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In the 1790s, the United States faced a series of crises—both domestic and foreign—which many believed threatened the nation’s very existence. These culminated in the Quasi-War with France beginning in 1796. The Federalist majority identified the greatest threats to the Republic as foreigners and their willing or unwitting American allies. Thus, they enacted the Alien and Sedition Acts in 1798 and other laws to allay these threats. Throughout the ensuing debates, Federalists emphasized the dangers of foreign nations who sought to separate the American people from their government. Republicans challenged Federalists’ fears as overblown and defined the real threat as the Federalists themselves who justified the expansion of the general government’s power and the infringement of individual rights in the name of national security. Americans engaged in their first debate about the meaning and limits of liberty and security.
This review presents evidence related to the postprandial responses after consumption of dairy products focusing on the effect of the dairy matrix and lipid response, which was also presented as part of a speech at the Nutrition Society Winter Conference, January 2023. The key findings are that the dairy product(s) that differentiate from others in the postprandial TAG response are products with a semi-solid structure. There were no differences in lipid responses between cheese and butter. The main factors viscosity, fat globule size and milk fat globule membrane do not seem to explain the effect of the dairy matrix in the acute postprandial response. In summary, it is very difficult to investigate the effects of the dairy matrix per see and with the few studies conducted to date, no clear cause and effect can be established. Future research should focus on the semi-solid dairy matrix, and studies investigating specifically the yoghurt matrix are warranted.
The diagnosis of dementia poses several challenges, as a consequence of which the condition has been widely reported to be underdiagnosed in the general population. Currently, there is no single diagnostic test for dementia and the clinical judgement of primary care physicians is therefore a key determinant in identifying which patients are referred to specialist services for further assessment. This month's Cochrane Corner review found that the clinical judgement of general practitioners is more specific (58–99%) than sensitive (34–91%) in diagnosing dementia, although the data were limited by small sample size and significant heterogeneity. This commentary provides a critical appraisal of this systematic review and attempts to extrapolate conclusions relevant to current clinical practice, including potential areas of further research, to facilitate appropriate and timely referral of patients with suspected dementia to specialist services.
Theories about state-led Islamisation tend to attribute the phenomenon to domestic dynamics, such as political competition, institutional co-optation, and changing social norms. When exogenous factors are considered, they usually refer to imported ideologies. Moreover, Islamisation is often depicted as a firm rejection of the West. This article seeks to complicate those explanations. Using insights from the ontological security literature in International Relations, I argue that Malaysia's state-led Islamisation cannot be understood comprehensively without looking at macro-historical factors, particularly Malaysia's postcoloniality and its elites’ perception of the global order. Instead of being a manifestation of anti-West sentiments, I argue that the initial receptivity towards Islamisation by Malaysia's largely secular ethnonationalist elites constitutes a quest for recognition within an international order within which the Muslim identity is racialised and stigmatised. This is most obvious in Mahathir Mohamad's ideas on Islam, in that his calling for a developmentalist Islam has as its (imagined) respondent the stigmatising ‘West’. I argue that the forms of Islamisation undertaken during the Mahathir administration reflected this drive to catch up with the West while simultaneously securing recognition for Islam; and that such a leitmotif persisted even into the post-September 11, post-Barisan Nasional world.
Coronavirus disease (COVID-19) lockdowns disproportionately affect older people where most suffer from social isolation and loneliness, which translate into higher rates of depression and anxiety. This study aimed to explore the accessibility, outcomes, and challenges of social technology use among community-dwelling older adults, older adults in long-term care, older adults with neurocognitive disorder, and older adults with pre-frailty and frailty, to help guide future research in this area. A rapid review was conducted, and articles were retrieved from four online databases, including Medline, AgeLine, EconLit and CINAHL, and grey literature from Google Scholar. Of the 131 articles retrieved, 24 were included in this review. The positive outcomes of social technology use include improved mental and physical health, reduced health disparities, and increased autonomy. Adverse outcomes include furthering the digital divide. More research surrounding the economic impacts of social technologies is warranted.
In chronic spinal cord injury (SCI), individuals experience dietary inadequacies complicated by an understudied research area. Our objectives were to assess (1) the agreement between methods of estimating energy requirement (EER) and estimated energy intake (EEI) and (2) whether dietary protein intake met SCI-specific protein guidelines. Persons with chronic SCI (n = 43) completed 3-day food records to assess EEI and dietary protein intake. EER was determined with the Long and Institute of Medicine (IOM) methods and the SCI-specific Farkas method. Protein requirements were calculated as 0·8–1·0 g/kg of body weight (BW)/d. Reporting accuracy and bias were calculated and correlated to body composition. Compared with IOM and Long methods (P < 0·05), the SCI-specific method did not overestimate the EEI (P = 0·200). Reporting accuracy and bias were best for SCI-specific (98·9 %, −1·12 %) compared with Long (94·8 %, −5·24 %) and IOM (64·1 %, −35·4 %) methods. BW (r = –0·403), BMI (r = –0·323) and total fat mass (r = –0·346) correlated with the IOM reporting bias (all, P < 0·05). BW correlated with the SCI-specific and Long reporting bias (r = –0·313, P = 0·041). Seven (16 %) participants met BW-specific protein guidelines. The regression of dietary protein intake on BW demonstrated no association between the variables (β = 0·067, P = 0·730). In contrast, for every 1 kg increase in BW, the delta between total and required protein intake decreased by 0·833 g (P = 0·0001). The SCI-specific method for EER had the best agreement with the EEI. Protein intake decreased with increasing BW, contrary to protein requirements for chronic SCI.
