To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Patients with major depressive disorder (MDD) or bipolar disorder (BD) exhibit difficulties with emotional cognition even during remission. There is evidence for aberrant emotional cognition in unaffected relatives of patients with these mood disorders, but studies are conflicting. We aimed to investigate whether emotional cognition in unaffected first-degree relatives of patients with mood disorders is characterised by heterogeneity using a data-driven approach.
Data from 94 unaffected relatives (33 of MDD patients; 61 of BD patients) and 203 healthy controls were pooled from two cohort studies. Emotional cognition was assessed with the Social Scenarios Test, Facial Expression Recognition Test and Faces Dot-Probe Test. Hierarchical cluster analysis was conducted using emotional cognition data from the 94 unaffected relatives. The resulting emotional cognition clusters and controls were compared for emotional and non-emotional cognition, demographic characteristics and functioning.
Two distinct clusters of unaffected relatives were identified: a relatively ‘emotionally preserved’ cluster (55%; 40% relatives of MDD probands) and an ‘emotionally blunted’ cluster (45%; 29% relatives of MDD probands). ‘Emotionally blunted’ relatives presented with poorer neurocognitive performance (global cognition p = 0.010), heightened subsyndromal mania symptoms (p = 0.004), lower years of education (p = 0.004) and difficulties with interpersonal functioning (p = 0.005) than controls, whereas ‘emotionally preserved’ relatives were comparable to controls on these measures.
Our findings show discrete emotional cognition profiles that occur across healthy first-degree relatives of patients with MDD and BD. These emotional cognition clusters may provide insight into emotional cognitive markers of genetically distinct subgroups of individuals at familial risk of mood disorders.
For some time, the impact of counterterrorism (CT) measures and sanctions on humanitarian action did not attract the attention that it merited. However, owing to a surge in awareness of this issue over the past two years, the fact that CT measures and sanctions can have negative consequences for principled humanitarian action is now widely accepted by a broad range of actors, and is supported by a strong body of research identifying and analyzing these impacts. This article adds to this existing work by examining recent developments related to this issue. It looks at the impact of growing risk aversion in relation to CT measures and sanctions among donors, humanitarian organizations and other actors on principled humanitarian action, and highlights recent efforts to address and mitigate these impacts. The central argument is that CT and sanctions risks cannot be eliminated from humanitarian action. As such, policy change is needed to protect principled humanitarian action from further detrimental impacts and to ensure that people can access the assistance they need, regardless of where they are located.
The chapter begins with a brief genealogy of new materialism and inquiry into the significance of the nonhuman stories entangled in the ethical, political, scientific, and theoretical complexities of the Anthropocene. It first explains the convergence of the new materialism(s) and environmental humanities on ecologically engaged collaborative thinking in responding to bioethical, socio-cultural, and scientific questions that arise from the challenges of Anthropocene. It then discusses how new materialism has espoused the postmodern and poststructuralist disclosure of the link between the dualistic conceptions of the world and the traditional realist systems of representation. The broad argument is that the significance of the agentic capacity of matter in producing layers of expressivity has undermined the established credo about storytelling being uniquely all too human. The “nonhuman story” is argued to mark an important shift in the foundational notions of narrative and storytelling. Material ecocriticism re-envisions narrative as the signifying agency of living matter or narrative agency. Material ecocriticism sees the world as a site of narrativity where narrative agencies – the building blocks of storied matter – demonstrate some degree of creative experience.
Celebrations of playing through risk, skepticism of athletes perceived as faking injuries, unregulated training regimens, the mythos of amateurism, and lack of accountability for preventable health harms have long characterized many college football programs. Setting policies that effectively prioritize player health will require taking this history into account.
