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Major depressive disorder (MDD) was previously associated with negative affective biases. Evidence from larger population-based studies, however, is lacking, including whether biases normalise with remission. We investigated associations between affective bias measures and depressive symptom severity across a large community-based sample, followed by examining differences between remitted individuals and controls.
Methods
Participants from Generation Scotland (N = 1109) completed the: (i) Bristol Emotion Recognition Task (BERT), (ii) Face Affective Go/No-go (FAGN), and (iii) Cambridge Gambling Task (CGT). Individuals were classified as MDD-current (n = 43), MDD-remitted (n = 282), or controls (n = 784). Analyses included using affective bias summary measures (primary analyses), followed by detailed emotion/condition analyses of BERT and FAGN (secondary analyses).
Results
For summary measures, the only significant finding was an association between greater symptoms and lower risk adjustment for CGT across the sample (individuals with greater symptoms were less likely to bet more, despite increasingly favourable conditions). This was no longer significant when controlling for non-affective cognition. No differences were found for remitted-MDD v. controls. Detailed analysis of BERT and FAGN indicated subtle negative biases across multiple measures of affective cognition with increasing symptom severity, that were independent of non-effective cognition [e.g. greater tendency to rate faces as angry (BERT), and lower accuracy for happy/neutral conditions (FAGN)]. Results for remitted-MDD were inconsistent.
Conclusions
This suggests the presence of subtle negative affective biases at the level of emotion/condition in association with depressive symptoms across the sample, over and above those accounted for by non-affective cognition, with no evidence for affective biases in remitted individuals.
This article is a clinical guide which discusses the “state-of-the-art” usage of the classic monoamine oxidase inhibitor (MAOI) antidepressants (phenelzine, tranylcypromine, and isocarboxazid) in modern psychiatric practice. The guide is for all clinicians, including those who may not be experienced MAOI prescribers. It discusses indications, drug-drug interactions, side-effect management, and the safety of various augmentation strategies. There is a clear and broad consensus (more than 70 international expert endorsers), based on 6 decades of experience, for the recommendations herein exposited. They are based on empirical evidence and expert opinion—this guide is presented as a new specialist-consensus standard. The guide provides practical clinical advice, and is the basis for the rational use of these drugs, particularly because it improves and updates knowledge, and corrects the various misconceptions that have hitherto been prominent in the literature, partly due to insufficient knowledge of pharmacology. The guide suggests that MAOIs should always be considered in cases of treatment-resistant depression (including those melancholic in nature), and prior to electroconvulsive therapy—while taking into account of patient preference. In selected cases, they may be considered earlier in the treatment algorithm than has previously been customary, and should not be regarded as drugs of last resort; they may prove decisively effective when many other treatments have failed. The guide clarifies key points on the concomitant use of incorrectly proscribed drugs such as methylphenidate and some tricyclic antidepressants. It also illustrates the straightforward “bridging” methods that may be used to transition simply and safely from other antidepressants to MAOIs.
The centenary of the Cambridge Law Journal represents an important milestone not only for the Journal itself but for the Faculty of Law at Cambridge. As the current Chair of the Faculty Board of Law, it is an honour and a great pleasure to have the opportunity to write the preface to this special issue, in which we celebrate a hundred years of outstanding legal scholarship by republishing – and offering contemporary reflections stimulated by – a series of seminal articles that have featured in the Journal.
For a number of years there has been nothing at all unusual about the United Kingdom finding itself in a state of constitutional upheaval; indeed, for some time, this has been the UK constitution’s default setting. This has sometimes been as a result of long-anticipated and carefully planned reforms, such as the enactment, in the late 1990s, of legislation to give domestic effect to the European Convention on Human Rights and to introduce devolved systems of government in Scotland, Wales and Northern Ireland. In contrast, more recent upheaval is attributable to often unexpected reactions to often unexpected events. For example, legislation making substantial changes to the devolution scheme in Scotland – providing, among other things, for the constitutional permanence of the Scottish Parliament and Government – was enacted to implement panicked promises made by UK politicians in the dying days of the Scottish independence referendum campaign, at which point a vote in favour of independence seemed a distinct possibility. And then, needless to say, there is Brexit – about which it is almost impossible to be guilty of hyperbole when describing its constitutional implications, so numerous and potentially far-reaching are they.
