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The COllaborative project of Development of Anthropometrical measures in Twins (CODATwins) project is a large international collaborative effort to analyze individual-level phenotype data from twins in multiple cohorts from different environments. The main objective is to study factors that modify genetic and environmental variation of height, body mass index (BMI, kg/m2) and size at birth, and additionally to address other research questions such as long-term consequences of birth size. The project started in 2013 and is open to all twin projects in the world having height and weight measures on twins with information on zygosity. Thus far, 54 twin projects from 24 countries have provided individual-level data. The CODATwins database includes 489,981 twin individuals (228,635 complete twin pairs). Since many twin cohorts have collected longitudinal data, there is a total of 1,049,785 height and weight observations. For many cohorts, we also have information on birth weight and length, own smoking behavior and own or parental education. We found that the heritability estimates of height and BMI systematically changed from infancy to old age. Remarkably, only minor differences in the heritability estimates were found across cultural–geographic regions, measurement time and birth cohort for height and BMI. In addition to genetic epidemiological studies, we looked at associations of height and BMI with education, birth weight and smoking status. Within-family analyses examined differences within same-sex and opposite-sex dizygotic twins in birth size and later development. The CODATwins project demonstrates the feasibility and value of international collaboration to address gene-by-exposure interactions that require large sample sizes and address the effects of different exposures across time, geographical regions and socioeconomic status.
Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.
We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.
16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (−0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).
PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.
Scholars have recently investigated the efficacy of applying globalisation models to ancient cultures such as the fourth-millennium BC Mesopotamian Uruk system. Embedded within globalisation models is the ‘complex connectivity‘ that brings disparate regions together into a singular world. In the fourth millennium BC, the site of Çadır Höyük on the north-central Anatolian plateau experienced dramatic changes in its material culture and architectural assemblages, which in turn reflect new socio-economic, sociopolitical and ritual patterns at this rural agro-pastoral settlement. This study examines the complex connectivities of the ancient Uruk system, encompassing settlements in more consistent contact with the Uruk system such as Arslantepe in southeastern Anatolia, and how these may have fostered exchange networks that reached far beyond the Uruk ‘global world‘ and onto the Anatolian plateau.
Road traffic collisions (RTC) are the leading cause of preventable death among those aged 15–29 years worldwide. More than 1.2 million lives are lost each year on roads. Ninety percent of these deaths take place in low- and middle-income countries. The General Assembly of the United Nations (UN) proclaimed the period from 2011-2020 the “Decade of Action for Road Safety,” with the objective of stabilizing and reducing the number of deaths by 50% worldwide. In this context, the government of Colombia established the National Road Safety Plan (PNSV) for the period 2011–2021 with the objective of reducing the number of fatalities by 26%. However, the effectiveness of road safety policies in Colombia is still unknown.
To evaluate the effect of road safety laws on the incidence of RTC, deaths, and injuries in Colombia.
RTC data and fatality numbers for the time period of January 1, 2010, to December 31, 2017, were collated from official Colombian governmental publications and analyzed for reductions and trends related to the introduction of new road safety legislation.
Data analysis are expected to be completed by January 2019.
RTC remains the leading preventable cause of death in Colombia despite the PNSV. Data is being mined to determine the trends of these rates of crashes and fatalities, and their relation to the introduction of national traffic laws. Overall, while the absolute numbers of RTC and deaths have been increasing, the rate of RTC per 10,000 cars has been decreasing. This suggests that although the goals of the PNSV may not be realized, some of the laws emanating from it may be beneficial, but warrant further detailed analysis.
Human Stampedes (HS) occur at religious mass gatherings. Religious events have a higher rate of morbidity and mortality than other events that experience HS. This study is a subset analysis of religious event HS data regarding the physics principles involved in HS, and the associated event morbidity and mortality.
To analyze reports of religious HS to determine the initiating physics principles and associated morbidity and mortality.
Thirty-four reports of religious HS were analyzed to find shared variables. Thirty-three (97.1%) were written media reports with photographic, drawn, or video documentation. 29 (85.3%) cited footage/photographs and 1 (2.9%) was not associated with visual evidence. Descriptive phrases associated with physics principles contributing to the onset of HS and morbidity data were extracted and analyzed to evaluate frequency before, during, and after events.
