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Core outcome sets are an agreed, standardised set of outcomes based on what key stakeholders consider the important outcomes in the management or prevention of a condition. They are crucial to unifying research data from different trials, allowing outcomes to be combined and compared. Core outcome sets in miscarriage prevention and management and ectopic pregnancy have been produced. The final outcomes for miscarriage management are: efficacy of miscarriage treatment, heavy vaginal bleeding, pelvic infection, maternal death, procedural related complications and patient satisfaction. The final outcomes for miscarriage prevention are: pregnancy loss, live birth, congenital abnormalities, fetal growth restriction, gestation at birth, pre-term birth, neonatal or infant death, maternal complications, compliance with intervention, patient satisfaction, maternal hospitalisation and neonatal or infant hospitalisation. The final outcomes for ectopic pregnancy are: treatment success, resolution time of EP, number of additional interventions, adverse events, mortality and severe morbidity and treatment satisfaction.
Delphi studies allow for the generaztion of a consensus among experts. This has historically been professional experts in their field. This study aimed to obtain a consensus regarding the most important components of cognitive behavioural therapy (CBT) for depression not only for professional experts (therapists) but also for adult experts by experience. Perceptions of importance between therapists and experts by experience differed in multiple areas including content components such as behavioural activation and experiments, psychoeducation, and homework, which the latter did not agree were important. Experts by experience found several components relating to delivery process important which therapists did not, such as delivery method and session length. The strongest agreement from both groups involved the importance of positive therapist factors such as being non-judgemental, knowledgeable, understanding, and trustworthy. Both groups were in agreement on the importance of cognitive restructuring. Neither experts by experience nor therapists met consensus agreement on the inclusion of mindfulness as part of a wider CBT intervention for depression, being rated among the lowest components for both groups. Findings highlight several aspects of CBT content and delivery which may benefit from review in order to increase acceptability for recipients.
Key learning aims
(1) To identify what recipients and deliverers feel are the most important parts of a CBT intervention for depression.
(2) To compare these responses, and consider reasons why these similarities and differences may exist.
(3) To discuss ways in which these differences could impact acceptability and perceived efficacy of cognitive behavioural therapy.
(4) To reflect on ways gained knowledge could be used to consider ways to improve the delivery of cognitive behavioural therapy.
The idea of the Amazons is one of the most romantic and resonant in all antiquity. Greeks were fascinated by images and tales of these fierce female fighters. At Troy, Achilles' duel with Penthesilea was a clash of superman and superwoman. Achilles won the fight, but the queen's dying beauty had torn into his soul. This vibrant new book offers the first complete picture of the reality behind the legends. It shows there was much more to the Amazons than a race of implacable warrior women. David Braund casts the Amazons in a new light: as figures of potent agency, founders of cities, guileful and clever as well as physically impressive and sexually alluring to men. Black Sea mythologies become key to unlocking the Amazons' mystery. Investigating legend through history, literature, and archaeology, the author uncovers a truth as surprising and evocative as any fiction told through story or myth.
Defending the indefensible and praising the unpraiseworthy were staples of Greek declamation in the Roman imperial period. Lucian’s Phalaris I and II have generally been considered as undemanding rhetorical exercises, inverting the standard tropes of anti-tyrant invective to produce a paradoxical encomium of the proverbially wicked tyrant Phalaris of Akragas. This paper argues that Phalaris I and II are in fact considerably more sophisticated and caustic texts then they appear at first sight. Phalaris’ letter to the Delphians in Phalaris I is carefully crafted to show that Phalaris is indeed, despite his protestations, a self-deluding psychopath; he now wishes to dedicate his notorious bronze bull to the Delphic Apollo in order to whitewash his terrible reputation. The speech of the anonymous Delphian in Phalaris II makes a radically cynical case for welcoming the gift of the bull with no questions asked, in full knowledge that Phalaris may be just as wicked as he is reputed to be. The texts are an ironic commentary on the murky ethics of Delphic patronage in the second century CE, and the venality of oracular shrines more generally; Lucian may specifically have in mind the lavish Delphic patronage of the Roman emperor Domitian.
