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In light of important political events that go beyond the nation state (e.g., migration, climate change, and the coronavirus pandemic), domestic politicians are increasingly pressured to scrutinize and speak out on European policy-making. This creates a potential trade-off between allocating effort to domestic and supranational affairs, respectively. We examine how citizens perceive legislator involvement in European Union (EU) politics with a pre-registered conjoint experiment in Germany. Our results show that Members of Parliament (MPs) are not disadvantaged when allocating effort to European affairs as compared to local and national affairs. In addition, voters tend to prefer MPs who engage in EU policy reform over those who do not. As demand for legislator involvement in European politics is on the rise, we provide empirical evidence that MPs can fulfill this demand without being disadvantaged by the electorate.
Whether powerful media outlets have effects on public opinion has been at the heart of theoretical and empirical discussions about the media’s role in political life. Yet, the effects of media campaigns are difficult to study because citizens self-select into media consumption. Using a quasi-experiment—the 30-year boycott of the most important Eurosceptic tabloid newspaper, The Sun, in Merseyside caused by the Hillsborough soccer disaster—we identify the effects of The Sun boycott on attitudes toward leaving the EU. Difference-in-differences designs using public opinion data spanning three decades, supplemented by referendum results, show that the boycott caused EU attitudes to become more positive in treated areas. This effect is driven by cohorts socialized under the boycott and by working-class voters who stopped reading The Sun. Our findings have implications for our understanding of public opinion, media influence, and ways to counter such influence in contemporary democracies.
Previous research reports that parties in established European democracies learn from and emulate the successful election strategies of foreign incumbents, i.e., successful parties are influential abroad. We theorize that—in addition to incumbency (or success)—exchange takes place through transnational party alliances in the European Union. Relying on party manifesto data and spatial econometric analyses, we show that belonging to the same European Parliament (EP) party group enhances learning and emulation processes between national political parties. Estimated short- and long-term effects are approximately two and three times greater when foreign incumbents are in the same EP party group compared to other foreign incumbents. Our results have implications for our understanding of how transnational party groups influence national parties’ policy positions.
Ptychites is among the most widely distributed ammonoid genera of the Triassic and is namesake of a family and superfamily. However, representatives of the genus mostly show low-level phenotypic disparity. Furthermore, a large number of taxa are based on only a few poorly preserved specimens, creating challenges to determine ptychitid taxonomy. Consequently, a novel approach is needed to improve ptychitid diversity studies. Here, we investigate Ptychites spp. from the middle and late Anisian of Nevada. The species recorded include Ptychites embreei n. sp., which is distinguished by an average conch diameter that is much smaller and shows a more evolute coiling than most of its relatives. The new species ranges from the Gymnotoceras mimetus to the Gymnotoceras rotelliformis zones, which makes it the longest-ranging species of the genus. For the first time, the ontogenetic development of Ptychites was obtained from cross sections where possible. Cross-sectioning highlights unique ontogenetic trajectories in ptychitids. This demonstrates that, despite showing little phenotypic disparity, Ptychites was highly ontogenetically differentiated, and thus the high taxonomic diversity at the species level is justified for the species investigated.
We report on a patient with schizoaffective disorder who was on combination therapy of lithium, carbamazepine, and the neuroleptic trifluperidol. He experienced a lobar pneumonia and developed an acute and persistent cerebellar deterioration which was most likely due to lithium toxicity, while the serum lithium level was within the therapeutic range. The combination of lithium, carbamazepine, and neuroleptics is common, and is generally considered to be safe. The reported case suggests that this regimen might increase the risk of intoxication with potentially disabling side-effects.
We showed previously that 31% of Swiss population (N=1002)suffers from insomnia(DSM-IV criteria) (Delini-Stula et al. 2007). We report here the results of the analysis of the causes, day-time consequences and treatments.
An 80 items questionnaire was addressed (telephone interview)to a random sample of subjects of both sexes. The recorded responses were either transformed into numerical and categorical values or expressed in percentages of observations. The results were descriptively analyzed.
The main causes of insomnia were classified into 6 categories: personal-, professional and financial problems, diseases, alcoholism and environmental factors. The most frequent were personal (32%) and professional (34%) problems. Only 1% of subjects reported financial worries as cause of insomnia. The most prominent day-time consequences were: fatigue (72%, p<0.003) reduced vitality (46%, p<0.002), irritability (54%, p<0.001) depressed mood (44%, p<002)and impaired cognition (44-51 %, p<0.001). 70% of insomnia subjects reported never to use any treatment. Only 40% of severe insomniacs used prescribed drugs. Also, of the whole population only 44% believed in the efficacy of the hypnotics, but 56% though that herbal products are effective.
