The structure of paranoia in the general population

Background: Psychotic phenomena appear to form a continuum with normal experience and beliefs, and may build on common emotional interpersonal concerns. Aims: We tested predictions that paranoid ideation is exponentially distributed and hierarchically arranged in the general population, and that persecutory ideas build on more common cognitions of mistrust, interpersonal sensitivity and ideas of reference. Method: Items were chosen from the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II) questionnaire and the Psychosis Screening Questionnaire in the second British National Survey of Psychiatric Morbidity (n = 8580), to test a putative hierarchy of paranoid development using confirmatory factor analysis, latent class analysis and factor mixture modelling analysis. Results: Different types of paranoid ideation ranged in frequency from less than 2% to nearly 30%. Total scores on these items followed an almost perfect exponential distribution (r = 0.99). Our four a priori first-order factors were corroborated (interpersonal sensitivity; mistrust; ideas of reference; ideas of persecution). These mapped onto four classes of individual respondents: a rare, severe, persecutory class with high endorsement of all item factors, including persecutory ideation; a quasi-normal class with infrequent endorsement of interpersonal sensitivity, mistrust and ideas of reference, and no ideas of persecution; and two intermediate classes, characterised respectively by relatively high endorsement of items relating to mistrust and to ideas of reference. Conclusions: The paranoia continuum has implications for the aetiology, mechanisms and treatment of psychotic disorders, while confirming the lack of a clear distinction from normal experiences and processes.

Rapid-onset opioids and the management of episodic pain

This is the fourth in a short series of articles that focus on what GPs should consider when monitoring and prescribing specialist-initiated palliative-care medicines. Here, the authors summarise the key issues around the use of apid onset opioids in palliative care.

The causes of prescribing errors in English general practices: a qualitative study

Aim: To examine the causes of prescribing and monitoring errors in English general practices and provide recommendations for how they may be overcome. Design: Qualitative interview and focus group study with purposive sampling and thematic analysis informed by Reason’s accident causation model. Participants: General practice staff participated in a combination of semi-structured interviews (n=34) and six focus groups (n=46). Setting: Fifteen general practices across three primary care trusts in England. Results: We identified seven categories of high-level error-producing conditions: the prescriber, the patient, the team, the task, the working environment, the computer system, and the primary-secondary care interface. Each of these was further broken down to reveal various error-producing conditions. The prescriber’s therapeutic training, drug knowledge and experience, knowledge of the patient, perception of risk, and their physical and emotional health, were all identified as possible causes. The patient’s characteristics and the complexity of the individual clinical case were also found to have contributed to prescribing errors. The importance of feeling comfortable within the practice team was highlighted, as well as the safety of general practitioners (GPs) in signing prescriptions generated by nurses when they had not seen the patient for themselves. The working environment with its high workload, time pressures, and interruptions, and computer related issues associated with mis-selecting drugs from electronic pick-lists and overriding alerts, were all highlighted as possible causes of prescribing errors and often interconnected. Conclusion: This study has highlighted the complex underlying causes of prescribing and monitoring errors in general practices, several of which are amenable to intervention.

Older people's perceptions of assistive technology — An exploratory pan-European study

This paper describes a study undertaken to explore how assistive technology in the form of a wrist-worn device is perceived by older people for whom it has been devised.

Wearable device to assist independent living

Older people increasingly want to remain living independently in their own homes. The aim of the ENABLE project is to develop a wearable device that can be used to support older people in their daily lives and which can monitor their health status, detect potential problems, provide activity reminders and offer communication and alarm services. In order to determine the specifications and functionality required for the development of the device, user surveys and focus groups were undertaken, use case analysis and scenario modeling carried out. The project has resulted in the development of a wrist-worn device and mobile phone combination that can support and assist older and vulnerable wearers with a range of activities and services both inside their home and as they move around their local environment. The device is currently undergoing pilot trials in five European countries. The aim of this paper is to describe the ENABLE device, its features and services, and the infrastructure within which it operates.

