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A national need is to prepare for and respond to accidental or intentional disasters categorized as chemical, biological, radiological, nuclear, or explosive (CBRNE). These incidents require specific subject-matter expertise, yet have commonalities. We identify 7 core elements comprising CBRNE science that require integration for effective preparedness planning and public health and medical response and recovery. These core elements are (1) basic and clinical sciences, (2) modeling and systems management, (3) planning, (4) response and incident management, (5) recovery and resilience, (6) lessons learned, and (7) continuous improvement. A key feature is the ability of relevant subject matter experts to integrate information into response operations. We propose the CBRNE medical operations science support expert as a professional who (1) understands that CBRNE incidents require an integrated systems approach, (2) understands the key functions and contributions of CBRNE science practitioners, (3) helps direct strategic and tactical CBRNE planning and responses through first-hand experience, and (4) provides advice to senior decision-makers managing response activities. Recognition of both CBRNE science as a distinct competency and the establishment of the CBRNE medical operations science support expert informs the public of the enormous progress made, broadcasts opportunities for new talent, and enhances the sophistication and analytic expertise of senior managers planning for and responding to CBRNE incidents.
Immune system markers may predict affective disorder treatment response, but whether an overall immune system marker predicts bipolar disorder treatment effect is unclear.
Bipolar CHOICE (N = 482) and LiTMUS (N = 283) were similar comparative effectiveness trials treating patients with bipolar disorder for 24 weeks with four different treatment arms (standard-dose lithium, quetiapine, moderate-dose lithium plus optimised personalised treatment (OPT) and OPT without lithium). We performed secondary mixed effects linear regression analyses adjusted for age, gender, smoking and body mass index to investigate relationships between pre-treatment white blood cell (WBC) levels and clinical global impression scale (CGI) response.
Compared to participants with WBC counts of 4.5–10 × 109/l, participants with WBC < 4.5 or WBC ≥ 10 showed similar improvement within each specific treatment arm and in gender-stratified analyses.
An overall immune system marker did not predict differential treatment response to four different treatment approaches for bipolar disorder all lasting 24 weeks.
The mental health and social functioning of millions of forcibly displaced individuals worldwide represents a key public health priority for host governments. This is the first longitudinal study with a representative sample to examine the impact of interpersonal trust and psychological symptoms on community engagement in refugees.
Participants were 1894 resettled refugees, assessed within 6 months of receiving a permanent visa in Australia, and again 2–3 years later. Variables measured included post-traumatic stress disorder symptoms, depression/anxiety symptoms, interpersonal trust and engagement with refugees’ own and other communities.
A multilevel path analysis was conducted, with the final model evidencing good fit (Comparative Fit Index = 0.97, Tucker–Lewis Index = 0.89, Root Mean Square Error of Approximation = 0.05, Standardized Root-Mean-Square-Residual = 0.05). Findings revealed that high levels of depression symptoms were associated with lower subsequent engagement with refugees’ own communities. In contrast, low levels of interpersonal trust were associated with lower engagement with the host community over the same timeframe.
Findings point to differential pathways to social engagement in the medium-term post-resettlement. Results indicate that depression symptoms are linked to reduced engagement with one's own community, while interpersonal trust is implicated in engagement with the broader community in the host country. These findings have potentially important implications for policy and clinical practice, suggesting that clinical and support services should target psychological symptoms and interpersonal processes when fostering positive adaptation in resettled refugees.
