We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save 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 saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
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 saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved 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.
Electronic health records (EHRs), increasingly available in low- and middle-income countries (LMICs), provide an opportunity to study transdiagnostic features of serious mental illness (SMI) and its trajectories.
Aims
Characterise transdiagnostic features and diagnostic trajectories of SMI using an EHR database in an LMIC institution.
Method
We conducted a retrospective cohort study using EHRs from 2005–2022 at Clínica San Juan de Dios Manizales, a specialised mental health facility in Colombia, including 22 447 patients with schizophrenia (SCZ), bipolar disorder (BPD) or severe/recurrent major depressive disorder (MDD). Using diagnostic codes and clinical notes, we analysed the frequency of suicidality and psychosis across diagnoses, patterns of diagnostic switching and the accumulation of comorbidities. Mixed-effect logistic regression was used to identify factors influencing diagnostic stability.
Results
High frequencies of suicidality and psychosis were observed across diagnoses of SCZ, BPD and MDD. Most patients (64%) received multiple diagnoses over time, including switches between primary SMI diagnoses (19%), diagnostic comorbidities (30%) or both (15%). Predictors of diagnostic switching included mentions of delusions (odds ratio = 1.47, 95% CI 1.34–1.61), prior diagnostic switching (odds ratio = 4.01, 95% CI 3.7–4.34) and time in treatment, independent of age (log of visit number; odds ratio = 0.57, 95% CI 0.54–0.61). Over 80% of patients reached diagnostic stability within 6 years of their first record.
Conclusions
Integrating structured and unstructured EHR data reveals transdiagnostic patterns in SMI and predictors of disease trajectories, highlighting the potential of EHR-based tools for research and precision psychiatry in LMICs.
This study investigates noise generation from co-rotating rotors arranged in a side-by-side configuration. The analysis examines the effects of different phase delays and separation distances. A simple mathematical model is developed to provide insight into constructive and destructive noise interference. An experimental campaign was carried out to validate the proposed analytical model. Furthermore, the study introduces a space–time proper orthogonal decomposition technique to separate broadband and tonal components. Subsequently, wavelet analysis is applied to the tonal component, revealing a transition to chaos via intermittency, characterised by the local birth and decay of periodic oscillations. This phenomenon highlights the intricate and fascinating chaotic nature of interference transitions. The chaotic behaviour of the tonal component is related to the macro time scale of pressure fluctuations, and has been incorporated into the mathematical model. This model has several applications, including its potential use in the development of active control systems and the design of quieter distributed propulsion systems.
In the past 20 years, there has been growing interest in post-traumatic stress disorder (PTSD) in people with intellectual disabilities. It is now widely recognised that individuals with intellectual disabilities are more likely to be affected by traumatic experiences than those without. The authors discuss advancements in understanding trauma and PTSD in individuals with intellectual disabilities, as well as improvements in clinical assessment and treatment. They also emphasise the need for further research into the effects of trauma and PTSD on this vulnerable and often marginalised population.
Although some modern popular songs are deliberately composed for the purpose of commentary or protest, most are produced for commercial reasons. However, such songs may nonetheless be adopted by political, cultural, and social movements, and in these cases, fans’ participatory meaning-making has an important role in the songs’ new purpose. Taking the 1935 Korean ballad ‘Tears of Mokp’o’ as a representative example, this article traces how the melancholy love song acquired successive layers of meaning against the backdrop of changing politico-economic contexts throughout the twentieth century. Drawing on political, popular music, and sports histories, I first examine how ‘Tears of Mokp’o’ became known as an anti-colonial anthem under Japanese rule, a position that persisted in postwar South Korea. I then investigate the ways in which fans of the Haitai Tigers, a professional baseball team, utilized the song to express a complex set of emotions and commitments regarding their politically oppressed and economically neglected home region of Chŏlla. Against the backdrop of their traumatic memories of the 1980 Kwangju Uprising, Haitai fans, through their collective singing of ‘Tears of Mok’po’ in stadiums during games, transformed it from a colonial-era pop hit/anti-colonial anthem into a baseball fight song that expressed their spirit of regional insubordination in the 1980s and 1990s. Entering the twenty-first century, ‘Tears of Mok’po’ no longer played the same role for the Tigers and their fans, and it receded into historical memory. This change in meaning and association shows how the political and historical meaning-making of popular songs can be constructed, reintegrated, and even dismissed.
Historians of the Indian Partition focus on the permit systems the governments of India and Pakistan put in place to stem refugee entry and prevent the return of evacuees. However, the prevention of exit became, alongside non-entrée and the prevention of return, part of an official strategy of immobility in South Asia directed at marginalized castes. At Partition, Pakistan saw the labour of ‘non-Muslim’ marginalized castes as essential to its national wealth. It believed it had to retain them at all costs. On the other side of the border, the article discusses the Indian government’s laggardly, and often indifferent, response to the struggles of caste-oppressed groups trying to migrate to India. The article builds on scholarship on mobility capital and partial citizenship in the aftermath of Partition to argue that with the prevention of exit, citizenship incorporated an imposed nationalization that embodied the status of marginalized castes as more than a minority and produced a form of bonded citizenship.