The responsibility to record civilian casualties

The responsibility to record civilian casualties in both armed conflict and civil disturbances must be an integral element of the responsibility to protect, particularly in the application of the just cause principles. The first part of this article examines the threshold issue of the possibility of large-scale civilian casualties which triggers the international community’s responsibility to react. The reports recommending the responsibility to protect emphasise the need to establish the actuality or risk of ‘large scale’ loss of life which is not possible in the current context without a civilian casualty recording structure. The second part of the article outlines the international legal obligation to record civilian casualties based on international humanitarian law and international human rights law. Thirdly, the responsibility to protect and the legal obligation to record casualties are brought together within the framework of Ban Ki-moon’s reports on implementation of the Responsibility to Protect. The fourth and final part of the article reviews the situations in Sri Lanka and Syria. Both states represent egregious examples of governments hiding the existence of casualties, resulting in paralysis within the international community. These situations establish, beyond doubt, that the national obligation to record civilian casualties must be part and parcel of the responsibility to protect.

Identifying and recording every casualty of armed conflict

This article discusses the international legal obligation to identify and record every casualty of armed conflict that finds its basis in the treaties and customs of international humanitarian law and international human rights law. The article applies the various facets of the legal obligation to the armed conflicts in Iraq and Sri Lanka and argues that the parties in these conflicts failed in their international legal responsibility to civilians.

‘Due libertie and proportiond equalitie’: Milton, democracy, and the republican tradition

John Milton’s political thought has been interpreted in strikingly divergent ways. This article argues that he should be seen as a classical republican, and locates key aspects of his political thought within an ancient Greek discourse critical of democracy or extreme democracy. Milton was clearly familiar with the ancient texts expounding this critique, and he himself deployed both the arguments and the characteristic discourse of the anti-democratic thinkers across the span of his writing. This vision of politics emphasized the rightly-ordered soul of the masculine republican citizen, in contrast to the unruly passions seen both in tyrants and in the democratic rabble.

Biochar alteration of the sorption of substrates and products in Soil Enzyme Assays

Pine wood and barley straw biochar amendments to Kettering and Cameroon sandy silt loam soils (15, 30, or 150 mg biochar g−1 soil) caused significant reductions (up to 80%,

Six new loci associated with body mass index highlight a neuronal influence on body weight regulation

Common variants at only two loci, FTO and MC4R, have been reproducibly associated with body mass index (BMI) in humans. To identify additional loci, we conducted meta-analysis of 15 genome-wide association studies for BMI (n > 32,000) and followed up top signals in 14 additional cohorts (n > 59,000). We strongly confirm FTO and MC4R and identify six additional loci (P < 5 x 10(-8)): TMEM18, KCTD15, GNPDA2, SH2B1, MTCH2 and NEGR1 (where a 45-kb deletion polymorphism is a candidate causal variant). Several of the likely causal genes are highly expressed or known to act in the central nervous system (CNS), emphasizing, as in rare monogenic forms of obesity, the role of the CNS in predisposition to obesity.

Cross-cultural generality and specificity in self-regulation: avoidance personal goals and multiple aspects of well-being in the United States and Japan

The authors examined avoidance personal goals as concurrent (Study 1) and longitudinal (Study 2) predictors of multiple aspects of well-being in the United States and Japan. In both studies, participants adopted more avoidance personal goals in Japan relative to the United States. Both studies also demonstrated that avoidance personal goals were significant negative predictors of the most relevant aspects of well-being in each culture. Specifically, avoidance personal goals were negative predictors of intrapersonal and eudaimonic well-being in the United States and were negative predictors of interpersonal and eudaimonic well-being in Japan. The findings clarify and extend puzzling findings from prior empirical work in this area, and raise provocative possibilities about the nature of avoidance goal pursuit.

