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Automated virtual reality therapies are being developed to increase access to psychological interventions. We assessed the experience with one such therapy of patients diagnosed with psychosis, including satisfaction, side effects, and positive experiences of access to the technology. We tested whether side effects affected therapy.
In a clinical trial 122 patients diagnosed with psychosis completed baseline measures of psychiatric symptoms, received gameChange VR therapy, and then completed a satisfaction questionnaire, the Oxford-VR Side Effects Checklist, and outcome measures.
79 (65.8%) patients were very satisfied with VR therapy, 37 (30.8%) were mostly satisfied, 3 (2.5%) were indifferent/mildly dissatisfied, and 1 (0.8%) person was quite dissatisfied. The most common side effects were: difficulties concentrating because of thinking about what might be happening in the room (n = 17, 14.2%); lasting headache (n = 10, 8.3%); and the headset causing feelings of panic (n = 9, 7.4%). Side effects formed three factors: difficulties concentrating when wearing a headset, feelings of panic using VR, and worries following VR. The occurrence of side effects was not associated with number of VR sessions, therapy outcomes, or psychiatric symptoms. Difficulties concentrating in VR were associated with slightly lower satisfaction. VR therapy provision and engagement made patients feel: proud (n = 99, 81.8%); valued (n = 97, 80.2%); and optimistic (n = 96, 79.3%).
Patients with psychosis were generally very positive towards the VR therapy, valued having the opportunity to try the technology, and experienced few adverse effects. Side effects did not significantly impact VR therapy. Patient experience of VR is likely to facilitate widespread adoption.
In this article, I show that Richard Rorty’s unduly neglected normative political theory advances a far more distinct and demanding form of liberalism than is usually attributed to him. Attention to how Rorty understands solidarity—and its corresponding conception of public obligations—encourages analysis of his nonjuridical vision of liberal community. Through examination of his oft-ignored, revealing interpretation of Vladimir Nabokov and instructive comparison with the thought of Judith Shklar, I argue that, for Rorty, the sustainability of a liberal community requires an ethos of curiosity, whereby citizens feel moved to uncover and understand the personal experiences of cruelty and humiliation endured by others. We can make sense of this ethos and its demands of us through rethinking the idea of political conversation. This understanding of Rorty’s intellectual project not only enriches our appreciation of his complex political theory but also contests the meaning and implications of liberalism itself.
Many patients with mental health disorders become increasingly isolated at home due to anxiety about going outside. A cognitive perspective on this difficulty is that threat cognitions lead to the safety-seeking behavioural response of agoraphobic avoidance.
We sought to develop a brief questionnaire, suitable for research and clinical practice, to assess a wide range of cognitions likely to lead to agoraphobic avoidance. We also included two additional subscales assessing two types of safety-seeking defensive responses: anxious avoidance and within-situation safety behaviours.
198 patients with psychosis and agoraphobic avoidance and 1947 non-clinical individuals completed the item pool and measures of agoraphobic avoidance, generalised anxiety, social anxiety, depression and paranoia. Factor analyses were used to derive the Oxford Cognitions and Defences Questionnaire (O-CDQ).
The O-CDQ consists of three subscales: threat cognitions (14 items), anxious avoidance (11 items), and within-situation safety behaviours (8 items). Separate confirmatory factor analyses demonstrated a good model fit for all subscales. The cognitions subscale was significantly associated with agoraphobic avoidance (r = .672, p < .001), social anxiety (r = .617, p < .001), generalized anxiety (r = .746, p < .001), depression (r = .619, p < .001) and paranoia (r = .655, p < .001). Additionally, both the O-CDQ avoidance (r = .867, p < .001) and within-situation safety behaviours (r = .757, p < .001) subscales were highly correlated with agoraphobic avoidance. The O-CDQ demonstrated excellent internal consistency (cognitions Cronbach’s alpha = .93, avoidance Cronbach’s alpha = .94, within-situation Cronbach’s alpha = .93) and test–re-test reliability (cognitions ICC = 0.88, avoidance ICC = 0.92, within-situation ICC = 0.89).
