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In this paper, I question the argument from human dignity found in the Universal Declaration on the Human Genome and Human Rights (UDHGHR) and in the recent views of the International Bioethics Committee (IBC). I focus on what this argument says about the permissibility of two broad categories of reprogenetic choices that may be available to prospective parents in the genomic era. The argument from human dignity holds that non-medical genetic selection and somatic enhancements ought to be prohibited because they violate the principle of human dignity. I argue that human dignity need not be violated by the enterprise of human genetic selection/somatic enhancement if reasonable social safeguards are established. In particular, I argue that respecting the reprogenetic choices of the decision-maker is paramount within the boundaries of (i) prohibiting the infliction of a shortened lifespan or pain upon the child; (ii) prohibiting the actualization of demeaning beliefs or intentions such as viewing certain groups as inferior; (iii) prohibiting the choice resulting from an expression of unwillingness to love and care for the child; and, with respect to somatic gene enhancements in particular, (iv) the potentially unjustified effects of the enhancement on others, if any, are reasonably addressable (and addressed) via social modifications so as to ensure the enhancement no longer risks adversely affecting them. With these limits, reprogenetic autonomy cannot be said to undermine the dignity of humans by creating unjustified harms or expressing demeaning ideas.
From 1972 to 1991, a network of Chicago Police detectives used torture to force confessions from over 100 criminal suspects. Almost all were Black men, and many were wrongly convicted, some for capital offenses. I synthesize insights from comparative research on human rights, state abuse, and police violence in democracies to explain why, for nearly two decades, liberal institutions in Chicago failed to stop the torture. I argue that the nature of state violence in this case—targeting marginalized individuals uninvolved in political activity—intensified the practical, affective, and informational obstacles that are inherent to activating liberal institutions—courts, elected officials, media, and civil society—to fulfill their roles as rights enforcers. Applying these literatures to a type of case they typically overlook—a wealthy liberal democracy—contributes to understanding why state violence persists in such states and why it tends to concentrate on marginalized populations.
The UK government launched a two-component sugar-reduction programme in 2016, one component is the taxation of sugar-sweetened beverages, the Soft Drinks Industry Levy, and the second is a voluntary sugar reduction programme for products contributing most to children’s sugar intakes. These policies provided incentives both for industry to change the products they sell and for people to change their food and beverage choices through a ‘signalling’ effect that has raised awareness of excess sugar intakes in the population. In this study, we aimed to identify the relative contributions of the supply- and demand-side drivers of changes in the sugar density of food and beverages purchased in Great Britain. While we found that both supply- and demand-side drivers contributed to decreasing the sugar density of beverage purchases (reformulation led to a 19 % reduction, product renewal 14 %, and consumer switching between products 8 %), for food products it was mostly supply-side drivers (reformulation and product renewal). Reformulation contributed consistently to a decrease in the sugar density of purchases across households, whereas changes in consumer choices were generally in the opposite direction, offsetting benefits of reformulation. We studied the social gradient of sugar density reduction for breakfast cereals, achieved mostly by reformulation, and found increased reductions in sugar purchased by households of lower socio-economic status. Conversely, there was no social gradient for soft drinks. We conclude that taxes and reformulation incentives are complementary and combining them in a programme to improve the nutritional quality of foods increases the probability of improvements in diet quality.
Activation policies, especially formal upskilling, can strengthen social inequality among long-term unemployed people. Also, receiving skill-enhancing activities may be at odds with the ‘work first’ principle. Drawing on interviews with frontline workers in the Norwegian employment and welfare service (NAV), this article analyses how frontline workers handle the challenging aspects arising from activation policies in providing enabling activities to claimants who need comprehensive support. The findings suggest that frontline workers face claimants who expect to embark on an education, and on the contrary, claimants who lack motivation or capability to do so. In both cases, frontline workers are challenged in terms of experiencing contradictory expectations from policies and users and in assessing future outcomes and suitability of the services. Education activities provided by the public employment agency (PES) involves multiple policy fields and require specific competency on the part of frontline workers.