34 (39.1%) reports of HS found in the literature review were associated with religious HS. Of these, 83% were found to take place in an open space, and 82.3% were associated with population density changes. 82.3% of events were associated with architectural nozzles (small streets, alleys, etc). 100% were found to have loss of XY-axis motion and 89% reached an average velocity of zero. 100% had loss of proxemics and 91% had associated Z-axis displacement (falls). Minimum reported attendance for a religious HS was 3000. 100% of religious HS had reported mortality at the event and 56% with further associated morbidity.
HS are deadly events at religious mass gatherings. Religious events are often recurring, planned gatherings in specific geographic locations. They are frequently associated with an increase in population density, loss of proxemics and velocity, followed by Z-axis displacements, leading to injury and death. This is frequently due to architectural nozzles, which those organizing religious mass gatherings can predict and utilize to mitigate future events.
Healthcare facilities frequently use disaster codes as a way to communicate with employees that an emergency or incident is occurring. As increasing numbers of providers work at multiple facilities, and healthcare systems continue to build disaster response teams and protocols covering multiple facilities, standardization of disaster code terminology is critical. A lack of consistency in terminology can potentially have a devastating impact on the understanding and response of visiting or relief staff.
To evaluate the level of standardization in terminology of disaster codes in healthcare facilities.
A convenience sample was taken from a private Facebook™ group consisting of emergency department nurses from a wide range of facilities. The Facebook™ group was asked to share their hospital disaster codes. Of the 40,179 total members, 78 commented, including 55 photos of quick reference badges, and the rest were descriptions/lists of codes. One badge was excluded due to a blurry photograph. Results were collated and analyzed for trends and standardization.
The most common codes were, “Code Red” for fire (72.7%), “Code Blue” for cardiac arrest (44.9%), “Code Silver” for active shooter/weapons event (37.7%) and “Code Orange” for hazardous materials (33.8%). There were 168 instances of a code term being associated with a particular event by five or fewer facilities. Two facilities used numeric systems, with 11 using plain language descriptions.
Disaster code language is inconsistent. Few of the codes were consistently assigned to the same meaning, and none were universal. Color coding was the most common method, but there was little consistency even within color code systems. Additionally, some facilities used a combination of colors, numbers, terms, and plain language. Healthcare facilities should embrace standard terminology and create a consistent language for disaster codes to enhance response capabilities and medical security.
Children represent a particularly vulnerable population in disasters. Disaster Risk Reduction refers to a systematic approach to identifying, assessing, and reducing risks of disaster through sets of interventions towards disaster causes and population vulnerabilities. Disaster Risk Reduction through the education of the population, and especially children, is an emerging field requiring further study.
To test the hypothesis that an educational program on Disaster Risk Reduction can induce a sustained improvement in knowledge, risk perception, awareness, and attitudes toward preparedness behavior of children.
A Disaster Risk Reduction educational program for students aged 10-12 was completed in an earthquake-prone region of Jordan (Madaba). Subject students (A) and control groups of similarly aged untrained children in public (B) and private (C) schools were surveyed one year after the program. Surveys focused on disaster knowledge, risk perception, awareness, and preparedness behavior. Likert scales were used for some questions and binary yes/no for others. Results were collated and total scores averaged for each section. Average scores were compared between groups and analyzed using SPSS.
Students who had completed the Disaster Risk Reduction program were found through Levene’s test to have statistically significant improvement in earthquake knowledge (5.921 vs. 4.55 vs. 5.125), enhanced risk perception (3.966 vs. 3.580 vs. 3.789), and improved awareness of earthquakes (4.652 vs. 3.293 vs. 4.060) with heightened attitudes toward preparedness behavior (8.008 vs. 6.517 vs. 7.597) when compared to untrained public and private school control groups, respectively.
Disaster Risk Reduction education programs can have lasting impacts when applied to children. They can improve students’ knowledge, risk perception, awareness, and attitudes towards preparedness. Further work is required to determine the frequency of re-education required and appropriate age groups for educational interventions.
