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This chapter examines the main challenges posed by remote working from the perspective of occupational health and safety protection. Methodologically, the chapter utilizes a multi-level perspective and also focuses on how the temporal and spatial breadth of remote work affect health and safety at work and its regulations. The chapter analyzes the problem of applying the current concepts of effective working time and rest time to the new activity times that arise in remote work. The study also examines the problems that arise regarding controlling and recording working time in remote work, as well as the legal limits of the new forms of control used by companies. The need to articulate specific forms of digital disconnection and to introduce online working time as a psychosocial risk factor is addressed. The chapter also examines the implications of remote work for the management of occupational risk prevention. In addition to how occupational risk prevention planning is carried out, special attention is paid to the new occupational risks that may appear in the digital sphere, such as cyber-bullying, but also the increase in more traditional psychosocial risks, and the difficulties that arise in achieving an effective assessment of these risks.
Chronic otitis and mastoiditis are inflammatory processes that can lead to deafness and disability if left untreated, especially in the pre-antibiotic era and in fishing communities with high exposure to infection. This study describes lesions on temporal bones found in Tzintzuntzan, a prehispanic city located near Lake Pátzcuaro, Michoacán, in western Mexico. A multidisciplinary team analyzed a sample (N = 96) of temporal bones using morphoscopic analysis, multidetector CT scanning, and 2D and 3D virtual reconstruction. All evaluations were double-blinded using a previously standardized process and a validated questionnaire. The combination of multiple methodologies and a multidisciplinary team of evaluators improved the likelihood of classifying lesions. Nearly one-third of the lesions (31.25%) are compatible with the diagnoses of chronic otitis and mastoiditis. The frequency of these lesions is high in fishing communities such as in the city of Tzintzuntzan, possibly leading to significant hearing impairment among the population and affecting individuals’ abilities to perform essential aquatic activities.
In 1988, meteorological measurements started at the Spanish research station Juan Carlos I (JCI) on Livingston Island. A second station - Gabriel de Castilla (GdC) - was installed in 2005 on Deception Island. These long-term measurements improved our climatological understanding of the western region of the South Shetland Islands (SSI), a region that has received less attention than the more station-populated King George Island in the central SSI. Here, we present a complete climatological analysis of these stations after undertaking a full quality control process of the data. This analysis covers temperature, wind, precipitation, radiation, relative humidity and pressure, as well as trends and variability. The results show: 1) the stations along the western SSI coastline, particularly JCI, are warmer than those on the central SSI, especially in summer, 2) at GdC, winters are colder due to stagnant cold air pooling within the Deception Island caldera, 3) the importance of island orography in shaping local climatology, especially regarding wind patterns, and 4) the critical need to correct precipitation measurements for undercatchment of solid precipitation by common pluviometers. This study provides a climatological framework to support further research conducted in the region.
Atop El Castillo, the largest pyramid within the Maya site of Chichen Itza, in Mexico’s Yucatan Peninsula, stand two ruined columns that once portrayed the feathered serpent deity K’uk’ulkan. 3D-imaging technologies have identified scattered sculptural fragments belonging to these columns, allowing a digital reconstruction that opens new possibilities for their conservation.
Given the growing global prevalence and significant impact of depression and anxiety, both in general and within the workplace, understanding the underlying mechanisms contributing to emotional disorders is essential. This study examined whether self-esteem mediates the relationship between experiential avoidance and emotional disorders, focusing on depression and anxiety. We conducted a cross-sectional analysis of 174 outpatients from a community mental health center, who completed self-report measures of experiential avoidance, self-esteem, depression, and anxiety. We used the PROCESS macro for mediation analysis, and the results indicated that self-esteem significantly mediated the relationship between experiential avoidance and both depression and anxiety. We analyzed the mediation model within the framework of self-determination theory, which suggested that interventions aimed at reducing experiential avoidance and enhancing self-esteem could be effective for emotional disorders. In this study, we highlight the importance of addressing both experiential avoidance and self-esteem in the therapeutic context. We also discuss implications for clinical practice and limitations of the current study.