The O-CDQ, consisting of three separate scales, has excellent psychometric properties and may prove a helpful tool for understanding agoraphobic avoidance across mental health disorders.
Orange wheat blossom midge, Sitodiplosis mosellana (Géhin) (Diptera: Cecidomyiidae), has been successfully reared in the laboratory for more than 20 years in Winnipeg, Manitoba, Canada. The rearing method has been developed to the point where it efficiently produces large numbers of wheat midge continuously under laboratory conditions for use in experiments on wheat midge biology and for screening wheat lines for crop resistance. Adult survival was extended by providing high humidity, and oviposition was increased by simulating natural dawn and dusk conditions and by supplying preflowering spring wheat to adults. Preventing desiccation of the wheat midge larvae in the wheat spikes before overwintering in soil and providing optimal cold conditions for a long enough period to break larval diapause enabled successful adult emergence. We provide data to facilitate the coordination of timing of wheat midge emergence from diapause with the wheat susceptible period. The method can be readily scaled up for screening many lines for resistance or scaled down for small experiments. Here, we report details of the rearing method so that others can implement it for research on the management of this internationally important pest.
Agoraphobic avoidance of everyday situations is a common feature in many mental health disorders. Avoidance can be due to a variety of fears, including concerns about negative social evaluation, panicking, and harm from others. The result is inactivity and isolation. Behavioural avoidance tasks (BATs) provide an objective assessment of avoidance and in situ anxiety but are challenging to administer and lack standardisation. Our aim was to draw on the principles of BATs to develop a self-report measure of agoraphobia symptoms.
The scale was developed with 194 patients with agoraphobia in the context of psychosis, 427 individuals in the general population with high levels of agoraphobia, and 1094 individuals with low levels of agoraphobia. Factor analysis, item response theory, and receiver operating characteristic analyses were used. Validity was assessed against a BAT, actigraphy data, and an existing agoraphobia measure. Test–retest reliability was assessed with 264 participants.
An eight-item questionnaire with avoidance and distress response scales was developed. The avoidance and distress scales each had an excellent model fit and reliably assessed agoraphobic symptoms across the severity spectrum. All items were highly discriminative (avoidance: a = 1.24–5.43; distress: a = 1.60–5.48), indicating that small increases in agoraphobic symptoms led to a high probability of item endorsement. The scale demonstrated good internal reliability, test–retest reliability, and validity.
The Oxford Agoraphobic Avoidance Scale has excellent psychometric properties. Clinical cut-offs and score ranges are provided. This precise assessment tool may help focus attention on the clinically important problem of agoraphobic avoidance.
Seven species of Turdidae (Aves: Passeriformes) in Manitoba, Canada were examined for chewing lice (Phthiraptera) in 1993–2019: Turdus migratorius (N = 570), Catharus ustulatus (N = 135), Catharus guttatus (N = 49), Catharus minimus (N = 12), Catharus fuscescens (N = 1), Sialia sialis (N = 4), and Sialia currucoides (N = 3). Five species of lice on T. migratorius had a prevalence of 24.0% and a mean intensity of 16.7. Overall prevalence for lice on C. ustulatus, C. guttatus, and C. minimus was 25.0%–59.2%; mean intensity was 7.0–23.3. On S. sialis, the prevalence was 50.0%; mean intensity was 10.0. No lice infested C. fuscescens or S. currucoides. Infestation parameters for each louse–host combination are provided. Louse infestations were highly aggregated. Female lice were more prevalent than males, especially for Ricinus elongatus (Phthiraptera: Amblycera: Ricinidae) infesting T. migratorius (eight males; 81 females), or there was no significant deviation from 50:50. Infestation parameters were higher for adult T. migratorius than for juveniles or feathered chicks but not significantly so. Mean intensity was greater in spring than in fall. Louse abundance was lower than on hosts of similar size in Manitoba and lower than on thrushes in other studies.
