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Ontario seniors face a range of challenges as they age, including financial, physical and social barriers. Addressing these challenges is essential to improving the health and well-being of older adults in the province. Objective: The discussion proposes that naturally occurring retirement communities (NORCs) offer a viable and safe alternative to formal retirement communities and evaluates how NORCs can support seniors when examined through the lens of the social determinants of health.
Methods
The analysis focuses on the role and impact of NORC-specific service programming, distinct from NORCs themselves, and assesses their potential in mitigating age-related challenges faced by seniors in Ontario.
Findings
NORC-specific service programs have shown success in supporting senior wellness and improving quality of life. These service address key social determinants of health and demonstrate potential for broader application across Ontario’s NORCs.
Discussion
The discussion recommends increased attention from governments and policymakers, including efforts to identify NORCs across Ontario, expand affordable and accessible housing options for seniors, and invest in health and social supports. Strategic development of NORC programs can play a significant role in building capacity and delivering targeted wellness services to seniors.
Voter turnout has declined across established democracies, which has been accompanied by an increase in turnout disparities along class lines. In contrast to most advanced democracies, class voting has largely been neglected in Canada. Using the entire series of the Canadian Election Study (1965–2021), this article examines the turnout gap in Canada over time by class, education, and income, and whether the offerings of political parties impact these relationships. Results find major class-based participatory inequalities, which have worsened over time. The magnitude of the turnout gap between lower and higher socio-economic status (SES) individuals has mainly been driven by the demobilization of lower-SES individuals and a significant factor is the reduced saliency of economic issues in the party system. The findings contribute to our understanding of how economic inequalities translate into political inequalities and show that rising turnout inequality between politically relevant cleavages, represents a deterioration of democratic representation.
What are the consequences of selective emigration from a closed regime? To answer this question, I focus on socialist East Germany and leverage an emigration reform in 1983 that led to the departure of about 65,200 citizens. Analyzing panel data on criminal activity in a difference-in-differences framework, I demonstrate that emigration can be a double-edged sword in contexts where it is restricted. Emigration after the reform had benefits in the short run and came with an initial decline in crime. However, it created new challenges for the regime as time passed. Although the number of ordinary crimes remained lower, border-related political crimes rose sharply in later years. Analysis of emigration-related petitioning links this result to a rise in demand for emigration after the initial emigration wave. These findings highlight the complexities of managing migration flows in autocracies and reveal a key repercussion of using emigration as a safety valve.
Gut microbiota (GM) affects muscle homeostasis, and growing evidence indicates dysbiosis of GM may be a contributing factor in the pathogenesis of dystrophies. Furthermore, GM metabolites can interact with DNA methylation. Facioscapulohumeral muscular dystrophy (FSHD) is the second common dystrophy with hypomethylation of DR1 and 5P regions of D4Z4 repeat on 4qter.
Objective:
Considering alteration of GM may be a contributing factor, we investigated (i) GM alterations and (ii) the correlation of microbial-derived free fatty acids (FFAs) with methylation of DR1 and 5P regions in FSHD.
Methods:
Twenty-eight FSHD patients and 28 gender-age-matched controls were included. GM characterisation was performed through 16S-rRNA sequencing. Methylation levels of DR1 and 5P regions were assessed by bisulphite sequencing. Faecal and circulating FFAs including short-chain fatty acids (SCFAs), medium-chain fatty acids (MCFAs) and long-chain fatty acids (LCFAs) were analysed with gas chromatography-mass spectrometry.
Results:
Altered GM was observed in patients, along with distinct profiles of faecal and circulating SCFAs, MCFAs and LCFAs. DR1 and 5P regions exhibited significant hypomethylation in FSHD compared to control. Hypomethylation correlated with faecal and circulating FFAs in patients, while no correlation was identified in healthy controls. The severely affected patients exhibited a notable increase in the prevalence of Pasteurellaceae, while the FFA profile was similar among mild and severely affected patients. This is the first study revealing that FSHD patients showed compositional and functional GM dysbiosis. A strong association between proximal D4Z4 hypomethylation with microbial-derived SCFAs was identified.