The treatment of asymptomatic bacteriuria (AB) has been associated with increased in antibiotic resistance and Clostridioides difficile infection, without clinical benefit. One strategy to improve management is to incorporate a recommendation in the microbiological report. The aim of the study was to assess the impact of this intervention on antibiotic prescribing for AB.
Methods:
Potential cases of AB were identified, and the following comment was included in the microbiology report: “Assess according to clinical findings. In AB, no treatment is recommended”. Patient demographics, sample characteristics, reason for request, isolated microorganism, resistance profile, time to clinician’s review of the report, initiation of treatment and its causes, and repeat urine culture were collected. Factors associated with adherence to the recommendations were evaluated.
Results:
A total of 391 possible AB cases were identified. The majority of samples originated, from primary care (96%) and in women over 65 years of age (98%). Antibiotic treatment was initiated in 60% of cases, while the microbiological recommendation was followed in 40%. Factors associated with nonadherence to the recommendation included urine culture request prompted by foul-smelling or cloudy urine, and repeat culture. In contrast, urine cultures requested during routine health checks were more likely to be associate with adherence to the recommendation.
Conclusions:
The inclusion of a commentary in the microbiology report contributed to a reduction in antimicrobial prescription in AB. This intervention may be effective in optimising antibiotic prescribing practices and improving urine culture request management policies.
Non-suicidal self-injury (NSSI) is associated with mental disorders, yet work regarding the direction of this association is inconsistent. We examined the prevalence, comorbidity, time–order associations with mental disorders, and sex differences in sporadic and repetitive NSSI among emerging adults.
Methods
We used survey data from n = 72,288 first-year college students as part of the World Mental Health-International College Student Survey Initiative (WMH-ICS) to explore time–order associations between onset of NSSI and mental disorders, based on retrospective age-of-onset reports using discrete-time survival models. We distinguished between sporadic (1–5 lifetime episodes) and repetitive (≥6 lifetime episodes) NSSI in relation to DSM-5 mood, anxiety, and externalizing disorders.
Results
We estimated a lifetime NSSI rate of 24.5%, with approximately half reporting sporadic NSSI and half repetitive NSSI. The time–order associations between onset of NSSI and mental disorders were bidirectional, but mental disorders were stronger predictors of the onset of NSSI (median RR = 1.94) than vice versa (median RR = 1.58). These associations were stronger among individuals engaging in repetitive rather than sporadic NSSI. While associations between NSSI and mental disorders generally did not differ by sex, repetitive NSSI was a stronger predictor for the onset of subsequent substance use disorders among females compared to males. Most mental disorders marginally increased the risk for persistent repetitive NSSI (median RR = 1.23).
Conclusions
Our findings offer unique insights into the temporal order between NSSI and mental disorders. Further work exploring the mechanism underlying these associations will pave the way for early identification and intervention of both NSSI and mental disorders.
Idiopathic orbital myositis is a rare inflammatory condition that predominantly affects multiple extraocular muscles. Isolated involvement of a single muscle is very uncommon. Isolated levator palpebrae myositis is a diagnostic challenge that should be considered in patients with periocular pain and complete eyelid ptosis without ophthalmoparesis or pupillary dysfunction. We propose a comprehensive set of diagnostic tests to identify the underlying etiology and a recommended treatment regimen. Additionally, we present a case from our clinical practice that illustrates this rare presentation, of which few cases have been described in the literature.
An archaeological investigation at the western margin of the Cordillera de la Sal Formation in Catarpe (San Pedro de Atacama, northern Chile), revealed a series of pyrometallurgical furnaces from the Late period (AD 1400–1536). The furnaces, found at the Catarpe Túnel archaeological site, were used to reduce atacamite, clinoatacamite, brochantite, chrysocolla, and azurite to obtain unalloyed copper prills. Exceptional for the Atacama oasis and salt flats, Catarpe Túnel represents the only major archaeometallurgical site recorded in the area. Archaeometric analysis has determined the type of ore smelted, the composition of the metallic copper produced, and the characteristics of the fuel used by the operations. Although these operations are typical of the local metallurgical tradition, their proximity to a documented section of the Qhapaq Ñan and the Inka administrative center of Catarpe Este led us to wonder about the possible Tawantinsuyu influence in the region.