The majority of psychological treatment research is dedicated to investigating the effectiveness of cognitive behavioural therapy (CBT) across different conditions, population and contexts. We aimed to summarise the current systematic review evidence and evaluate the consistency of CBT's effect across different conditions. We included reviews of CBT randomised controlled trials in any: population, condition, format, context, with any type of comparator and published in English. We searched DARE, Cochrane, MEDLINE, EMBASE, PsycINFO, CINAHL, CDAS, and OpenGrey between 1992 and January 2019. Reviews were quality assessed, their data extracted and summarised. The effects upon health-related quality of life (HRQoL) were pooled, within-condition groups. If the across-condition heterogeneity was I2 < 75%, we pooled effects using a random-effect panoramic meta-analysis. We summarised 494 reviews (221 128 participants), representing 14/20 physical and 13/20 mental conditions (World Health Organisation's International Classification of Diseases). Most reviews were lower-quality (351/494), investigated face-to-face CBT (397/494), and in adults (378/494). Few reviews included trials conducted in Asia, South America or Africa (45/494). CBT produced a modest benefit across-conditions on HRQoL (standardised mean difference 0.23; 95% confidence intervals 0.14–0.33, I2 = 32%). The effect's associated prediction interval −0.05 to 0.50 suggested CBT will remain effective in conditions for which we do not currently have available evidence. While there remain some gaps in the completeness of the evidence base, we need to recognise the consistent evidence for the general benefit which CBT offers.
The climate crisis requires nations to achieve human well-being with low national levels of carbon emissions. Countries vary from one another dramatically in how effectively they convert resources into well-being, and some nations with low levels of emissions have relatively high objective and subjective well-being. We identify urgent research and policy agendas for four groups of countries with either low or high emissions and well-being indicators. Least studied are those with low well-being and high emissions. Understanding social and political barriers to switching from high-carbon to lower-carbon modes of production and consumption, and ways to overcome them, will be fundamental.
‘Discourses of climate delay’ pervade current debates on climate action. These discourses accept the existence of climate change, but justify inaction or inadequate efforts. In contemporary discussions on what actions should be taken, by whom and how fast, proponents of climate delay would argue for minimal action or action taken by others. They focus attention on the negative social effects of climate policies and raise doubt that mitigation is possible. Here, we outline the common features of climate delay discourses and provide a guide to identifying them.
The annual abundance of chewing lice (Phthiraptera) was recorded on great horned owls (Bubo virginianus (Gmelin), Aves: Strigidae) from 1994 to 2015 in Manitoba, Canada. Kurodaia magna Emerson (Amblycera: Menoponidae) had a mean annual abundance about half that for Strigiphilus oculatus (Rudow) (Ischnocera: Philopteridae). Mean intensity, rather than prevalence, explained the variation in annual abundance. Temporal variation (measured as population variability) in abundance and mean intensity were high and similar (0.62–0.67), but lower for nymph to female ratio (0.36–0.38). Temporal variation of prevalence and sex ratio were higher for K. magna (0.34–0.35) than for S. oculatus (0.21–0.22), and typical for other louse species. The high temporal variability for abundance and mean intensity suggest lower year-to-year stability than exhibited by other chewing lice, but over 80% of this variability was due to sampling error resulting from small sample sizes in some years and extreme intensities in the aggregated distributions of intensity. The remaining variation, < 20%, revealed no significant differences in annual abundance or mean intensity among years, and therefore stable populations over 22 years. Populations of 12 species of chewing lice show lower temporal variability and therefore greater stability than three other insect taxa.
