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This paper presents data obtained in a one-day census investigation in five European countries (Austria, Hungary, Romania, Slovakia, Slovenia). The census forms were filled in for 4191 psychiatric inpatients. Concerning legal status, 11.2% were hospitalised against their will (committed) and 21.4% were treated in a ward with locked doors. There was only a small correlation between commitment and treatment in a locked ward. More frequent than treatment of committed patients in locked wards was treatment of committed patients in open wards (Austria, Hungary) and treatment of voluntary patients in closed wards (Slovakia, Slovenia). Concerning employment, 27.7% of patients aged 18–60 held a job before admission. The vast majority of patients (84.8%) had a length of stay of less than 3 months. A comparison of these data with the results of a study performed in 1996 and using the same method shows a decrease of rates of long-stay patients. In 1996 the rates of employment were significantly higher in Romania (39.3%) and Slovakia (42.5%) compared to Austria (30.7%). These differences disappeared in 1999 due to decreasing rates of employment in Romania and Slovakia. The numbers of mental health personnel varies between types of institution (university or non-university) and countries, being highest in Austria and lowest in Romania. A considerable increase in the numbers of staff was found in Slovakia.
Halting biodiversity loss depends on changing people’s choices and actions. Increasingly, conservationists use approaches based on social marketing to influence people’s behaviour for the benefit of wider society through techniques developed in the business world. We give definitions of the terms and outline when it should be used instead of, or alongside, law-based, education-based and technical intervention-based approaches. We then illustrate the systematic, step-by-step process underpinning social marketing campaigns with an example from the Caribbean, where the number of people taking wild parrots as pets was successfully reduced. This is followed by examples of social marketing from three different conservation contexts: in community-based natural resource management to reduce the spread of aquatic invasive species, in demand reduction for rhino horn products, and in flagship species fundraising to broaden the benefits for biodiversity. We discuss the lessons that relate more broadly to conservation, including the need to acknowledge ethical issues and the difficulties involved in changing behaviour and the importance of identifying target audiences and evaluating campaigns.
Infant colic is a condition of unknown cause which can result in carer distress and attachment difficulties. Recent studies have implicated the gut microbiota in infant colic, and certain probiotics have demonstrated possible efficacy. We aim to investigate whether the intestinal microbiota composition in infants with colic is associated with cry/fuss time at baseline, persistence of cry/fuss at 4-week follow-up, or child behavior at 2 years of age. Fecal samples from infants with colic (n = 118, 53% male) were analyzed using 16S rRNA sequencing. After examining the alpha and beta diversity of the clinical samples, we performed a differential abundance analysis of the 16S data to look for taxa that associate with baseline and future behavior, while adjusting for potential confounding variables. In addition, we used random forest classifiers to evaluate how well baseline gut microbiota can predict future crying time. Alpha diversity of the fecal microbiota was strongly influenced by birth mode, feed type, and child gender, but did not significantly associate with crying or behavioral outcomes. Several taxa within the microbiota (including Bifidobacterium, Clostridium, Lactobacillus, and Klebsiella) associate with colic severity, and the baseline microbiota composition can predict further crying at 4 weeks with up to 65% accuracy. The combination of machine learning findings with associative relationships demonstrates the potential prognostic utility of the infant fecal microbiota in predicting subsequent infant crying problems.
No evidence-based therapy for borderline personality disorder (BPD) exhibits a clear superiority. However, BPD is highly heterogeneous, and different patients may specifically benefit from the interventions of a particular treatment.
From a randomized trial comparing a year of dialectical behavior therapy (DBT) to general psychiatric management (GPM) for BPD, long-term (2-year-post) outcome data and patient baseline variables (n = 156) were used to examine individual and combined patient-level moderators of differential treatment response. A two-step bootstrapped and partially cross-validated moderator identification process was employed for 20 baseline variables. For identified moderators, 10-fold bootstrapped cross-validated models estimated response to each therapy, and long-term outcomes were compared for patients randomized to their model-predicted optimal v. non-optimal treatment.
Significant moderators surviving the two-step process included psychiatric symptom severity, BPD impulsivity symptoms (both GPM > DBT), dependent personality traits, childhood emotional abuse, and social adjustment (all DBT > GPM). Patients randomized to their model-predicted optimal treatment had significantly better long-term outcomes (d = 0.36, p = 0.028), especially if the model had a relatively stronger (top 60%) prediction for that patient (d = 0.61, p = 0.004). Among patients with a stronger prediction, this advantage held even when applying a conservative statistical check (d = 0.46, p = 0.043).
Patient characteristics influence the degree to which they respond to two treatments for BPD. Combining information from multiple moderators may help inform providers and patients as to which treatment is the most likely to lead to long-term symptom relief. Further research on personalized medicine in BPD is needed.
The national implementation of competency-based medical education (CBME) has prompted an increased interest in identifying and tracking clinical and educational outcomes for emergency medicine training programs. For the 2019 Canadian Association of Emergency Physicians (CAEP) Academic Symposium, we developed recommendations for measuring outcomes in emergency medicine training in the context of CBME to assist educational leaders and systems designers in program evaluation.
We conducted a three-phase study to generate educational and clinical outcomes for emergency medicine (EM) education in Canada. First, we elicited expert and community perspectives on the best educational and clinical outcomes through a structured consultation process using a targeted online survey. We then qualitatively analyzed these responses to generate a list of suggested outcomes. Last, we presented these outcomes to a diverse assembly of educators, trainees, and clinicians at the CAEP Academic Symposium for feedback and endorsement through a voting process.