Cognitive deficits and immune system dysregulation are core features of psychotic disorders. Among inflammatory markers, interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-α) have been linked to both psychosis pathophysiology and related cognitive impairments.
Methods
We investigated associations among IL-6, TNF-α, and neurocognitive performance in 107 participants: individuals at clinical high risk for psychosis (CHR-P, n = 35), first-episode psychosis (FEP, n = 39), and healthy controls (HC, n = 33). Assessments included memory, processing speed, executive function, and social cognition. Cytokines were measured from fasting serum samples. Analyses included ANOVA, correlations, and multivariate regressions controlling for age, sex, IQ, group, and symptom severity.
Results
TNF-α levels were significantly elevated in FEP compared to CHR-P (p = 0.0251); IL-6 differences were non-significant. FEP showed poorer performance in multiple cognitive domains, especially social cognition. CHR-P individuals exhibited intermediate profiles between FEP and HC in cognition. In adjusted regression models, IL-6 was significantly associated with undermentalization on the MASC task (β = 0.28, p = 0.0337) and showed a trend-level association with slower processing speed (β = 0.98, p = 0.075). TNF-α levels predicted poorer facial emotion recognition (β = −1.37, p = 0.0022). IQ and group were significant covariates in most models.
Conclusions
Our findings suggest that peripheral inflammation, particularly IL-6 and TNF-α, may selectively impact social cognitive functioning in early psychosis. Though modest, these associations highlight potential inflammatory contributions to functional impairment and support further investigation of immunological targets in early intervention.
Intentionally enhancing and supporting the early careers of individuals from populations underrepresented in science and medicine (URSM) is essential to achieving health equity. The Health Equity Leadership and Mentoring (HELM) Program at the University of Minnesota and the University of Utah is designed to foster academic excellence and build leadership capacity of postdoctoral fellows, clinical fellows, and early-career faculty who identify as URSM and/or who are committed to careers in health equity research and clinical care. HELM models a culture of psychosocial safety to create a sense of belonging and uses evidence-based and culturally aware mentoring and career development strategies with the goal of retaining diverse faculty. HELM proved agile and adaptive during the Covid-19 pandemic and has been successful in states with and without legislation limiting diversity programs. Across the 2 institutions, the HELM program has supported over 200 trainees and early-career faculty through mid-2024. Among HELM participants who joined the program as faculty, 85%–95% have remained in their faculty positions.
Selective serotonin reuptake inhibitors (SSRIs) are the first-line treatment for major depressive disorder (MDD), but initial outcomes can be modest.
Aims
To compare SSRI dose optimisation with four alternative second-line strategies in MDD patients unresponsive to an SSRI.
Method
Of 257 participants, 51 were randomised to SSRI dose optimisation (SSRI-Opt), 46 to lithium augmentation (SSRI+Li), 48 to nortriptyline combination (SSRI+NTP), 55 to switch to venlafaxine (VEN) and 57 to problem-solving therapy (SSRI+PST). Primary outcomes were week-6 response/remission rates, assessed by blinded evaluators using the 17-item Hamilton Depression Rating Scale (HDRS-17). Changes in HDRS-17 scores, global improvement and safety outcomes were also explored. EudraCT No. 2007-002130-11.