The Arctic marine environment is undergoing a transition from thick multi-year to first-year sea-ice cover with coincident lengthening of the melt season. Such changes are evident in the Baffin Bay-Davis Strait-Labrador Sea (BDL) region where melt onset has occurred ~8 days decade−1 earlier from 1979 to 2015. A series of anomalously early events has occurred since the mid-1990s, overlapping a period of increased upper-air ridging across Greenland and the northwestern North Atlantic. We investigate an extreme early melt event observed in spring 2013. (~6σ below the 1981–2010 melt climatology), with respect to preceding sub-seasonal mid-tropospheric circulation conditions as described by a daily Greenland Blocking Index (GBI). The 40-days prior to the 2013 BDL melt onset are characterized by a persistent, strong 500 hPa anticyclone over the region (GBI >+1 on >75% of days). This circulation pattern advected warm air from northeastern Canada and the northwestern Atlantic poleward onto the thin, first-year sea ice and caused melt ~50 days earlier than normal. The episodic increase in the ridging atmospheric pattern near western Greenland as in 2013, exemplified by large positive GBI values, is an important recent process impacting the atmospheric circulation over a North Atlantic cryosphere undergoing accelerated regional climate change.
Several different types of laterally extensive debris bands occur along the western terminus region of the Matanuska Glacier, Alaska, U.S.A. An ice-bed process, which to our knowledge has not previously been recognized and described, forms the most common and most prominent type of debris band at Matanuska Glacier’s terminus. The debris bands are composed of one or several millimeter-thick laminations of silt-rich ice having much higher sediment content than that of the surrounding ice. Samples of these bands and their surrounding englacial ice have been analyzed for anthropogenic tritium (3H), oxygen-18 (δ18O), and deuterium (δD).We interpreted the laminated, silt-rich debris bands as basal fractures, along which silt-laden, glaciohydraulically supercooled and pressurized waters flowed, healing the fractures by ice growth. This process is analogous to the inward growth of hydrothermal quartz from the sides of an open fracture.
The numerous debris bands in the terminus region of Matanuska Glacier, Alaska, U.S.A., were formed by injection of turbid meltwaters into basal crevasses. The debris bands are millimeter(s)-thick layers of silt-rich ice cross-cutting older, debris-poor englacial ice. The sediment grain-size distribution of the debris bands closely resembles the suspended load of basal waters, and of basal and proglacial ice grown from basal waters, but does not resemble supraglacial debris, till or the bedload of subglacial streams. Most debris bands contain anthropogenic tritium (3H) in concentrations similar to those of basal meltwater and ice formed from that meltwater, but cross-cut englacial ice lacking tritium. Stable-isotopic ratios (δ18O and δD) of debris-band ice are consistent with freezing from basal waters, but are distinct from those in englacial ice. Ice petrofabric data along one debris band lack evidence of active shearing. High basal water pressures and locally extensional ice flow associated with overdeepened subglacial basins favor basal crevasse formation.
The contribution to sea level to 2200 from the grounded, mainland Antarctic Peninsula ice sheet (APIS) was calculated using an ice-sheet model initialized with a new technique computing ice fluxes based on observed surface velocities, altimetry and surface mass balance, and computing volume response using a linearized method. Volume change estimates of the APIS resulting from surface mass-balance anomalies calculated by the regional model RACMO2, forced by A1B and E1 scenarios of the global models ECHAM5 and HadCM3, predicted net negative sea-level contributions between −0.5 and −12 mm sea-level equivalent (SLE) by 2200. Increased glacier flow due to ice thickening returned ∼15% of the increased accumulation to the sea by 2100 and ∼30% by 2200. The likely change in volume of the APIS by 2200 in response to imposed 10 and 20 km retreats of the grounding line at individual large outlet glaciers in Palmer Land, southern Antarctic Peninsula, ranged between 0.5 and 3.5 mm SLE per drainage basin. Ensemble calculations of APIS volume change resulting from imposed grounding-line retreat due to ice-shelf break-up scenarios applied to all 20 of the largest drainage basins in Palmer Land (covering ∼40% of the total area of APIS) resulted in net sea-level contributions of 7–16 mm SLE by 2100, and 10–25 mm SLE by 2200. Inclusion of basins in the northern peninsula and realistic simulation of grounding-line movement for AP outlet glaciers will improve future projections.