Discussion of the transfer of cult knowledge from Anatolia to European Hellas in both the Bronze Age and Iron Age, with a close examination of Ephesian Artemis and other Asian Mother-goddess figures with consideration of Ur-Aeolian (= Ahhiyawan) and Aeolian involvement in the process.
An investigation of the Luvo-Hittite dammara- religious functionaries (male and female) and the borrowing of the term into Ahhiyawan (Ur-Aeolian) and, thence, European Mycenaean cult vocabulary as dumartes and its variant damartes (a scribal borrowing), and an exploration of the Anatolian source of the theonym Artemis. The intersection of both the cult title and divine name with Mycenaean dialect variation is carefully examined.
A synthetic, concluding discussion addressing the relationship between Ur-Aeolic and Special Mycenean and providing a historical framework for, especially, the introduction of Aeolic language and culture (pre-Thessalian/Boeotian) into European Greece following the Bronze-Age collapses and for the spread of pre-Aeolians (Iron-Age Ahhiyawans) eastward into Cilicia.
Investigation of the Bee-nymphs of Mt. Parnassus and the ancestral Indo-European strain and Anatolian strains of divination introduced into European Hellas by migrant pre-Aeolian communities.
While many medical practitioners value the interactive nature of in-person conferences, results of these interactions are often poorly documented. The objective of this study was to pilot the Delphi method for developing consensus following a national conference and to compare the results between experts who did and did not attend.
Methods:
A 3-round Delphi included experts attending the 2023 Society of Disaster Medicine and Health Preparedness Annual Meeting and experts who were members of the society but did not attend. Conference speakers provided statements related to their presentations. Experts rated the statements on a 1–7 scale for agreement using STAT59 software (STAT59 Services Ltd, Edmonton, Alberta, Canada). Consensus was defined as a standard deviation of ≤ 1.0.
Results:
Seventy-five statements were rated by 27 experts who attended and 10 who did not: 2634 ratings in total. There was no difference in the number of statements reaching consensus in the attending group (26/75) versus that of the nonattending group (27/75) (P = 0.89). However, which statements reached consensus differed between the groups.
Conclusion:
The Delphi method is a viable method to document consensus from a conference. Advantages include the ability to involve large groups of experts, statistical measurement of the degree of consensus, and prioritization of the results.
Dementia in-patient units (DIU) are mental health wards that care for people living with dementia (PLWD) whose symptoms are causing severe distress or potential risk. DIUs look after some of the most vulnerable and unwell people in society, yet they are environments that are underresearched: a recent systematic review revealed only 36 articles worldwide relating to DIUs. To better understand research priorities in DIUs, we undertook a two-round online Delphi survey of PLWD with experience of DIUs, their carers and professionals who work in DIUs.
Results
Ten research priorities were described and ranked. The top three were how to use non-pharmacological techniques to manage non-cognitive symptoms of dementia, supporting families and better understanding of how to discharge PLWD safely and healthily.
Clinical implications
This is the first Delphi consensus to describe DIU research priorities. This paper will help researchers focus on the areas that matter most to people who use DIUs.
This chapter discusses Plutarch’s On the Oracles at Delphi, and in particular the account of the grammarian Theon as to how prose came to replace verse, not just in the delivery of the Delphic oracle, but in literary discourse as a whole. Theon’s account of the history of Greek literate culture is an important document of how learned Greeks in the Roman empire imagined how their world had changed, along with the literature in which it was represented. The first part of the chapter considers another Plutarchan account of cultural and intellectual change, namely the opening of On the Obsolescence of Oracles, which tells the foundation story of Delphi. Both texts lay weight upon the fact of change itself, rather than on any detailed plotting of that change, let alone a chronology for it; so too, both illustrate a tendency to see recurrent patterns of change, by which the outlines of Greek literary history are found already adumbrated in classical literature itself. Among the classical texts which are central to this appropriation of past models are the programmatic chapters of Thucydides and Aristotle’s account of the development of poetic language.
