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 email@example.com
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.
Concerns have been raised about the utility of self-report assessments in predicting future suicide attempts. Clinicians in pediatric emergency departments (EDs) often are required to assess suicidal risk. The Death Implicit Association Test (IAT) is an alternative to self-report assessment of suicidal risk that may have utility in ED settings.
A total of 1679 adolescents recruited from 13 pediatric emergency rooms in the Pediatric Emergency Care Applied Research Network were assessed using a self-report survey of risk and protective factors for a suicide attempt, and the IAT, and then followed up 3 months later to determine if an attempt had occurred. The accuracy of prediction was compared between self-reports and the IAT using the area under the curve (AUC) with respect to receiver operator characteristics.
A few self-report variables, namely, current and past suicide ideation, past suicidal behavior, total negative life events, and school or social connectedness, predicted an attempt at 3 months with an AUC of 0.87 [95% confidence interval (CI), 0.84–0.90] in the entire sample, and AUC = 0.91, (95% CI 0.85–0.95) for those who presented without reported suicidal ideation. The IAT did not add significantly to the predictive power of selected self-report variables. The IAT alone was modestly predictive of 3-month attempts in the overall sample ((AUC = 0.59, 95% CI 0.52–0.65) and was a better predictor in patients who were non-suicidal at baseline (AUC = 0.67, 95% CI 0.55–0.79).
In pediatric EDs, a small set of self-reported items predicted suicide attempts within 3 months more accurately than did the IAT.
Although mania is the hallmark symptom of bipolar I disorder (BD-I), most patients initially present for treatment with depressive symptoms. Misdiagnosis of BD-I as major depressive disorder (MDD) is common, potentially resulting in poor outcomes and inappropriate antidepressant monotherapy treatment. Screening patients with depressive symptoms is a practical strategy to help healthcare providers (HCPs) identify when additional assessment for BD-I is warranted. The new 6-item Rapid Mood Screener (RMS) is a pragmatic patient-reported BD-I screening tool that relies on easily understood terminology to screen for manic symptoms and other BD-I features in <2 minutes. The RMS was validated in an observational study in patients with clinically confirmed BD-I (n=67) or MDD (n=72). When 4 or more items were endorsed (“yes”), the sensitivity of the RMS for identifying patients with BP-I was 0.88 and specificity was 0.80; positive and negative predictive values were 0.80 and 0.88, respectively. To more thoroughly understand screening tool use among HCPs, a 10-minute survey was conducted.
A nationwide sample of HCPs (N=200) was selected using multiple HCP panels; HCPs were asked to describe their opinions/current use of screening tools, assess the RMS, and evaluate the RMS versus the widely recognized Mood Disorder Questionnaire (MDQ). Results were reported by grouped specialties (primary care physicians, general nurse practitioners [NPs]/physician assistants [PAs], psychiatrists, and psychiatric NPs/PAs). Included HCPs were in practice <30 years, spent at least 75% of their time in clinical practice, saw at least 10 patients with depression per month, and diagnosed MDD or BD in at least 1 patient per month. Findings were reported using descriptive statistics; statistical significance was reported at the 95% confidence interval.
Among HCPs, 82% used a tool to screen for MDD, while 32% used a tool for BD. Screening tool attributes considered to be of the greatest value included sensitivity (68%), easy to answer questions (66%), specificity (65%), confidence in results (64%), and practicality (62%). Of HCPs familiar with screening tools, 70% thought the RMS was at least somewhat better than other screening tools. Most HCPs were aware of the MDQ (85%), but only 29% reported current use. Most HCPs (81%) preferred the RMS to the MDQ, and the RMS significantly outperformed the MDQ across valued attributes; 76% reported that they were likely to use the RMS to screen new patients with depressive symptoms. A total of 84% said the RMS would have a positive impact on their practice, with 46% saying they would screen more patients for bipolar disorder.
The RMS was viewed positively by HCPs who participated in a brief survey. A large percentage of respondents preferred the RMS over the MDQ and indicated that they would use it in their practice. Collectively, responses indicated that the RMS is likely to have a positive impact on screening behavior.
This chapter argues that, although Samuelson developed much of the standard welfare theory based on individualism and the Pareto criterion, he attached great importance to ethical judgments that went beyond welfarism. Following his teacher, Frank Knight, he consistently argued that welfare judgments had to be based on ethical assumptions, his social welfare function providing a way that the implications of alternative ethical judgements could be analyzed. He attached great importance to the distribution of income and his own ethical values involved non-consequentialist elements.