Tuberculosis (TB) is the leading cause of death caused by single pathogenic microorganism, Mycobacterium tuberculosis (MTB). The study aims to explore the associations of microRNA (miRNA) single-nucleotide polymorphisms (SNPs) with pulmonary TB (PTB) risk. A population-based case−control study was conducted, and 168 newly diagnosed smear-positive PTB cases and 251 non-TB controls were recruited. SNPs located within miR-27a (rs895819), miR-423 (rs6505162), miR-196a-2 (rs11614913), miR-146a (rs2910164), miR-618 (rs2682818) were selected and MassARRAY® MALDI-TOF System was employed for genotyping. SPSS19.0 was adopted for statistical analysis, non-conditional logistic regression was performed. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were computed to estimate the associations. Associations of haplotypes with PTB risk were performed with online tool. Rs895819 CT/CC genotype was associated with reduced PTB risk among female population (OR = 0.45, 95% CI: 0.23–0.98), P = 0.045. Haplotypes (combined with rs895819, rs2682818, rs2910164, rs6505162 and rs11614913) TCCCT, TAGCC, CCCCC, CCGCT and TCGAT were associated with reduced PTB risk and the ORs were 0.67 (95% CI: 0.45–0.99), 0.49 (0.25–0.94), 0.34 (95% CI: 0.14–0.81), 0.22 (95% CI: 0.06–0.84) and 0.24 (95% CI: 0.07–0.79), respectively; while the haplotypes of TAGCT, CCCCT, CACCT and TCCAT were associated with increased PTB risk, and the ORs were 3.63 (95% CI: 1.54–8.55), 2.20 (95% CI: 1.00–4.86), 3.90 (95% CI: 1.47–10.36) and 2.95 (95% CI: 1.09–7.99), respectively. Rs895819 CT/CC genotype was associated with reduced female PTB risk and haplotype TCCCT, TAGCC, CCCCC, CCGCT and TCGAT were associated with reduced PTB risk, while TAGCT, CCCCT, CACCT and TCCAT were associated with increased risk.
Quality is an important issue for the software industry, though there is a balance between cost and quality. Starting with a few examples of software failures, this chapter discusses the need for testing, and uses an example to demonstrate why heuristics are needed to test software. A seven-step approach to testing software is introduced: analysis, identifying test coverage items and test cases, verifying the test design, implementing and executing the tests, and interpreting the test results. Key concepts are defined as used throughout the book, with a reference to the key IEEE/ISO software testing standard.
The Epilogue returns us to the Prologue. To the big questions as they pertain to leadership and followership. To leaders and their followers. To what is the role of and the responsibility of followers who find themselves in situations that are uncomfortable. That are uncomfortable because their leaders, those more highly positioned then they, are either incompetent, or immoral, or both. “The fault, dear Brutus, is not in our stars, But in ourselves, that we are underlings,” wrote Shakespeare in “Julius Caesar.” In other words, if we are followers, not leaders, we are not, not at all, absolved of responsibility. If things go wrong, we share blame for not speaking up and out, for not having the guts to speak truth to power – even if doing so comes at a cost.
Over the years, Colombia has faced disaster situations that have generated changes in risk management models. These situations have brought suffering, destruction, and loss of human life, but have also served as lessons to develop procedures aimed at minimizing the risks caused by the presence of hazards. The objective of this article is to provide general evidence-based guidelines for formulating disaster risk management plans for each of the 3 action processes: risk awareness, risk reduction, and disaster management in Colombia. These plans can be achieved by preparing responses to different emergencies, which arise from threats in each of the possible scenarios, and are adverse events that alter the normal functioning of entities and communities. The implementation of these prevention strategies will allow communities to respond effectively to emergencies and recover rapidly in the face of adversity.
Accurate and objective risk assessment is important in the evaluation of many mental disorders and behaviours. For example, in the evaluation of suicidal behaviour or the assessment of accidents in ADHD. Video games could contribute to improve the assessment and increase engagement.
Our hypothesis is that the proposed videogame can precisely evaluate risk. In addition, the developed game is able to indirectly assess the risk. This feature is useful in setups where patients are prone to lie.
We have developed a car driving video game where users are told that they should drive near to the border but not too much. We record distance to the border and each key pulsation every 0.1 seconds.