In view of marked day-time consequences and obviously under-treatment, insomnia (defined by DSM-IV criteria) in Switzerland is a problem that needs more attention.
Non-drug-related healthcare resource use represents an under-investigated contribution to the total healthcare cost of adult patients with attention-deficit/hyperactivity disorder (ADHD).
To assess non-drug healthcare resource use in adult patients with ADHD undergoing pharmacotherapy.
Practising psychiatrists in Scotland, Sweden and Denmark were invited from a healthcare professional database to complete an online survey between January and August 2014. Resource use estimations were based on typical adult patients (≥18 years) diagnosed with ADHD and showing either adequate or inadequate responses to ADHD medication.
Participating psychiatrists in Scotland (n=20), Sweden (n=20) and Denmark (n=15) saw a mean (standard deviation [SD]) of 10.3 (8.2), 17.8 (12.7) and 16.9 (16.5) adult patients with ADHD per month, respectively. Methylphenidate was the most commonly utilised first-line medication (74% of psychiatrists). Tables 1 and 2 show mean prescribed daily drug doses and resource use estimates.
Findings suggest that patients with an inadequate response to pharmacotherapy consume more non-drug healthcare resources than those with an adequate response. Whilst limited in sample size, this study provides initial data on non-drug healthcare resource use in adult ADHD.
Daily drug dose (mg) by country. n/a, not asked.
Estimated mean resource use (visits/consultations) per year per patient.
Attention-deficit/hyperactivity disorder (ADHD) is a chronic neurobehavioural disorder with considerable costs. Lisdexamfetamine dimesylate (LDX) is approved in the UK for ADHD treatment in children and adolescents.
To perform an economic analysis of LDX for adults with ADHD from the UK National Health Service (NHS) perspective.
To estimate cost-effectiveness of LDX compared with methylphenidate (MPH) and atomoxetine (ATX).
A 1-year decision-analytic model was developed. Health events included response, non-response and unable to tolerate. Efficacy data were taken from a mixed-treatment comparison (MTC) analysis of all clinical trials. Response was defined as a score of 1 or 2 on the Clinical Global Impression–Improvement scale. Tolerability was assessed by discontinuation rates due to adverse events. Utility weights were identified via a systematic literature review. Healthcare resource use estimates were obtained via a survey of clinicians. Daily drug costs were based on mean doses reported in the trials used in the MTC. One-way and probabilistic sensitivity analyses were performed.
The comparison of LDX and MPH for 100 people resulted in an increased annual cost of £34 and quality-adjusted life-years (QALYs) of 0.5, with an incremental cost-effectiveness ratio of £64 per QALY. When compared with ATX for 100 people, LDX was a dominant strategy, with lower annual costs (–£26,700) and higher QALYs (1.0). There was a 62% probability of LDX being cost-effective versus MPH-ER at a threshold of £20,000 per QALY.
From the perspective of the UK NHS, LDX provides a cost-effective treatment option for adults with ADHD.
Serum BDNF levels are decreased in major depressive disorder (MDD) and tend to normalize under antidepressant treatment, serving as a treatment outcome predictor. BDNF is initially synthetized as precursor protein proBDNF and is cleaved to mature BDNF (mBDNF) while only the latter exerts neurotrophic activity.
The aim was to explore if a specific enzyme-linked immunosorbent assay (ELISA) kit for mBDNF in serum would be superior to the unspecific assessment of total serum BDNF in predicting treatment response in MDD.
Twenty-five patients with MDD underwent standardized treatment with duloxetine. Severity of depression was measured by Hamilton Depression Rating Scale (HDRS) at baseline (BL), after one (W1), two (W2) and six weeks (W6) of treatment. Treatment response was defined as a HDRS ≥ 50% reduction of BL score at W6. mBDNF and total BDNF serum levels were determined at BL, W1 and W2.
A high and stable correlation was found between mBDNF and total BDNF serum levels over all measurements. The predictive value of mBDNF BL levels and mBDNFΔW1 to response was similar to that of total BDNF BL and total BDNFΔW1. The assessment of serum mBDNF was not superior to total BDNF in prediction of treatment outcome.
Not only baseline total BDNF but also mBDNF is predictive to treatment outcome. The later might represent the main player in this respect, which supports the idea of a functional link between neuroplasticity and MDD.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Pathological gambling is a behavioural addiction with negative economic, social, and psychological consequences. Identification of contributing genes and pathways may improve understanding of aetiology and facilitate therapy and prevention. Here, we report the first genome-wide association study of pathological gambling. Our aims were to identify pathways involved in pathological gambling, and examine whether there is a genetic overlap between pathological gambling and alcohol dependence.