Specimens (n = 508) of eight species of owl (Aves: Strigiformes) collected from 1994 to 2017 in Manitoba, Canada, were weighed and examined for chewing lice (Phthiraptera: Amblycera, Ischnocera). The relationship between host body mass and infestation by 12 species of lice was examined. Host body mass explained 52% (P = 0.03) of the variation in mean intensity of louse infestation among hosts, due primarily to a high abundance of lice on the heaviest owl species. The relationship was due to the mean intensity of lice, and neither species richness nor the prevalence of lice was related to host body mass. For individual louse species, the relationship was due primarily to Kurodaia acadicae Price and Beer, Kurodaia magna Emerson, and an undetermined species of Kurodaia Uchida (Phthiraptera: Menoponidae) (R2 = 0.997), but not the nine Strigiphilus Mjöberg (Phthiraptera: Philopteridae) species (R2 = 0.27). Louse intensity did not increase with body size for individual birds of any of the owl species. Mean intensity is expected to increase in proportion with the size, specifically the surface area, of the host. Why that relationship holds only for one louse genus, and not for the most abundant genus of lice on owls, and weakly compared with other families of birds, has yet to be determined.
Eleven of the 12 species of owls (Aves: Strigidae, Tytonidae) known to occur in Manitoba, Canada, were examined for chewing lice (Phthiraptera: Amblycera, Ischnocera) from 1976 to 2015: barn owl (Tyto alba (Scopoli); Aves: Tytonidae) (n = 2), snowy owl (Bubo scandiacus (Linnaeus); Aves: Strigidae) (n = 77), great horned owl (Bubo virginianus (Gmelin); Aves: Strigidae) (n = 262), great grey owl (Strix nebulosa Förster; Aves: Strigidae) (n = 142), barred owl (Strix varia Barton; Aves: Strigidae) (n = 10), northern hawk owl (Surnia ulula (Linnaeus); Aves: Strigidae) (n = 18), short-eared owl (Asio flammeus (Pontoppidan); Aves: Strigidae) (n = 74), long-eared owl (Asio otus (Linnaeus); Aves: Strigidae) (n = 67), eastern screech owl (Megascops aslo (Linnaeus); Aves: Strigidae) (n = 59), boreal owl (Aegolius funereus (Linnaeus); Aves: Strigidae) (n = 47), and northern saw-whet owl (Aegolius acadicus (Gmelin); Aves: Strigidae) (n = 44), a total of 802 owls. No lice were found infesting barn owl (Tyto alba (Scopoli); Aves: Tytonidae) or eastern screech owl (Megascops asio (Linnaeus); Aves: Strigidae). We collected a total of 113 810 lice of 12 species: Kurodaia Uchida (Phthiraptera: Menoponidae) – three species; and Strigiphilus Mjöberg (Phthiraptera: Philopteridae) – nine species. Overall prevalence of infestation ranged from 10.0% to 88.9%. Mean intensity for total lice ranged from 22.4 to 506.5. Infestation parameters for each louse–host combination are provided; prevalence and mean intensity were not related for louse–host species combinations. Distribution of louse infestations was highly aggregated. In all louse–host combinations but one, either females were more prevalent than males or there was no significant deviation from 50:50. Male Strigiphilus ceblebrachys Denny significantly outnumbered females in snowy owls. There was a tendency for louse species to co-occur on the same host specimen. Where sample sizes for owls were large enough, no seasonal patterns in abundance of lice were detected.
Workforce shortages in psychiatry are common worldwide. The international literature provides insights into factors influencing decisions to train in psychiatry but is predominately survey based. This national cohort study aimed to identify the characteristics of doctors who were most likely to apply to psychiatry training programmes. The sample comprised doctors who entered UK medical schools in 2007/8 and who made first-time specialty training applications in 2015. The association between application to psychiatry and doctors' sociodemographic and educational characteristics was examined using multivariable logistic regression.
Those most likely to apply were White, privately educated older doctors with below average performance at medical school.
To reduce workforce shortages, psychiatry must make itself more attractive to all doctors, especially those from underrepresented groups such as state-educated Black and minority ethnic individuals. Otherwise, national policies to widen participation in the study of medicine by such groups may exacerbate the current recruitment crisis.
