controlled for.
A total of 627 French teachers took part in the two waves of this study, launched in 2012. About three of four participants were female and mean age at time 1 (T1) was 41. Depression was assessed with the 9-item depression module of the Patient Health Questionnaire (PHQ-9). Using the PHQ-9, the severity of depressive symptoms can be graded and provisional diagnoses of major depressive disorders can be established. Burnout was measured with the Maslach Burnout Inventory. Participants completed the follow-up on an average 21 months after completing the initial survey.
Hierarchical multiple regression analysis showed that a model involving T1 burnout and depression as predictors did not explain more variance in depression at follow-up than a model involving T1 depression as the only predictor. Binary logistic regression analyses indicated that T1 burnout no longer predicted cases of major depression at follow-up when T1 depression was included in the tested model. All these results were obtained controlling for gender, age, and length of employment.
This study confirms that burnout overlaps with depression. Assessing burnout in addition to depression may not be as useful as assumed in the past.
More than 40 years after the introduction of the construct in the literature, the status of “burnout” remains unclear. Whether burnout is anything other than a depressive syndrome has been increasingly discussed in recent years.
We examined the extent to which burnout can be considered distinct from depression.
We reviewed the literature dedicated to burnout-depression overlap over the last decade.
Recent research suggests that burnout and depression overlap in terms of (a) etiology, with (chronic) unresolvable stress a common, key causal factor, (b) clinical picture and course, with burnout and depressive manifestations inextricably linked such that they increase or decrease together over time, (c) cognitive biases, with burnout and depressive symptoms similarly predicting increased attention to negative stimuli and decreased attention to positive stimuli, (d) dispositional correlates (e.g, neuroticism, rumination, pessimism), and (e) allostatic load—an index of the biological cost of adaptation to life adversity. Hypocortisolism has been linked to both burnout and depression with atypical features—a highly prevalent form of depression. The often-invoked argument that burnout is singularized by its job-related character is actually invalid given that (a) depression can also be job-related and (b) the “job-relatedness” of a syndrome is not nosologically discriminant in itself.
Robust evidence that burnout overlaps with depression has accumulated in recent years. The burnout construct is unlikely to capture a distinct pathological phenomenon. We propose that burnout be characterized as a depressive syndrome for the sake of conceptual parsimony, theoretical clarity, and effective public health policies.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Disasters are high-acuity, low-frequency events which require medical providers to respond in often chaotic settings. Due to this infrequency, skills can atrophy, so providers must train and drill to maintain them. Historically, drilling for disaster response has been costly, and thus infrequent. Virtual Reality Environments (VREs) have been demonstrated to be acceptable to trainees, and useful for training Disaster Medicine skills. The improved cost of virtual reality training can allow for increased frequency of simulation and training.
The problem addressed was to create a novel Disaster Medicine VRE for training and drilling.
A VRE was created using SecondLife (Linden Lab; San Francisco, California USA) and adapted for use in Disaster Medicine training and drilling. It is easily accessible for the end-users (trainees), and is adaptable for multiple scenario types due to the presence of varying architecture and objects. Victim models were created which can be role played by educators, or can be virtual dummies, and can be adapted for wide ranging scenarios. Finally, a unique physiologic simulator was created which allows for dummies to mimic disease processes, wounds, and treatment outcomes.
The VRE was created and has been used extensively in an academic setting to train medical students, as well as to train and drill disaster responders.
This manuscript presents a new VRE for the training and drilling of Disaster Medicine scenarios in an immersive, interactive experience for trainees.
Stationary ice-penetrating radar (sIPR) systems can be used to monitor temporal changes in electromagnetically sensitive properties of glaciers and ice sheets. We describe a system intended for autonomous operation in remote glacial environments, and document its performance during deployments in cold and temperate settings. The design is patterned after an existing impulse radar system, with the addition of a fibre-optic link and timing module to control transmitter pulses, a micro-UPS (uninterruptable power supply) to prevent uncontrolled system shutdown and a customized satellite telemetry scheme. Various implementations of the sIPR were deployed on the Kaskawulsh Glacier near an ice-marginal lake in Yukon, Canada, for 44–77 days in summers 2014, 2015 and 2017. Pronounced perturbations to englacial radiostratigraphy were observed commensurate with lake filling and drainage, and are interpreted as changes in englacial water storage. Another sIPR was deployed in 2015–2016 on ice island PII-A-1-f, which originated from the Petermann Glacier in northwest Greenland. This system operated autonomously for almost a year during which changes in thickness of the ice column were clearly detected.