Four hundred and forty-five individuals with a diagnosis of pathological gambling according to the Diagnostic and Statistical Manual of Mental Disorders were recruited in Germany, and 986 controls were drawn from a German general population sample. A genome-wide association study of pathological gambling comprising single marker, gene-based, and pathway analyses, was performed. Polygenic risk scores were generated using data from a German genome-wide association study of alcohol dependence.
No genome-wide significant association with pathological gambling was found for single markers or genes. Pathways for Huntington's disease (P-value = 6.63 × 10−3); 5′-adenosine monophosphate-activated protein kinase signalling (P-value = 9.57 × 10−3); and apoptosis (P-value = 1.75 × 10−2) were significant. Polygenic risk score analysis of the alcohol dependence dataset yielded a one-sided nominal significant P-value in subjects with pathological gambling, irrespective of comorbid alcohol dependence status.
The present results accord with previous quantitative formal genetic studies which showed genetic overlap between non-substance- and substance-related addictions. Furthermore, pathway analysis suggests shared pathology between Huntington's disease and pathological gambling. This finding is consistent with previous imaging studies.
Little is known about the impact of brief alcohol interventions on mental and general health. The aim was to investigate whether brief interventions for general hospital inpatients with at-risk drinking can improve mental and general health over 2 years; and whether effects are dependent on how they are delivered: in-person or through computer-generated feedback letters (CO).
Three-arm randomized controlled trial with 6-, 12-, 18-, and 24-month follow-ups. Data were collected on 13 general hospital wards from four medical departments (internal medicine, surgical medicine, trauma surgery, and ear-nose-throat) of one university hospital in northeastern rural Germany. A consecutive sample of 961 18- to 64-year-old general hospital inpatients with at-risk alcohol use was recruited through systematic screening. Inpatients with particularly severe alcohol problems were excluded. Participants were allocated to: in-person counseling (PE), CO, and assessment only (AO). PE and CO included three contacts: on the ward, 1, and 3 months later. Mental and general health were assessed using the five-item mental health inventory (0–100) and a one-item general health measure (0, poor – 4, excellent).
Latent growth models including all participants revealed: after 24 months and in contrast to AO, mental and general health were improved in PE (change in mean difference, ΔMmental = 5.13, p = 0.002, Cohen's d = 0.51; ΔMgeneral = 0.20, p = 0.005, d = 0.71) and CO (ΔMmental = 6.98, p < 0.001, d = 0.69; ΔMgeneral = 0.24, p = 0.001, d = 0.86). PE and CO did not differ significantly.
Beyond drinking reduction, PE and CO can improve general hospital inpatients’ self-reported mental and general health over 2 years.
The distribution range of the Near Threatened Marco Polo argali, or Marco Polo sheep, Ovis ammon polii is restricted to the Pamir Mountains, spanning Afghanistan, Tajikistan, China and Pakistan. Until the early 1970s the Marco Polo argali was abundant in northern areas of Pakistan, particularly in the Khunjerab and Misgar Valleys around the Pamir Knot, bordering China, Afghanistan and Tajikistan. In Pakistan the subspecies now occurs only in one small watershed, in Khunjerab National Park, bordering China, which it visits sporadically during summer. We used map-based questionnaire surveys, double-observer surveys and camera trapping in a search for Marco Polo argali in the Pakistani Pamirs. We observed a herd of 19 individuals in Karachanai Nallah, in Khunjerab National Park, in 2012. The population that was formerly present in the Misgar Valley appears to have been extirpated, presumably as a result of anthropogenic factors such as poaching, competition with livestock, habitat disturbance, and the construction of a fence along the international border with China. Transboundary migration and range expansion into Pakistan could be facilitated by removal of the border fence adjacent to the Kilik–Mintika area and by limiting livestock grazing in former lambing areas.
Light adaptive strategies were studied in a comparative analysis of the congeneric seagrass species Zostera muelleri and Zostera marina at two case study areas in New Zealand and Germany. Surveys in intertidal seagrass meadows were conducted from pre-dawn until sunset on days when either low or high tide coincided with noon. The results show marked fluctuations of photophysiology (optimum and effective quantum yield, non-photochemical quenching, cycling of xanthophyll cycle (XC) pigments) over daily and tidal cycles. At both locations, we observed a near complete conversion (de-epoxidation) of violaxanthin to zeaxanthin at times with high irradiance and a rapid and complete re-epoxidation under subsequent lower light conditions. At the New Zealand site we also observed significantly larger XC-pigment pool sizes in seagrass leaves sampled in a week when low tide coincided with noon (larger daily fluence and higher maximum irradiance), compared with leaves sampled in a week when high tide was at noon. This dynamic adjustment of xanthophyll pool size has not been previously reported for intertidal seagrasses. It adds to our understanding of an important adaptive feature in a highly dynamic light environment and to the general ecology and adaptability of seagrasses.