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Clarifying the relationship between depression symptoms and cardiometabolic and related health could clarify risk factors and treatment targets. The objective of this study was to assess whether depression symptoms in midlife are associated with the subsequent onset of cardiometabolic health problems.
The study sample comprised 787 male twin veterans with polygenic risk score data who participated in the Harvard Twin Study of Substance Abuse (‘baseline’) and the longitudinal Vietnam Era Twin Study of Aging (‘follow-up’). Depression symptoms were assessed at baseline [mean age 41.42 years (s.d. = 2.34)] using the Diagnostic Interview Schedule, Version III, Revised. The onset of eight cardiometabolic conditions (atrial fibrillation, diabetes, erectile dysfunction, hypercholesterolemia, hypertension, myocardial infarction, sleep apnea, and stroke) was assessed via self-reported doctor diagnosis at follow-up [mean age 67.59 years (s.d. = 2.41)].
Total depression symptoms were longitudinally associated with incident diabetes (OR 1.29, 95% CI 1.07–1.57), erectile dysfunction (OR 1.32, 95% CI 1.10–1.59), hypercholesterolemia (OR 1.26, 95% CI 1.04–1.53), and sleep apnea (OR 1.40, 95% CI 1.13–1.74) over 27 years after controlling for age, alcohol consumption, smoking, body mass index, C-reactive protein, and polygenic risk for specific health conditions. In sensitivity analyses that excluded somatic depression symptoms, only the association with sleep apnea remained significant (OR 1.32, 95% CI 1.09–1.60).
A history of depression symptoms by early midlife is associated with an elevated risk for subsequent development of several self-reported health conditions. When isolated, non-somatic depression symptoms are associated with incident self-reported sleep apnea. Depression symptom history may be a predictor or marker of cardiometabolic risk over decades.
Emerging research suggests that maternal immune activation (MIA) may be associated with an increased risk of adverse neurodevelopmental and mental health outcomes in offspring. Using data from the Raine Study, we investigated whether MIA during pregnancy was associated with increased behavioral and emotional problems in offspring longitudinally across development.
Mothers (Generation 1; N = 1905) were classified into the following categories: AAAE (Asthma/Allergy/Atopy/Eczema; N = 1267); infection (during pregnancy; N = 1082); no AAAE or infection (N = 301). The Child Behavior Checklist (CBCL) was administered for offspring at ages 5, 8, 10, 14, and 17. Generalized estimating equations were used to investigate the effect of maternal immune status on CBCL scores.
AAAE conditions were associated with significant increases in CBCL Total (β 2.49; CI 1.98–3.00), Externalizing (β 1.54; CI 1.05–2.03), and Internalizing (β 2.28; CI 1.80–2.76) scores. Infection conditions were also associated with increased Total (β 1.27; CI 0.77–1.78), Externalizing (β 1.18; CI 0.70–1.66), and Internalizing (β 0.76; CI 0.28–1.24) scores. Exposure to more than one AAAE and/or infection condition was associated with a greater elevation in CBCL scores than single exposures in males and females. Females showed greater increases on the Internalizing scale from MIA, while males showed similar increases on both Internalizing and Externalizing scales.
MIA was associated with increased behavioral and emotional problems in offspring throughout childhood and adolescence. This highlights the need to understand the relationship between MIA, fetal development, and long-term outcomes, with the potential to advance early identification and intervention strategies.
Stigma against mental illness and the mentally ill is well known. However, stigma against psychiatrists and mental health professionals is known but not discussed widely. Public attitudes and also those of other professionals affect recruitment into psychiatry and mental health services. The reasons for this discriminatory attitude are many and often not dissimilar to those held against mentally ill individuals. In this Guidance paper we present some of the factors affecting the image of psychiatry and psychiatrists which is perceived by the public at large. We look at the portrayal of psychiatry, psychiatrists in the media and literature which may affect attitudes. We also explore potential causes and explanations and propose some strategies in dealing with negative attitudes. Reduction in negative attitudes will improve recruitment and retention in psychiatry. We recommend that national psychiatric societies and other stakeholders, including patients, their families and carers, have a major and significant role to play in dealing with stigma, discrimination and prejudice against psychiatry and psychiatrists.