Conclusion:
These findings suggest that GM modulation with its metabolites could be a promising strategy for interventions in FSHD management.
The n-3 index has been proposed as a risk factor for CVD endpoints. However, the association of the O3I defined with different cut-offs and cardiometabolic risk factors has been less studied. This study aimed to investigate the association between two cut-off points of the O3I and cardiometabolic risk factors in Brazilian and Puerto Rican adults. This cross-sectional analysis included 249 Brazilians and 1261 Puerto Ricans, aged 45–75 years. Fatty acids composition was quantified in erythrocyte membranes using GC with a flame ionisation detector. The O3I was categorised as ≤ 4 % (low), > 4–8 % (intermediate) and ≥ 8 % (desirable), and as ≤ 4 % (very low), > 4–6 % (low), > 6–8 % (moderate) and > 8 % (high) in the second cut-off classification. Serum lipids, waist circumference and insulin resistance were measured from standardised protocols. Multivariable-adjusted linear models tested the association between the O3I and cardiometabolic factors. Brazilians had a mean (sd) O3I of 4·65 % (1·19 %) v. 4·43 % (1·14 %) in Puerto Ricans (P = 0·033), with only 1·6 % of Brazilians and 1·2 % of Puerto Ricans presenting a desirable/high O3I. The O3I, as continuous or for > 4 % (v. ≤ 4 %), was inversely associated with TAG, VLDL and TAG/HDL-cholesterol ratio in Puerto Ricans. In Brazilians, an O3I > 6 % (v. ≤ 6 %) was associated with higher total cholesterol, LDL-cholesterol and non-HDL-cholesterol. Both populations presented O3I below the desirable levels, and the magnitude and direction of associations with cardiometabolic factors varied by study and cut-offs, reinforcing the importance of expanding these investigations to more diverse populations.
We present a philosophically motivated framework for modelling moral agency. In addition to choosing strategies, agents in this framework choose among an appropriate exogenous set of moralities that depends on the context of the game. Further, agents can use mixed strategies to choose their degree of morality. We present two models to demonstrate the framework. In the first model, agents choose between empathy and selfishness while playing prisoner’s dilemma. In the second, agents choose between Kantian universalizing and selfishness while playing a public goods game. For both models, the degree of morality gets determined endogenously rather than assigned parametrically.
Finding the right balance between education and entertainment in science communication has always been a challenge. This essay argues that this balance has often been framed in terms of the correct proportion and use of animation and live-action footage in popular-science media. Clarifying the assumptions behind a century of concerns about animation and science, this historical case study examines the advisory board’s complaints about animation in the Bell System Science Series, which aired in the United States between 1956 and 1964. AT&T interrupted the series mid-stream by switching the creative team from Frank Capra and his production company to Owen Crump at Warner Bros. Studio. Capra’s use of animation in the series featured prominently in this decision. The historical record – as well as Capra’s and Crump’s different aesthetic choices about animation – tells us much about the board’s objections and how they were resolved in production. This essay examines the differences between the two parts of the series to uncover a course correction steered primarily by the scientific advisory board, which reveals a sometimes-fraught relationship between live-action footage and animation in science education that persists even today.
Nursing homes residents have a high prevalence of multidrug-resistant organism (MDRO) colonization. Recent trials demonstrated that decolonizing residents reduces infection. However, decolonization’s impact on environmental MDRO contamination is not well understood.
Methods:
We performed a 9-month pilot (3-month baseline, 3-month phase-in and 3-month intervention) in 3 nursing homes implementing routine chlorhexidine bathing/showering and nasal iodophor. We repeatedly tested for colonization via skin and nasal swabs for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), extended-spectrum beta-lactamase producers (ESBLs), and carbapenem-resistant Enterobacterales (CRE). We also swabbed high-touch surfaces in rooms of MDRO carriers for MDRO fomite contamination.