A considerable knowledge gap exists in relation to the presence and even existence of seagrass within Northern Ireland’s waters. Peer-reviewed publications on the historical ecology of seagrass are scarce and a collated timeline of references directly focusing on Northern Irish seagrasses does not exist. Recognising abiotic and biotic induced environmental change within key marine features such as seagrass is vital when attempting to measure the biodiversity and carbon sequestration services they provide. The research undertaken during this study identified three distinct periods within the archival records, which could be matched to the ecological history of seagrass in Northern Ireland. The first period (extensive and dense seagrass meadows from 1790 to 1880) was characterised by extensive seagrass meadows which were dense and healthy. The second period (degradation from 1880 to 1940) saw the beginnings of decline in seagrass from the 1790s, initially from anthropogenic influences and later from the seagrass wasting disease) and the final period (signs of recovery from 1940 to present day) showed small amounts of local regrowth of seagrass but at far reduced densities compared to the historical baseline described. These three defined periods all delivered varying degrees of anthropogenic stressors which determined the conservational health of seagrass in Northern Ireland. Seagrass habitats have become integral components in future-proofing the coastal marine environment against the effects of climate change and its associated impacts. Therefore, it is envisaged that the historical baseline that this manuscript provides will greatly benefit habitat managers in protecting, repairing, and restoring lost seagrass meadows.
Microswimmers display an intriguing ability to navigate through fluids with spatially varying viscosity, a behaviour known as viscotaxis, which plays a crucial role in guiding their motion. In this study, we reveal that the orientation dynamics of chiral squirmers in fluids with uniform viscosity gradients can be elegantly captured using the Landau–Lifshitz–Gilbert equations, originally developed for spin systems. Remarkably, we discover that chiral swimmers demonstrate negative viscotaxis, tracing spiral trajectories as they move. Specifically, a chiral squirmer with a misaligned source dipole and rotlet dipole exhibits a steady-state spiral motion – a stark contrast to the linear behaviour observed when the dipoles are aligned. This work provides fresh insights into the intricate interplay between microswimmer dynamics and fluid properties.
The monumental alignments found in southern Brittany, particularly Carnac, potentially mark the beginnings of the megalithic tradition in north-west Europe. Radiocarbon dates from excavations at a previously unknown section of this extensive megalithic complex, presented here, provide new insights into the dynamic history of construction during the fifth millennium cal BC. This refined chronology reveals not only that the site of Le Plasker—consisting of a pre-megalithic monumental tomb, alignments of standing stones and hearths—developed over 300 years in the Middle Neolithic, but that the choice of location may have been influenced by an earlier Late Mesolithic occupation.
Nurses play a critical role in preventing health care-acquired infections (HAIs) by applying infection control practices during hospitalization, in health care settings, and after patient discharge. Our aim was to evaluate the effect of an HAIs educational workshop on the knowledge, attitude, and practice of pediatric nurses at Al-Mezan Hospitals in Palestine.
Methods
A quasi-experimental study was conducted in 2022 among 44 pediatric nurses working in the PICU, NICU, pediatric ward, and nursery departments. Data were collected using demographic, knowledge, attitude, and practice questionnaires before and after the intervention. The educational workshop consisted of 4 sessions, each lasting 45 minutes. Data were analyzed using SPSS version 23, including descriptive statistics and paired t tests, with a significance level set at P < 0.05.
Results
Post-intervention scores showed significant improvements: knowledge increased from 52.9 ± 3.3 to 61.9 ± 4.1, attitude from 44.1 ± 4.1 to 52.6 ± 3.4, and practice from 42.1 ± 5.7 to 53.3 ± 3.3. All changes were statistically significant (P ≤ 0.001), indicating the effectiveness of the workshop.
Conclusions
The HAIs educational workshop significantly enhanced the knowledge, attitudes, and practices of pediatric nurses regarding infection control. These findings highlight the importance of continuous education and training programs to improve health care quality and patient safety.
It is a well known and easily verifiable fact that not all integer triangles have integer areas. Consider the triangles with sides {9, 10, 17}, {13, 14, 15}, {5, 7, 8} and {6, 7, 9} with respective areas 36, 84, and . The first two, whose areas are integers, are called Heronian triangles. The second triangle also has the additional property that its sides are consecutive integers and is an example of a Brahmagupta triangle, named after an Indian mathematician, born in AD 598. These are called Super-Heronian triangles in [1] and a method is developed there for generating examples of such triangles.
The Blue Shield UK Underwater Heritage Working Group (UHWG) is dedicated to protecting underwater cultural heritage in crisis, both within the United Kingdom (UK), UK Overseas Territories and internationally. In pursuit of this mission, the UHWG’s objectives are threefold:
We prove the conjecture of Franceschini and Lorenzini [‘Fat points of $\mathbb P^n$ whose support is contained in a linear proper subspace’, J. Pure and Appl. Algebra160 (2001), 169–182] about the regularity index of fat points of $\mathbb P^n$ whose support is contained in a linear proper subspace.