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Dialectical behavior therapy (DBT) is a specialized treatment that has a growing evidence base for binge-spectrum eating disorders. However, cost and workforce capacity limit wide-scale uptake of DBT since it involves over 20 in-person sessions with a trained professional (and six sessions for guided self-help format). Interventions translated for delivery through modern technology offer a solution to increase the accessibility of evidence-based treatments. We developed the first DBT-specific skills training smartphone application (Resilience: eDBT) for binge-spectrum eating disorders and evaluated its efficacy in a randomized clinical trial.
Method
Participants reporting recurrent binge eating were randomized to Resilience (n = 287) or a waitlist (n = 289). Primary outcomes were objective binge eating episodes and global levels of eating disorder psychopathology. Secondary outcomes were behavioral and cognitive symptoms, psychological distress, and the hypothesized processes of change (mindfulness, emotion regulation, and distress tolerance).
Results
Intention-to-treat analyses showed that the intervention group reported greater reductions in objective binge eating episodes (incidence rate ratio = 0.69) and eating disorder psychopathology (d = −0.68) than the waitlist at 6 weeks. Significant group differences favoring the intervention group were also observed on secondary outcomes, except for subjective binge eating, psychological distress, and distress tolerance. Primary symptoms showed further improvements from 6 to 12 weeks. However, dropout rate was high (48%) among the intervention group, and engagement decreased over the study period.
Conclusion
A novel, low-intensity DBT skills training app can effectively reduce symptoms of eating disorders. Scalable apps like these may increase the accessibility of evidence-based treatments.
According to International Union for the Conservation of Nature (IUCN) guidelines, all species must be assessed against all criteria during the Red Listing process. For organismal groups that are diverse and understudied, assessors face considerable challenges in assembling evidence due to difficulty in applying definitions of key terms used in the guidelines. Challenges also arise because of uncertainty in population sizes (Criteria A, C, D) and distributions (Criteria A2/3/4c, B). Lichens, which are often small, difficult to identify, or overlooked during biodiversity inventories, are one such group for which specific difficulties arise in applying Red List criteria. Here, we offer approaches and examples that address challenges in completing Red List assessments for lichens in a rapidly changing arena of data availability and analysis strategies. While assessors still contend with far from perfect information about individual species, we propose practical solutions for completing robust assessments given the currently available knowledge of individual lichen life-histories.
From early on, infants show a preference for infant-directed speech (IDS) over adult-directed speech (ADS), and exposure to IDS has been correlated with language outcome measures such as vocabulary. The present multi-laboratory study explores this issue by investigating whether there is a link between early preference for IDS and later vocabulary size. Infants’ preference for IDS was tested as part of the ManyBabies 1 project, and follow-up CDI data were collected from a subsample of this dataset at 18 and 24 months. A total of 341 (18 months) and 327 (24 months) infants were tested across 21 laboratories. In neither preregistered analyses with North American and UK English, nor exploratory analyses with a larger sample did we find evidence for a relation between IDS preference and later vocabulary. We discuss implications of this finding in light of recent work suggesting that IDS preference measured in the laboratory has low test-retest reliability.
This chapter examines the boundary-breaking spatial and social dynamism of animalian entities embodied within LB I–LB II polychrome murals of Crete and Thera. In these innovative paintings, animalian entities engaged with both painted and lived contexts, taking on novel manners of involvement in Aegean sociocultural spaces; some established new aspects of creaturely identity and relation. We begin with three animalian entities considered – boar’s tusk helmets, ox-hide shields and ikria – examining how their presence in murals further challenged long-standing parameters of two-dimensional representation. Here discussion broadens to consider how renderings of various animals in Minoan frescoes charged and unsettled the fabric of powerful built spaces. Innovations in color, scale and the creation of spatial depth approached the ways animalian bodies were experienced in the round. Simultaneously, details of the frescoes kept the painted creatures, and the spaces they occupied, tautly embroiled in the structured order of the wall. We close by considering how polychrome frescoes could foster radical newness in animals’ identities, focusing on renderings of blue simians. This blueness, regardless of whether originally intended to approximate biological hues, engendered distinct status for simians in the Aegean, with fascinating connections to renderings of young peoples.
