To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Spiritual distress is a common symptom among patients with cancer. Spiritual injury (SI), a type of spiritual distress, occurs when there is a breakdown in the relationship between the individual and their higher power. Patients who experience spiritual injury may have poor health outcomes.
A case report of a woman with stage IV non-small cell lung cancer who had experienced a SI.
The palliative care team, in collaboration with the palliative care chaplain, was able to recognize that the patient had experienced a SI. They were able to help the patient to process and reflect upon this experience and ultimately treat her suffering.
Significance of results
All palliative care providers should assess their patients’ spiritual health and monitor for the existence of SI.
Declines in mental health among youth in the COVID-19 pandemic have been observed, yet longitudinal studies on how housing may impact these declines are lacking.
Our aim was to determine whether changes in mental health among Danish youth were dependent on their housing conditions.
Young participants from the Danish National Birth Cohort, who had responded to an online questionnaire at 18 years of age, and later during the initial national Danish lockdown, were included. Associations between housing conditions (direct access to outdoor spaces, urbanicity, household density, and household composition) and changes in mental health (mental well-being, quality of life (QoL) and loneliness) were examined in multivariate linear and logistic regression analyses.
We included 7455 participants. Greater decreases in mental well-being were observed for youth with no access to direct outdoor spaces and those living in denser households (mean difference -0.83 [95 % CI -1.19, -0.48], -0.30 [-0.43, -0.18], respectively). Onset of low mental well-being was associated with no access and living alone (odds ratios (OR) 1.68 [1.15, 2.47] and OR 1.47 [1.05, 2.07], respectively). Household density was negatively associated with QoL (mean difference -0.21 [-0.30, -0.12]). Youth living alone experienced more loneliness (OR 2.12 [95 % CI 1.59, 2.82]).
How youth’s mental health changed from before to during lockdown was associated with housing conditions. Among the Danish youth in our study, greater decreases in mental health during lockdown were observed among youth without access to outdoor spaces, living alone, or living in denser households.
Social Anxiety Disorder (SAD) is considered the most prevalent anxiety disorder with the highest disease burden amongst anxiety disorders. Despite available effective treatment with Cognitive Behavioral Therapy, a majority of individuals with SAD do not seek treatment and many drop out when confronted with elements of exposure. Several studies highlight the many advantages virtual reality exposure holds over in vivo exposure. In this study, we investigate the added effect of real-time biofeedback during virtual reality exposure.
The current study is part of a large scale study called VR8. The current study aims to develop and evaluate the feasibility of a VR-biofeedback-intervention for adults with mild to severe social anxiety disorder, before continuing randomized controlled trials.
Data from semi-structured interviews and surveys will be compared to biodata collected during VR exposure. Participants include a minimum of (n=10) patients and (n=10) clinicians from the Mental Health Services in the Region of Southern Denmark. Surveys include questionnaires used for assessment of anxiety symptoms, usability of technology, and presence in the virtual environment. Collected biodata includes heart rate variability and electrodermal activity. Behavioral markers include eye-gaze. The findings will be analyzed and discussed in a mixed methods design.
The study is ongoing. Preliminary results will be available at presentation.
Successful development and implementation of a biofeedback-informed virtual reality exposure intervention may provide increased reach for patients and individuals who would have otherwise not sought- or dropped out of regular treatment, as well as inform the clinician on how to proceed during virtual exposure.
Conflict of interest
Prof. Stephané Bouchard is consultant to and own equity in Cliniques et Développement In Virtuo, which develops virtual environments, and conflicts of interests are managed according to UQO’s conflict of interests policy; however, Cliniques et Développeme
The authorship policies of scientific journals often assume that in order to be able to properly place credit and responsibility for the content of a collaborative paper we should be able to distinguish the contributions of the various individuals involved. Hence, many journals have introduced a requirement for author contribution statements aimed at making it easier to place credit and responsibility on individual scientists. We argue that from a purely descriptive point of view the practices of collaborating scientists are at odds with the requirement for author contribution statements. We also argue that from a normative point of view the authorship policies may be unnecessary. Our arguments draw on an examination of 35 years of retraction notices in the journal Science.
It is widely assumed that people with obesity have several common eating patterns, including breakfast-skipping (1), eating during the night (2) and high fast-food consumption (3). However, differences in individual meal and dietary patterns may be crucial to optimizing obesity treatment. Therefore, we investigated the inter-individual variation in eating patterns, hypothesizing that individuals with obesity show different dietary and meal patterns, and that these associate with self-reported energy intake (rEI) and/or anthropometric measures.