This article explains why autocrats love constitutional pluralism and constitutional identity. Though these concepts were developed by scholars and jurists with the best of intentions in mind, we explain why they are also attractive to and inherently prone to abuse by autocrats. We then describe how the regimes in Hungary and Poland have made use of these concepts in their drive to consolidate autocracy. We conclude that given the dangers inherent in constitutional pluralism and its susceptibility to abuse, it should be replaced with a more traditional understanding of the primacy of EU law.
Despite evidence of some intergenerational continuity of maltreatment, a notable proportion of parents maltreated in childhood do not perpetuate the cycle of maltreatment. The aim of this study was to identify factors that would distinguish mother–child dyads where intergenerational continuity was present from dyads characterized by intergenerational discontinuity. The sample included 193 children and their mothers, drawn from two populations: 74 maltreated children recruited through Child Protection Services and 119 nonmaltreated children recruited among low-income families. Factors investigated included maternal childhood maltreatment, psychological functioning, and family ecology. Compared to maltreated mothers who broke the cycle of maltreatment, those who perpetuated the cycle were more likely to have experienced childhood physical neglect and multitype maltreatment, and to experience sociodemographic risk, intimate partner violence, and lack of family support. Compared to nonmaltreated mothers who maintained a nonmaltreating child-rearing environment: (a) maltreated mothers who broke the cycle were more likely to experience residential instability and lack of family support, and (b) nonmaltreated mothers whose child was maltreated were more likely to experience sociodemographic risk and lack of family support. Maternal psychological functioning did not discriminate maltreatment groups. Lending empirical support to a diathesis-stress model of poor parenting, these findings suggest that family-ecology related stress, but not maternal psychological difficulties, may create additional burden that will precipitate the risk of maltreatment intergenerational continuity.
To examine the associations between adolescents’ diet quality and their perceived relatives’ and peers’ diet engagement and encouragement.
Cross-sectional study performed in European countries. Diet quality was scored using the Diet Quality Index for Adolescents (DQI-A) based on four components: quality, diversity, balance and meal frequency. Perceived diet quality engagement and perceived encouragement of the relatives/peers were assessed using the questions ‘How healthy is each of the following persons’ diet?’ and ‘How often does each of the following persons encourage you to eat a healthy diet?’
Vienna, Ghent, Lille, Athens, Heraklion, Pecs, Rome, Dortmund, Zaragoza and Stockholm.
Healthy adolescents (n 2943).
The perceived engagement level of the mother, father and sister was each positively associated with the DQI-A (P<0·05). A positive association was found for the perceived engagement level of siblings, father and mother with all specific components (P<0·05). DQI-A was negatively associated with the perceived encouragement level from a best friend and positively associated with the encouragement level of the mother and father (P<0·05). Diversity, balance and quality components were positively associated with the perceived encouragement level from the mother and father (P<0·05), whereas the best friend’s perceived encouragement was negatively associated with the meal frequency component (P<0·01).
These findings highlight the role of social engagement and encouragement of relatives and peers in adolescents’ diet quality. Intervention or promotion programmes aimed at enhancing diet quality in adolescents should target both family and peers.
We propose a hierarchy of low-dimensional proper orthogonal decomposition (POD) models for the transient and post-transient flow around a high-lift airfoil with unsteady Coanda blowing over the trailing edge. The modal expansion comprises actuation modes as a lifting method for wall actuation following Graham et al. (Intl J. Numer. Meth. Engng, vol. 44 (7), 1999, pp. 945–972) and Kasnakoğlu et al. (Intl J. Control, vol. 81 (9), 2008, pp. 1475–1492). A novel element is separate actuation modes for different frequencies. The structure of the dynamic model rests on a Galerkin projection using the Navier–Stokes equations, simplifying mean-field considerations, and a stochastic term representing the background turbulence. The model parameters are identified with a data assimilation (4D-Var) method. We propose a model hierarchy from a linear oscillator explaining the suppression of vortex shedding by blowing to a fully nonlinear model resolving unactuated and actuated transients with steady and high-frequency modulation of blowing. The models’ accuracy is assessed through the mode amplitudes and an estimator for the lift coefficient. The robustness of the model is physically justified, and then observed for the training and the validation dataset.