This chapter examines how movable renderings of animals contributed to sociopolitical experience in Minoan Crete, with close attention to zoomorphic vessels. Beginning in the Prepalatial period, we examine a group of clay body-form vessels that could stand independently. While typically labelled “anthropomorphic,” the vessels’ identities are more complex: their forms do not neatly suggest a particular species, and their affordances as objects are integral to what they are and how they are experienced. Through analysis of their unique corporeal characters and depositional circumstances, I argue that these figures could have been experienced as distinct productive agents, who participated in cultivating community space between Prepalatial tombs and settlements. Next, looking forward, we consider how animalian vessels continued to contribute to Cretan social venues, while subtle changes to how they embodied animals could imply profound shifts in their presence and performance. From the late Protopalatial, we see rhyta rendered as bodiless animal heads, most bovine. Unlike the Prepalatial vessels, these appeared dramatically dependent on living people to become productive, placing emphasis on human action. I contextualize these rhyta with a problematization of palatial-era politico-environmental developments and changes in social performance and “cattle culture.”
Through close analyses of a wide range of Minoan animalian things, we have explored the specificity of their involvements in the experiences of people, and how those engagements contributed to the unique character of sociocultural life in the Aegean, on various levels. Here we draw out key points from across the foregoing analyses. Special attention has come to the objects’ inter-corporeal relationships with living humans and the connections that would have been realized through the objects’ particular qualities—connections with other animals, things, and spaces. Such relations were afforded through different dynamics, including bodily juxtaposition, cultivation of formal assonance, the sharing of specific features (e.g., a forward gaze), and embodiment with the same substances, as well as through similarities in size, composition (e.g., in friezes), and contextualization. Moreover, by working beyond an implicit focus on the design of the objects, to instead emphasize people’s actual experiences with them, we have opened the space for appreciating how both intended and unintended associations involving these complex things were in play together. We should view these not as alternative lenses on the objects, but as forces working concurrently, and upon one another, in the creative realizations that the animalian objects were.
Chapter 4 fundamentally rethinks the identity of “composite” or “hybrid” creatures as they were embodied and experienced in Crete and the southern Cyclades from the late third to mid-second millennium BCE. I argue that, when pondered closely and in their contexts, many of the creatures to which we apply this label in fact would have been experienced not as counterintuitive compounds of body parts stemming from other species, but, instead, as whole beings that were perceived as being similar to a range of other creatures. These lines of similitude could concern matters of form as well as other aspects of the creatures’ natures (e.g., color, efficacies). With this, the traditional category of the “composite” being is set aside as a larger swath of interconnected creatures comes into view. These remarkable creatures share amongst them the quality of having apparent connections both beyond the Aegean, with thingly embodiments of beasts from overseas, and more locally, with other Aegean fabricated and biological animals. An iconic creature of the Aegean Bronze Age, the griffin, provides a jumping off point for different parts of this discussion, as we reconsider the creativity realized in such beasts.
The sociocultural spaces of the “Minoan” Aegean were teeming with animal bodies. Many of these animals were alive, but many were not—and never had been; the latter are our focus here. Realized across a range of media, such as zoomorphic vessels, frescoes, and seal stones, animals’ bodies took on a rich diversity of material and spatial qualities that could afford distinctive interactive experiences that the notion of “representations” fails to capture. By recognizing both biological and fabricated entities as real embodiments of animals, which could coexist and interact in Aegean spaces, the nature of our discussion changes. We see that the dynamics of representation were caught up in a much wider field of relationships involving these crafted bodies, which characterized their engagements with people. Doing so moves us beyond questions of signification and intentional design, and toward a fuller recognition of people’s actual experiences of animalian bodies. Looking closely at a variety of venues, ranging from palatial courts to a modest house bench, our focus thus can turn to how the world of animalian things was a crucial part of social life in Aegean spaces, and how direct interactions with these other animal bodies were central, yet often overlooked and minimized, components of human relations with nonhuman beasts.
entities stand as crystallizations of a distinctly Aegean manner of animalian compositeness that is highly intuitive in its integration. These entities – the boar’s tusk helmet, ox-hide shield and ikrion (ship cabin) – embody this dynamic in an arrant fashion, since, while each is prominently animalian and bodily, they do not themselves take the shapes of animal physiques. Instead, they brought novel, conventional object-forms to animalian presences in the Aegean. By not standing as animals themselves, they starkly draw out the potent relational dynamics that could be realized between creatures, and between creatures and things. Discussion ultimately concerns the added complexity introduced to the statuses of these entities when rendered in movable representational media like glyptic and painted ceramics; particular attention comes to their frequent rendering in series. While seriation is often read as simplifying something’s status to the merely ornamental, I argue, instead, that articulation of shields, helmets and ikria in series imbued them with a peculiar, complex dynamism.