Roles for pharmacists in general practice are developing in Australia. It is known that pharmacists can provide effective smoking cessation services in other settings but evidence in general practice is lacking.
To determine whether a pharmacist can provide effective smoking cessation services within general practice.
Data from smoking cessation consultations were obtained for 66 consecutive patients seen by one practice pharmacist. The pharmacist tailored interventions to the individual. Medication was offered in collaboration with community pharmacists and general practitioners. Quit coaching, based on motivational interviewing, was conducted. Smoking status was ascertained at least 6 months after the intended quit date and verified by a carbon monoxide breath test where possible.
The patients’ median age was 43 years (range 19–74 years); 42 were females (64%). At baseline, the median (i) number of pack years smoked was 20 (range: 1–75); (ii) Fagerstrom Test of dependence score was 6 (1–10); and (iii) number of previous quit attempts was 3 (0–10). Follow-up after at least 6 months determined a self-reported point prevalence abstinence rate of 30% (20/66). Of all patients who reported to be abstinent, 65% (13/20) were tested for carbon monoxide breath levels and were all below 7 ppm. The biochemically verified smoking abstinence rate was therefore 20% overall (13/66). Successful quit attempts were associated with varenicline recommendation (69% v 25%), increased median number of practice pharmacist consultations (4 v 2 per patient) and mental health diagnosis (85% v 51%).
Our observed abstinence rate was comparable or better than those obtained by practice nurses, community pharmacists and outpatient pharmacists, indicating the general practice pharmacist provided an effective smoking cessation intervention. A larger randomised trial is warranted.
This paper describes a model of electron energization and cyclotron-maser emission applicable to astrophysical magnetized collisionless shocks. It is motivated by the work of Begelman, Ergun and Rees [Astrophys. J. 625, 51 (2005)] who argued that the cyclotron-maser instability occurs in localized magnetized collisionless shocks such as those expected in blazar jets. We report on recent research carried out to investigate electron acceleration at collisionless shocks and maser radiation associated with the accelerated electrons. We describe how electrons accelerated by lower-hybrid waves at collisionless shocks generate cyclotron-maser radiation when the accelerated electrons move into regions of stronger magnetic fields. The electrons are accelerated along the magnetic field and magnetically compressed leading to the formation of an electron velocity distribution having a horseshoe shape due to conservation of the electron magnetic moment. Under certain conditions the horseshoe electron velocity distribution function is unstable to the cyclotron-maser instability [Bingham and Cairns, Phys. Plasmas 7, 3089 (2000); Melrose, Rev. Mod. Plasma Phys. 1, 5 (2017)].
A new deep level transient spectroscopy (DLTS) technique is described, called half-width at variable intensity analysis. This method utilizes the width and normalized intensity of a DLTS signal to determine the activation energy and capture cross section of the trap that generated the signal via a variable, kO. This constant relates the carrier emission rates giving rise to the differential capacitance signal associated with a given trap at two different temperatures: the temperature at which the maximum differential capacitance is detected, and an arbitrary temperature at which some nonzero differential capacitance signal is detected. The extracted activation energy of the detected trap center is used along with the position of the peak maximum to extract the capture cross section of the trap center.
To investigate the relative importance of 10 attributes identified in prior studies as essential for effective disaster medical responders and leaders.
Emergency and disaster medical response personnel (N=220) ranked 10 categories of disaster worker attributes in order of their importance in contributing to the effectiveness of disaster responders and leaders.
Attributes of disaster medical leaders and responders were rank ordered, and the rankings differed for leaders and responders. For leaders, problem-solving/decision-making and communication skills were the highest ranked, whereas teamwork/interpersonal skills and calm/cool were the highest ranked for responders.
The 10 previously identified attributes of effective disaster medical responders and leaders include personal characteristics and general skills in addition to knowledge of incident command and disaster medicine. The differences in rank orders of attributes for leaders and responders suggest that when applying these attributes in personnel recruitment, selection, and training, the proper emphasis and priority given to each attribute may vary by role. (Disaster Med Public Health Preparedness. 2019;page 1 of 4)
This method describes the addition of cerium (IV) oxide to a lithium borate flux. CeO2 provides a non-analytic glass former to the melt production. CeO2 also acts as an interelemental buffer replacing the use of lanthanum oxide for long wavelength absorption. With cerium oxide addition, excellent results are produced, resulting in part from the elimination of recrystallization problems encountered with lanthanum oxide use. Analytical results easily meet the ASTM C-114 qualification requirements for rapid method analysis of hydraulic cements.