Hoerl & McCormack's theory defines temporal behavior from an awareness of time, but lacks one critical element: the impact of “psychological presence” in the “moment now.” Central to experience of temporal non-stationarity: “Nowness” links future with past in the context of time flow. Does this differ between species? Evidence suggests not: Different temporal experiences between species requires greater critical evaluation.
‘In law context is everything.’ So said Lord Steyn in the case of R (Daly) v. Secretary of State for the Home Department.1 In doing so, he was perhaps making a statement of the blindingly obvious, but that does not undermine either the veracity or the broad pertinence of the observation. Indeed, it is an insight onto which the comparative lawyer in particular, and perhaps the comparative constitutional lawyer even more especially, must fasten. One of the great virtues of comparative study is its capacity to illuminate one’s comprehension of a given legal phenomenon or system through an appreciation of how and why things are done differently elsewhere. Understanding why such differences arise can illuminate one’s ‘home’ jurisdiction in fresh ways, subtly, or even radically, changing one’s perspective, and opening up new avenues of inquiry. This can be particularly instructive when the jurisdictions under consideration are, in general, relatively similar – for in such circumstances, individual points of contrast are not readily dismissible as functions of macro-divergence. It is for this reason that comparative scholarship that examines different members of a jurisdictional family, such as the common law systems that form the focus of this book, can be so fruitful.
The new mineral species barlowite, ideally Cu4FBr(OH)6, has been found at the Great Australia mine, Cloncurry, Queensland, Australia. It is the Br and F analogue of claringbullite. Barlowite forms thin blue, platy, hexagonal crystals up to 0.5 mm wide in a cuprite-quartz-goethite matrix associated with gerhardtite and brochantite. Crystals are transparent to translucent with a vitreous lustre. The streak is sky blue. The Mohs hardness is 2–2.5. The tenacity is brittle, the fracture is irregular and there is one perfect cleavage on {001}. Density could not be measured; the mineral sinks in the heaviest liquid available, diluted Clerici solution (D &3.8 g/cm3). The density calculated from the empirical formula is 4.21 g/cm3. Crystals are readily soluble in cold dilute HCl. The mineral is optically non-pleochroic and uniaxial (–). The following optical constants measured in white light vary slightly suggesting a small variation in the proportions of F, Cl and Br: ω 1.840(4)–1.845(4) and ε 1.833(4)–1.840(4). The empirical formula, calculated on the basis of 18 oxygen atoms and H2O calculated to achieve 8 anions and charge balance, is Cu4.00F1.11Br0.95Cl0.09(OH)5.85. Barlowite is hexagonal, space group P63/mmc, a = 6.6786(2), c = 9.2744(3) Å , V = 358.251(19) Å3, Z = 2. The five strongest lines in the powder X-ray diffraction pattern are [d(Å )(I)(hkl)]: 5.790(100)(010); 2.889(40)(020); 2.707(55)(112); 2.452(40)(022); 1.668(30)(220).
MISAPPREHENSIONS about the UK's constitution are ten-a-penny. Most prominent among them, perhaps, are the notions that the UK “has no constitution” and that fundamental rights cannot meaningfully exist without an “entrenched” or “written constitution”. To that list of misunderstandings can now be added the ideas – brought to light by the Supreme Court's judgment in R. (UNISON) v Lord Chancellor [2017] UKSC 51, [2017] 3 W.L.R. 409 – that the judicial system, far from being a non-negotiable feature of any constitutional democracy, is nothing more than a public service, and that access to it can be regulated by the executive accordingly. To describe UNISON as a welcome corrective to such misconceptions would be to engage in rash understatement. In a tour de force that ought to be compulsory reading for every Minister and parliamentarian, the Court elucidates the true value of independent courts and tribunals, illuminates the common law's potential as a guarantor of basic rights, and reiterates an axiomatic set of constitutional home truths.