It has been observed that the median of recorded distance positively correlated with the score obtained by Self-report of Risk-taking Behaviors (SRB). In addition, the interquartile range significant correlates with the global score obtained in this questionnaire.
The proposed videogame is able of performing an accurate risk assessment. Our game takes seven minutes and it does not need complicated nor expensive hardware and could be deployed online. Results obtained open up new possibilities of creating video games which make an objective assessment risk.
Empathy is generally viewed as a “positive” trait, while the Dark Triad traits are regarded as a “negative” side of a Dark personality. The perception of Risk is less univocal, as it plays a role in both courage and questionable behavior.
We posed the following research questions: 1. Is risk linked to empathy and the Dark Triad traits? 2. Which traits help distinguish between participants with contrasting latent profiles (determined cumulatively for the specified personality variables)?
Participants (n=250) completed three questionnaires: the Dirty Dozen, Personality Factors of Decision-making and the Questionnaire of Cognitive and Affective Empathy (QCAE). Correlation and Latent profile analysis (LPA) were performed.
Risk was linked to Machiavellianism, psychopathy, and decentration (positively) and to emotion contagion and affective empathy (negatively). Rationality was positively correlated with cognitive empathy. Machiavellianism correlated negatively with rationality and online simulation (a cognitive empathy subscale). Empathy subscales were linked to psychopathy (negatively) and to narcissism (positively). LPA established two latent profiles: the smallest BIC value was obtained for the model with two profiles (log-likelihood: -3204.013, df=77, BIC=-6833; VEE). Analysis of means revealed that Class 1 was characterized by significantly higher Dark Triad values and higher Risk, whereas Class 2 was characterized by lower Dark Triad traits, lower Risk, and higher Rationality (see Figure 1).
Figure 1. Latent profile analysis
The Dark Triad traits and Risk are the more discriminative variables, while Empathy subscales do not help distinguish between the two classes of participants. The study was supported by the Russian Foundation for Basic Research, project 19-29-07069.
ADHD limits the ability to comply with Covid-19 prevention recommendations. We hypothesized that ADHD constitutes a risk factor for Covid-19 infection and that pharmacotherapy may lower that risk.
To test our hypothesis we studied the data of all patients admitted to (N=14,022) Leumit Health Services in Israel between February 1st - April 30th, 2020, who underwent at least one Covid-19 test.
Data were collected from the electronic health records. Purchasing consecutively at least 3 ADHD-medication-prescriptions during past year was considered drug-treatment.
1,416 (10.1%) subjects (aged 2 months - 103 years) were Covid-19-positive.They were significantly younger, and had higher rates of ADHD (adjOR 1.58 (95%CI; 1.27-1.96, p<0·001) than Covid-19-negative subjects. The risk for Covid-19-Positive was higher in untreated-ADHD subjects compared to non-ADHD subjects [crudeOR 1.61 (95%CI 1.36-1.89, p<0.001)], while no higher risk was detected in treated ones [crudeOR 1.07 (95% CI 0·78-1.48 p=0.65)].
Untreated ADHD seems to constitute a risk factor for Covid-19 infection while drug-treatment ameliorates this effect.
Assessing risk is an important core skill yet there is not a consensus as to how to teach it. Clinically, there has been a move away from using risk prediction tools in favour of clinical judgement.We describe an iterative process to develop high quality, online teaching around risk assessment for medical undergraduates.
To teach the clinical skill of risk assessment to enable medical students to evaluate and manage risk when encountering patients with mental health issues.
A half day tutorial was designed and refined in an iterative process using feedback from participants on this session and other concurrent teaching occurring in the department. Sessions were also reviewed by external medical educators to ensure quality and learning objectives were met.
The average rating from 62 students was 4.4/5. Students commented that the session was well organised and delivered. Following feedback, the use of actors was prioritised to simulate evolving clinical situations. Students placed a high value on this: “simulated patients were amazing! They were really interesting and I was able to practice the skills I learnt over placement”. Logistical changes e.g. more breaks, followed appreciation of the exhausting nature of the session and maintained student engagement. There was increased emphasis on promoting group interaction through functions like a ‘break-out room’.