Results:
Decolonization decreased the odds of MDRO colonization in nursing home residents by 55% (OR 0.45, P < 0.001, raw reduction from 46% (411/900) to intervention: 29% (262/900); colonization with MRSA, VRE, and ESBL all significantly decreased (P < 0.001). Among residents who remained colonized with any MDRO, 288/330 (87%) of high-touch bedroom objects were colonized with ≥1 MDRO. In a multivariable analysis, MDRO fomite contamination in rooms of MDRO carriers was associated with antibiotic use (OR = 1.54 [95% CI: 1.19–1.98], wound presence (OR = 1.34 (95% CI: 1.02–1.77), and specific fomites such as bedside table/bedrails (OR = 12.7 (95% CI: 9.37–17.25), but not the intervention period (OR = 1.02 [0.81–1.27]).
Conclusion:
Routine chlorhexidine bathing and nasal iodophor significantly reduced MDRO body colonization among nursing home residents. However, in rooms of residents who remained MDRO carriers, environmental contamination was unchanged during the decolonization intervention. Efforts to ensure fomite surface clearance in rooms of MDRO carriers may be key to reducing environmental MDRO spread.
We show that for every non-spherical set X in $\mathbb {E}^d$, there exists a natural number m and a red/blue-coloring of $\mathbb {E}^n$ for every n such that there is no red copy of X and no blue progression of length m with each consecutive point at distance $1$. This verifies a conjecture of Wu and the first author.
This article re-examines the A-scholia to Homer, Iliad 11.101 (= SH 701 = Posidippus 144 AB) and their reinterpretation of the term sôros, which designates the location where Aristarchus discovered the ‘Bêrisos epigram’ of Posidippus. The article challenges the prevailing and widely embraced hypothesis positing that sôros serves as the title of a lost collection of Hellenistic epigrams.
Power outages can lead to food-borne and water-borne illness risks for consumers if proper protective measures are not taken at home. The purpose of this study was to understand the behaviors of Canadians related to food and water safety preparedness at home during power outages and floods.
Methods
A qualitative descriptive study was conducted, consisting of 6 virtual focus groups, each with 8 people, in July 2023. Participants were selected from geographically dispersed locations in Ontario, Canada that had experienced power outages due to weather events. Thematic analysis was conducted to generate key themes.
Results
Four themes were generated related to participants’ food and water safety preparedness: 1) trusted information sources and lived experiences; 2) support and resources; 3) factors beyond one’s control; and 4) differences in psychosocial determinants.
Conclusions
Effective risk communication targeting misconceptions, incentivization programs, and community resilience planning may help prevent or reduce enteric illness risks during such emergencies.
Diagnostic stewardship of urine cultures is a recognized tool for CAUTI prevention, yet few diagnostic algorithms have been validated. This study of a novel diagnostic CAUTI algorithm showed a significant and durable improvement in urine culturing, catheter exchange, and CAUTI rate, supporting this algorithm as an effective diagnostic stewardship tool.
Can we quantify over absolutely every set? Absolutists typically affirm, while relativists typically deny, the possibility of unrestricted quantification (in set theory). In the first part of this article, I develop a novel and intermediate philosophical position in the absolutism versus relativism debate in set theory. In a nutshell, the idea is that problematic sentences related to paradoxes cannot be interpreted with unrestricted quantifier domains, while prima facie absolutist sentences (e.g., “no set is contained in the empty set”) are unproblematic in this respect and can be interpreted over a domain containing all sets. In the second part of the paper, I develop a semantic theory that can implement the intermediate position. The resulting framework allows us to distinguish between inherently absolutist and inherently relativist sentences of the language of set theory.