Psychiatry is that branch of the medical profession, which deals with the origin, diagnosis, prevention, and management of mental disorders or mental illness, emotional and behavioural disturbances. Thus, a psychiatrist is a trained doctor who has received further training in the field of diagnosing and managing mental illnesses, mental disorders and emotional and behavioural disturbances. This EPA Guidance document was developed following consultation and literature searches as well as grey literature and was approved by the EPA Guidance Committee. The role and responsibilities of the psychiatrist include planning and delivering high quality services within the resources available and to advocate for the patients and the services. The European Psychiatric Association seeks to rise to the challenge of articulating these roles and responsibilities. This EPA Guidance is directed towards psychiatrists and the medical profession as a whole, towards other members of the multidisciplinary teams as well as to employers and other stakeholders such as policy makers and patients and their families.
Successful conservation depends on human attitudes, values, and support. Increasingly scientists and managers analyse not only species status and needs, but also the long-term cost, risk, and effectiveness of activities. Socioeconomic costs and benefits are integral to these analyses. Gorongosa National Park in Mozambique provides a case study of conservation integrated with local community needs. Endangered Delta smelt in California exemplify conflicts around water apportionment. Case studies demonstrating the importance of socioeconomic considerations are provided by management of gray wolves and grizzly bears in the United States. The story of sage grouse illustrates how a regional agreement that resulted from many years of collaboration among stakeholders can be nullified by political changes at the national level. The cultural and socioeconomic values and rights of indigenous people play a prominent role in salmon management that can run counter to the interests of hydroelectric companies and other water users. Case studies illustrate how habitat management can be facilitated by participation by non-governmental organizations. Socioeconomic and political consideration also underlie the question of who can take responsibility for managing conservation-reliant species.
A conservation-reliant species is vulnerable to threats that persist; it requires continued management intervention to prevent a decline toward extinction or to maintain a population. The degree of conservation reliance varies over time and among species. Globally, the extent of conservation reliance is accelerating faster than we can provide resources to combat extinctions and promote recovery. A species is recognized as being conservation reliant or emerging from that status based on a general assessment that includes status and threats, the potential for managing the threats, actions taken to manage the threats and the species itself, population monitoring, and monitoring of threats. Species differ in their susceptibility to threats and their potential to respond to management actions, and threats differ in manageability. We use California condor management as a case study for these features of conservation reliance.
Understanding threats and our ability to manage them is the first step in shepherding conservation-reliant species toward sustainability or recovery. This chapter contrasts situations in which a single threat dominates with more complex situations in which multiple threats interact. Interactions among threats raise the likelihood of conservation reliance, as this chapter illustrates in a case study of vultures. Several other case studies illustrate the effectiveness of different legal and management approaches to imperilment and the importance of identifying its root causes. Case studies, including some revolving around dams, also illustrate the complexities that attend socioeconomic drivers of imperilment and differences in the scale and manageability of threats. The chapter also describes several threats such as storms, tsunamis, or volcanic eruptions that are not manageable.
The array of tools for addressing the needs of imperiled and conservation-reliant species is increasing. This chapter provides case studies and examples of the use of translocation and captive breeding for addressing threats, and discuss attributes of receiving sites. Tools for tracking species movements and for remote sensing can efficiently provide large amounts of habitat and species data. Sometimes tools can be used to address common threats such as those created by habitat change or pesticide use, benefitting multiple species. We provide Old World vultures offer a case study. Managing for surrogate, umbrella, indicator, focal, keystone, or pollinator species may assist other species as well. Such roles should be acknowledged in prioritizing conservation activities. Emerging technologies, including genetic tools and artificial intelligence, can help to address imperilment and conservation reliance if ethical issues can be navigated.
