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The claims of those who are compelled to migrate are, in general, taken to be more urgent and pressing than the claims of those who were not forced to do so. This article does not defend the moral relevance of voluntarism to the morality of migration, but instead seeks to demonstrate two complexities that must be included in any plausible account of that moral relevance. The first is that the decision to start the migration journey is distinct from the decision to stop that journey, through resettlement; the latter may involve voluntary choice, without that voluntarism impugning the involuntary nature of the former. The second is that the migration decision of the individual might be voluntary, even while that individual's family or social network might be compelled to insist upon some particular individual member's migration. That is, the fact that any particular person might be free to refuse migration does not contradict the fact that the group in question does not have the effective freedom to avoid the migration of some group members. Once these two complexities are understood, I argue, the moral relevance of voluntarism in the ethics of migration becomes more complex and nuanced than is generally understood.
Valence is a crucial concept in studying spatial voting and party competition. The widely adopted approach is to rely on intercepts of vote choice models and to infer, based on their size and direction, how valence affects party strategies in empirical settings. The approach suffers from fundamental statistical flaws. This contribution provides the statistical fundamentals to advance the empirical modeling of valence. It proposes an appropriate modeling approach to interpret intercepts as valences and alternate specifications to parameterize the effects of valence.
Events in recent years have underscored the dependence of the liberal international order (LIO) on the domestic fate of liberalism in countries like the United States—where, according to critics such as Mark Lilla and Francis Fukuyama, liberals have imperiled themselves through an unwise embrace of identity politics. These critics argue that identity politics undermines solidarity and empowers the illiberal right, and that it should be rejected in favor of a unifying creedal nationalism based on common liberal values. This analysis, I argue, overlooks the fact that “common” creedal values have expanded in American history when their meanings were being controversially reinterpreted from identity-based perspectives. If American liberalism is to emerge from its current crisis, it will need to incorporate the claims of identity into a sense of national belonging that can resist the authoritarian, ethnoracial nationalism promoted by the LIO's enemies. The likelihood that such a process will be controversial is reason for liberal critics of identity politics to consider how the claims of identity might be an asset, not an obstacle, to revitalizing liberal democracy against its challengers.
This article investigates how superpower rivalry affects public perceptions of international organization (IO) legitimacy in the hegemon. We argue that the representation of a superpower rival state at an IO in the form of its key decision maker's nationality can dampen the IO's perceived legitimacy within the rival power. We test this argument using a survey experiment in the United States under President Trump, where we manipulate the nationality of the International Court of Justice (ICJ) judge who casts a tie-breaking vote against the United States. Our results show that when the judge is Chinese, there is a strong and robust dampening of Americans’ perceptions of the ICJ's legitimacy, with no comparable effect arising when the judge is from other countries, including Russia. Replication of the experiment in the United States under President Biden offers external validity for our findings, which may have important implications for the future of the liberal international order.
The concept of voluntariness permeates the ethics and politics of migration and is commonly used to distinguish refugees from migrants. Yet, neither the precise nature and conditions of voluntariness nor its ethical significance for migrant rights and state obligations has received enough attention. The articles in this collection move the debate forward by demonstrating the complex ethical judgments involved in delineating voluntary from forced migration and in drawing out its political and institutional implications. In addition to highlighting the interplay between the voluntary and nonvoluntary elements of migration over time and across different sites of the migration journey, they provide a nuanced account of the various conditions of voluntariness and they challenge common ideas about its normative political consequences.
The coronavirus disease 2019 (COVID-19) pandemic deleteriously impacted physical and mental health. In the summer of 2020, return-to-learn plans were enacted, including virtual, hybrid, and in-person plans, impacting educators and students. We examined (1) how return-to-learn plan was related to depressive and social anxiety symptoms among educators and (2) how psychological flexibility related to symptoms.