Both extreme weather and climate change have been linked to distress and at times mental health problems. Pro-environmental actions have often been related to higher distress. The uncertainty distress model (Freeston et al., 2020) proposes that in real-world situations, perceptions of threat and uncertainty contribute to distress. The aim of this study is to integrate variables from these two literatures and examine their relationships.
Method:
A community sample (n=327) was recruited and completed an online survey. Network analysis was used to analyse the relationships between the variables. Exposure to extreme weather, perceptions of climate change, climate change distress and pro-environmental action were measured along with symptoms of adjustment disorder and post-traumatic stress disorder, and uncertainty intolerance and behaviours.
Results:
There was variable exposure to extreme weather, but greater exposure was associated with more severe post-traumatic symptoms. Pro-environmental action was associated with greater severity of adjustment disorder symptoms. The perception that climate change was happening now was linked positively to pro-environmental action and negatively to perceptions of uncertainty about whether climate change was happening.
Discussion:
The results replicate several findings from the emerging climate change distress literature and are consistent with some predictions of the uncertainty distress model, but not others. Uncertainty as to whether climate change is happening now may be a less distressing position. Research that simultaneously considers extreme weather and climate change may help understanding the range of complex responses that may arise as the frequency of extreme weather increases and evidence for anthropogenic climate change strengthens.
Key learning aims
(1) To consider why the uncertainty distress model may be an appropriate framework to understand responses to extreme weather and climate change.
(2) To consider how the perceived proximity of climate change may play a role in peoples’ emotional and behavioural responses to climate change.
(3) To consider some of the variables that are linked to pro-environmental action.
(4) To consider whether an uncertainty-based understanding of extreme weather and climate change has helpful implications for practice.
Ebstein’s anomaly is rarely accompanied by coarctation of the aorta, although patients with Ebstein’s anomaly have a relatively small left ventricle. Here, we report a rare case of Ebstein’s anomaly with coarctation of the aorta and a bicuspid aortic valve. We compared the foetal echocardiographic parameters of five previous cases with Ebstein’s anomaly without left heart obstruction to explore the association between left ventricular volume, Ebstein’s anomaly severity, and left heart obstruction.
The U.S. Centers for Disease Control and Prevention encourages nurses to evaluate penicillin allergies as part of hospital-based antibiotic stewardship programs. We evaluated the feasibility of an implementation strategy to improve nurses’ comprehensive documentation of penicillin allergies. We defined feasibility as the uptake and acceptability of documentation procedures.
Outpatient surgical areas of an academic medical center located in the U.S.
Intervention:
The implementation strategy was guided by the Capability, Opportunity, Motivation Model for Behavior Change and included, building an interdisciplinary coalition to iteratively evaluate the implementation effort, educational meetings with surgical prescribers and perioperative nurses, the development and distribution of educational pocket cards, and structured communication messages in the electronic medical record.
Results:
A total of 426 patients with 487 penicillin allergy records (216 records pre-implementation period, 271 records post-implementation period) were analyzed. Penicillin allergy documentation contained the following information in the pre- versus post-implementation period: symptoms of the reaction (87% vs 87%), timing/years since reaction (8% vs 26%), onset of reaction in relation to taking penicillin (0% vs 21%), how symptoms resolved (0% vs 21%), and penicillin re-exposure (3% vs 21%). Focus groups revealed nurses perceived documentation procedures as highly acceptable. Major drivers of acceptability included the perceived effectiveness of a detailed allergy history and self-efficacy in conducting a detailed allergy history.
Conclusions:
Nurses perceived the comprehensive documentation of penicillin allergy history intervention as acceptable, and uptake improved following a theory-informed implementation strategy. We offer implementation strategy components to facilitate nurses’ engagement in penicillin allergy evaluation.
