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Deserts, the Red Land, bracket the narrow strip of alluvial Black Land that borders the Nile. Networks of desert roads ascended to the high desert from the Nile Valley, providing access to the mineral wealth and Red Sea ports of the Eastern Desert, the oasis depressions and trade networks of the Western Desert. A historical perspective from the Predynastic through the Roman Periods highlights how developments in the Nile Valley altered the Egyptian administration and exploitation of the deserts. For the ancient Egyptians, the deserts were a living landscape, and at numerous points along the desert roads, the ancient Egyptians employed rock art and rock inscriptions to create and mark places. Such sites provide considerable evidence for the origin of writing in northeast Africa, the religious significance of the desert and expressions of personal piety, and the development of the early alphabet.
UK Biobank is a well-characterised cohort of over 500 000 participants including genetics, environmental data and imaging. An online mental health questionnaire was designed for UK Biobank participants to expand its potential.
Describe the development, implementation and results of this questionnaire.
An expert working group designed the questionnaire, using established measures where possible, and consulting a patient group. Operational criteria were agreed for defining likely disorder and risk states, including lifetime depression, mania/hypomania, generalised anxiety disorder, unusual experiences and self-harm, and current post-traumatic stress and hazardous/harmful alcohol use.
A total of 157 366 completed online questionnaires were available by August 2017. Participants were aged 45–82 (53% were ≥65 years) and 57% women. Comparison of self-reported diagnosed mental disorder with a contemporary study shows a similar prevalence, despite respondents being of higher average socioeconomic status. Lifetime depression was a common finding, with 24% (37 434) of participants meeting criteria and current hazardous/harmful alcohol use criteria were met by 21% (32 602), whereas other criteria were met by less than 8% of the participants. There was extensive comorbidity among the syndromes. Mental disorders were associated with a high neuroticism score, adverse life events and long-term illness; addiction and bipolar affective disorder in particular were associated with measures of deprivation.
The UK Biobank questionnaire represents a very large mental health survey in itself, and the results presented here show high face validity, although caution is needed because of selection bias. Built into UK Biobank, these data intersect with other health data to offer unparalleled potential for crosscutting biomedical research involving mental health.
This chapter engages the history of key literary prizes that have been awarded to black and Asian writers. What is the impact of awards which prize otherness, celebrate diversity, and demand BAME writers to engage a fixed range of topics, arguably in a limited number of forms? While literary awards create visibility, stimulate sales, and direct critical attention to selected writers and texts, the trade-off is the required negotiation of thematic, formal, and identitarian templates confronting potential recipients.
There are many ways of conceptualising the circumstances of those affected by child sexual exploitation. In this chapter consideration will be given to a theoretical framework – lifespan developmental theory – which will assist in shedding light on the processes underlying human development. In the context of this theory there will be a particular focus on adolescence as a developmental stage within the lifespan. The notion of transition will be explored, and this will include reference to puberty, brain development and the variety of social and emotional changes that impact on the young person during this period. The chapter will conclude by examining possible reasons why certain young people might be vulnerable in their early sexual relationships.
Lifespan development theory
Lifespan development theory is an approach that explores particular challenges associated with different life stages, and identifies factors affecting adjustment across the lifespan (see Coleman 2011; Hendry 2015). In this case I will concentrate on those factors associated with the adolescent life stage. Lifespan developmental theory emphasises four elements which affect human development. I will deal with each of these concepts in turn, showing how they assist us in grasping the nature of adolescent development while also contributing to a better understanding of both strengths and vulnerabilities (Coleman and Hagell 2007).
The concept of continuity underlines the fact that human development can only be understood if we look at each stage in relation to previous stages. In the case of adolescence this is especially important since so much changes following puberty. As a result, there is sometimes the experience of the adolescent as a ‘new’ person arriving in the family. This means we cannot make sense of the behaviour and experiences of a young person without taking into account what has happened in childhood.