Academic Symposium attendees endorsed the measurement and linkage of CBME educational and clinical outcomes. Twenty-five outcomes (15 educational, 10 clinical) were derived from the qualitative analysis of the survey results and the most important short- and long-term outcomes (both educational and clinical) were identified. These outcomes can be used to help measure the impact of CBME on the practice of Emergency Medicine in Canada to ensure that it meets both trainee and patient needs.
The climate crisis requires nations to achieve human well-being with low national levels of carbon emissions. Countries vary from one another dramatically in how effectively they convert resources into well-being, and some nations with low levels of emissions have relatively high objective and subjective well-being. We identify urgent research and policy agendas for four groups of countries with either low or high emissions and well-being indicators. Least studied are those with low well-being and high emissions. Understanding social and political barriers to switching from high-carbon to lower-carbon modes of production and consumption, and ways to overcome them, will be fundamental.
This paper provides an up-to-date review of the problems related to the generation, detection and mitigation of strong electromagnetic pulses created in the interaction of high-power, high-energy laser pulses with different types of solid targets. It includes new experimental data obtained independently at several international laboratories. The mechanisms of electromagnetic field generation are analyzed and considered as a function of the intensity and the spectral range of emissions they produce. The major emphasis is put on the GHz frequency domain, which is the most damaging for electronics and may have important applications. The physics of electromagnetic emissions in other spectral domains, in particular THz and MHz, is also discussed. The theoretical models and numerical simulations are compared with the results of experimental measurements, with special attention to the methodology of measurements and complementary diagnostics. Understanding the underlying physical processes is the basis for developing techniques to mitigate the electromagnetic threat and to harness electromagnetic emissions, which may have promising applications.
The science of studying diamond inclusions for understanding Earth history has developed significantly over the past decades, with new instrumentation and techniques applied to diamond sample archives revealing the stories contained within diamond inclusions. This chapter reviews what diamonds can tell us about the deep carbon cycle over the course of Earth’s history. It reviews how the geochemistry of diamonds and their inclusions inform us about the deep carbon cycle, the origin of the diamonds in Earth’s mantle, and the evolution of diamonds through time.
Analysis of human remains and a copper band found in the center of a Late Archaic (ca. 5000–3000 cal BP) shell ring demonstrate an exchange network between the Great Lakes and the coastal southeast United States. Similarities in mortuary practices suggest that the movement of objects between these two regions was more direct and unmediated than archaeologists previously assumed based on “down-the-line” models of exchange. These findings challenge prevalent notions that view preagricultural Native American communities as relatively isolated from one another and suggest instead that wide social networks spanned much of North America thousands of years before the advent of domestication.
Command responsibility, as a modern doctrine of criminal law, originates in the atrocities committed by members of the Imperial Japanese Army in the Philippines between 9 October 1944 and 2 September 1945. That the atrocities – starvation, execution, rape and burning of homes – violated the laws of war is uncontroversial. More controversial, and of enduring doctrinal interest, was the potential individual responsibility of General Yamashita, Commanding General of the Imperial Army’s Fourteenth Group prior to his surrender to US forces.
Criminal responsibility for contributing to a group acting with a common purpose is a key – yet controversial – issue in ICL. On the one hand, it is well-known that international crimes are normally committed by groups of people acting pursuant to joint plans or agreements. This calls for liability theories that establish responsibility based on the accused’s participation in a collective criminal effort. On the other hand, the principles of individual criminal responsibility and personal guilt proscribe the attribution of crimes committed by others to the accused merely because of his/her membership in a group or organization.
Commission is a well-established form of liability in ICL. In the Tadić Appeal Judgment, the ICTY confirmed that commission is first and foremost ‘the physical perpetration … by the offender himself’. Additionally, multiple other forms of commission exist, some of which do not necessarily require that a perpetrator commit a physical offence directly.
Historically, aiding and abetting, as such, was not included in the Charter of the Nuremberg Tribunal or the Charter of the Tokyo Tribunal. Rather, Control Council Law No. 10 first provided for the criminal prosecution of persons who were ‘accessor[ies] to the commission of any … crime or ordered or abetted the same’. Oddly, aiding and abetting was also not explicitly included in the 1950 Nuremberg Principles or the 1954 ILC Draft Code of Crimes – in both documents ‘complicity’ is employed – but it reappeared in Article 3(2) of the 1991 ILC Draft Code of Crimes and in Article 2(3)(d) of the 1996 ILC Draft Code of Crimes. Nonetheless, it is now consistently found in the Statutes of all modern international criminal tribunals.
Despite recent developments, prosecuting attempts to commit international crimes have typically been rare at the international level. The infrequency of prosecution can be explained by several factors. Some scholars have argued that attempt liability for war crimes, crimes against humanity or genocide might not have met the ‘seriousness requirement’ in order to be brought within the ICTY and the ICTR’s respective jurisdictions or might not ‘have implicated the collective considerations of peace and security that animated the creation of the tribunals in first instance’. Moreover, according to Schabas, prosecuting attempted international crimes was not entirely necessary since international courts and tribunals were generally established ex post facto, that is once such crimes have already been committed.
While it is impossible to summarize the findings of this book, a few observations, points of interest, can be made. First of all, a few words on the customary law status of the modes of liability and inchoate concepts of liability that we discuss.