This article analyzes the second-century Acts of John 56–57, in which Antipatros seeks healing for his twin sons whom he claims he cannot support as he ages. I argue that this passage turns on a layered critique of Antipatros. First, the text censures medical commerce. Second, it uses his threat of murder, economic circumstances, and name to undermine Antipatros as both father and inquiring disciple. The episode thus leverages criticism of a character whose negative attitudes lead him to contemplate destruction of those with infirmities. However, it retains a mixed message: while the character of the apostle John comes to focus on the sons, the narrative silences them. Ultimately, the text emphasizes what the critique means for the flawed male, elite father, rather than the experience of the impaired sons. Such dynamics warrant close attention as we continue to expand our understanding of attitudes to disability in sources from antiquity.
This study explores the link between stylized forms of language and the construction of social identities in performance in the Beijing hip hop community. It focuses on the indexical process by which rappers rely on existing characterological figures and local linguistic variables in Beijing Mandarin (i.e. rhotacized syllable finals, lenited retroflexes, interdentalized dental sibilants, and fronted palatals) to construct hip hop affiliated identities. A variationist analysis provides evidence of style-shifting between two generations of Beijing male rappers, who employ these socially salient linguistic features to different degrees, but always in a semiotically coherent package, in their performance. The analysis further demonstrates how the rappers maintain street credibility through a cultural alignment between hip hop and local social types. By examining the indexicality of these variables, the study highlights the interplay of hip hop ideology, local linguistic features, and local social types in stylistic practices and personae construction. (Hip hop, indexicality, iconicity, performance, Mandarin Chinese)*
Despite the increasing rates of carbapenem-resistant Acinetobacter baumannii (CRAB) carriage among hospitalized patients in endemic settings, the role of active surveillance cultures and cohorting is still debated. We sought to determine the long-term effect of a multifaceted infection-control intervention on the incidence of CRAB in an endemic setting.
Methods:
A prospective, quasi-experimental study was performed at a 670-bed, acute-care hospital. The study consisted of 4 phases. In phase I, basic infection control measures were used. In phase II, CRAB carriers were cohorted in a single ward with dedicated nursing and enhanced environmental cleaning. In phase III large-scale screening in high-risk units was implemented. Phase IV comprised a 15-month follow-up period.
Results:
During the baseline period, the mean incidence rate (IDR) of CRAB was 44 per 100,000 patient days (95% CI, 37.7–54.1). No significant decrease was observed during phase II (IDR, 40.8 per 100,000 patient days; 95% CI, 30.0–56.7; P = .97). During phase III, despite high compliance with control measures, ongoing transmission in several wards was observed and the mean IDR was 53.9 per 100,000 patient days (95% CI, 40.5–72.2; P = .55). In phase IV, following the implementation of large-scale screening, a significant decrease in the mean IDR was observed (25.8 per 100,000 patient days; 95% CI, 19.9–33.5; P = .03). An overall reduction of CRAB rate was observed between phase I and phase IV (rate ratio, 0.6; 95% CI, 0.4–0.9; P < .001).
Conclusions:
The comprehensive intervention that included intensified control measures with routine active screening cultures was effective in reducing the incidence of CRAB in an endemic hospital setting.
Psoriasis is a chronic, systemic, immune-mediated, inflammatory skin disease associated with significant comorbidities. Globally, there are an estimated 60 million people living with psoriasis (PLwP). There is a growing body of evidence on the role of diet in psoriasis management, and demand for dietary advice is high. However, there are no specific, evidence-based dietary guidelines. This scoping review summarises the literature on use and effectiveness of diet in the management of psoriasis to improve understanding of the evidence and assist PLwP and healthcare professionals (HCPs) to discuss diet. The findings were categorised into three themes: (1) dietary intakes of PLwP, (2) the perceived role of diet in psoriasis management and (3) dietary approaches to manage psoriasis symptoms. In cross-sectional studies PLwP were reported to have higher fat and lower fibre intakes compared with controls, and lower psoriasis severity was associated with higher fibre intake. However, research is limited. PLwP perceive diet to have an impact on symptoms and make dietary modifications which are often restrictive. Systematic reviews and RCTs found certain dietary approaches improved symptoms, but only in specific populations (e.g. PLwP with obesity and PLwP with coeliac disease), and evidence for supplement use is inconclusive. The grey literature provides limited guidance to PLwP; focusing on weight loss and associated comorbidities. Larger, controlled trials are required to determine dietary approaches for psoriasis management, especially in PLwP without obesity and non-coeliac PLwP. Further understanding of diet modification, information acquisition and experiences among PLwP will enhance holistic care for psoriasis management.
While startups are acknowledged for their potential to address sustainability issues, little is known on how to assess their impact, given the uncertainty they deal with and their lack of resources. This paper investigates the ones that are supposed to be ‘best-in-class’ in that matter, that is, startups targeting sustainability, in order to explore how they integrate sustainability impact assessment in their entrepreneurial process. We conducted a multiple case study of eight sustainable startups, based on a 2-year longitudinal research in their incubator to gather multiple sources of information. Our results revealed that the integration of the triple bottom line in the entrepreneurial process has a major effect on startups’ sustainability impact assessment practices. ‘Born-sustainable startups’, which have aimed for the triple bottom line since idea generation, have more robust tools and routines than ‘Transitioned sustainable startups’, which integrated the triple bottom line during prototype/validation.
Wartime pressures to protect national military and security interests inevitably create threats to civil liberties. This essay reviews the abuses of the period, carried on by public officials as well as citizens who saw themselves as acting on their behalf. There was a remarkable range of targets—with few spies to find, broadly defined disloyalty sufficed. The attempt to create a unified, loyal culture extended to wide areas of the culture, such as the teaching of history, aided by volunteers. The public and private efforts brought ruined reputations, imprisonments, public shaming, murders, and awful behavior on the part of courts and citizens. These were bad times for civil liberties. This essay reviews the history and explores the legacies.