Methods:
Educators (N = 853) completed a survey via Qualtrics that assessed internalizing symptoms, psychological flexibility, and occupational characteristics. Two one-way analyses of variance (ANOVAs) examined between-group differences in return-to-learn plans across depression and social anxiety. Two hierarchical linear regressions examined the relation between psychological flexibility components and depressive and social anxiety symptoms.
Results:
Median T-scores were well above the national normative means for General Depression (median T-score: 81) and Social Anxiety (median T-score: 67). There were no significant differences between reopening plans in general depression nor social anxiety T-scores. Psychological flexibility accounted for 33% of the variance in depressive symptoms and 24% of the variance in social anxiety symptoms.
Conclusions:
Results indicated high levels of psychiatric symptoms among educators during COVID-19, and psychological flexibility was associated with lower symptoms. Addressing educator mental health is of utmost importance in future research.
Common data elements (CDEs) for concussion, as established by international bodies, are not being widely used in Ontario, resulting in significant variability in the data being assessed and collected across clinics. CDEs support standardization of care as well as large-scale data sharing for high impact research. A collaborative network – Concussion Ontario Network: Neuroinformatics to Enhance Clinical care and Translation (CONNECT) – comprised of health care professionals, researchers, members from advocacy groups, and patients was formed to establish and implement CDEs for concussion care and research. While the seeds have been planted and initial effectiveness demonstrated, future challenges exist.
Many providers use severe acute respiratory coronavirus virus 2 (SARS-CoV-2) cycle thresholds (Ct values) as approximate measures of viral burden in association with other clinical data to inform decisions about treatment and isolation. We characterized temporal changes in Ct values for non–SARS-CoV-2 respiratory viruses as a first step to determine whether cycle thresholds could play a similar role in the management of non–SARS-CoV-2 respiratory viruses.
Design:
Retrospective cohort study.
Setting:
Brigham and Women’s Hospital, Boston.
Methods:
We retrospectively identified all adult patients with positive nasopharyngeal PCRs for influenza, respiratory syncytial virus (RSV), parainfluenza, human metapneumovirus (HMPV), rhinovirus, or adenovirus between January 2022 and March 2023. We plotted Ct distributions relative to days since symptom onset, and we assessed whether distributions varied by immunosuppression and other comorbidities.
Results:
We analyzed 1,863 positive samples: 506 influenza, 502 rhinovirus, 430 RSV, 219 HMPV, 180 parainfluenza, 26 adenovirus. Ct values were generally 25–30 on the day of symptom onset, lower over the ensuing 1–3 days, and progressively higher thereafter with Ct values ≥30 after 1 week for most viruses. Ct values were generally higher and more stable over time for rhinovirus. There was no association between immunocompromised status and median intervals from symptom onset until Ct values were ≥30.
Conclusions:
Ct values relative to symptom onset for influenza, RSV, and other non–SARS-CoV-2 respiratory viruses generally mirror patterns seen with SARS-CoV-2. Further data on associations between Ct values and viral viability, transmissibility, host characteristics, and response to treatment for non-SARS-CoV-2 respiratory viruses are needed to determine how clinicians and infection preventionists might integrate Ct values into treatment and isolation decisions.
Transient acquisition of methicillin-resistant Staphylococcus aureus (MRSA) on healthcare personnel (HCP) gloves and gowns following patient care has been examined. However, the potential for transmission to the subsequent patient has not been studied. We explored the frequency of MRSA transmission from patient to HCP, and then in separate encounters from contaminated HCP gloves and gowns to a subsequent simulated patient as well as the factors associated with these 2 transmission pathways.
Methods:
We conducted a prospective cohort study with 2 parts. In objective 1, we studied MRSA transmission from random MRSA-positive patients to HCP gloves and gowns after specific routine patient care activities. In objective 2, we simulated subsequent transmission from random HCP gloves and gowns without hand hygiene to the next patient using a manikin proxy.
