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Existing reviews on mental health disparities between deaf and hard‐of‐hearing (DHH) and hearing populations have focused predominantly on children, adolescents, or older adults, leaving a gap for working-age adults. We conducted a systematic review comparing the prevalence, incidence, and severity of any DSM-5-TR or ICD-11 mental disorder between DHH and hearing adults aged 18–60 years. We aimed to quantify disparities and examine disorder-specific patterns to inform future research, policy, and service development.
Methods
On 13 December 2025, we searched Ovid Medline, Embase, APA PsycINFO and Web of Science. We included analytical observational studies involving DHH and hearing adults aged 18–60 years, reporting mental disorder prevalence, incidence, or severity. Two researchers independently extracted data, and risk of bias (RoB) was assessed using the modified CLARITY tool. We narratively synthesised findings by aggregating outcomes at the study level using two approaches: summary and majority of the effect directions within a study. Subgroup syntheses examined outcome type, study RoB, age group and mental disorder category.
Results
Sixty studies (n = 8 578 466) met inclusion. In the summary-direction synthesis, 58.3% (35/60) of studies reported higher mental disorder outcomes for DHH adults, 21.7% (13/60) found no difference and 20.0% (12/60) had mixed findings; none indicated lower mental disorder outcomes for DHH. Under the majority-direction approach, 65.0% (39/60) showed higher mental disorder outcomes and 35.0% (21/60) no difference. These patterns were consistent across prevalence (62.8–72.1% higher) and severity (61.1% higher). Studies with higher RoB more often reported higher mental disorder outcomes (66.7–72.2%) than lower-RoB studies (54.8–61.9%), though both mirrored the overall synthesis. Effects were similar across younger (61.9–71.4%) and older adult samples (61.1–66.7% higher). Disorder-specific syntheses identified psychotic disorders, post-traumatic stress disorder and suicidal outcomes as having the strongest disparities (≥72.2% higher), followed by general mental disorders, anxiety and depression. Fewer than five studies examined each of the other disorders, thereby limiting conclusions for these disorders.
Conclusions
Most available evidence indicates that the prevalence and severity of mental disorders are higher among DHH adults aged 18–60 years than among hearing adults, with limited evidence on incidence. No studies reported lower aggregated mental disorder outcomes for DHH adults. Addressing these disparities requires targeted intervention research, supported by population-based, longitudinal and (quasi-)experimental studies including comprehensive reporting of participant characteristics. This will inform more tailored interventions, improve screening and ultimately contribute to better mental health and quality of life for DHH adults.
The efficacy of the “future-proof” Unfair Commercial Practices Directive against dark patterns is undermined by the fragmented regulatory landscape introduced by the Digital Services Act. Article 25 DSA creates four weaknesses: a general prohibition that is vague compared to the UCPD’s detailed framework; a narrow subjective scope that excludes many online traders; an exclusion clause in Article 25(2) that replaces cumulative application with an opaque hierarchy; and slow soft-law mechanisms for updating the law in response to new dark patterns. To resolve these contradictions, this article proposes four targeted reforms: first, repurposing Article 25(1) DSA as an institutional gateway for DSA authorities to apply substantive UCPD rules using the stronger DSA sanctions and enforcement regime; second, extending the prohibition’s scope to all intermediary service providers; third, the repeal of Article 25(2) DSA; and fourth, granting the Commission the power to update the UCPD blacklist via delegated acts for a swift response to emerging dark patterns. These reforms, particularly in combination, offer a coherent, future-proof regulatory framework that restores the centrality of the UCPD, preserves the innovations of the DSA, and equips EU law to address both current and emerging forms of dark patterns.
Polyethylene liners dropped onto operating room floors rapidly acquire bacterial contamination, including clinically important pathogens. In a randomized bench study, sterile chlorhexidine–alcohol and povidone-iodine immersion significantly reduced bioburden compared with ethanol or no intervention. When replacement is not feasible, chlorhexidine or iodine is preferable.
Efforts to counter Christian nationalism focus on the power of ideas—that Christian nationalism is historically inaccurate, religiously heretical, or even fascist. Those efforts build upon a vast research agenda on Christian nationalism in the social sciences to argue, at least implicitly, that a Christian nationalist worldview rejects religious, racial, and political pluralism in favor of a (white) Christian-centric goal for the United States. But they may be wrong on at least one account. In a January 2024 survey of 1,500 American Christians, we piloted “anti-Christian nationalism” measures, expecting to find a robust negative relationship with established measures of Christian nationalism. Instead, we find that many Christian nationalists already hold pluralist ideas in their heads. We then explore whether anti-Christian nationalism can work to counter, moderate, or align attitudes with Christian nationalism on political tolerance. We find that Christian nationalism often overrules anti-Christian nationalism, especially when the threat is high.
Previous research conducted in closed autocracies indicates that government propaganda can deter opposition, shift political attitudes, and influence emotions. Yet the specific mechanisms and contextual factors influencing how and when propaganda works remain unclear. We theorize how power-projecting government propaganda works differently for government supporters and opponents in polarized electoral authoritarian regimes, focusing on emotional reactions, sense of societal belonging, and downstream effects on contentious political behavior. Through two preregistered surveys in Turkey (N = 6,286), we find that supporters exposed to propaganda videos feel a greater sense of belonging and are more susceptible to engage in pro-government activities. Opponents report heightened anger and anxiety and seem deterred from protesting. However, the latter effect weakened during the highly contested 2023 electoral campaign. These results indicate that propaganda can help electoral authoritarian regimes deter anti-government action and encourage pro-government action, but that its deterrent effects may weaken during periods of high mobilization and contention.
