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This chapter zeros in on six pathways to early death: genes and epigenetics, adverse childhood experiences, high-risk health behaviors, autonomic imbalance, hormonal turmoil, and low-grade inflammation. And each one of these pathways may weave through the others, eventually creating a Gordian knot of dysregulations that may be experienced by you as fibromyalgia, depression after a heart attack, or a perplexing and debilitating tremor in your hands and legs. This chapter closes with a summary of what we know about the stress and illness relationship and the key questions we need to study.
How fast or slow does the process of dysregulating the stress response system go before a disease emerges? This chapter builds a model for how this process works over the lifespan. The apparently sudden onset of diabetes or heart disease in our fifties or sixties can often be traced to dysregulations that began years or decades before, invisible to the unsuspecting and asymptomatic. Toxic stress accelerates illness and speeds up aging. How do we know if we’re on a fast track to future illness and early death? And when is the best time to intervene? That depends on how we measure stress. Consider Teresa Langford’s pathways from genes to stress to illness over 53 years.
Many developing countries still face difficulties initiating and sustaining economic development. Such difficulties have been exacerbated by the COVID-19 pandemic, resulting in an increasing divergence between rich and poor countries. One crucial question is whether to follow the trajectories of present-day rich countries or seek out different, new trajectories. Although this is a fundamental question, scholars offering mainstream prescriptions have not sufficiently explored it. Drawing on extensive empirical studies of firms and industries, Innovation and Development Detours for Latecomers proposes an effective alternative to prevailing development thinking. It presents a rich menu of development pathways, including a new role for Schumpeterian states whereby they do not follow the paths of technological development already taken by advanced countries. Rather, they can skip certain stages and even create their own detours thereby leapfrogging advanced countries in both manufacturing and service sectors. This title is also available as Open Access on Cambridge Core.
People with a wide range of mental health and neurodevelopmental conditions are found amongst criminal justice populations, and many present with co-occurring disorders. These may include other neurodevelopmental conditions, substance use disorders or physical health conditions. It is now standard practice to use a pathways approach to organise and deliver services, and journeys taken by many people within criminal justice systems lend themselves to this, at least in theory. Basic requirements of this approach include police custody and prison reception screening, providing organised multidisciplinary care and introducing appropriate interventions as part of individual care plans. There is much we still do not know about vulnerable people in prisons, and service provision remains far from optimal. In particular, insufficient specialist provision means that many people with neurodevelopmental conditions are not identified appropriately, and do not have their needs met as they should. Further, in the absence of support, the presentations of some people render them vulnerable to specific aspects of prison life.
Edited by
Bruce Campbell, Clim-Eat, Global Center on Adaptation, University of Copenhagen,Philip Thornton, Clim-Eat, International Livestock Research Institute,Ana Maria Loboguerrero, CGIAR Research Program on Climate Change, Agriculture and Food Security and Bioversity International,Dhanush Dinesh, Clim-Eat,Andreea Nowak, Bioversity International
Multiple social, systemic, and structural factors threaten our current food systems. Climate change is pushing us to transform these systems, not only to mitigate its impact but also to ensure food and nutrition security and pursue other ecological, social, political, and economic benefits. Research and innovation have a unique value proposition in the context of food-system transformation. By creating, reorienting, and phasing out aspects of our current research systems, we can realise their potential. We can phase out research institutions, mental models, and incentives that are siloed and that promote top-down silver-bullet thinking. Agricultural research for development can also be reorientated to food system research wherein performance is measured based on benefits to users and the ability to scale rapidly. We can also create spaces and matching incentives to catalyse action, imagine shared futures among stakeholders, and support intergenerational allyship and learning.