This session may give educators confidence that they can take risks when teaching the skill of risk assessment. Students were receptive and meaningfully engaged with concepts such as clinical judgement and bio-psycho-social formulations as opposed to ‘tick box’ assessments.
Although childhood depressive disorders are relatively rare, the experience of depression in children's lives is not. Developmental contextual perspectives denote the importance of considering both depressive disorder and the experience of subclinical depressive symptoms in the child and the family to fully understand the implications of depressive experience for children's developmental well-being. This Element draws on basic emotion development and developmental psychopathology perspectives to address the nature of depressive experience in childhood, both symptoms and disorder, focusing on seminal and recent research that details critical issues regarding its phenomenology, epidemiology, continuity, etiology, consequences, and interventions to ameliorate the developmental challenges inherent in the experience. These issues are addressed within the context of the child's own experience and from the perspective of parent depression as a critical context that influences children's developmental well-being. Conclusions include suggestions for new directions in research on children's lives that focus on more systemic processes.
Individuals at clinical high risk of psychosis (CHR-P) recruited in randomized clinical trials (RCTs) and observational cohorts may display a different enrichment and hence risk of transition to psychosis. No meta-analysis has ever addressed this issue.
“Preferred Reporting Items for Systematic reviews and Meta-Analyses” (PRISMA) and “Meta-analysis Of Observational Studies in Epidemiology” (MOOSE)–compliant meta-analysis. PubMed and Web of Science were searched until November 2020 (PROSPERO:CRD42021229223). We included nonoverlapping longitudinal studies (RCTs-control condition and observational cohorts) reporting the transition to psychosis in CHR-P individuals. The primary effect size measure was the cumulative risk of transition at 0.5, 1, and 2 years follow-up in RCTs compared to observational cohorts. Random effects meta-analyses, heterogeneity assessment, quality assessment, and meta-regressions were conducted.
Ninety-four independent studies (24 RCTs, 70 observational cohorts) and 9,243 individuals (mean age = 20.1 ± 3.0 years; 43.7% females) were included. The meta-analytical risk of transitioning to psychosis from a CHR-P stage was 0.091 (95% confidence intervals [CI] = 0.068–0.121) at 0.5 years, 0.140 (95% CI = 0.101–0.191) at 1 year and 0.165 (95% CI = 0.097–0.267) at 2 years follow-up in RCTs, and 0.081 (95% CI = 0.067–0.099) at 0.5 years, 0.138 (95% CI = 0.114–0.167) at 1 year, and 0.174 (95% CI = 0.156–0.193) at 2 years follow-up in observational cohorts. There were no between-group differences in transition risks (p > 0.05). The proportion of CHR-P individuals with substance use disorders (excluding alcohol and cannabis) was higher in observational cohorts (16.8, 95% CI = 13.3–21.0%) than in RCTs (3.4, 95% CI = 0.8–12.7%; p = 0.018).
There is no meta-analytic evidence supporting sampling biases in RCTs of CHR-P individuals. Further RCTs are needed to detect effective interventions to prevent psychosis in this at-risk group.