The chapter reflects on reasons economists have departed from welfarism when considering practical problems. Economists generally accept that using ethical values other than individual utility requires departing from neutrality but, if confronted with political contexts involving issues such as distribution, the environment or discrimination, they find it hard not to take an ethical position. Merit or public goods cannot be reduced to the satisfaction of individual utilities insofar as they are meaningful only in a social context. The individualism imposed by welfarism is also debatable when facing the interdependencies that exist between real-world individuals. Lastly, while welfare economics aims to avoid paternalism, reliance on preferences alone can be problematic. The paternalism implied by going beyond welfarism raises issues regarding democratic values such as agency and public reasoning that suggests that, instead of merely substituting non-welfarism for welfarism, there is a need for public debate on moral values. We conclude that economics, when inspired by theory and involved in practices with political consequences, should become more of a moral science.
The Introduction explains the concepts of welfarism and non-welfarism, relating it to the way economistss have typically approached the problem of welfare. Drawing on the chapters in the volume, it explores ways in which economists have departed from welfarism when tackling practical problems and discussing public policy.
This innovative history of welfare economics challenges the view that welfare economics can be discussed without taking ethical values into account. Whatever their theoretical commitments, when economists have considered practical problems relating to public policy, they have adopted a wider range of ethical values, whether equality, justice, freedom, or democracy. Even canonical authors in the history of welfare economics are shown to have adopted ethical positions different from those with which they are commonly associated. Welfare Theory, Public Action, and Ethical Values explores the reasons and implications of this, drawing on concepts of welfarism and non-welfarism developed in modern welfare economics. The authors exemplify how economic theory, public affairs and political philosophy interact, challenging the status quo in order to push economists and historians to reconsider the nature and meaning of welfare economics.
To examine associations between diet and risk of developing gastro-oesophageal reflux disease (GERD).
Prospective cohort with a median follow-up of 15·8 years. Baseline diet was measured using a FFQ. GERD was defined as self-reported current or history of daily heartburn or acid regurgitation beginning at least 2 years after baseline. Sex-specific logistic regressions were performed to estimate OR for GERD associated with diet quality scores and intakes of nutrients, food groups and individual foods and beverages. The effect of substituting saturated fat for monounsaturated or polyunsaturated fat on GERD risk was examined.
A cohort of 20 926 participants (62 % women) aged 40–59 years at recruitment between 1990 and 1994.
For men, total fat intake was associated with increased risk of GERD (OR 1·05 per 5 g/d; 95 % CI 1·01, 1·09; P = 0·016), whereas total carbohydrate (OR 0·89 per 30 g/d; 95 % CI 0·82, 0·98; P = 0·010) and starch intakes (OR 0·84 per 30 g/d; 95 % CI 0·75, 0·94; P = 0·005) were associated with reduced risk. Nutrients were not associated with risk for women. For both sexes, substituting saturated fat for polyunsaturated or monounsaturated fat did not change risk. For both sexes, fish, chicken, cruciferous vegetables and carbonated beverages were associated with increased risk, whereas total fruit and citrus were associated with reduced risk. No association was observed with diet quality scores.
Diet is a possible risk factor for GERD, but food considered as triggers of GERD symptoms might not necessarily contribute to disease development. Potential differential associations for men and women warrant further investigation.
Suicide accounts for 2.2% of all years of life lost worldwide. We aimed to establish whether infectious epidemics are associated with any changes in the incidence of suicide or the period prevalence of self-harm, or thoughts of suicide or self-harm, with a secondary objective of establishing the frequency of these outcomes.
In this systematic review and meta-analysis, MEDLINE, Embase, PsycINFO and AMED were searched from inception to 9 September 2020. Studies of infectious epidemics reporting outcomes of (a) death by suicide, (b) self-harm or (c) thoughts of suicide or self-harm were identified. A random-effects model meta-analysis for the period prevalence of thoughts of suicide or self-harm was conducted.
In total, 1354 studies were screened with 57 meeting eligibility criteria, of which 7 described death by suicide, 9 by self-harm, and 45 thoughts of suicide or self-harm. The observation period ranged from 1910 to 2020 and included epidemics of Spanish Flu, severe acute respiratory syndrome, human monkeypox, Ebola virus disease and coronavirus disease 2019 (COVID-19). Regarding death by suicide, data with a clear longitudinal comparison group were available for only two epidemics: SARS in Hong Kong, finding an increase in suicides among the elderly, and COVID-19 in Japan, finding no change in suicides among children and adolescents. In terms of self-harm, five studies examined emergency department attendances in epidemic and non-epidemic periods, of which four found no difference and one showed a reduction during the epidemic. In studies of thoughts of suicide or self-harm, one large survey showed a substantial increase in period prevalence compared to non-epidemic periods, but smaller studies showed no difference. As a secondary objective, a meta-analysis of thoughts of suicide and self-harm found that the pooled prevalence was 8.0% overall (95% confidence interval (CI) 5.2–12.0%; 14 820 of 99 238 cases in 24 studies) over a time period of between seven days and six months. The quality assessment found 42 studies were of high quality, nine of moderate quality and six of high quality.