Results:
For the first objective, among 98 MRSA-positive patients with 333 randomly selected individual patient–HCP interactions, HCP gloves or gowns were contaminated in 54 interactions (16.2%). In a multivariable analysis, performing endotracheal tube care had the greatest odds of glove or gown contamination (OR, 4.06; 95% CI, 1.3–12.6 relative to physical examination). For the second objective, after 147 simulated HCP–patient interactions, the subsequent transmission of MRSA to the manikin proxy occurred 15 times (10.2%).
Conclusion:
After caring for a patient with MRSA, contamination of HCP gloves and gown and transmission to subsequent patients following HCP-patient interactions occurs frequently if contact precautions are not used. Proper infection control practices, including the use of gloves and gown, can prevent this potential subsequent transmission.
The global impacts of COVID-19 have been calamitous, unleashing widespread human suffering and exacerbating health crises, all while worsening pre-existing inequalities and transgressing fundamental human rights. Despite earnest pleas from the United Nations and developing nations for an equitable distribution of COVID-19 vaccines, these appeals were largely unheeded. Instead, major pharmaceutical manufacturers and high-income countries (HICs) had maintained a stranglehold on vaccine technology through the safeguarding of intellectual property rights (IPRs), leading to exorbitant pricing and preferential distribution to affluent regions. This vaccine hoarding has left low- and middle-income countries (LMICs) with delayed and insufficient supplies, endangering the lives of the most vulnerable. The stringent enforcement of IPRs mechanisms, rather than aligning with international human rights obligations, has further marginalised the right to life, health, and access to vaccines and medicines, particularly in LMICs. This study ardently advocates for a policy shift that promotes the decolonisation of human rights in the context of IPRs and global health law.
While invalid voting is often treated as protest behavior in an electoral context, its association with actual political protests has not yet been empirically demonstrated. The relative scarcity of research on the topic is likely due to the hybrid nature of invalid voting as a both formal and informal political gesture. The novel availability of event-based data for public protests in Latin America allows for testing whether their occurrence is connected with changes in spoiled and blank ballots. Using an appropriate dynamic regression model covering variations in the 148 intervals between Latin American legislative elections in the 1979–2021 period, this study finds a strong connection between the emergence of antigovernment protests and surges in invalid voting (and vice versa). This relationship still holds at parity of economic conditions and it is reinforced by a lack of alternation in the party of power. Conversely, the appearance of workers’ strikes appears to work as a substitute for this behavior, which is also chosen by voters when democracy deteriorates, while corruption has no independent impact on invalid voting. Overall this work’s findings promise to send the research agenda on invalid voting in a new direction, previously unexplored because of an absence of fitting data.
Little is known about helminth parasites of the Bismarck Archipelago, in either archaeological or modern contexts. This study presents a parasitological analysis of soil samples from Early Lapita habitation layers at Kamgot (3300–3000 BP). Evidence for the presence of pigs and dogs and the timing of their arrival in Early Lapita contexts have been contested in the literature. The finding of parasite eggs in samples from Kamgot supports the presence of pigs and dogs at the site. Six types of helminth eggs were identified: pig nematode Trichuris suis, dog nematode Toxocara canis, and cestode Dipylidium caninum, as well as two unknown trematodes and a possible anoplocephalid cestode, thereby indicating the local presence of other mammals or birds. This study represents the first confirmed record of ancient helminth parasites in tropical Oceania.
Lodging is the permanent displacement of stalks due to disrupted secondary cell walls caused by external factors, plant characters and their interaction. Anatomical, morphological and compositional traits are among lodging-inducing plant traits. In comparison with morphological and anatomical features, the correlation of lodging resistance and cell wall composition is not frequently reviewed. In this review, the relation between cell wall composition and lodging resistance of cereal stalks is comprehensively reviewed based on major cell wall components (lignin, cellulose and hemicellulose) and trace minerals. From the body of literatures reviewed across all cereal crops, lignin and cellulose were found to have significant positive correlation with lodging resistance. However, the effect of structural features of cellulose and lignin on lodging resistance was not investigated in most of the studies. This review also highlights the importance of biomass recalcitrance and lodging resistance trade-offs in the spectrum of genetic cell wall modifications.