If there is a Greek tragedy that is not often associated with choral song this must surely be Sophocles’ Oedipus Tyrannus. The play has become synonymous with the story about the young Oedipus’ fate made famous by Sigmund Freud, and as such it has been canonized as the founding myth of psychoanalysis. As Freud first put it, in the fourth of his Five Lectures on Psychoanalysis: ‘The child takes both of its parents, and more particularly one of them, as the object of its erotic wishes … the child reacts to this by wishing, if he is a son, to take his father’s place, and, if she is a daughter, her mother’s … The myth of King Oedipus, who killed his father and took his mother to wife, reveals, with little modification, the infantile wish, which is later opposed and repudiated by the barrier against incest.’
Like names, the ‘physiognomy’ attributed to the gods by the Greeks helps to differentiate divine entities from one another or, conversely, to link them together, making explicit the nature and the scope of their powers. This chapter addresses the meaning of the adjective khruskomas, ‘with golden hair’, frequently attributed to Apollo: does it mean that the Greeks had in mind a blond god? The analysis of texts and images shows that it is much more complicated. First, onomastic attributes and iconographic attributes do not necessarily coincide. Depending on the media, craftsmen may represent a dark-haired Apollo without this being seen as a contradiction with the images conveyed by the poets. Immortals, unlike humans, take on any appearance they want. Second, the colour of gold is not exactly equivalent to blondness (for example, that of Demeter xanthe): the brilliance of the incorruptible metal expresses the radiance that emanates from the young god, notably through his eternally young hair. Khrusokomas thus expresses one of the manifold facets of Phoibos by summoning the image of his delphic sanctuary, where opulence reigns. The chapter thus shows that the colour of Apollo’s hair deserves to be taken seriously.
Nobody hates like a Greek neighbour does, to paraphrase Simon Hornblower. But did this reflect a genuine inimical attitude, or are there more layers to commemorative practices? An analysis of the neighbourly commemorative practices reveals a different reality. Looking at dedications, festivals and literary sources provides a more nuanced insight. Rather than a preference for Panhellenic arenas to propagate a warring rivalry to the largest audience, local venues and spaces were preferred. The thinking behind this localised commemoration are the intentions to strengthen local cohesion vis-à-vis a known ‘other’, in this case the neighbouring polity. Dedications at sanctuaries like Olympia or Delphi were inspired by a desire to proclaim credentials for leadership over all of Greece, rather than stress the localised interactions. Often these were made with or in relation to the Spartans, meaning these sanctuaries provided a different audience for other goals. This becomes clearest by looking at a local sanctuary, the Amphiareion at Oropos. Here both polities aimed to promote their ownership by mostly targeting local audiences. This example demonstrates the potential of contested sanctuaries for understanding local rivalries and commemorative practices and how they acted as mirrors for neighbourly relations.
This paper focuses on three famous hexameters allegedly uttered by Apollo in Delphi for Emperor Julian by means of the emperor’s physician Oribasius. Since the nineteenth century, this text, in which Apollo announces the destruction of his temple and the silence of the oracle, has been the subject of numerous interpretations. Some scholars regard it as a genuine oracle produced in Delphi and intended for the pagan Emperor Julian while he was in Antioch (362–3). Others argue that it is a Christian forgery and piece of anti-pagan propaganda written shortly after Julian’s death. In this chapter, I first discuss the literary context of this oracle’s quotation in the Artemii Passio, an anonymous and fictitious seventh-century hagiographical work. I argue that we cannot date the text to the fourth century, because its attribution to the lost Church History of Philostorgius appears to be spurious and is not grounded. Second, I analyse the anonymous hagiographer’s construction of this episode and compare it to similar late Byzantine pseudo-oracles about the fate of pagan temples in order to provide a new interpretation of this prophecy.
