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A substantial proportion of persons with mental disorders seek treatment from complementary and alternative medicine (CAM) professionals. However, data on how CAM contacts vary across countries, mental disorders and their severity, and health care settings is largely lacking. The aim was therefore to investigate the prevalence of contacts with CAM providers in a large cross-national sample of persons with 12-month mental disorders.
In the World Mental Health Surveys, the Composite International Diagnostic Interview was administered to determine the presence of past 12 month mental disorders in 138 801 participants aged 18–100 derived from representative general population samples. Participants were recruited between 2001 and 2012. Rates of self-reported CAM contacts for each of the 28 surveys across 25 countries and 12 mental disorder groups were calculated for all persons with past 12-month mental disorders. Mental disorders were grouped into mood disorders, anxiety disorders or behavioural disorders, and further divided by severity levels. Satisfaction with conventional care was also compared with CAM contact satisfaction.
An estimated 3.6% (standard error 0.2%) of persons with a past 12-month mental disorder reported a CAM contact, which was two times higher in high-income countries (4.6%; standard error 0.3%) than in low- and middle-income countries (2.3%; standard error 0.2%). CAM contacts were largely comparable for different disorder types, but particularly high in persons receiving conventional care (8.6–17.8%). CAM contacts increased with increasing mental disorder severity. Among persons receiving specialist mental health care, CAM contacts were reported by 14.0% for severe mood disorders, 16.2% for severe anxiety disorders and 22.5% for severe behavioural disorders. Satisfaction with care was comparable with respect to CAM contacts (78.3%) and conventional care (75.6%) in persons that received both.
CAM contacts are common in persons with severe mental disorders, in high-income countries, and in persons receiving conventional care. Our findings support the notion of CAM as largely complementary but are in contrast to suggestions that this concerns person with only mild, transient complaints. There was no indication that persons were less satisfied by CAM visits than by receiving conventional care. We encourage health care professionals in conventional settings to openly discuss the care patients are receiving, whether conventional or not, and their reasons for doing so.
The treatment gap between the number of people with mental disorders and the number treated represents a major public health challenge. We examine this gap by socio-economic status (SES; indicated by family income and respondent education) and service sector in a cross-national analysis of community epidemiological survey data.
Data come from 16 753 respondents with 12-month DSM-IV disorders from community surveys in 25 countries in the WHO World Mental Health Survey Initiative. DSM-IV anxiety, mood, or substance disorders and treatment of these disorders were assessed with the WHO Composite International Diagnostic Interview (CIDI).
Only 13.7% of 12-month DSM-IV/CIDI cases in lower-middle-income countries, 22.0% in upper-middle-income countries, and 36.8% in high-income countries received treatment. Highest-SES respondents were somewhat more likely to receive treatment, but this was true mostly for specialty mental health treatment, where the association was positive with education (highest treatment among respondents with the highest education and a weak association of education with treatment among other respondents) but non-monotonic with income (somewhat lower treatment rates among middle-income respondents and equivalent among those with high and low incomes).
The modest, but nonetheless stronger, an association of education than income with treatment raises questions about a financial barriers interpretation of the inverse association of SES with treatment, although future within-country analyses that consider contextual factors might document other important specifications. While beyond the scope of this report, such an expanded analysis could have important implications for designing interventions aimed at increasing mental disorder treatment among socio-economically disadvantaged people.
Whether monozygotic (MZ) and dizygotic (DZ) twins differ from each other in a variety of phenotypes is important for genetic twin modeling and for inferences made from twin studies in general. We analyzed whether there were differences in individual, maternal and paternal education between MZ and DZ twins in a large pooled dataset. Information was gathered on individual education for 218,362 adult twins from 27 twin cohorts (53% females; 39% MZ twins), and on maternal and paternal education for 147,315 and 143,056 twins respectively, from 28 twin cohorts (52% females; 38% MZ twins). Together, we had information on individual or parental education from 42 twin cohorts representing 19 countries. The original education classifications were transformed to education years and analyzed using linear regression models. Overall, MZ males had 0.26 (95% CI [0.21, 0.31]) years and MZ females 0.17 (95% CI [0.12, 0.21]) years longer education than DZ twins. The zygosity difference became smaller in more recent birth cohorts for both males and females. Parental education was somewhat longer for fathers of DZ twins in cohorts born in 1990–1999 (0.16 years, 95% CI [0.08, 0.25]) and 2000 or later (0.11 years, 95% CI [0.00, 0.22]), compared with fathers of MZ twins. The results show that the years of both individual and parental education are largely similar in MZ and DZ twins. We suggest that the socio-economic differences between MZ and DZ twins are so small that inferences based upon genetic modeling of twin data are not affected.
