To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
This article investigates the DDIS scandal in Denmark through the lens of Erving Goffman’s dramaturgical theory, focusing on the performative dimensions of the case and its portrayal in the media. We explore how this scandal, situated in a Scandinavian high-trust context, contributes to broader debates on intelligence accountability – an area predominantly examined in Anglo-Saxon settings. Drawing on a qualitative document analysis of media coverage, we argue that the scandal, whether framed as an intelligence or political affair, reveals a breakdown in dramaturgical discipline among key actors, challenging public perceptions of legitimacy and control. However, this breakdown has not yet translated into significant changes in intelligence practices or societal norms regarding intelligence oversight. Reflecting on de Blic and Lemieux’s notion of scandals as tests of societal norms, we find that pre-existing norms of high trust in intelligence authorities remain largely unaffected. Instead, criticism was absorbed through a reframing of the scandal as a complex, political, and person-centred issue, with the primary implication being increased secrecy and political control rather than enhanced accountability.
We examine the response of the exchange rate to monetary policy shocks using structural vector autoregression (SVAR). The SVAR approach in this study differs from previous studies by incorporating uncertainty measures and employing shock-restricted identification constraints. Using structural shocks that are in accordance with the event and external variable constraints, we demonstrate that the US exchange rate appreciates immediately in response to contractionary monetary policy shocks, with the maximum appreciation occurring within one to two months. Our finding highlights the importance of allowing contemporaneous interaction between interest rate and exchange rate, as facilitated by the shock-restricted SVAR, and accounting for uncertainties to address the puzzle of the exchange rate response.
In the Southern and Eastern Mediterranean (SEMed) region, the transition to low-carbon power must be achieved while ensuring security of supply, affordability and development. Using the Just and Sustainable Energy Transition framework and a neo-institutional lens, we analysed 470 study–country–family observations (2000–2025) across 11 jurisdictions and 7 instrument families to create an institutional mechanism map. Three regularities stand out. Systems performance signals dominate in nine countries, primarily through time-differentiated pricing, settlement discipline and codified connection, queuing and curtailment rules. Financing and integration risks are often addressed together where auctions, revenue-support schemes, published access terms and standardised long-term contracts coexist with system rules. Equity-related signals arise where prosumer compensation and reconciliation rules influence participation and cost sharing at the retail margin. These patterns provide an interpretive basis for sequencing constraint-led reforms in SEMed power systems that target binding risks while respecting fiscal and distributional constraints.
Limited studies have conducted a comprehensive investigation on the impact of China’s birth policy change on the mental health among women of childbearing age. This study aimed to explore the potential impact of China’s Universal two-child policy on depressive symptoms among women of childbearing age, based on national-representative, longitudinal survey data.
Methods
Data we employed in this study were derived from the China Family Panel Study (CFPS) for the waves of 2012, 2014, 2016, 2018 and 2020. We included 7481 currently married females (17079 for pooled sample) aged 20–40 years. Depressive symptoms were assessed using the Kessler 6 Rating Scale (K6) and the Center for Epidemiologic Studies Depression Scale (CES-D). All scores were standardized for analysis. We employ the difference-in-difference model to investigate the association between the implementation of the Universal Two-child Policy (UTP) and women’s depressive symptoms.
Results
Women in the exposed group, after implementing UTP, had a standardized score of depressive symptoms 0.10 higher (95% CI: 0.03–0.16, p = 0.007) than during the pre-intervention period after controlling for multiple covariates. They also faced a higher risk of having moderate or severe depressive symptoms (OR = 1.45, 95% CI: 1.12–1.87, p = 0.004). The stratified analysis revealed that the negative impact of UTP on mental health was pronounced among women with advanced age, low education, medium family income, only male offspring before UTP, and no new birth after UTP.
Conclusion
We observed that the implementation of the UTP was associated with increased depressive symptoms among married women of childbearing age in China, with significant heterogeneity across different sociodemographic groups. Greater attention should be paid to the complex psychological conditions of women of childbearing age when adjusting fertility policies, which is crucial to prevent women from suffering poor mental health and to advance high-quality development in population health.
Despite its vast human and natural resources, Nigeria continues to grapple with many socio-political and economic crises that have challenged the nation’s internal security and territorial integrity. These challenges underscore a significant deficit of social justice. Using phenomenological descriptive and analytical research design, this study explores the role of the Church of Nigeria (Anglican Communion) in the pursuit of social justice in Nigeria. The study found that the church has risen to challenge the culture of social injustice in Nigeria, taking the lead and paving the way in the campaign of building “a nation where peace and justice shall reign”. The Anglican Church in Nigeria has played a significant role in promoting social justice through advocacy, education, and community development.