The explicit aim of the IPCC is to influence policymaking. By synthesising research on climate change and presenting it to policymakers, the IPCC tries to meet its self-imposed goal of being policy-relevant and policy-neutral, but not policy-prescriptive. The hallmark of the IPCC has been to offer a strong scientific voice demonstrating the necessity of climate policy and action, but without giving firm political advice. Yet scholars have contested the idea of maintaining such a strong boundary between science and policy in the IPCC, questioning whether upholding this boundary has been successful and whether continuing to do so offers a viable way forward. The Paris Agreement provides a new political context for the IPCC, implying a need for solution-oriented assessments. The IPCC itself has also argued that large-scale transformations of society are needed to meet the targets set by the Agreement. To be relevant and influence policymaking in this new political context, the IPCC needs to provide policy advice.
In this chapter I take a deep dive into contemporary examples of EV including its sources and the pathways of EV to people’s lives, as well as the everyday life practices that both produce and are affected by EV. We will see how EV is both produced by everyday life practices, and how it harms or changes everyday life practices: it is both a product and transformer of the contemporary human niche, a recursive linkage. I more fully examine aspects of time, accumulation, and scale. I discuss the mutual emission and dynamism between toxic and nontoxic pollutants, since they are often emitted together, as copollutants. I close the chapter by reviewing the politics of EV and demonstrating why the anthropological ecosystems approach, informed by complex adaptive systems and human niche construction theory, is vital to the process of identifying, tracking, and measuring EV in the Earth system and its impacts on everyday life.
The charismatic, ideological, and pragmatic (CIP) theory of leadership has emerged as a novel framework for thinking about the varying ways leaders can influence followers. The theory is based on the principle of equifinality, or the notion that there are multiple pathways to the same outcome. Researchers of the CIP theory have proposed that leaders are effective by engaging in one, or a mix of, three leader pathways: the charismatic approach focused on an emotionally evocative vision, an ideological approach focused on core beliefs and values, or a pragmatic approach focused on an appeal of rationality and problem solving. Formation of pathways and unique follower responses are described. The more than 15 years of empirical work investigating the theory are summarized, and the theory is compared and contrasted to other commonly studied and popular frameworks of leadership. Strengths, weaknesses, and avenues for future investigation of the CIP theory are discussed.
This chapter reviews what is known about the developmental antecedents of adult antisocial personality. It addresses the question of why it is that, while many people may have personality difficulties, a minority develop a severe and persistent dysfunction of personality that is more or less life-long, leading them into a pattern of chronic antisocial behaviour. Findings reviewed in this chapter suggest that the route to adult antisociality is marked by a cascade of developmental roadblocks and insults arising during childhood and adolescence. The authors emphasise the importance of adolescence as a period when things can go seriously awry and personality can deviate from a normal track. They further emphasise the critical importance of substance abuse, particularly the misuse of alcohol, in the genesis of life-course-persistent antisociality. Two possible developmental pathways are described, one predominantly male, the other predominantly female, through which adult antisociality results from adverse circumstances in childhood and adolescence.
Women from ethnic minorities who experience mental health problems during the perinatal period are disproportionately represented in involuntary care. They have poorer access to community care but have higher engagement with services once accessed. Their pathways to accessing perinatal mental health care remain underexplored.
Objectives
To investigate the pathways to perinatal mental health services for women across different ethnic groups, including number of caregivers encountered and time elapsed between referrals.
Methods
Analysis of patient records and routine service data from community and inpatient perinatal mental health services in the United Kingdom. Use of an adaptation of the WHO’s pathway encounter form.
Results
Women from ethnic minority groups experience increased levels of complexity on their journey to accessing perinatal mental health care. We will present a detailed analysis of patient and service characteristics.
Conclusions
Referral pathways to perinatal mental health services need to be optimised for women from underrepresented groups.