DNA methylation is one of the most important epigenetic modifications in breast cancer (BC) development, and long-term dietary habits can alter DNA methylation. Cadherin-4 (CDH4, a member of the cadherin family) encodes Ca2+-dependent cell–cell adhesion glycoproteins. We conducted a case–control study (380 newly diagnosed BC and 439 cancer-free controls) to explore the relationship of CDH4 methylation in peripheral blood leukocyte DNA (PBL DNA), as well as its combined and interactive effects with dietary factors on BC risk. A case-only study (335 newly diagnosed BC) was conducted to analyse the association between CDH4 methylation in breast tissue DNA and dietary factors. CDH4 methylation was detected using quantitative methylation-specific PCR. Unconditional logistic regressions were used to analyse the association of CDH4 methylation in PBL DNA and BC risk. Cross-over analysis and unconditional logistic regression were used to calculate the combined and interactive effects between CDH4 methylation in PBL DNA and dietary factors in BC. CDH4 hypermethylation was significantly associated with increased BC risk in PBL DNA (ORadjusted (ORadj) = 2·70, (95 % CI 1·90, 3·83), P < 0·001). CDH4 hypermethylation also showed significant combined effects with the consumption of vegetables (ORadj = 4·33, (95 % CI 2·63, 7·10)), allium vegetables (ORadj = 7·00, (95 % CI 4·17, 11·77)), fish (ORadj = 7·92, (95 % CI 3·79, 16·53)), milk (ORadj = 6·30, (95 % CI 3·41, 11·66)), overnight food (ORadj = 4·63, (95 % CI 2·69, 7·99)), pork (ORadj = 5·59, (95 % CI 2·94, 10·62)) and physical activity (ORadj = 4·72, (95 % CI 2·87, 7·76)). Moreover, consuming milk was significantly related with decreased risk of CDH4 methylation (OR = 0·61, (95 % CI 0·38, 0·99)) in breast tissue. Our findings may provide direct guidance on the dietary intake for specific methylated carriers to decrease their risk for developing BC.
In the fifteenth century, a new moral allegory connected to the figure of fortuna began to develop. In contrast to the Boethian one, discussed in Chapter 5, the moral force of this allegory aimed at not missing the opportunities for profit and success offered by fortuna. This chapter argues that this new allegory, which underlay the development of the new concept of the future as unknown time-yet-to-come, emerged first in mercantile culture. It traces its development in the writings and visual world of three Florentine merchants whose careers spanned the late fourteenth to the late fifteenth centuries. While never breaking with the providential future of Christianity, these merchants began to articulate ideas about the rewards of financial speculation and the promise and potential of taking risks on unknown future outcomes.
After gamblers, merchants in Renaissance Italy had the deepest professional familiarity with experiencing the unknown future, in all its risks and potential. This chapter examines how the well-established notion that trust was crucial to the functioning of the premodern economy connected to ideas about temporality and the future. It argues that the experience of trusting strangers and distant agents or business partners was fundamentally a temporal one. The chapter traces the institutions and mechanisms used by sixteenth-century merchants to manage the temporal problems of trust. It also demonstrates the continuing persistence of a providential understanding of the future, based on Christian faith, in mercantile culture, revealing the complex multiplicity of Italian attitudes toward the future.
Like the authors on games examined in Chapter 1, sixteenth-century merchants also constructed an identity based on expertise in futurity. This chapter examines how they did so through the deployment of rich, varied, and precise vocabulary for discussing the opportunities and risk of speculating on future profits. It traces the fine-grained way that merchants discussed the passing of time, demonstrating the ways in which they thought about time and risk as commodities that could be weighed and priced. It develops on Chapter 3, however, by showing these same merchants continued to think about the future and nature of the world in profoundly religious ways, complicating notions of straightforward linear progression for medieval to modern notions of temporality.
This innovative cultural history of financial risk-taking in Renaissance Italy argues that a new concept of the future as unknown and unknowable emerged in Italian society between the mid-fifteenth and mid-sixteenth centuries. Exploring the rich interchanges between mercantile and intellectual cultures underpinning this development in four major cities - Florence, Genoa, Venice, and Milan - Nicholas Scott Baker examines how merchants and gamblers, the futurologists of the pre-modern world, understood and experienced their own risk taking and that of others. Drawing on extensive archival research, this study demonstrates that while the Renaissance did not create the modern sense of time, it constructed the foundations on which it could develop. The new conceptions of the past and the future that developed in the Renaissance provided the pattern for the later construction a single narrative beginning in classical antiquity stretching to the now. This book thus makes an important contribution toward laying bare the historical contingency of a sense of time that continues to structure our world in profound ways.