Many nations have developed policies and enforced legal approaches for addressing the needs of species at risk of extinction. Generally, however, conservation reliance is not acknowledged legally and is therefore ignored. Increasingly, legal approaches reflect the importance of (1) values in addition to hunting and fishing, (2) wildlife as a shared resource, (3) intrinsic rather than instrumental value, (4) helping species to become self-sustaining, and (5) long-term support for imperiled species. The International Union for the Conservation of Naturehas provided an international standard for recognizing species status. In the United States, the Endangered Species Act and National Environmental Policy Act provide a legal framework for species conservation that has been effective (although these acts have also spawned many legal challenges that have consumed the time and resources of stakeholders). The effectiveness of imperiled species laws depends on funding that can vary, leading to varying implementation and enforcement. Conservation reliance is seldom addressed explicitly. Responsibility for implementation may be spread across national, state or province, and more local entities.
Current methods for making decisions about what to fund and at what level are not sufficiently transparent or objective. Acknowledging conservation reliance fosters a realistic approach and outcomes. Prioritization requires an agreed-upon pool of species to consider within a defined area. Defining and ranking prioritization criteria presents a variety of challenges, including accounting for the manageability of threats, species vulnerability, and species genetic and phenotypic traits. Including social and economic factors increases the probability that plans will be implemented. This chapter also considers how factor weightings are derived and means of dealing with uncertainty. Four examples of prioritization processes illustrate the variety of current approaches. Few approaches explicitly consider the long-term demands of conservation reliance. The ethics that underlie conservation triage affect how people undertake prioritization. This book advocates the use of explicit prioritization criteria that include uncertainties and derive from values and interests of diverse stakeholders. Models should acknowledge a wide array of ecological and socioeconomic costs and benefits, probabilities of success, and projected conservation reliance.
Conservation reliance exists along a spectrum from species extinction to species recovery; from requiring intensive to minimal management. This chapter provides case studies of full or partial recovery and explores what made this possible using the Oregon chub, Aleutian cackling goose, southern white rhinoceros, black-capped vireo, and Robbins’ cinquefoil. Toward the other end of the spectrum, continued translocations or releases are required to maintain Oregon silverspot butterflies and Chatham Island black robins. Management is not always successful, however, as seen for Australian woylies. Some species, such as the Guam kingfisher, are extinct in the wild but maintained in zoos. Finally, there are lessons to be learned from species such as the po’ouli, dusky seaside sparrow, and Christmas Island pipistrelle, for which investments were too little or too late. Management of imperiled species is a societal investment and people’s attitudes play an important role in successful recovery. Participation by citizens and non-governmental organizations is particularly important when species are conservation reliant, as the long-term investment required can rarely be sustained otherwise.
People differ in how and how much they value nature, and in their attitudes toward conservation. This affects the implementation of laws and regulations and the criteria used in prioritization of conservation actions. Yet collaboration is essential, especially when conservation reliance requires long-term commitments. Individuals, communities, government agencies, and non-governmental organizations must all be involved. Shepherding nature is about taking responsibility for watching over and caring for species and Earth’s biodiversity. Countering the rising rate of extinctions will require a transformative change in how people relate to the environment, nature, and one another.
Expanding the scope of conservation beyond species and taking a broader, more holistic approach can provide greater and more lasting benefits to a wider ecological community. However, doing so can reduce our capacity to understand and ameliorate threats to individual species. Factors that favor a broader approach can be used to prioritize areas for protection. Protected areas can benefit from appropriate management of surrounding areas and from connectivity to other protected or partially protected habitat. Eradicating invasive species can benefit multiple imperiled species—although fencing and monitoring entail long-term costs, contributing to conservation reliance. This chapter provides examples, especially from oceanic islands. Managing fire regimes, either by controlling or setting fires, is another way to improve habitat and benefit multiple species. There are trade-offs in both cost and effectiveness between single- and multi-species management.
Recognition of the existence and extent of conservation reliance in laws, regulations, and prioritization schemes has been slow to emerge. Mike Scott and Dale Goble put forth the concept based on their experiences with management and legal approaches, respectively. Recognizing conservation reliance will improve trust and support for conservation projects across a broad segment of society.