This is not necessarily a deterministic point of view. Much can change during the adolescent period. Nonetheless the young person does not arrive at the age of 13 without a history. If we are able to understand that history we will be better able to understand the young person as an adolescent. In recent years there has been much discussion (for example, Ogden and Hagen 2018) of what are known as ACEs (adverse childhood experiences). It is precisely through the lens of continuity that such a notion has been investigated. How do early experiences, especially if they involve trauma or disruption, affect later development?
The rocky shores of the north-east Atlantic have been long studied. Our focus is from Gibraltar to Norway plus the Azores and Iceland. Phylogeographic processes shape biogeographic patterns of biodiversity. Long-term and broadscale studies have shown the responses of biota to past climate fluctuations and more recent anthropogenic climate change. Inter- and intra-specific species interactions along sharp local environmental gradients shape distributions and community structure and hence ecosystem functioning. Shifts in domination by fucoids in shelter to barnacles/mussels in exposure are mediated by grazing by patellid limpets. Further south fucoids become increasingly rare, with species disappearing or restricted to estuarine refuges, caused by greater desiccation and grazing pressure. Mesoscale processes influence bottom-up nutrient forcing and larval supply, hence affecting species abundance and distribution, and can be proximate factors setting range edges (e.g., the English Channel, the Iberian Peninsula). Impacts of invasive non-native species are reviewed. Knowledge gaps such as the work on rockpools and host–parasite dynamics are also outlined.
A national need is to prepare for and respond to accidental or intentional disasters categorized as chemical, biological, radiological, nuclear, or explosive (CBRNE). These incidents require specific subject-matter expertise, yet have commonalities. We identify 7 core elements comprising CBRNE science that require integration for effective preparedness planning and public health and medical response and recovery. These core elements are (1) basic and clinical sciences, (2) modeling and systems management, (3) planning, (4) response and incident management, (5) recovery and resilience, (6) lessons learned, and (7) continuous improvement. A key feature is the ability of relevant subject matter experts to integrate information into response operations. We propose the CBRNE medical operations science support expert as a professional who (1) understands that CBRNE incidents require an integrated systems approach, (2) understands the key functions and contributions of CBRNE science practitioners, (3) helps direct strategic and tactical CBRNE planning and responses through first-hand experience, and (4) provides advice to senior decision-makers managing response activities. Recognition of both CBRNE science as a distinct competency and the establishment of the CBRNE medical operations science support expert informs the public of the enormous progress made, broadcasts opportunities for new talent, and enhances the sophistication and analytic expertise of senior managers planning for and responding to CBRNE incidents.
The SALT Triage system has been advocated as an easy-to-use sorting and treatment system for mass casualty incidents (MCI). Minimally injured (GREEN) patients tend to be in the majority and may cause impediments to access and treatment of the most critically injured (RED). By identifying flaws in MCI communications that impair effective patient care, responders can be more effective.
To discover strategies that effectively manage the minimally injured and leverage their help, increasing triage efficiency and treatment of the immediate casualties.
Direct observation, after-action debriefing, and literature search.
The literature was vague regarding recommendations on a bystander and trained provider communication best practices. Feedback from standardized patients (actors) and participants during a structured debriefing following a 2018 American Society of Anesthesiology MCI exercise suggested that triaging providers under stress may communicate poorly, contributing to increased patient anxiety, disruptive behavior, and less effective team dynamics during a disaster. Strategies suggested include: eye contact; therapeutic touch (culturally appropriate); using slow, clear, reassuring speech; clearly explaining what is happening and why (sickest (RED and YELLOW) first priority, minimal (GREEN) next, expectant (BLACK) last); acknowledging their emotional state and their grief (not ignoring them); assigning nontechnical tasks to those capable of helping (putting pressure on a wound, moving casualties, or comforting the injured, dying, and the emotionally distraught).
Bystander engagement has been repeatedly identified as a means to increase the capacity of first responders to provide care to patients during an MCI. Utilization and management of the minimally injured and any uninjured bystanders and responders can become a force multiplier for the triage/treating responders. Developing a best practice dialogue to be used in training first responders could help improve many of these issues and augment current MCI training programs.