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Psychosocial and health-related risk factors for depressive symptoms are known. It is unclear if these are associated with depressive symptom patterns over time. We identified trajectories of depressive symptoms and their risk factors among midlife women followed over 15 years.
Participants were 3300 multiracial/ethnic women enrolled in a multisite longitudinal menopause and aging study, Study of Women's Health Across the Nation. Biological, psychosocial, and depressive symptom data were collected approximately annually. Group-based trajectory modeling identified women with similar longitudinal patterns of depressive symptoms. Trajectory groups were compared on time-invariant and varying characteristics using multivariable multinomial analyses and pairwise comparisons.
Five symptom trajectories were compared (50% very low; 29% low; 5% increasing; 11% decreasing; 5% high). Relative to whites, blacks were less likely to be in the increasing trajectory and more likely to be in the decreasing symptom trajectory and Hispanics were more likely to have a high symptom trajectory than an increasing trajectory. Psychosocial/health factors varied between groups. A rise in sleep problems was associated with higher odds of having an increasing trajectory and a rise in social support was associated with lower odds. Women with low role functioning for 50% or more visits had three times the odds of being in the increasing symptom group.
Changes in psychosocial and health characteristics were related to changing depressive symptom trajectories. Health care providers need to evaluate women's sleep quality, social support, life events, and role functioning repeatedly during midlife to monitor changes in these and depressive symptoms.
Many women experience both vasomotor menopausal symptoms (VMS) and depressed mood at midlife, but little is known regarding the prospective bi-directional relationships between VMS and depressed mood and the role of sleep difficulties in both directions.
A pooled analysis was conducted using data from 21 312 women (median: 50 years, interquartile range 49−51) in eight studies from the InterLACE consortium. The degree of VMS, sleep difficulties, and depressed mood was self-reported and categorised as never, rarely, sometimes, and often (if reporting frequency) or never, mild, moderate, and severe (if reporting severity). Multivariable logistic regression models were used to examine the bi-directional associations adjusted for within-study correlation.
At baseline, the prevalence of VMS (40%, range 13–62%) and depressed mood (26%, 8–41%) varied substantially across studies, and a strong dose-dependent association between VMS and likelihood of depressed mood was found. Over 3 years of follow-up, women with often/severe VMS at baseline were more likely to have subsequent depressed mood compared with those without VMS (odds ratios (OR) 1.56, 1.27–1.92). Women with often/severe depressed mood at baseline were also more likely to have subsequent VMS than those without depressed mood (OR 1.89, 1.47–2.44). With further adjustment for the degree of sleep difficulties at baseline, the OR of having a subsequent depressed mood associated with often/severe VMS was attenuated and no longer significant (OR 1.13, 0.90–1.40). Conversely, often/severe depressed mood remained significantly associated with subsequent VMS (OR 1.80, 1.38–2.34).
Difficulty in sleeping largely explained the relationship between VMS and subsequent depressed mood, but it had little impact on the relationship between depressed mood and subsequent VMS.
The discovery of the first electromagnetic counterpart to a gravitational wave signal has generated follow-up observations by over 50 facilities world-wide, ushering in the new era of multi-messenger astronomy. In this paper, we present follow-up observations of the gravitational wave event GW170817 and its electromagnetic counterpart SSS17a/DLT17ck (IAU label AT2017gfo) by 14 Australian telescopes and partner observatories as part of Australian-based and Australian-led research programs. We report early- to late-time multi-wavelength observations, including optical imaging and spectroscopy, mid-infrared imaging, radio imaging, and searches for fast radio bursts. Our optical spectra reveal that the transient source emission cooled from approximately 6 400 K to 2 100 K over a 7-d period and produced no significant optical emission lines. The spectral profiles, cooling rate, and photometric light curves are consistent with the expected outburst and subsequent processes of a binary neutron star merger. Star formation in the host galaxy probably ceased at least a Gyr ago, although there is evidence for a galaxy merger. Binary pulsars with short (100 Myr) decay times are therefore unlikely progenitors, but pulsars like PSR B1534+12 with its 2.7 Gyr coalescence time could produce such a merger. The displacement (~2.2 kpc) of the binary star system from the centre of the main galaxy is not unusual for stars in the host galaxy or stars originating in the merging galaxy, and therefore any constraints on the kick velocity imparted to the progenitor are poor.
Germany is pivotal to the success of any trade agreement between the European Union and the United States. As the third largest exporter in the world, Germany is dependent on open markets; throughout the post-war period, government support for free trade has been unequivocal. Despite these positive incentives for expanding free trade, both German business and the wider public voiced fierce opposition to the Transatlantic Trade and Investment Partnership (TTIP). TTIP became a flash point for the German public to overcome collective action problems and create a broad protest movement against a free trade agreement for the first time in German history. This movement enabled the public to successfully exercise influence on German foreign economic policy-making, which had long been protected from public pressure. By 2015, the success of that pressure in penetrating the policy-making apparatus combined with growing government concern about the potential of international firms to undermine national policy. As a result of the confluence of these two forces, German leaders changed their position in TTIP negotiations.