The application of passive microwave radiometry to the remote sensing of snow properties is based on the ratio of emitted to scattered portions of the upwelling radiation. Increased scattering is indicative of increased snow amount, i.e. the number of snow grains present. However, scattering is also directly proportional to snow grain-size for a given snow amount. Current snow cover retrieval algorithms produce inaccurate results when snow grain-sizes are unusually large. Therefore, it is necessary to characterize snow grain-size on a regional scale (and perhaps local scale in extreme situations) in order to adjust passive microwave algorithms. Preliminary analysis indicates that: (1) algorithms are not as sensitive to the presence of large grain-sizes as the initial theory had indicated; (2) standard deviation of grain-size diameters throughout the total snow cover may often be less than 0.5 mm, thus average grain-size data may often serve to characterize the detailed stratigraphy of the total snow cover; (3) conditions in subfreezing snow which produce grain-sizes that greatly exceed a mean diameter value of 1–2 mm result from snow cover/climate relationships which can be modelled/monitored on a regional scale. A preliminary method is investigated for selecting snow retrieval algorithms according to prevailing regional-scale grain-size.
New radiocarbon calibration curves, IntCal04 and Marine04, have been constructed and internationally ratified to replace the terrestrial and marine components of IntCal98. The new calibration data sets extend an additional 2000 yr, from 0–26 cal kyr BP (Before Present, 0 cal BP = AD 1950), and provide much higher resolution, greater precision, and more detailed structure than IntCal98. For the Marine04 curve, dendrochronologically-dated tree-ring samples, converted with a box diffusion model to marine mixed-layer ages, cover the period from 0–10.5 cal kyr BP. Beyond 10.5 cal kyr BP, high-resolution marine data become available from foraminifera in varved sediments and U/Th-dated corals. The marine records are corrected with site-specific 14C reservoir age information to provide a single global marine mixed-layer calibration from 10.5–26.0 cal kyr BP. A substantial enhancement relative to IntCal98 is the introduction of a random walk model, which takes into account the uncertainty in both the calendar age and the 14C age to calculate the underlying calibration curve (Buck and Blackwell, this issue). The marine data sets and calibration curve for marine samples from the surface mixed layer (Marine04) are discussed here. The tree-ring data sets, sources of uncertainty, and regional offsets are presented in detail in a companion paper by Reimer et al. (this issue).
The IntCal04 and Marine04 radiocarbon calibration curves have been updated from 12 cal kBP (cal kBP is here defined as thousands of calibrated years before AD 1950), and extended to 50 cal kBP, utilizing newly available data sets that meet the IntCal Working Group criteria for pristine corals and other carbonates and for quantification of uncertainty in both the 14C and calendar timescales as established in 2002. No change was made to the curves from 0–12 cal kBP. The curves were constructed using a Markov chain Monte Carlo (MCMC) implementation of the random walk model used for IntCal04 and Marine04. The new curves were ratified at the 20th International Radiocarbon Conference in June 2009 and are available in the Supplemental Material at www.radiocarbon.org.
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/.
Intracranial volume (ICV) has been proposed as a measure of maximum lifetime brain size. Accurate ICV measures require neuroimaging which is not always feasible for epidemiologic investigations. We examined head circumference as a useful surrogate for ICV in older adults.
99 older adults underwent Magnetic Resonance Imaging (MRI). ICV was measured by Statistical Parametric Mapping 8 (SPM8) software or Functional MRI of the Brain Software Library (FSL) extraction with manual editing, typically considered the gold standard. Head circumferences were determined using standardized tape measurement. We examined estimated correlation coefficients between head circumference and the two MRI-based ICV measurements.
Head circumference and ICV by SPM8 were moderately correlated (overall r = 0.73, men r = 0.67, women r = 0.63). Head circumference and ICV by FSL were also moderately correlated (overall r = 0.69, men r = 0.63, women r = 0.49).
Head circumference measurement was strongly correlated with MRI-derived ICV. Our study presents a simple method to approximate ICV among older patients, which may prove useful as a surrogate for cognitive reserve in large scale epidemiologic studies of cognitive outcomes. This study also suggests the stability of head circumference correlation with ICV throughout the lifespan.