Background: Neurosurgical residents face a unique combination of challenges, including long duty hours, technically challenging cases, and uncertain employment prospects. We sought to assess the demographics, interests, career goals, self-rated happiness, and overall well-being of Canadian neurosurgery residents. Methods: A cross-sectional survey was developed and sent through the Canadian Neurosurgery Research Collaborative to every resident enrolled in a Canadian neurosurgery program as of April 1, 2016. Results: We analyzed 76 completed surveys of 146 eligible residents (52% response rate). The median age was 29 years, with 76% of respondents being males. The most popular subspecialties of interest for fellowship were spine, oncology, and open vascular neurosurgery. The most frequent self-reported number of worked hours per week was the 80- to 89-hour range. The majority of respondents reported a high level of happiness as well as stress. Sense of accomplishment and fatigue were reported as average to high and overall quality of life was low for 19%, average for 49%, and high for 32%. Satisfaction with work-life balance was average for 44% of respondents and was the only tested domain in which significant dissatisfaction was identified (18%). Overall, respondents were highly satisfied with their choice of specialty, choice of program, surgical exposure, and work environment; however, intimidation was reported in 36% of respondents and depression by 17%. Conclusions: Despite a challenging residency and high workload, the majority of Canadian neurosurgery residents are happy and satisfied with their choice of specialty and program. However, work-life balance, employability, resident intimidation, and depression were identified as areas of active concern.
In R. (Miller) v Secretary of State for Exiting the European Union, the Supreme Court of the UK (1) held that the UK Government had no prerogative power to initiate the formal process whereby the UK will withdraw from the EU and (2) declined to recognise any requirement that the devolved legislatures’ consent be obtained in respect of legislation authorising the Government to commence the withdrawal process. This article critically examines Miller, arguing that the majority's analysis veers between unwarranted muscularity in relation to the prerogative issue and unnecessary conservatism as regards the devolution issue. The article goes on to argue that while the majority judgment's restrictive approach to the prerogative may be viewed as a progressive victory for constitutional principle, such an evaluation can be sustained only if a set of relatively traditional constitutional premises are adopted to begin with. The article also contends that the general approach adopted by the majority is problematic, given its willingness to invoke arguments of constitutional principle without adequately engaging with questions about what the pertinent principles are, and argues that such an intellectually lackadaisical mode of constitutional adjudication is to be deprecated.
Background Currently, the literature lacks reliable data regarding operative case volumes at Canadian neurosurgery residency programs. Our objective was to provide a snapshot of the operative landscape in Canadian neurosurgical training using the trainee-led Canadian Neurosurgery Research Collaborative. Methods: Anonymized administrative operative data were gathered from each neurosurgery residency program from January 1, 2014, to December 31, 2014. Procedures were broadly classified into cranial, spine, peripheral nerve, and miscellaneous procedures. A number of prespecified subspecialty procedures were recorded. We defined the resident case index as the ratio of the total number of operations to the total number of neurosurgery residents in that program. Resident number included both Canadian medical and international medical graduates, and included residents on the neurosurgery service, off-service, or on leave for research or other personal reasons. Results: Overall, there was an average of 1845 operative cases per neurosurgery residency program. The mean numbers of cranial, spine, peripheral nerve, and miscellaneous procedures were 725, 466, 48, and 193, respectively. The nationwide mean resident case indices for cranial, spine, peripheral nerve, and total procedures were 90, 58, 5, and 196, respectively. There was some variation in the resident case indices for specific subspecialty procedures, with some training programs not performing carotid endarterectomy or endoscopic transsphenoidal procedures. Conclusions: This study presents the breadth of neurosurgical training within Canadian neurosurgery residency programs. These results may help inform the implementation of neurosurgery training as the Royal College of Physicians and Surgeons residency training transitions to a competence-by-design curriculum.