Results
Alternative second-line strategies led to higher response (28.2% v. 14.3%, odds ratio = 2.36 [95% CI 1.0–5.6], p = 0.05) and remission (16.9% v. 12.2%, odds ratio = 1.46, [95% CI 0.57–3.71], p = 0.27) rates, with greater HDRS-17 score reductions (−2.6 [95% CI −4.9 to −0.4], p = 0.021]) than SSRI-Opt. Significant/marginally significant effects were only observed in both response rates and HDRS-17 decreases for VEN (odds ratio = 2.53 [95% CI 0.94–6.80], p = 0.067; HDRS-17 difference: −2.7 [95% CI −5.5 to 0.0], p = 0.054) and for SSRI+PST (odds ratio = 2.46 [95% CI 0.92 to 6.62], p = 0.074; HDRS-17 difference: −3.1 [95% CI −5.8 to −0.3], p = 0.032). The SSRI+PST group reported the fewest adverse effects, while SSRI+NTP experienced the most (28.1% v. 75%; p < 0.01), largely mild.
Conclusions
Patients with MDD and insufficient response to SSRIs would benefit from any other second-line strategy aside from dose optimisation. With limited statistical power, switching to venlafaxine and adding psychotherapy yielded the most consistent results in the DEPRE'5 study.
This work reports the X-ray powder diffraction (XRPD) data recorded at room temperature (293 K) of dibromidodioxido-[(4,4′-di-tert-butyl)-2,2′-bipyridine]molybdenum(VI). The analysis of the powder diffraction pattern led to an orthorhombic united cell with parameters a = 17.9205(23) Å, b = 13.4451(16) Å, c = 18.1514(19) Å, V = 4,373.5(11) Å3, and values of Z = 8 and Z’ = 2. The crystal structure of this material corresponds to the structure of entry IFUJEC of the Cambridge Structural Database (CSD), determined at 90 K. The excellent Rietveld refinement, carried out with General Structure and Analysis Software II (GSAS-II), showed the single-phase nature of the material and the good quality of the data. This material was also characterized by elemental analysis, UV–vis, Fourier transform infrared spectroscopy (FTIR), and proton nuclear magnetic resonance (1H-NMR) techniques.
The Puerto Rico Plain Pigeon Patagioenas inornata wetmorei suffered a severe population decline after hurricanes Irma and Maria in September 2017. We used distance sampling to estimate abundance (density and population size) in April–June 1986−2024, accounting for changes in detection probability. We used the distance-sampling abundance estimates to populate a Bayesian state–space logistic model and update posterior estimates of population carrying capacity, maximum population growth rate, population recovery time, and predicted abundance in April–June 2025−2034, accounting for observation and process variances. In addition, we used predicted abundance to assess potential extinction risk (probability Pr[N2025−2034 = 0|data]), population self-sustainability above 5,000 individuals (Pr[N2025−2034 >5,000|data]), and population surpassing the 2.5th percentile of carrying capacity (Pr[N2025−2034 >30,000|data]). The population has not recovered from the hurricanes, with estimated density averaging 0.0015 individuals/ha (bootstrapped standard error [SE] = 0.0006) and population size averaging 1,097 individuals (SE = 455) at the 749,000-ha survey region in April–June 2018−2024. Posterior mean estimates were 41,580 individuals (Markov Chain Monte Carlo standard deviation [SD] = 8,052) for population carrying capacity, 0.183 (SD = 0.056) for maximum population growth rate, six years (SD = 2) for recovery time, and 7,173 individuals (SD = 12,309) for predicted abundance in April–June 2025−2034. The population may reach self-sustainability levels (range Pr[N2025−2034 >5,000|data] = 0.326−0.631) but currently is undergoing a prolonged bottleneck and may become extinct (range Pr[N2025−2034 = 0|data] = 0.199−0.332), particularly if reproduction continues to be mostly unsuccessful, anthropogenic disturbances remain unabated, and on top of that another devastating hurricane makes landfall during the next 10 years. The Puerto Rico Plain Pigeon subspecies is in urgent need of management aiming to increase and maintain abundance above 5,000 individuals but preferably surpassing the 2.5th percentile of population carrying capacity as in the late 1990s (range Pr[N2025−2034 >30,000|data] = 0.000−0.181).