Introduction: Data regarding adverse events (AEs) (unintended harm to the patient from health care provided) among children seen in the emergency department (ED) are scarce despite the high risk setting and population. The objective of our study was to estimate the risk and type of AEs, and their preventability and severity, among children treated in pediatric EDs. Methods: Our prospective cohort study enrolled children <18 years of age presenting for care during 21 randomized 8 hr-shifts at 9 pediatric EDs from Nov 2014 to October 2015. Exclusion criteria included unavailability for follow-up or insurmountable language barrier. RAs collected demographic, medical history, ED course, and systems level data. At day 7, 14, and 21 a RA administered a structured telephone interview to all patients to identify flagged outcomes (e.g. repeat ED visits, worsening/new symptoms, etc). A validated trigger tool was used to screen admitted patients’ health records. For any patients with a flagged outcome or trigger, 3 ED physicians independently determined if an AE occurred. Primary outcome was the proportion of patients with an AE related to ED care within 3 weeks of their ED visit. Results: We enrolled 6377 (72.0%) of 8855 eligible patients; 545 (8.5%) were lost to follow-up. Median age was 4.4 years (range 3 months to 17.9 yrs). Eight hundred and seventy seven (13.8%) were triaged as CTAS 1 or 2, 2638 (41.4%) as CTAS 3, and 2839 (44.7%) as CTAS 4 or 5. Top entrance complaints were fever (11.2%) and cough (8.8%). Flagged outcomes/triggers were identified for 2047 (32.1%) patients. While 252 (4.0%) patients suffered at least one AE within 3 weeks of ED visit, 163 (2.6%) suffered an AE related to ED care. In total, patients suffered 286 AEs, most (67.9%) being preventable. The most common AE types were management issues (32.5%) and procedural complications (21.9%). The need for a medical intervention (33.9%) and another ED visit (33.9%) were the most frequent clinical consequences. In univariate analysis, older age, chronic conditions, hospital admission, initial location in high acuity area of the ED, having >1 ED MD or a consultant involved in care, (all p<0.001) and longer length of stay (p<0.01) were associated with AEs. Conclusion: While our multicentre study found a lower risk of AEs among pediatric ED patients than reported among pediatric inpatients and adult ED patients, a high proportion of these AEs were preventable.
It is a new concept for porous media flow that a hydrodynamic lifting force is generated inside a highly compressible porous layer as a planing surface glides over it. The concept originated from the observation of the pop-out phenomena of red blood cells over the endothelial glycocalyx layer (EGL) lining the inner surface of our blood vessels (Feng & Weinbaum, J. Fluid Mech., vol. 422, 2000, pp. 282–317). In the current paper, we report an experimental study to examine this concept. A novel testing set-up was developed that consists of a running conveyer belt covered with a soft porous sheet, and a fully instrumented upper planar board, i.e. planing surface. The generation of pore pressure was observed and captured by pressure transducers when the planing surface glides over the porous sheet. Its distribution strongly depends on the relative velocity between the planing surface and the running belt, the mechanical and transport properties of the porous sheet as well as the compression ratios at the leading and trailing edges. The relative contribution of the transiently trapped air to the total lift was evaluated by comparing the pore pressure to the total lifting pressure measured by a load cell mounted between two adjacent pressure transducers. For a typical running condition with a polyester porous material (
, are the porous layer thickness at the leading and trailing edges, respectively;
is the un-deformed porous layer thickness; and
is the velocity of the running belt), over 68 % of the local lift is generated by the pore pressure. The results conclusively verified the validity of lift generation in a highly compressible porous layer as a planing surface glides over it. This study provides the foundation for the application of highly compressible porous media for soft lubrication with minimal frictional losses. It also sheds some light on the biophysics study of the EGL.
Pauline theology is a well-established undertaking in modern New Testament studies, and yet it is almost entirely without precedent prior to the nineteenth century. This article explores the enterprise of Pauline theology by considering an important and overlooked exception to its otherwise exclusively modern provenance: Priscillian of Avila's fourth-century Canons on the Letters of the Apostle Paul. The key to Priscillian's dogmatic synthesis of Paul's thought was his innovative ‘versification’ of Paul's letters, which facilitated efficient citation and cross-referencing of epistolary data. This article uses Priscillian's literary creation to examine the intriguing correlation of technologies for ordering textual knowledge with the systematic abstraction of Pauline theology.