Although the individual has been the focus of most research into judgment and decision-making (JDM), important decisions in the real world are often made collectively rather than individually, a tendency that has increased in recent times with the opportunities for easy information exchange through the Internet. From this perspective, JDM research that factors in this social context has increased generalizability and mundane realism relative to that which ignores it. We delineate a problem-space for research within which we locate protocols that are used to study or support collective JDM, identify a common research question posed by all of these protocols—‘What are the factors leading to opinion change for the better (‘virtuous opinion change’) in individual JDM agents?’—and propose a modeling approach and research paradigm using structured groups (i.e., groups with some constraints on their interaction), for answering this question. This paradigm, based on that used in studies of judge-adviser systems, avoids the need for real interacting groups and their attendant logistical problems, lack of power, and poor experimental control. We report an experiment using our paradigm on the effects of group size and opinion diversity on judgmental forecasting performance to illustrate our approach. The study found a U-shaped effect of group size on the probability of opinion change, but no effect on the amount of virtuous opinion change. Implications of our approach for development of more externally valid empirical studies and theories of JDM, and for the design of structured-group techniques to support collective JDM, are discussed.
This chapter traces the different uses of the term φοῖνιξ / Φοῖνιξ, the cognate adjectives φοινικός and φοινικοβαφής, and verb φοινίττω, running from this last’s allusive use to describe Theagenes’ bloodstained cheek at the beginning of Book 1 to the revelation at the novel’s close that its writer is a Φοῖνιξ, ‘Phoenician’. Ι noted how these uses span the word’s range of meanings – crimson, date, palm, Phoenician – and how Phoenicia’s importance is augmented by the mysteriously unnamed Tyrian’s victory at Delphi and by the description of the ship on which the trio escape as Φοινίκιον … φιλοτέχνημα, ‘a Phoenician masterpiece’ (5.18), a mis-en-abyme of the literary masterpiece which transports the couple from Delphi to Meroe.
This chapter compares Philicus’ Demeter of ca. 275 BC (which, at the time of writing, I followed all scholars since Medea Norsa in classifying as a hymn) with the Delphic paeans of Philodamus (ca. 340 BC) and Limenius (between 128 and 108 BC). It argues that Philicus’ poem locates the exchange between Iambe and the Demeter not at Eleusis but at Prospalta, where a cult of Demeter and Persephone is attested, and that it may have proposed a role for that cult in the development of ritual αὶσχρολογία in Attica. The interest in Attic cults shown by a Corcyrean domiciled in Alexandria matches Callimachus’ decision to compose his very Attic Hecale. By contrast the Delphic paean of Philodamus is focussed chiefly on its place of performance and monumental inscription, albeit setting Dionysus’ arrival at Delphi, where he is be honoured alongside Apollo with cyclic choruses, in a wider geographical frame. Geography is important for the paean of Limenius too, offering a very Athenian version of Apollo’s reaching mainland Greece and proceeding to Delphi, a version appropriate for the Pythais from Athens by which we know it to have been performed.
In this volume, Gabriel Zuchtriegel revisits the idea of Doric architecture as the paradigm of architectural and artistic evolutionism. Bringing together old and new archaeological data, some for the first time, he posits that Doric architecture has little to do with a wood-to-stone evolution. Rather, he argues, it originated in tandem with a disruptive shift in urbanism, land use, and colonization in Archaic Greece. Zuchtriegel presents momentous architectural change as part of a broader transformation that involved religion, politics, economics, and philosophy. As Greek elites colonized, explored, and mapped the Mediterranean, they sought a new home for the gods in the changing landscapes of the sixth-century BC Greek world. Doric architecture provided an answer to this challenge, as becomes evident from parallel developments in architecture, art, land division, urban planning, athletics, warfare, and cosmology. Building on recent developments in geography, gender, and postcolonial studies, this volume offers a radically new interpretation of architecture and society in Archaic Greece.
The Introduction situates Plutarch in his literary context, as a vivid and original thinker and writer whose popularity remains enormous, as well as his historical context as an innovator in the writing of biography. Some authors discuss Plutarch’s role in the development of the biographical tradition and his relationship to the classical Greek past. Others examine his Roman context as a Greek living in an occupied country, and his views on politics, particularly those involving barbarians or "others." Multiple essays illuminate Plutarch’s relationship to Plato and Platonism, often in the context of his influence on education, while other essays look at Plutarch in his everyday life, investigating his thoughts on gender, sexuality, wealth, and animals. Five essays focus on reception.