The objective of this study was to investigate how different obesity measures link to circulating metabolites, and whether the connections are due to genetic or environmental factors. A cross-sectional analysis was performed on follow-up survey data at the Chinese National Twin Registry (CNTR), which was conducted in four areas of China (Shandong, Jiangsu, Zhejiang and Sichuan) in 2013. The survey collected detailed questionnaire information and conducted physical examinations, fasting blood sampling and untargeted metabolomic measurements among 439 adult twins. Linear regression models and bioinformatics analysis were used to examine the relation of obesity measures, including body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) with serum metabolite levels and related pathways. A co-twin control study was additionally conducted among 15 obesity-discordant monozygotic (MZ) pairs (intrapair BMI difference >3 kg/m2) to examine any differences in metabolites controlling for genetic factors. Eleven metabolites were associated with BMI, WC and WHR after controlling for genetic and shared environmental factors. Pathway analysis identified pathways such as phenylalanine metabolism, purine metabolism, valine, leucine and isoleucine biosynthesis that were associated with obesity. A wide range of unfavorable alterations in the serum metabolome was associated with obesity. Obesity-discordant twin analysis suggests that these associations are independent of genetic liability.
The analysis in this chapter emphasises that there can only ever be two places that law, in its present state, can lead embryos to: a woman’s womb, or its own destruction and disposal. Ultimately, this chapter has been developed with a view to answering: how might we use a liminal lens to bring lessons from ‘the gothic’, from conceptualisation to realisation? This chapter addresses the latter in four sections. First, it briefly takes stock of the analysis and ‘lessons’ highlighted by the book so far, before going on to synthesise this analysis, and in doing so, considering the ways in which law can lead embryos out of liminality. Second, it focuses on the roles of persons in embryonic processes in vitro; and Third, it draws out the contours of a context-based approach, including what the approach is not; Finally, it, discusses the potential effects of a context-based approach for the issues (i.e. the contours of the ‘legal gap’) discussed in Part One of this book. It suggests that a context-based approach has the potential to justify affording embryos in vitro different ‘statuses’ depending on the relationally guided and defined pathway on which it is, or onto which it is put.
A student’s hope – their ability to both envision paths to desirable future goals and believe that they will get there – is a powerful force within the school context. In this chapter, I discuss the relevance and utility of hope within the school setting for school psychologists. The chapter begins with an overview of hope theory, including how it is typically measured and its documented relationships with the achievement, academic engagement, mental health, and socioemotional functioning of students. Next, I discuss several ways school psychologists can promote hope schoolwide through various school policies and actions. Lastly, I go over several research-based hope interventions that can be employed in small groups as well as several informal hope-based interventions that can be utilized by school personnel more broadly. There are many ways that hope can be useful to school psychologists. This chapter provides a starter hope toolkit for how it can be leveraged.
The use of quality-adjusted life-years (QALYs) to set healthcare priorities has been criticized as unfair to people with disabilities that affect their health or lifespan. For instance, because many quality-of-life assessments associate paraplegia with lower quality of life, individuals with paraplegia are assigned lower priority for transplantable organs when those organs are distributed using QALY-based approaches. This consequence of using QALYs to set priorities has prompted a variety of responses. Some have argued that priorities should be set using life-years rather than QALYs. Others have argued that discriminating against people with disabilities is justified.
Characterised by its population density, cultural and ethnic diversity, familial fragmentation and high levels of HIV/AIDS, crime and homelessness, Paris poses specific problems with regard to mental healthcare.
Methods
Epidemiological studies show high rates of generalised anxiety and drug and alcohol abuse and dependence, greater use ofpsychoactive medication and, at the same time, apprehension about looking after mentally ill family members at home.
Results
Although the Greater Paris area has a much higher density of GPs and specialists than the national mean, there are considerable variations within the region itself, with the central area having up to four times as many GPs or psychiatrists as the outer suburbs. On the other hand, although the number of mental health medical acts and the number of people receiving mental health care have been rising dramatically over the last 15 years, Paris has considerably less adult psychiatry beds and day care places per head of population than the rest of France.
Discussion
Current planning targets include a more equitable distribution of mental health care service provision for the rapidly evolving urban population, early prevention of psycho-affective disorders, suicide and drug and alcohol misuse and the creation of low threshold services for adolescents in difficulty.
To describe principles and characteristics of mental health care in Rome.
Method
Based on existing data, service provision, number of professionals working in services, funding arrangements, pathways tocare, user/carer involvement and specific issues are reported.