The renewed interest in virtue ethics raises again a persistent question, namely, the relationship between the virtue ethics theory and liberalism as a political philosophy. Virtue ethicists focus on the good—i.e., human flourishing—and debate what constitutes that good. This focus creates a problem for liberals who are rights-oriented, which is the dominant form of contemporary liberalism.
The recent and timely book by Menachem Mautner, Human Flourishing, Liberal Theory, and the Arts, reminds us, however, that liberalism comes in many stripes. There is no one liberalism. Rather, there are many liberalisms. I discuss three aspects of Mautner’s remarkable and important book: first, his conception of human flourishing and its relationship to liberalism; second, his argument that a liberal political order committed to human flourishing ought to promote the arts; and third, his argument that the liberalism of flourishing is better able than neutralist liberalism to compete with religion in providing what Mautner calls “Big Meaning.”
Small landholders’ contribution to Amazon deforestation in Brazil has been persistent even after government actions have allowed a steep reduction in the overall annual deforestation area since 2004. We investigate land clearing and the incentives to comply versus not to comply with environmental legislation, allowing for selection into compliance or noncompliance due to unobserved perceptions of Forest Code enforcement. Our dynamic land clearing model is empirically tested through an endogenous switching regression method applied to data collected from households in the Transamazon-BR163 region between 2003 and 2014, when Forest Code enforcement supposedly increased. We show that smallholder compliance and noncompliance preferences lead to a selection problem that must be addressed in any land clearing behavior examination. We find that greater marginalization, longer land tenure and transitions to cattle grazing, but not agricultural rents, are major contributors to forest clearance and incentives not to comply with the Forest Code.
Violent hazing has been a longstanding issue within African American, collegiate fraternities and sororities, otherwise known as black Greek‐letter organizations (BGLOs). This article investigates how and what hazing victims know about their hazing experiences. Additionally, the article examines how victims' knowledge of hazing may hold serious implications for tort defense doctrines like assumption of risk and comparative fault. Specifically, the authors conduct two studies—one quantitative and the other qualitative—to find that not only are BGLO pledges aware that their pledge experiences are likely to involve mental and physical hazing, but that they believe such experiences will likely continue throughout the entirety of their induction process. Moreover, appreciation for hazing experiences is often captured in the fraternal chants, greetings, and songs they learn or create, which together reflects some understanding of danger and risk. The authors contend that these elements of black “Greek” hazing culture may serve as evidence of assumption of risk or comparative fault.
This article argues that Internet censorship is more fragile than is generally supposed and is, in fact, vulnerable to abrupt collapse. The volume and rapidity of online communication renders perfect policing of the Internet technologically impossible. Authoritarian governments are thus forced to rely on Internet users to police themselves in the form of self-censorship. This strategy has proven largely successful—legal ambiguity regarding what constitutes impermissible speech fosters norms of self-censorship. This reliance on self-censorship, however, renders these censorial systems susceptible to shocks. We set out a model that explains sudden breakdowns in Internet censorship that we term “cyberspeech cascades.” A cyberspeech cascade occurs when small expressions of online dissent produce large shifts in public perception regarding the acceptable limits of online expression that are, in fact, inaccurate. Online bandwagons of progressively more brazen speech proliferate into large-scale torrents of uncensored expression, triggering the temporary collapse of self-censorship norms online.
The question whether unjust dispossessions of land perpetrated on whole peoples in the past should be corrected by restitution in kind, that is, granting reparations in the form of returning land to the dispossessed former owners or their present‐day successors, is substantially more complex than the questions posed by other forms of reparations. I argue that the complexities involved in all the situations where claims for land reparations are made to correct historic injustices give us good reasons to be hesitant about granting such claims. At the same time, we should not dismiss such claims out of hand. Reparations that take a form other than restitution of dispossessed land may be both necessary and sufficient to establish a public marker of acknowledgment.