Vegetation cover in drylands tends to be sparse and organised as a mosaic of patches with high biomass interspersed within a bare soil component. Water availability and vegetation are tightly coupled in these environments, where landscape function is determined by hydrologic and sediment connectivity. In this chapter, we analyse and synthesise previous studies describing how understanding, measuring and modifying connectivity can be used to guide the design of management strategies aiming at improving landscape resilience. We describe how drylands are very sensitive to both water and wind erosion, which have the potential to increase connectivity beyond tipping points at which the system transitions abruptly to a degraded state that may be irreversible. We discuss methods for the identification of early warning indicators of transition to degraded states, which could be used as a preventive management tool. We also describe existing strategies and approaches to reduce connectivity at different spatial scales as a way of managing degraded landscapes.
We perform an experiment which provides a laboratory replica of some important features of the welfare state. In the experiment, all individuals in a group decide whether to make a costly effort, which produces a random (independent) outcome for each one of them. The group members then vote on whether to redistribute the resulting and commonly known total sum of earnings equally amongst themselves. This game has two equilibria, if played once. In one of them, all players make effort and there is little redistribution. In the other one, there is no effort and nothing to redistribute. A solution to the repeated game allows for redistribution and high effort, sustained by the threat to revert to the worst of these equilibria. Our results show that redistribution with high effort is not sustainable. The main reason for the absence of redistribution is that rich agents do not act differently depending on whether the poor have worked hard or not. The equilibrium in which redistribution may be sustained by the threat of punishing the poor if they do not exert effort is not observed in the experiment. Thus, the explanation of the behavior of the subjects lies in Hobbes, not in Rousseau.
Two new sites, identified during a survey of the Tajuña River Valley, central Iberia, show evidence of both flint extraction and working, specifically for the production of long blades. These are an important addition to the limited number of such sites known in Eurasia.
The establishment of the possible presence of life on Mars (past or present) is based on the study of planetary analogues, which allow in situ analysis of the environments in which living organisms adapt to often extreme conditions. Although Mars has been a candidate for hosting life, based on observations made decades ago, it is thanks to the characteristics identified in environments, mainly volcanic, that it has been possible to calibrate instruments and detail the features of the red planet. In this paper, we present a review of the main characteristics of different planetary analogues, particularly deepening the study of Antarctica, to later expose the factors studied in Deception Island that have contributed to considering it as an analogue of Mars from different perspectives. Although geological and geomorphological studies on the analogies of the island already exist, detailed analyses that present the approach of astrobiological analogues are required, thus allowing further research.
Living with major depressive disorder (MDD) reduces life expectancy, with respiratory disease being a significant threat. However, evidence on respiratory disease in this population has not yet been meta-analyzed.
Methods
This meta-analysis examines respiratory disease prevalence and odds ratio (OR) in patients with MDD and treatment resistant depression (TRD). A systematic literature search was conducted, with a snowball search of reference and citation lists. Inclusion criteria covered studies in MDD and TRD patients with confirmed diagnoses of respiratory diseases (asthma, chronic obstructive pulmonary disease [COPD], pneumonia, lung cancer, and tuberculosis), comparing with a control group when possible.
Results
From 4,138 retrieved articles, 15 (including 476,927 individuals with MDD, 50,680 with TRD, and 1,108,979 control group) met the inclusion criteria. In MDD patients, COPD prevalence was 9.0% (95% CI: 3.8–19.6%), asthma 8.6% (95% CI: 5.7–12.8%), and pneumonia 2.5% (95% CI: 2.2–2.9%). In TRD patients, COPD prevalence was 9.9% (95% CI: 4.2–21.9%) and asthma 10.9% (95% CI: 10.7–11.2%), but meta-analysis limited to those diseases showed no significant relative risk differences. Compared to the general population, individuals with MDD had significantly higher rates of COPD (OR 1.79, 95% CI: 1.49–2.16), even higher in younger populations (1.85 [95% CI: 1.74–1.97]) and more prevalent in women.
Conclusions
This first meta-analysis on this topic shows that MDD is associated with an increased risk of respiratory illness compared to the general population. The prevalence of asthma doubles the mean described in the general population worldwide, and in COPD, women and younger people are at particular risk. Prevention policies are urgently needed.