This article is an intervention in recent debates about conceptual and normative theorisations of human rights, which have been increasingly characterised by a divide between ‘moral’ and ‘practice-based’/’political’ understandings. My aim is to articulate an alternative, pragmatist understanding of human rights, one that is importantly distinct from the practice-based account with which it might be thought affiliated. In the first part of the article, I reveal the fundamental flaw in the practice-based account of human rights: I argue that it is undermined by the ontological thesis at its heart, which naturalises and reifies political arrangements and institutions that are radically contingent. In the second part, I identify, and outline the attractiveness of, a pragmatist normative account of human rights. In contrast to the practice-based approach, this pragmatist account construes human rights in ideational terms. The pragmatist understanding accepts both the contingency of our practices and the cultural limits to moral justification, while nevertheless retaining a commitment to the enterprise of normative philosophical conversation. I argue, in contrast to prevailing interpretations, that the international theory advanced by John Rawls exemplifies a pragmatist account of human rights and points a way forward for theoretically fruitful but appropriately circumscribed analysis of the concept.
The annual abundance of chewing lice (Phthiraptera) was recorded from 1996 to 2015 in Manitoba, Canada, on two species of woodpeckers (Piciformes: Picidae). Yellow-bellied sapsuckers (Sphyrapicus varius (Linnaeus)) were infested with Menacanthus pici (Denny) (Amblycera: Menoponidae) and Penenirmus auritus (Scopoli) (Ischnocera: Philopteridae); northern flickers (Colaptes auratus (Linnaeus)) were also infested with M. pici, as well as two other Ischnocera, Penenirmus jungens (Kellogg) and Picicola porisma Dalgleish. The mean annual abundance varied from nine to 51 lice per bird for the four species, with prevalence, mean intensity, sex ratio, and nymphs per female also varying among louse species. Menacanthus pici populations on both hosts were unstable: abundance rose over two decades because of increasing prevalence, whereas the abundance of the other three louse species fluctuated around a mean. Population variability was similar for the lice on both hosts, with the metric, PV, ranging from 0.41 to 0.51 on a 0–1 scale, once the effect of the trend in abundance for M. pici had been removed. Although the population dynamics for species of lice on these two woodpeckers were distinct, inter-specific differences in population stability were less pronounced than observed in the few other species of bird lice studied in this way.
Long-term trap catches of seedcorn maggot, Delia platura (Meigen), onion maggot, Delia antiqua (Meigen), and cabbage maggot, Delia radicum (Linnaeus) (Diptera: Anthomyiidae), were used to test the hypothesis that related species have more similar population variability than unrelated ones. Annual abundance was estimated from trap catches for 32 years (two species) or 17 years (one species). Population variability was quantified as PV, a proportion between 0 and 1. The three Delia Robineau-Desvoidy species had PV values of 0.51–0.55 that did not differ significantly. These PV values were found to differ significantly from two unrelated species studied over the same time period in the same habitat, which had PV values of 0.39 and 0.67. The hypothesis that related species have more similar population variabilities than unrelated species in the same habitat was supported. These data strengthen the view that PV is a species-specific trait reflecting the adaptation of life histories to their habitat, with related species showing more similar adaptations than unrelated species. The polyphagous and saprophagous seedcorn maggot had PV similar to the two oligophagous herbivores, casting doubt on the hypothesis that more generalist feeders have less variable populations than more specialised feeders.
Long-term, twice weekly, trap catches of the native carrot weevil, Listronotus oregonensis (LeConte) (Coleoptera: Curculionidae), and the introduced carrot rust fly, Psila rosae (Fabricius) (Diptera: Psilidae), were used to test the hypothesis that native populations fluctuate less from year-to-year than those of introduced species, because the native species has had more time to adapt to temporal variability in its habitat than an introduced species. Variability in annual abundance was estimated for 33 years, and for 11-year or 16–17-year subsets of the 33-year time series. Temporal population variability was quantified as PV, a proportion between 0 and 1. The native carrot weevil had a PV of 0.39, less than that of the introduced carrot rust fly with a PV of 0.67, supporting the hypothesis. Generation 1 for both species showed a decline in PV over three decades consistent with the hypothesis that adaptation to variability in the habitat leads to lower PV. Over 33 years, the carrot weevil developed a second generation with a PV of 0.70, higher than that of the first generation, which is consistent with the hypothesis that adaptation is required to stabilise population dynamics in a new habitat, in this case a new temporally defined habitat.