Parallel editing, multi-positionality and maximalism: cosmopolitan effects as explored in some art works by Melanie Jackson and Vivienne Dick

Garfield produces a critique of neo-minimalist art practice by demonstrating how the artist Melanie Jackson’s Some things you are not allowed to send around the world (2003 and 2006) and the experimental film-maker Vivienne Dick’s Liberty’s booty (1980) – neither of which can be said to be about feeling ‘at home’ in the world, be it as a resident or as a nomad – examine global humanity through multi-positionality, excess and contingency, and thereby begin to articulate a new cosmopolitan relationship with the local – or, rather, with many different localities – in one and the same maximalist sweep of the work. ‘Maximalism’ in Garfield’s coinage signifies an excessive overloading (through editing, collage, and the sheer density of the range of the material) that enables the viewer to insert themselves into the narrative of the work. In the art of both Jackson and Dick Garfield detects a refusal to know or to judge the world; instead, there is an attempt to incorporate the complexities of its full range into the singular vision of the work, challenging the viewer to identify what is at stake.

Messages about antibiotic resistance in different newspaper genres

Poorer people are more likely to use antibiotics; inappropriate antibiotic use causes resistance, and health campaigns attempt to change behaviour through education. However, fuelled by the media, the public think antibiotic resistance is outside their control. Differences in the attribution of blame for antibiotic resistance in two genres of UK newspapers, targeting distinct socioeconomic groups, were examined using a mixed methods approach. Firstly, depiction of blame was categorised as either external to the lay public (outside their control) or internal (lay person accountable) and subjected to a chi-square test. Secondly, using critical discourse analysis, we examined the portrayal of the main agents through newspaper language. Data from 597 articles (307 broadsheets) analysed revealed a significant association between newspaper genre and attribution of blame for antibiotic resistance. While both newspaper types blamed antibiotic resistance predominantly on factors external to the lay public, broadsheets were more likely to acknowledge internal factors than tabloids. Tabloids provided a more skewed representation, exposing readers to inaccurate explanations about antibiotic resistance. They highlighted ineptitude in health professionals, victimising patients and blaming others, while broadsheets used less emotive language. Pharmacists should take special care to communicate the importance of appropriate antibiotic use against this backdrop of distortion.

Dissociation between the impact of evidence on eye movement target choice and confidence judgements

It has been suggested that the evidence used to support a decision to move our eyes and the confidence we have in that decision are derived from a common source. Alternatively, confidence may be based on further post-decisional processes. In three experiments we examined this. In Experiment 1, participants chose between two targets on the basis of varying levels of evidence (i.e., the direction of motion coherence in a Random-Dot-Kinematogram). They indicated this choice by making a saccade to one of two targets and then indicated their confidence. Saccade trajectory deviation was taken as a measure of the inhibition of the non-selected target. We found that as evidence increased so did confidence and deviations of saccade trajectory away from the non-selected target. However, a correlational analysis suggested they were not related. In Experiment 2 an option to opt-out of the choice was offered on some trials if choice proved too difficult. In this way we isolated trials on which confidence in target selection was high (i.e., when the option to opt-out was available but not taken). Again saccade trajectory deviations were found not to differ in relation to confidence. In Experiment 3 we directly manipulated confidence, such that participants had high or low task confidence. They showed no differences in saccade trajectory deviations. These results support post-decisional accounts of confidence: evidence supporting the decision to move the eyes is reflected in saccade control, but the confidence that we have in that choice is subject to further post-decisional processes.

Are investors guided by the news disclosed by companies or by journalists?

Most previous studies demonstrating the influential role of the textual information released by the media on stock market performance have concentrated on earnings-related disclosures. By contrast, this paper focuses on disposal announcements, so that the impacts of listed companies’ announcements and journalists’ stories can be compared concerning the same events. Consistent with previous findings, negative words, rather than those expressing other types of sentiment, statistically significantly affect adjusted returns and detrended trading volumes. However, extending previous studies, the results of this paper indicate that shareholders’ decisions are mainly guided by the negative sentiment in listed companies’ announcements rather than that in journalists’ stories. Furthermore, this effect is restricted to the announcement day. The average market reaction–measured by adjusted returns–is inversely related only when the announcements are ignored by the media, but the dispersion of market reaction–measured by detrended trading volume–is positively affected only when announcements are followed up by journalists.