The first photographs for the Yale-San Juan Southern Proper Motion (SPM) program with respect to faint galaxies were taken with the collaboration of Columbia University in 1965. The first epoch photography was essentially completed in 1974 and plans are now under way to begin the second epoch observations in 1986.
We present a progress report on Washington photometry of several hundred new globular cluster (GC) candidates in M31 which were recently found from our new CCD survey of GCs. The Washington CMT1 filters that we used are very efficient to survey extragalactic GCs and to estimate the metallicity of GCs. Preliminary color-magnitude diagrams and color-color diagrams of the new GC candidates and known GCs in M31 are obtained.
Searching for globular cluster candidates in nearby galaxies such as M31 is the first step to study the characteristics of extragalactic globular cluster systems. Previous searches for M31 globular clusters were mostly based on visual inspection of photograpic plates. We have selected globular cluster candidates from a wide-field Washington CCD survey of M31, using various methods: color-magnitude diagrams, color-color diagrams, point spread function subtraction and visual inspection of the objects. The efficiency and accuracy of these methods for finding globular clusters are presented.
Traumatic events are common globally; however, comprehensive population-based cross-national data on the epidemiology of posttraumatic stress disorder (PTSD), the paradigmatic trauma-related mental disorder, are lacking.
Data were analyzed from 26 population surveys in the World Health Organization World Mental Health Surveys. A total of 71 083 respondents ages 18+ participated. The Composite International Diagnostic Interview assessed exposure to traumatic events as well as 30-day, 12-month, and lifetime PTSD. Respondents were also assessed for treatment in the 12 months preceding the survey. Age of onset distributions were examined by country income level. Associations of PTSD were examined with country income, world region, and respondent demographics.
The cross-national lifetime prevalence of PTSD was 3.9% in the total sample and 5.6% among the trauma exposed. Half of respondents with PTSD reported persistent symptoms. Treatment seeking in high-income countries (53.5%) was roughly double that in low-lower middle income (22.8%) and upper-middle income (28.7%) countries. Social disadvantage, including younger age, female sex, being unmarried, being less educated, having lower household income, and being unemployed, was associated with increased risk of lifetime PTSD among the trauma exposed.
PTSD is prevalent cross-nationally, with half of all global cases being persistent. Only half of those with severe PTSD report receiving any treatment and only a minority receive specialty mental health care. Striking disparities in PTSD treatment exist by country income level. Increasing access to effective treatment, especially in low- and middle-income countries, remains critical for reducing the population burden of PTSD.
Mechanical damage of non-metallic nuclear wasteforms can be caused by electrical fields induced by decaying clusters of radionuclides surrounded by an insulating matrix. We assess the electric fields near clusters with decaying radionuclides 244Cm, 241Am, 238,239Pu and 137Cs in a glass matrix determining that matrix destruction can gradually occur via electric breakdown discharges and diffusion-controlled change in form of clusters. The most important parameters that control potential matrix destruction are the radioactive cluster (inhomogeneity) size, radionuclide specific radioactivity and effective electrical conductivity of the matrix.
A trend toward greater body size in dizygotic (DZ) than in monozygotic (MZ) twins has been suggested by some but not all studies, and this difference may also vary by age. We analyzed zygosity differences in mean values and variances of height and body mass index (BMI) among male and female twins from infancy to old age. Data were derived from an international database of 54 twin cohorts participating in the COllaborative project of Development of Anthropometrical measures in Twins (CODATwins), and included 842,951 height and BMI measurements from twins aged 1 to 102 years. The results showed that DZ twins were consistently taller than MZ twins, with differences of up to 2.0 cm in childhood and adolescence and up to 0.9 cm in adulthood. Similarly, a greater mean BMI of up to 0.3 kg/m2 in childhood and adolescence and up to 0.2 kg/m2 in adulthood was observed in DZ twins, although the pattern was less consistent. DZ twins presented up to 1.7% greater height and 1.9% greater BMI than MZ twins; these percentage differences were largest in middle and late childhood and decreased with age in both sexes. The variance of height was similar in MZ and DZ twins at most ages. In contrast, the variance of BMI was significantly higher in DZ than in MZ twins, particularly in childhood. In conclusion, DZ twins were generally taller and had greater BMI than MZ twins, but the differences decreased with age in both sexes.