There is growing public health interest in ultra-processed foods (UPF), but limited research exploring consumers’ perceptions of these foods in the United States. We aimed to characterize consumers’ beliefs about UPFs, the association between perceived food processing and perceived food healthfulness, and alignment between consumers’ perceptions and objective measures of food processing and healthfulness.
Design:
In a cross-sectional survey, participants answered questions regarding their beliefs about UPFs. They rated the healthfulness and processing levels of a random selection of 10 out of 40 possible foods. We used descriptive statistics to examine participant beliefs about UPFs. We used linear regression models to test associations between perceived processing and perceived healthfulness, and between objective and perceived measures of food healthfulness and processing.
Setting:
We fielded an online survey in the United States in November 2023.
Participants:
This study included US adults aged >18 years (n=4455).
Results:
Fifty-four percent of participants correctly identified UPFs as “Food products submitted to a series of industrial processing” and 52% correctly identified UPFs as, “Food products that contain artificial ingredients.” However, one-third of participants believed UPFs were genetically modified products. While foods with higher perceived processing tended to have lower perceived healthfulness and individuals perceived UPFs as more processed and less healthful than minimally processed foods, healthfulness perceptions better aligned with Food Compass 2.0, a measure that integrates food processing and nutrient-profile.
Conclusions:
Educational and policy efforts (e.g., food labeling) are needed to help consumers distinguish UPFs, and holistically assess the healthfulness of foods and beverages.
L’objectif de cet article est de reconstruire la critique deleuzienne de Georg Wilhelm Friedrich Hegel en la réinscrivant dans la problématique rectrice de Différence et répétition : non pas celle de l’ontologie de la différence positive, mais celle du rapport entre la métaphysique de la différence et l’empirisme transcendantal. Gilles Deleuze critique Hegel au nom d’un nouveau sensualisme, d’un autre pluralisme et d’un anti-rationalisme (voire d’un néo-pragmatisme original). Ainsi, contre Hegel, Deleuze défend les droits de l’immédiat, l’extériorité des relations, et l’existence de pensées singulières créatrices de sens, qui se déploient à travers l’invention contingente de problématiques originales.
This study aimed to assess the oral health status of individuals with schizophrenia and explore its association with behavioural and pharmacological factors, with particular focus on long-term antipsychotic treatment and cumulative anticholinergic burden.
Methods
A total of 153 adults with schizophrenia (18–65 years) from the Mental Health Network of Bizkaia (Spain), all under antipsychotic treatment for ≥12 months, were evaluated and compared with 153 controls from the general population. Data on socio-demographic variables, tobacco use and oral hygiene habits were collected. Oral health was assessed using the Decayed, Missing and Filled Teeth (DMFT) index and the Community Periodontal Index of Treatment Needs (CPITN). Unstimulated salivary flow was measured, and subjective xerostomia symptoms were recorded. Cumulative anticholinergic burden was estimated using the Drug Burden Index, considering both psychotropic and non-psychotropic medications. The association between dental health and clinical, behavioural and pharmacological variables was analysed in patients with schizophrenia.
Results
Patients with schizophrenia exhibited significantly poorer oral health than controls, with higher mean DMFT scores (15.3 vs. 10.9; p < 0.001) and more advanced periodontal disease indicated by CPITN. Salivary hypofunction (<0.45 ml/min) was present in 31% of patients versus 12% of controls. In addition, high to very high anticholinergic burden was present in 71.9% of patients with schizophrenia, compared to only 3.3% of controls. In patients with schizophrenia, multivariate analyses identified the following as significant predictors of worse dental status (DMFT): age; smoking; female sex; illness duration; reduced salivary flow; poor tooth brushing; and anticholinergic burden. For periodontal health (CPITN), however, no variable was identified as a significant predictor of high-risk periodontal status.
Conclusions
Oral health is substantially compromised in individuals with schizophrenia, reflecting a multifactorial interplay of behavioural, systemic and pharmacological factors. Both cumulative anticholinergic burden and reduced salivary flow independently contribute to poorer dental health, while periodontal disease appears to result from more complex influences not fully captured with studied variables. These findings underscore the importance of proactive clinical strategies, including regular dental assessments, targeted oral hygiene interventions, interdisciplinary collaboration between mental health and dental care providers and careful review of psychopharmacological regimens to minimize unnecessary anticholinergic exposure. Such integrated approaches are essential to preserve oral health, enhance quality of life and improve long-term outcomes in this vulnerable population.