With formal international organizations (IOs) facing gridlock and informal IOs proliferating, cooperation in the twenty-first century looks different than it did in previous eras. Global governance institutions today also face additional challenges, including a fragmented information environment where publics are increasingly vulnerable to misinformation and disinformation. What do these trends portend for international politics? One way to answer this question is to return to a core ingredient of a well-functioning IO—information provision—and ask how such changes affect efficiency. Viewed through this lens, we see decline in some arenas and adaptation in others. Formal IOs are struggling to retain relevance as their weak policy responses and ambiguous rules create space for competing signals. The proliferation of informal institutions, on the other hand, may represent global governance evolution, as these technocratic bodies are often well-insulated from many political challenges. Yet even if global governance retains functionality, the legitimacy implications of such trends are troubling. IO legitimacy depends in part on process, and from this standpoint, the informational gains of informal governance must be weighed against losses of accountability and transparency. Ultimately, evaluating the normative implications of these trends requires making judgments about the preferred legitimizing principles for global governance.
We investigate a Leslie-type prey–predator system with an Allee effect to understand the dynamics of populations under stress. First, we determine stability conditions and conduct a Hopf bifurcation analysis using the Allee constant as a bifurcation parameter. At low densities, we observe that a weak Allee effect induces a supercritical Hopf bifurcation, while a strong effect leads to a subcritical one. Notably, a stability switch occurs, and the system exhibits multiple Hopf bifurcations as the Allee effect varies. Subsequently, we perform a sensitivity analysis to assess the robustness of the model to parameter variations. Additionally, together with the numerical examples, the FAST (Fourier amplitude sensitivity test) approach is employed to examine the sensitivity of the prey–predator system to all parameter values. This approach identifies the most influential factors among the input parameters on the output variable and evaluates the impact of single-parameter changes on the dynamics of the system. The combination of detailed bifurcation and sensitivity analysis bridges the gap between theoretical ecology and practical applications. Furthermore, the results underscore the importance of the Allee effect in maintaining the delicate balance between prey and predator populations and emphasize the necessity of considering complex ecological interactions to accurately model and understand these systems.
This essay reveals the institutional dynamics of hard times in the issue area of human rights. I show that the human rights regime has developed innovative-yet-informal institutions like individuals-based coalitions for the international protection and progressive development of human rights. Yet, as these informal institutions function very much based on, first, the interpersonal relations among their members, and, second, legal instruments that require no further consent by states, the advocacy success of liberal human rights defenders has, in turn, provided a playbook for advocates and governments from the illiberal end of the ideology spectrum. In addition, new human rights advocates in the form of certain private law firms have entered the UN through their pro bono work. They promise valuable resources for a crisis-ridden system but often represent corporate clients with conflicts of interest. Given the imminent risk of ideological capture and illiberal interests in human rights paralyzing the system, I reemphasize the need for regulating access to the human rights global governance institutions.
Physiologic changes in the peripartum period put women with CHD at increased risk for morbidity. This study examines factors associated with peripartum complications and length of stay compared to patients without CHD.
Methods:
This single-institution retrospective case-control study included women with CHD (2000–2017) and a control population without CHD. A review of clinical and echocardiographic data was used to assign baseline characteristics, disease severity, and adverse outcomes. Primary outcomes were composite variables of cardiac and obstetric adverse events, along with peripartum length of stay. The relationship between maternal CHD, baseline characteristics, and peripartum adverse events was evaluated by multivariable regression.
Results:
The cohort and control groups included 162 deliveries among 113 women and 321 deliveries among 321 women, respectively. Cardiac complications, including arrhythmia, heart failure, pulmonary oedema, and thromboembolic events, occurred in 8.6% of the cohort (RR 2.52, 95% CI 1.17–5.42), with the most common event being arrhythmia. Obstetric events, such as caesarean delivery, assisted vaginal delivery, preterm birth, and pre-eclampsia, occurred in 67.9% versus 56.1% in the control group (RR 1.21, 95% CI 1.05–1.40). In multivariable models, increasing age was associated with increased composite cardiac events. Length of stay was longer in the cohort group (p < 0.001) and significantly associated with modified World Health Organization classification (p = 0.016).
Conclusions:
Women with CHD experience increased cardiac and obstetric morbidity compared to controls during peripartum admission. Those with CHD have longer hospital stays around delivery, which is associated with disease severity.