Results
After the Italian psychiatric reform of 1978, an extensive network of community-based services has been set up in Romeproviding prevention, care and rehabilitation in mental health. A number of small public acute/emergency inpatient units inside general hospitals was created (median length of stay in 2002 = 8 days) to accomplish the shift from a hospital-based to a community-based psychiatric system of care. Some private structures provide inpatient assistance for less acute conditions (median length of stay in 2002 = 28 days), whilst the large Roman psychiatric hospital was closed in 1999.
Discussion
Whilst various issues of mental health care in Rome overlap with those in other European capitals, there also are some specific problems and features. During the last two decades, the mental health system in Rome has been successfully converted to a community-based one. Present issues concern a qualitative approach, with an increasing need to foresee adequate evaluation, especially considering mental health patients' satisfaction with services and economic outcomes.
To describe principles and characteristics of mental health care in Madrid.
Method
Based on existing data, service provision, number of professionals working in services, funding arrangements, pathways intocare, user/carer involvement and specific issues are reported.
Results
In Madrid, mental health services are organized into 11 zones/areas, divided into 36 districts, where there is a mental healthoutpatient service with a multi-disciplinary team. Home treatment and psychosocial rehabilitation services have been developed. Specialist programmes exist for vulnerable client groups, including Children and Adolescents, Addiction/Alcohol and Older People. The Madrid Mental Health Plan (2003–2008) is regarded as the key driver in implementing service improvement and increased mental health and well-being in Madrid. It has a meant global budget increase of more than 10% for mental health services. Results of the first 2 years are: an increase in mental health staff employed (17%), four new hospitalization units, 50% increase in places for children and adolescents Day Hospitals, 62 new beds in long care residential units, development of specific programmes for the homeless and gender-based violence, a significant investment in information systems (450 new computers) and development of best practice and operational guidelines. Mental health system was put to the test with Madrid's March 11th terrorist attack. A Special Mental Health Plan for Affected people was developed.
Discussion
Unlike some European countries, public mental health service is the main heath care provider. There are no voluntary agenciescollaborating with mental health care. Continuity of care and coordination between all mental health resources is essential in service delivery. Increased demand of care for minor psychiatric disorders, children and adolescent mental health care, and implementation of rehabilitation and residential facilities for chronic patients are outstanding challenges similar to those in other European capitals. Overall, the mental health system had successfully coped with last year's increased care demand after March 11th terrorist attack in Madrid.
To describe principles and characteristics of mental health care in London.
Method
Based on existing data, service provision, number of professionals working in services, funding arrangements, pathways intocare, user/carer involvement and specific issues are reported.
Results
London experiences high levels of need and use of mental health services compared to England as a whole. Inpatient andcompulsory admissions are considerably higher than the national average. Despite having more psychiatric beds and mental health staff, London has higher bed occupancy rates and staffing shortages. At the same time there is a trend away from institutionalised care to care in the community.
Conclusion
Mental health services in the UK are undergoing considerable reform. These changes will not remove the greater need formental health services in the capital, but national policy and funding lends support to cross-agency and pan-London work to tackle some of the problems characteristic of mental health in London. Whilst various issues of mental health care in London overlap with those in other European capitals, there also are some specific problems and features.
To provide information on the mental health care system in Berlin, Germany.
Method
Using available data we report on the spectrum of mental health care services provided in Berlin, the number of professionalsworking in these sectors, funding arrangements, pathways into care, and user/carer involvement.
Results
The health care system in Berlin consists of a network of inpatient, outpatient, ancillary, and rehabilitative facilities, all of which are meant to work in a synergistic fashion. However, although the individual treatment options are generally well-planned, there is still a lack of co-ordination between them. Currently, the entire network is threatened by cuts in state funding for ancillary and rehabilitative services, by further reductions in the number of hospital beds, and by insurance company cuts in prescription drug budgets, such as those used for atypical antipsychotics in outpatient care.
Discussion
Despite many similarities with the situation in other European capitals, the system of mental health care in Berlin suffersfrom a variety of problems related to co-ordination and costs that are unique to the German capital.