Mutual recognition is a cornerstone of European integration, enabling cooperation across diverse policy fields while allowing the Union to pursue unity without uniformity. Yet, the Posted Workers saga – widely framed as a tale of tension between social rights and economic freedoms – exposes some of its limits. This paper uses the Posted Workers saga as a case study of mutual recognition. Empirically, it draws on the legislative negotiations behind the 1996 and 2018 Directives and case law from Rush to Laval, to examine legislative intent. The analysis shows that the 1996 Directive was not primarily concerned with protecting workers but with regulating the cross-border provision of labour via the freedom to provide services, through a mutual recognition mechanism. The mechanism was asymmetrical by design: it privileged certain Member States’ labour rules over others to address social dumping. The Directive was intended to create a ceiling – rather than a floor – of standards under Article 3(1), subject to narrow exceptions. Conceptually, the paper argues that mutual recognition operates as a generative yet fragile mode of integration. It is generative, fostering coordination between Member States and enabling free movement. Yet it remains fragile where the interpretations of the ‘content’ of such rules diverge. In the Posted Workers context, such divergence is evident via the conflicting understandings of ‘minimum rates of pay’. The paper concludes that while mutual recognition can facilitate diversity, it cannot indefinitely substitute for substantive political engagement in defining the content and scope of shared rules.
Counting the number of isomers of a chemical molecule is one of the formative problems of graph theory. However, recent progress has been slow, and the problem has largely been ignored in modern network science. Here we provide an introduction to the mathematics of counting network structures and then use it to derive results for two new classes of molecules. In contrast to previously studied examples, these classes take additional chemical complexity into account and thus require the use of multivariate generating functions. The results illustrate the elegance of counting theory, highlighting it as an important tool that should receive more attention in network science.
The US Centers for Disease Control and Prevention (CDC) has listed vaccination as one the top 10 public health achievements,1 and vaccines have led to a tremendous reduction in deaths due to vaccine-preventable disease in the United States alone.2 There are over 22 million persons employed in healthcare in the United States, making healthcare personnel (HCP) an important population to target for vaccination efforts. Promoting vaccination for HCP as defined by the CDC is likely to become even more essential given the rising incidence in the United States of vaccine-preventable diseases such as measles and pertussis.3
This article explores how young people in Norilsk – Russia’s largest Arctic city and a global exemplar of industrial monotown development – negotiate their futures amid extreme environmental challenges, social isolation, and economic uncertainty. Drawing on 31 in-depth interviews with vocational students of industrial specialisations, the paper examines the ways in which youth navigate a unique “here” (Norilsk) versus “on the mainland” (the rest of Russia) divide that shapes both lived experience and imagined mobility. The analysis reveals that youth typically approach life in Norilsk as a temporary, but agentic strategy: they seek financial security and work experience locally before considering uncertain migration elsewhere. This calculated “staying,” termed “permanent temporality,” is influenced by limited educational and career opportunities, strong vocational pipelines, and family narratives that valorise the accumulation of a “safety cushion” prior to moving. While Norilsk offers predictability and stability, it is rarely seen as a place for long-term residence or generational settlement. The findings challenge assumptions of Arctic youth passivity or inevitable depopulation, highlighting instead the adaptive agency young people display in a context of structural constraint. The study situates these strategies between broader transformations in Russian education, shifting value attached to vocational and university pathways, and the specific vulnerabilities of Arctic urban environments. The article concludes by discussing the implications for regional policy, urban sustainability, and broader understandings of youth transition and mobility under conditions of global peripherality and rapid socioeconomic change.
The literature on American politics widely agrees that early victories in U.S. presidential primaries are pivotal for securing the nomination, a belief that underpins the front-loading behavior of states. However, demonstrating this success-breeds-success effect is challenging because unobserved candidate qualities could independently link early victories to later success. To address this, we used a regression-discontinuity design, focusing on variations near the victory threshold. Our analysis shows that conclusions about early states rely heavily on limited observations around the cutoff. If any inference is to be drawn, it is that winning in Iowa or New Hampshire has no lasting impact on subsequent contests, nor does winning on any election day affect outcomes on the next. These findings question the presence of momentum effects for winners in the primaries.
In light of contemporary geoengineering proposals to mitigate the impact of mining and climate change on glaciers in Chile, this article analyzes how imaginaries of glaciers have changed in recent decades. It focuses on recent proposals by consultancies and mining companies to relocate glaciers, including the transportation of over thirty thousand tons of ice to a valley with low exposure to the sun in 2007 to “save a glacier,” carried out under the auspices of Andina, a branch of Codelco, a national mining company that has the largest impact on rock glaciers in the world. This effort resonates historically with a mitigation strategy that the mining company Barrick Gold proposed in 2001 for Pascua-Lama, which in 2006 triggered an international controversy that resulted in the world’s first draft glacier bill, still under debate in the Chilean Congress, and which subsequently informed a proposal for a new constitution in Chile, rejected in 2022. This article argues that the underlying assumption behind glacier relocation initiatives is that glaciers are detachable elements from the landscape, composed of homogeneous and inert ice, the transformations of which are reversible. This assumption contrasts with conceptions of glaciers arising from earth system science and contemporary biology, which conceive of them as heterogeneous ecosystems bound to their surroundings, the eventual destruction of which is ultimately irreversible. The differences between these conceptions resonate with contrasting narratives of the place humans occupy in Earth’s history, which we term anthropocentric and planetary, according to which humans are conceived of, respectively, as masters of or in precarious balance with Earth’s history.