I report here centimeter–wavelength observations carried out at the Very Large Array (VLA) to help resolve two questions. First, what is the source of the far infrared (FIR) emission in infrared-luminous IRAS galaxies, active nuclei or more widely distributed star formation? And what physics underlies the tight correlation (Helou et al., 1985) between FIR and radio flux? To test potential answers to these questions, we believe it is important to study the most luminous IRAS galaxies. We selected 39 for study from the ultraluminous catalog of Strauss et al.(1990 and 1992). All sources had FIR luminosity ≥ 1011.4 L⊙. Radio wavelength observations of these systems provide several advantages. First, in the radio there is no obscuration, so we can “see” the active galactic nuclei, if present. Radio spectral indices can distinguish between synchrotron and thermal emission. And finally, observations at the VLA provide sub–kpc resolution. We observed these sources with the VLA in its C configuration. At 1460 MHz, the effective resolution was ≃ 15″; and ≃ 4″ at 4860 MHz. We made follow-up observations on 24 sources in the A configuration with resolution at 4860 MHz of ≃ 0″.5 (or 300–800 h–1 pc for these sources).
The chief activities of the Commission for this period were the organizing of two important meetings. The first was held as Joint Discussion 5 at the Kyoto General Assembly in August 1997. The proceedings have now appeared as “Preserving the Astronomical Windows”, edited by S. Isobe (1997).
In our target article, we made four claims: (1) Social psychology is now politically homogeneous; (2) this homogeneity sometimes harms the science; (3) increasing political diversity would reduce this damage; and (4) some portion of the homogeneity is due to a hostile climate and outright discrimination against non-liberals. In this response, we review these claims in light of the arguments made by a diverse group of commentators. We were surprised to find near-universal agreement with our first two claims, and we note that few challenged our fourth claim. Most of the disagreements came in response to our claim that increasing political diversity would be beneficial. We agree with our critics that increasing political diversity may be harder than we had thought, but we explain why we still believe that it is possible and desirable to do so. We conclude with a revised list of 12 recommendations for improving political diversity in social psychology, as well as in other areas of the academy.
New theoretical and practical approaches were used to determine the outcome of complex interorganizational networks during the 2009 H1N1 outbreak in Australia.
Seventy health professionals from different skill sets and organizational positions who participated in the 2009 swine influenza H1N1 outbreak in Australia were surveyed. Interviews were designed to collect both qualitative and quantitative data to build a comprehensive and in-depth understanding of the dynamics of interorganizational networks that evolve during the coordinated response to the H1N1 outbreak. Three main components of network theory, ie, degree centrality, connectedness, and tie strength, were used to construct a performance model for assessing networks of preparedness and response.
We observed that increasing communication frequency and diversifying the tiers of the interorganizational links enhanced the overall network’s performance in the case of formal coordination. Network measures such as centrality, connectedness, and tie strength were relevant and resulted in improving the entire network’s performance during the outbreak.
In the context of a disease outbreak in a complex environment and a large geographical area, this investigation has provided a new perspective for understanding how the structure of a collaborative network of personnel affects the performance of the overall network. (Disaster Med Public Health Preparedness. 2015;9:155-165)
Psychologists have demonstrated the value of diversity – particularly diversity of viewpoints – for enhancing creativity, discovery, and problem solving. But one key type of viewpoint diversity is lacking in academic psychology in general and social psychology in particular: political diversity. This article reviews the available evidence and finds support for four claims: (1) Academic psychology once had considerable political diversity, but has lost nearly all of it in the last 50 years. (2) This lack of political diversity can undermine the validity of social psychological science via mechanisms such as the embedding of liberal values into research questions and methods, steering researchers away from important but politically unpalatable research topics, and producing conclusions that mischaracterize liberals and conservatives alike. (3) Increased political diversity would improve social psychological science by reducing the impact of bias mechanisms such as confirmation bias, and by empowering dissenting minorities to improve the quality of the majority's thinking. (4) The underrepresentation of non-liberals in social psychology is most likely due to a combination of self-selection, hostile climate, and discrimination. We close with recommendations for increasing political diversity in social psychology.
There has been major concern about the ‘over-representation’ of Black and ethnic minority groups amongst people detained under the Mental Health Act (MHA). We explored the effect of patient ethnicity on detention following an MHA assessment, once confounding variables were controlled for.
Prospective data were collected for all MHA assessments over 4-month periods in the years 2008, 2009, 2010 and 2011 each in three regions in England: Birmingham, West London and Oxfordshire. Logistic regression modelling was conducted to predict the outcome of MHA assessments – either resulting in ‘detention’ or ‘no detention’.
Of the 4423 MHA assessments, 2841 (66%) resulted in a detention. A diagnosis of psychosis, the presence of risk, female gender, level of social support and London as the site of assessment predicted detention under the MHA. Ethnicity was not an independent predictor of detention.
There is no evidence for that amongst those assessed under the MHA, ethnicity has an independent effect on the odds of being detained.