The European Food Safety Authority’s 2010 scientific opinion on dietary reference values for total water intakes was partly based on observed intakes in population groups. Large variability was observed, and it is unlikely that these differences can be explained by differences in climate, activity level and/or culture. This suggests that there are uncertainties in the methodologies used to assess water intake from food and fluids, including all types of beverages. To determine current methods for recording and reporting total water, beverages and fluid intakes, twenty-one European countries were surveyed using an electronic questionnaire. In total, twelve countries responded and ten completed surveys were summarised. Countries reported that their survey was representative of the population in terms of age and socio-economic status. However, a variety of methods were used – that is, repeated 24-h recalls, estimated food diaries and FFQ. None of the methods were validated to assess water and fluid intakes. The methods used to record liquid foods – for example, soup and diluted drinks – were inconsistent. Clarity and consistency on definitions of categories of beverages to facilitate comparisons between countries are needed. Recommendations for a unified approach to surveying and quantifying intake of water from fluids and foods are proposed.
Many previous studies have shown that the turbulent mixing layer under periodic forcing tends to adopt a lock-on state, where the major portion of the fluctuations in the flow are synchronized at the forcing frequency. The goal of this experimental study is to apply closed-loop control in order to provoke the lock-on state, using information from the flow itself. We aim to determine the range of frequencies for which the closed-loop control can establish the lock-on, and what mechanisms are contributing to the selection of a feedback frequency. In order to expand the solution space for optimal closed-loop control laws, we use the genetic programming control (GPC) framework. The best closed-loop control laws obtained by GPC are analysed along with the associated physical mechanisms in the mixing layer flow. The resulting closed-loop control significantly outperforms open-loop forcing in terms of robustness to changes in the free-stream velocities. In addition, the selection of feedback frequencies is not locked to the most amplified local mode, but rather a range of frequencies around it.
SITELLE is the new imaging Fourier transform spectrograph of the Canada-France-Hawaii Telescope. It produces an impressive 4 million spectra in a single datacube in selected bandpasses from 350 to 900 nm. Its large FOV (11′x11′) and its high spatial sampling (0.32′′/pixel, seeing limited) allow us to study extended objects with an unprecedented view (Drissen et al. 2014). SITELLE’s first observations of nearby galaxies revealed its capabilities to conduct detailed studies of emission line regions.
The UVMag consortium proposed the space mission project Arago to ESA at its M4 call. Arago is dedicated to the study of the dynamic 3D environment of stars and planets. This space mission will be equipped with a high-resolution spectropolarimeter working from 119 to 888 nm. A preliminary optical design of the whole instrument has been prepared and is presented here. The design consists of the telescope, the instrument itself, and the focusing optics. Considering not only the scientific requirements, but also the cost and size constraints to fit an M-size mission, the telescope has a 1.3 m diameter primary mirror and is a classical Cassegrain-type telescope that allows a polarization-free focus. The polarimeter is placed at this Cassegrain focus. This is the key element of the mission and the most challenging one to be designed. The main challenge lies in the huge spectral range offered by the instrument; the polarimeter has to deliver the full Stokes vector with a high precision from the FUV (119 nm) to the NIR (888 nm). The polarimeter module is then followed by a high-resolution echelle-spectrometer achieving a resolution of 35000 in the visible range and 25000 in the UV. The two channels are separated after the echelle grating, allowing specific cross-dispersion and focusing optics for the UV and the visible ranges. Considering the large field of view and the high numerical aperture, the focusing optics for both the UV and the visible channels is a Three-Mirror-Anastigmatic (TMA) telescope, needed to focus the various wavelengths and many orders onto the detectors.