Specimens of five species of woodpeckers (Piciformes: Picidae) from Manitoba, Canada, were weighed and examined for chewing lice, 1998–2015: downy woodpecker (Picoides pubescens (Linnaeus), n=49), hairy woodpecker (Picoides villosus (Linnaeus), n=23), pileated woodpecker (Dryocopus pileatus (Linnaeus), n=10), northern flicker (Colaptes auratus (Linnaeus), n=170), and yellow-bellied sapsucker (Sphyrapicus varius (Linnaeus), n=239). The relationship between body mass of each host species and infestation by seven species of lice was analysed: Menacanthus pici (Denny) from all host species, Brueelia straminea (Denny) from Picoides Lacépède species, Penenirmus jungens (Kellogg) from northern flicker, Penenirmus auritus (Scopoli) from the other four hosts, Picicola porisma Dalgleish from northern flicker, Picicola snodgrassi (Kellogg) from Picoides species, and Picicola marginatulus (Harrison) from pileated woodpeckers. Mean abundance of lice increased with the mean mass of their host. Neither the species richness of lice nor the prevalence of lice were related to host body mass. Host body mass explained 98% of the variation in mean intensity of louse infestation among hosts. The positive association of mean intensity and body size was also detected for three genera of lice. Louse intensity also increased with body size for individual birds, more so for some species of lice and hosts than others. Body size matters, but the adaptations that allow higher mean intensity on larger host species remain to be determined.
Many aphid species (Hemiptera: Aphididae) that feed on herbaceous crops exhibit a rise and then sudden decline in abundance. Data from a nine-year study of Uroleucon rudbeckiae (Fitch) on Rudbeckia laciniata Linnaeus (Asteraceae) are used to investigate this pattern of seasonal abundance in a non-agricultural aphid. Aphids on a population of tagged and numbered flower stems were counted weekly. Abundance (mean aphids per stem) was partitioned into prevalence (proportion of stems colonised) and mean intensity (aphids per colonised stem), and also considered as the sum of the aphids in individual colonies. Abundance rose in mid-summer to late summer and then declined, peaking between the end of July and mid-September, earlier in years when the peak was higher. Prevalence showed a more uniform and consistent peak than mean intensity. Most of the 949 colonies were small and short-lived, but a small proportion were long-lived and reached 1000 aphids. Large colonies declined more slowly than moderately-sized colonies. Severe weather, shortening day-length, decline in host quality, density-dependent effects on rate of increase, and emigration failed to explain the population decline. An early rise and later decline in immigration, in conjunction with increasing predation through the summer, were consistent with the decline.
Variability is an important characteristic of population dynamics, but the length of the time series required to estimate population variability is poorly understood. To this end, population variability of Macrosiphum euphorbiae (Thomas), Myzus persicae (Sulzer), and Aphis nasturtii (Kaltenbach) (Hemiptera: Aphididae) was investigated. Population variability (measured as PV, a proportion between 0 and 1) was estimated for time series of 3–62 years, giving replicate estimates for time series of 3–20 years that were normally distributed. Mean values for PV were more uniform for a time series of 12 years or longer than for shorter ones. The standard deviation of PV declined to a minimum at 12–15 years, as the length of the time series increased. Discrimination of estimates of PV was reliable for 15-year time series and longer, but not necessarily for shorter ones. Although M. euphorbiae had a relatively low PV, the coefficient of variation of that PV (12.5), was higher than for the other two species (3.5, 4.5). For robust estimates of PV, a time series of 15 years is recommended, because it minimises the standard deviation of PV, and discriminates values of PV that differ by 0.06 on a 0–1 scale.