Iodine is a component of thyroid hormones and essential for neurological development. Objective: to evaluate the iodine nutritional status of pregnant women residing in Veneto and the possible role of thyroglobulin (Tg) as a proxy.
528 pregnant women in the third trimester of pregnancy were consecutively enrolled in this cross-sectional study, and were asked to provide an early-morning spot urine sample (for UI/Creat) and a blood sample (for thyroid function and Tg). They also completed a questionnaire. Infant anthropometric data at birth were obtained.
Median UI/Creat was 112.8 μg/g. 34.1% of women had a UI/Creat ≥150 μg/g. Iodized salt (IS) was used by 76.9% of women, iodine containing supplements (ICS) by 74.2%, and cow’s milk was regularly consumed by 46.0%. At multivariable analysis, regular cow’s milk consumption and ICS use were significant predictors of UI/Creat ≥150 μg/g (odds ratio (OR) 1.57, 95% confidence interval (CI): 1.06-2.32, and OR: 2.83, 95% CI: 1.66-4.82, respectively). The median Tg value was lower among the iodine-sufficient than among the iodine-deficient women (P = 0.005). At multiple linear regression analysis, Tg was among the factors associated with weight (β = -81.83, P <0.001) and length (β = -0.3, P <0.01) at birth, although weakly. Tg was a factor associated with pre-term delivery (OR: 1.52, 95% CI: 1.20-1.92).
Regular use of cow’s milk and ICS were factors associated with UI/Creat ≥150 μg/g. Tg was associated with iodine status and pregnancy outcomes, although it had only a modest discriminative ability for sufficiency.
High-energy, sugar-rich diets are associated with obesity and pancreatic disorders. We investigated the effects of consumption of a high-fat and high-fructose diet (HFFrD) on gene expression related to insulin synthesis, inflammation, and apoptosis in pancreatic β-cells. Weaned Wistar rats were fed either a control diet (CD; 11% kcal from fat and 0% from fructose) or an HFFrD (48% kcal from fat and 33% from fructose) for 22 weeks; after a 6-hour fast, animals were euthanized. Body weight and total fat were recorded. Serum analyses included: glucose, insulin, triglycerides, malondialdehyde (MDA), TNFα, IL-6, IL-10, and advanced glycation end-products (AGEs). Pancreatic islets were analyzed for gene expression linked to insulin synthesis, inflammation, and apoptosis. Pancreatic assessments included TUNEL assay and immunohistochemistry. HFFrD increased body weight, total fat, MDA, insulin, HOMA-IR, AGEs, triglycerides, and IL-6 concentrations in both sexes. Gene expression revealed sex-dependent differences: Glut2, Gck, Khk, Ins2 and the transcription factor Mafa were downregulated in males but upregulated in females. Pdx1 expression increased in females, whereas NeuroD1 increased in males. Pro-inflammatory markers (Il-1β, Il-6) increased in both sexes, whereas Il-10 decreased in males and increased in females. Bax/Bcl2 ratio decreased in males but increased in females; antioxidant and apoptotic markers Nrf2 and Casp3 increased in females. Endocannabinoid receptors (Cnr1, Cnr2) increased in both sexes. HFFrD altered the expression of genes involved in insulin synthesis, inflammation, and apoptosis in a sex-specific manner. Compared with males, females showed lower vulnerability, possibly because of adaptive responses in insulin synthesis signaling influenced by sex hormones.
Recent studies have shown that, in coastal waters where water depth decreases significantly due to rapid bathymetric changes, the non-equilibrium dynamics (NED) substantially increases the occurrence probability of extreme (rogue) waves. Nevertheless, research on depth-induced NED has been predominantly confined to unidirectional irregular waves, while the role of directionality remains largely unexplored. The scarce studies on multidirectional waves mainly rely on numerical simulations and have yielded conflicting results. In this work, we report on an experimental investigation of wave directionality on the depth-induced non-equilibrium wave statistics. High-order statistical moments, skewness and kurtosis, are used as proxies for the non-equilibrium wave response. Our results indicate that the directional spreading has a minor effect on decreasing the maximum values of these statistical moments. In contrast, the incidence direction plays a significant role in the non-equilibrium wave response, which is attributed to the effective bottom slope.
Supported decision-making is rapidly gaining attention as an alternative to guardianship and other forms of surrogate decision-making for people with cognitive disabilities. This article provides an overview of the legal status of supported decision-making in the United States, with particular attention to how states are recognizing supported decision-making in different legal contexts. It then explores how the law of supported decision-making applies to clinical research. It explains that although federal research regulations and guidance do not explicitly address formal supported decision-making, individuals may use supported decision-making to make decisions about participating in clinical research and researchers may be required to allow such use under federal laws that protect against disability discrimination. It then concludes by considering legal barriers to greater use of supported decision-making and how these barriers might be overcome.