Cross-sectional data from 192 participants (aged 20–55 years) with obesity, including 6 days of weighed food records, were analyzed. Meal patterns and dietary patterns were derived using exploratory hierarchical cluster analysis and k-means cluster analysis, respectively.
Five clear meal patterns were found based on the time-of-day with the highest mean rEI. The daily rEI (mean ± SD kcal) was highest among “midnight-eaters” (2550 ± 550), and significantly (p < 0.05) higher than “dinner-eaters” (2060 ± 550), “lunch-eaters” (2080 ± 520), and “supper-eaters” (2100 ± 460), but not “regular-eaters” (2330 ± 650). Despite differences of up to 490 kcal between meal patterns, there were no significant differences in anthropometric measures or physical activity level (PAL). Four dietary patterns were also found with significant differences in intake of specific food groups, but without significant differences in anthropometry, PAL, or rEI. Our data highlight meal timing as a determinant of individual energy intake in people with obesity. The study supports the importance of considering a person’s specific meal pattern, with possible implications for more person-focused guidelines and targeted advice.
The WHO recommends monitoring iodine status in all populations with median urinary iodine concentration (UIC) below 100 µg/l suggesting iodine deficiency. There are no data on the iodine intake among the population of the Faroe Islands. This study aimed to provide data on iodine nutrition in a representative sample of the general adult population from the Faroe Islands. We conducted a population-based cross-sectional survey in 2011–2012 and measured iodine in urine from 491 participants (294/197 men/women) using the ceri/arsen method after alkaline ashing. Participants include about 100 subjects in each of four adult decades and included participants from both the capital city and villages. The median UIC was low within the recommended range 101 µg/l (range 21–1870 µg/l). No samples were in the range suggesting severe iodine deficiency, but half of the samples were in the range of just adequate or mildly insufficient iodine intake with UIC markedly lower in women than in men (86 v. 115 µg/l; P < 0·001). Intake of fish and whale meals affected the UIC. In conclusion, nearly half of the population had an iodine excretion in the range of borderline or mild iodine deficiency. The lowest iodine nutrition level among Faroese women is a concern as it may extend to pregnancy with increased demands on iodine nutrition. In addition, we found that large variations and the intermittently excessive iodine intakes warrant follow-up on thyroid function in the population of the Faroe Islands.
In Latin America, goods substitution dynamics are evident in states that have recently opposed US hegemony, such as Venezuela and Ecuador. However, the case of Colombia – one of the USA’s closest allies in the region – shows how asset substitution dynamics come to operate under conditions of hierarchy. Colombia does not seek to challenge the USA directly. Rather, Colombia is consistently seeking to diversify its ties with the USA, thereby increasing its leverage and autonomy and hedging its bets from within a hierarchical arrangement. Colombia is a “least likely” case for the theory of goods substitution, and there is limited evidence of actual Chinese goods substitution in Colombia. Yet, China’s increasingly central role in a global goods ecology is a new context in which Colombian hedging strategies are used to threaten with goods substitution. This chapter shows that the mere threat of exiting or hedging strategies has the potential to effect policy change, particularly when combined with domestic political context – a diversification of ties interacts with domestic and international politics, with one area having possible unintended effects on the other.
This introductory chapter first reviews the major categories of goods: private, public, common-pool, and club, and discusses the concept of good specificity – essentially, the number of possible suppliers – which matters to the politics of substitution. It then turns toward a discussion of how this volume defines and understands international order: An important feature of international order is its “goods ecology” – that is, patterns in the production, supply, quality, and nature of international goods. The next major section elaborates the logic of goods substitution, which serves as the common framework for the chapters in the book, before illustrating how many of the goods in international politics are cultural or symbolic in character and having performative dimensions. The chapter concludes by laying out the plan of the volume and the contents of each of the chapters.
Advancing a new approach to the study of international order, this book highlights the stakes disguised by traditional theoretical languages of power transitions and hegemonic wars. Rather than direct challenges to US military power, the most consequential undermining of hegemony is routine, bottom-up processes of international goods substitution: a slow hollowing out of the existing order through competition to seek or offer alternative sources for economic, military, or social goods. Studying how actors gain access to alternative suppliers of these public goods, this volume shows how states consequently move away from the liberal international order. Examining unfamiliar – but crucial – cases, it takes the reader on a journey from local Faroese politics, to Russian election observers in Central Asia, to South American drug lords. Broadening the debate about the role of public goods in international politics, this book offers a new perspective of one of the key issues of our time.