There is little robust evidence on the association of infectious epidemics with suicide, self-harm and thoughts of suicide or self-harm. There was an increase in suicides among the elderly in Hong Kong during SARS and no change in suicides among young people in Japan during COVID-19, but it is unclear how far these findings may be generalised. The development of up-to-date self-harm and suicide statistics to monitor the effect of the current pandemic is an urgent priority.
Combining the strengths of “traditional” documentary filmmaking (as “creative treatments of actualité”) with the immersive power of interactive digital technologies (from 360° video to VR to data mining to algorithms), i-Docs can transform audiences into participants, co-creators, and collaborators in nonfiction storytelling, allowing them to not only explore and experience a story on their own terms but to remix, share, and contribute their own content to a collective story. i-Docs are cross- and multiplatform, screening across cinema, computers, smartphones, and gallery installations. Showcased at leading film festivals, increasingly adopted by broadcasters—including PBS, Al Jazeera, and BBC—and critically acclaimed from the Webbys and the Pulitzers to Cannes, the i-Doc sector is set to boom. After a close reading of two i-Docs, Hunt for the Inca Ruins (2017) and Saydnaya (2016), I consider the potential of i-Docs to resolve archaeologists’ concerns about misrepresentation, accuracy, information quality, (co)authorship, and crediting original research in documentary storytelling. I also examine the sector's shortcomings of unstable production pathways, funding sources, technologies, and difficulties assessing impact. I propose that archaeologists should engage proactively with the i-Doc sector if we wish to avoid the pitfalls previously encountered in film and factual TV and make the most of this new format.
Purpose: The novel coronavirus (severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)) first appeared in Wuhan, China, in December 2019, and rapidly spread across the globe. Since most respiratory viruses are known to show a seasonal pattern of infection, it has been hypothesised that SARS-CoV-2 may be seasonally dependent as well. The present study looks at a possible effect of atmospheric temperature, which is one of the suspected factors influencing seasonality, on the evolution of the pandemic. Basic procedures: Since confirming a seasonal pattern would take several more months of observation, we conducted an innovative day-to-day micro-correlation analysis of nine outbreak locations, across four continents and both hemispheres, in order to examine a possible relationship between atmospheric temperature (used as a proxy for seasonality) and outbreak progression. Main findings: There was a negative correlation between atmospheric temperature variations and daily new cases growth rates, in all nine outbreaks, with a median lag of 10 days. Principal conclusions: The results presented here suggest that high temperatures might dampen SARS-CoV-2 propagation, while lower temperatures might increase its transmission. Our hypothesis is that this could support a potential effect of atmospheric temperature on coronavirus disease progression, and potentially a seasonal pattern for this virus, with a peak in the cold season and rarer occurrences in the summer. This could guide government policy in both the Northern and Southern hemispheres for the months to come.
Climbing cacti with edible fruits have been proposed as new dryland fruit crops because their high water-use efficiency reduces water requirement. One lineage of climbers in the cactus family, the Hylocereus group of Selenicereus, includes several species that produce edible fruits and is currently cultivated around the world. Fruits are known as pitahayas, pitayas or dragon fruit. Here, by means of ecological niche-based modelling and analytical hierarchical modelling, the optimal areas for cultivating the three main species of this group in Mesoamerica – Selenicereus costaricensis, Selenicereus ocamponis and Selenicereus undatus – are identified. Data on distribution, physiological requirement and host preferences are taken into account to carry out ecological modelling for current and future scenarios of climate and determine its impact on cultivation. Two MIROC climatic future models, one optimistic (ssp216) and a pessimistic (ssp585) were selected and 554 records from Mexico and Central America were gathered. For all three species, temperature and precipitation seasonality, and solar radiation were the most significant variables in the niche modelling. In addition, for S. undatus the most important hosts, three species of mesquite legume trees were significant to forecast suitable areas for planting. Large areas on the Pacific side from Sinaloa to Costa Rica were predicted as favourable for cultivating the studied three species. Future scenarios of climate change predicted increase of suitable areas for two species and in particular for S. undatus the increment was the largest. Therefore, dragon fruits are corroborated as promising fruits in view of climate change.