In the Netherlands, around 750 children (0–21 year) die annually from potentially palliative conditions. The majority of these children reside at home, receiving care from hospital services and primary care. This study aims to examine general practice utilization for pediatric palliative care patients in the last 2 years of life.
Methods
A retrospective cohort study was performed using the routine healthcare database of the Julius General Practitioners’ Network. The main outcome for general practitioner (GP) utilization was the number of GP consultations for children in the last 3 months of life. Participants were included who were children (0–21 years), and deceased in the period 01-01-2013 to 31-12-2022 from an underlying chronic condition. Data were analyzed using descriptive statistics and tested for differences in provided care between children who died in hospital and who died at home.
Results
Forty-eight children from 32 GP practices met inclusion criteria. Median age was 10.0 years (interquartile range [IQR] 1.5–17.1). Common diagnoses were oncological (29%), congenital (29%), and metabolic conditions (23%). Ninety-six percent of children had contact with their GP in the last 3 months (median 7 consultations, IQR 3.0–10.0), i.e. 26 children who died in hospital had median 3.5 GP consultations compared to 20 children who died at home median 9.5 GP consultations (p < 0.001). Thirty-five percent of children were documented as being palliative, with 54% having some form of advance care planning discussions documented.
Significance of results
These results demonstrate that GPs are highly involved in providing pediatric palliative care. The palliative nature of these children and advance care planning discussions are not routinely documented and/or performed by GPs. Further insights into guidance that supports GPs, in collaboration with other healthcare professionals, in providing palliative care for children at home and their families are needed.
In the field of agroecology, on-farm experimentation often involves ‘co-design’ activities. This participatory openness exacerbates the challenges associated with the researcher’s stance and the use and goals of experimental approaches. To shed light on this situation and improve upon it, we conducted a reflective and comparative analysis of five agroecological projects involving co-design that were carried out by the co-authors. The aim was to identify and discuss how the use of co-design expanded and diversified the role of on-farm experimentation in scientific research. Three main themes arose from the analysis; each encompassed findings, lessons learned, and considerations to clarify the framework of collaborative on-farm experimentation. The first theme was related to the adaptable, contingent, and transdisciplinary nature of the examined projects. The projects followed a step-by-step design framework. The different phases of each project were completed using various methods and participation modalities, either sequentially or jointly. Farm fields and ponds were important places for social interactions and observations that fueled the ongoing processes of diagnosis, technique adaptation, and evaluation, and the development of shared assumptions and statements among academics and non-academics. The second theme addressed the different experimental approaches used and their relationships to scientific demonstration, depending on the objective of diagnosis and evaluation. We identified and conceptualized three approaches that were taken in the analyzed projects: practice-centered, ecosystem services-centered, and product-centered approaches. The third theme emphasized elements related to the transformative capacity of co-design activities with on-farm experimentation. It emphasized the influence of technical feasibility, expected gain, perceived risk, and the degree of systemic innovation required. Transformative capacity was associated with the conditions and development of the learning process, rather than the success of the innovative practices. This implies changes in farming practices that extend well beyond the project’s duration and are inadequately documented.
On March 25, 1994, the Boston Police Department executed a “no-knock” raid that ended in the death of Reverend Accelyne Williams, a seventy-five-year-old retired Black Caribbean minister. Acting on a faulty tip, a thirteen-member SWAT team stormed into the wrong Dorchester apartment, wrestled Williams to the ground, and triggered a fatal stress-induced heart attack. His death became a defining tragedy in Boston’s history of police violence and raised urgent questions about accountability. This article situates the Williams case within the broader history of Black Boston’s freedom struggle against police civil rights violations from the early twentieth century to the 1990s. Through a controlled case comparison of four major incidents, we analyze how moments of police brutality became catalysts for Black political mobilization, ministerial activism, and community resistance. The study addresses three central questions: How does the Williams case fit within the trajectory of Boston’s racial justice struggles? How do such incidents illuminate the city’s persistent racial inequality and segregation? And what can these histories teach us about the broader U.S. movement to “police the police”? Drawing on original archival research, we demonstrate that police abuses have consistently spurred waves of organized resistance in Boston, shaping both local and national debates on civil rights. We identify key historical breaks, continuities, and paradoxes in the struggle for accountability, showing how the demand to “police the police” has long been central to Black political life.