Chapter 3 explores the relationship of material and immaterial embodiments of animals in the Bronze Age Aegean, through the lion. Since populations of living lions were not present on Crete, representational embodiments were the basis of people’s physical encounters with the species; hence the peculiarities of these “object-bodies” powerfully contributed to the characterization of the beast. The vast majority of Cretan lion representations occurred in glyptic. Seals (as worn objects) and impressions (as material signifiers of identity) consistently placed the leonine in direct relation to the human, through bodily and sociocultural juxtapositions. Cretans also would have encountered lions in immaterial manifestations, through oral culture. Early Aegean poetic traditions formulated a paralleling of human and lion through similes that was remarkably similar to the paralleling juxtaposition generated between a lion-seal and person. In MBA III–LBA II, after centuries of development in Crete, the lion’s association with glyptic extended to the early Mycenaean mainland. This moment saw intense intra-Aegean exchange, with material, practical and linguistic dimensions. The epic tradition was taking form, including lion similes. Through its various embodiments, the lion was caught up in this interaction, as its Aegean juxtaposition with humans fluidly continued and developed.
Background: Degenerative Cervical Myelopathy (DCM) is the functional derangement of the spinal cord because of compression from degenerate tissues. Typical neurological symptoms of DCM include gait imbalance and upper extremity paresthesia. While it is thought that greater spinal cord compression leads to increased neurological deterioration, our clinical experience suggests a more complex mechanism involving spinal canal diameter (SCD). Methods: 124 MRI scans from 59 non-operative DCM patients underwent manual scoring of cord compression and SCD measurements. Unsupervised machine learning dimensionality reduction techniques and k-means clustering were used to establish patient groups. These patient groups underwent manual inspection of common compression patterns and SCD similarities to define their unique risk criteria. Results: We found that compression pattern is unimportant at SCD extremes (≤14.5 mm or >15.75 mm). Otherwise, stenosis with clear signs of cord compression at two disc levels and stenosis without clear signs of cord compression at two disc levels result in a relatively higher and lower likelihood of deterioration, respectively. We elucidated five patient groups with unique associated risks for neurological deterioration, according to both SCD range and their cord compression pattern. Conclusions: The specific combination of narrow SCD with focal cord compression increases the likelihood of neurological deterioration in non-operative patients with DCM.
Migration is a well-established risk factor for psychotic disorders, and migrant language has been proposed as a novel factor that may improve our understanding of this relationship. Our objective was to explore the association between indicators of linguistic distance and the risk of psychotic disorders among first-generation migrant groups.
Methods
Using linked health administrative data, we constructed a retrospective cohort of first-generation migrants to Ontario over a 20-year period (1992–2011). Linguistic distance of the first language was categorized using several approaches, including language family classifications, estimated acquisition time, syntax-based distance scores, and lexical-based distance scores. Incident cases of non-affective psychotic disorder were identified over a 5- to 25-year period. We used Poisson regression to estimate incidence rate ratios (IRR) for each language variable, after adjustment for knowledge of English at arrival and other factors.
Results
Our cohort included 1 863 803 first-generation migrants. Migrants whose first language was in a different language family than English had higher rates of psychotic disorders (IRR = 1.08, 95% CI 1.01–1.16), relative to those whose first language was English. Similarly, migrants in the highest quintile of linguistic distance based on lexical similarity had an elevated risk of psychotic disorder (IRR = 1.15, 95% CI 1.06–1.24). Adjustment for knowledge of English at arrival had minimal effect on observed estimates.
Conclusion
We found some evidence that linguistic factors that impair comprehension may play a role in the excess risk of psychosis among migrant groups; however, the magnitude of effect is small and unlikely to fully explain the elevated rates of psychotic disorder across migrant groups.
Since the earliest era of archaeological discovery on Crete, vivid renderings of animals have been celebrated as defining elements of Minoan culture. Animals were crafted in a rich range of substances and media in the broad Minoan world, from tiny seal-stones to life-size frescoes. In this study, Emily Anderson fundamentally rethinks the status of these zoomorphic objects. Setting aside their traditional classification as 'representations' or signs, she recognizes them as distinctively real embodiments of animals in the world. These fabricated animals-engaged with in quiet tombs, bustling harbors, and monumental palatial halls-contributed in unique ways to Bronze Age Aegean sociocultural life and affected the status of animals within people's lived experience. Some gave new substance and contour to familiar biological species, while many exotic and fantastical beasts gained physical reality only in these fabricated embodiments. As real presences, the creatures that the Minoans crafted artfully toyed with expectation and realized new dimensions within and between animalian identities.