For over 100 years, the genetics of human anthropometric traits has attracted scientific interest. In particular, height and body mass index (BMI, calculated as kg/m2) have been under intensive genetic research. However, it is still largely unknown whether and how heritability estimates vary between human populations. Opportunities to address this question have increased recently because of the establishment of many new twin cohorts and the increasing accumulation of data in established twin cohorts. We started a new research project to analyze systematically (1) the variation of heritability estimates of height, BMI and their trajectories over the life course between birth cohorts, ethnicities and countries, and (2) to study the effects of birth-related factors, education and smoking on these anthropometric traits and whether these effects vary between twin cohorts. We identified 67 twin projects, including both monozygotic (MZ) and dizygotic (DZ) twins, using various sources. We asked for individual level data on height and weight including repeated measurements, birth related traits, background variables, education and smoking. By the end of 2014, 48 projects participated. Together, we have 893,458 height and weight measures (52% females) from 434,723 twin individuals, including 201,192 complete twin pairs (40% monozygotic, 40% same-sex dizygotic and 20% opposite-sex dizygotic) representing 22 countries. This project demonstrates that large-scale international twin studies are feasible and can promote the use of existing data for novel research purposes.
The pH-dependence of glass corrosion rates has a well-known U-shaped form with minima for near-neutral solutions. This paper analyses the change of U-shaped form with time and reveals that the pH dependence evolves even for solutions that have pH not affected by glass corrosion mathematically corresponding to a zero surface to volume ratio. The U(t) dependence is due to changes of concentration profiles of elements in the near-surface layers of glasses in contact with water and is most evident within the initial stages of glass corrosion at relatively low temperatures. Numerical examples are given for the nuclear waste borosilicate glass K-26 which is experimentally characterised by an effective diffusion coefficient of caesium DCs = 4.5 10-12 cm2/day and by a rate of glass hydrolysis in non-saturated groundwater as high as rh = 100 nm/year The changes of U-shaped form need to be accounted when assessing the performance of glasses in contact with water solutions.
New Zealand is well known for its distinctive biota and high proportion of endemic taxa. A recent checklist of fossil and living plants and animals in terrestrial and marine ecosystems highlights spectacular local radiations coupled with unusual ecological niches and an amazing array of cryptic diversity across most habitats. Although New Zealand and Australia share common biotic antecedents, for the past 20 million years the New Zealand terrestrial biota has occupied constantly mesic habitats but has undergone major extinctions as climate cooled. On land, plants and animals have diversified in non-forest ecosystems, particularly shrublands and grasslands. New Zealand faces major challenges in protecting biodiversity and ecosystem services, in part because the biota is adjusting to relatively recent human occupation, and land use and marine harvesting are intensifying. Models for effective conservation in terrestrial environments are dependent on enduring predator control, legislative protection of remaining indigenous habitats and threatened species, and novel approaches that compensate land owners for contributing towards national biodiversity outcomes. Marine protected areas are minimal in extent although managed fish quota systems appear to be sustaining some species. Indigenous biodiversity in New Zealand remains vulnerable especially in ecosystems dominated by human activities.
New Zealand is often compared to an Ark, laden with a unique Gondwanan biota. While this emphasises remoteness and antiquity as major drivers of our biotic distinctiveness, it less adequately captures the composite elements of the biota or the complex history of immigration, extinction and speciation, and a changing geography and climate during the Cenozoic in both marine and terrestrial ecosystems. All of these factors have contributed to the evolution of an overwhelmingly endemic idiosyncratic biota that continues to adjust to natural environmental change and more recent anthropogenic impacts.
A simulated Magnox glass which is Mg- and Al- rich was subjected to aqueous corrosion in static mode with deionised water at 90 °C for 7-28 days and assessed using X-Ray Diffraction (XRD), Scanning Electron Microscopy (SEM) with Energy X-Ray Dispersive Spectroscopy (EDS) and Inductively Coupled Plasma – Optical Emission Spectroscopy (ICP-OES). XRD revealed both amorphous phase and crystals in the glass structure. The crystals were Ni and Cr rich spinels and ruthenium oxide. After two weeks of incubation in deionised water, the glass surface was covered by a ∼11 μm thick Si-rich layer whilst mobile elements and transition metals like Na, B, and Fe were strongly depleted. The likely corrosion mechanism and in particular the role of Mg and Al in the glass structure are discussed.
Preparation and characterization of a Simulated Spent Nuclear Fuel (SIMFuel), which replicates the chemical state and microstructure of Spent Nuclear Fuel (SNF) discharged from UK Advanced Gas-cooled Reactor (AGR) after a cooling time of 100 years is described. Thirteen stable elements were added to depleted UO2 and sintered to simulate the composition of fuel pellets after burn-ups of 25 and 43 GWd/tU and, as a reference, pure UO2 pellets were also investigated. The fission product distribution was calculated using the Fispin code provided by NNL. SIMFuel pellets exhibit a microstructure up to 92% TD. During the sintering process in H2 atmosphere Mo-Ru-Rh-Pd metallic precipitates and grey-phase ((Ba, Sr)(Zr, RE)O3 oxide precipitates) formed within the UO2 matrix. These secondary phases are present in real PWR and AGR SNF, although they are smaller in size than those examined in this study. The grain size of the produced SIMFuel is in good agreement with literature references.