Oral anticoagulation (OAC) prevents stroke in atrial fibrillation, yet a residual stroke risk remains. In this single-center retrospective analysis of acute ischemic stroke patients despite OAC, suboptimal OAC treatment is common (30%: inappropriate dosing (17%); patient non-adherence (13%)). Other causes of stroke included OAC interruption (14.5%), a competing stroke mechanism (11.0%), and undetermined breakthrough stroke in 44.5%. Overall, easily modifiable causes of ischemic stroke despite OAC are common. Accordingly, strategies to improve treatment compliance, including appropriate dosing along with guideline-based risk factor and periprocedural OAC management, should be emphasized to improve secondary stroke prevention in this patient population.
East Central Europe played a crucial role in shaping the development of sexual science from the 1870s onwards. The life-histories of influential and well-known figures such as Sigmund Freud (born in Freiberg/Příbor), Magnus Hirschfeld (born in Kolberg/Kolobrzeg) and Karl Maria Kertbeny (born in Vienna, based in Budapest) reveal the imperial interconnectedness of East Central Europe with what would become Western Europe. By 1932, when the World League for Sexual Reform held its congress in Brno (following previous meetings in Berlin, London, Vienna, and Copenhagen), the society had established branches across the region, including Poland, Austria, and Czechoslovakia. In that same year, Poland decriminalised homosexual acts. Yet, East Central Europe is often neglected in the history of sexology and little is known about how sexual science in these regions shaped, and was shaped by, global networks of knowledge production. Indeed, despite recent attempts to demonstrate the ways in which sexual science was a truly global enterprise, East Central Europe remains to be fully incorporated into our mapping of the global networks of sexological dialogue and exchange.1 This is especially true of scholarship on the period after the Second World War. Historians have tended to misconstrue the transnational nature of sexual science in East Central Europe both before and after 1945. First, the contribution of East Central Europeans to European cultures of scientific exchanges has been obscured by the tendency of much historical writing to focus on a small number of key pioneers (Krafft-Ebing, Magnus Hirschfeld, Sigmund Freud and Havelock Ellis). Second, it is assumed that East Central European sexual science was largely cut off from international networks of knowledge exchange after the Second World War following the onset of the Cold War.2 Third, there are preconceived notions that communist authoritarian governments, having curtailed political freedoms and economic entrepreneurialism, must have also taken a repressive stance against sexual expression.3 Fourth, the dominance of 1989 as the fundamental caesura has encouraged a periodisation that fails to draw enough attention to the shifts in transnational patterns of knowledge exchange around sexual politics during the period 1945 to 1989 and fails to identify key continuities that link the sexual politics of the contemporary world with those of the communist period. None of these assumptions can withstand scrutiny, as the articles in this forum reveal. Building on a recent boost in scholarly interest in the sexual histories of the region,4 we present a collection of papers that each detail the transnational connections of local sexual experts in creating sexual knowledge both before and during state socialism.5
A key question in the theory of migration and in public debates on immigration policies is when migration can be said to be voluntary and when, conversely, it should be seen as nonvoluntary. In a previous article, we tried to answer this crucial question by providing a list of conditions we view as sufficient for migration to be considered nonvoluntary. According to our account, one condition that makes migration nonvoluntary is when people migrate because they lack acceptable alternatives to doing so. In this article, we take the opportunity to further explore and clarify this crucial condition. More specifically, we focus on two main sets of questions. First, we ask whether migration is always voluntary when it serves goals that are voluntarily chosen, and whether those who decide to migrate voluntarily but only have the option of choosing among a limited set of dangerous, harmful, or illegal means for doing so, can be said to be forced to choose those means. Second, we ask whether what counts as “nonacceptable” alternatives should also include cases in which people could have their needs and fundamental rights met, but at the cost of betraying their moral principles or conceptions of the good.