In recent years, unmanned aerial vehicles (UAVs) have been applied in underground mine inspection and other similar works depending on their versatility and mobility. However, accurate localization of UAVs in perceptually degraded mines is full of challenges due to the harsh light conditions and similar roadway structures. Due to the unique characteristics of the underground mines, this paper proposes a semantic knowledge database-based localization method for UAVs. By minimizing the spatial point-to-edge distance and point-to-plane distance, the relative pose constraint factor between keyframes is designed for UAV continuous pose estimation. To reduce the accumulated localization errors during the long-distance flight in a perceptual-degraded mine, a semantic knowledge database is established by segmenting the intersection point cloud from the prior map of the mine. The topological feature of the current keyframe is detected in real time during the UAV flight. The intersection position constraint factor is constructed by comparing the similarity between the topological feature of the current keyframe and the intersections in the semantic knowledge database. Combining the relative pose constraint factor of LiDAR keyframes and the intersection position constraint factor, the optimization model of the UAV pose factor graph is established to estimate UAV flight pose and eliminate the cumulative error. Two UAV localization experiments conducted on the simulated large-scale Edgar Mine and a mine-like indoor corridor indicate that the proposed UAV localization method can realize accurate localization during long-distance flight in degraded mines.
In this communication, we present a brief response to Lykova et al. (2024) who, in a paper in volume 88 https://doi.org/10.1180/mgm.2024.1 (this journal), describe the occurrence of the new mineral natromelansonite, Na3Zr(Si7AlO19)⋅4–5H2O, and provide commentary on the related species, melansonite (Na,□)□2KZrSi8O19⋅5H2O. The comments in question revolve primarily around the roles and abundances of Al and Na in both minerals, and how their incorporation is best represented in their idealised formulae.
Lykova et al. (2024) state that Al is an essential component of both melansonite and natromelansonite and should thus be reflected in the ideal formulae. With respect to Na, they propose that the ideal formula of melansonite contains two Na apfu rather than one, as was presented in our initial definition of the mineral.
We reiterate there is no unequivocal evidence that Al is an essential component of melansonite, occupying a unique crystallographic site, but rather, it only substitutes for Si. Secondly, though the true Na content of melansonite is probably higher than were originally reported (this being simply explained by the thin nature of the crystals analysed and the volatility of Na under the electron beam), it cannot reconcile the doubling of the Na apfu for melansonite, as was suggested by Lykova et al. (2024).
Hydrogen sulfide (H2S) has been shown to play a significant role in oxidative stress across various tissues and cells; however, its role in sperm function remains poorly understood. This study aimed to investigate the protective effect of GYY4137, a slow-releasing H2S compound, on sperm damage induced by H2O2. We assessed the effects of GYY4137 on motility, viability, lipid peroxidation and caspase-3 activity in human spermatozoa in vitro following oxidative damage mediated by H2O2. Spermatozoa from 25 healthy men were selected using a density gradient centrifugation method and cultured in the presence or absence of 10 μM H2O2, followed by incubation with varying concentrations of GYY4137 (0.625–2.5 μM). After 24 h of incubation, sperm motility, viability, lipid peroxidation, and caspase-3 activity were evaluated. The results indicated that H2O2 adversely affected sperm parameters, reducing motility and viability, while increasing oxidative stress, as evidenced by elevated lipid peroxidation and caspase-3 activity. GYY4137 provided dose-dependent protection against H2O2-induced oxidative stress (OS). We concluded that supplementation with GYY4137 may offer antioxidant protection during in vitro sperm preparation for assisted reproductive technology.
Low temporal stability may complicate the interpretation of survey measures of conspiracy theories (CTs). Current study examines the stability of endorsement of CTs on a popular set of items addressing COVID-19-related CTs. An online survey tapping two CTs about COVID-19 was administered to 179 students of general medicine. The same items were presented twice in March 2022 and once in May 2022. The mean endorsement of the CTs did not differ between March and May. The correlation between answers provided in March and May was low (.5 < r < .7). Most of those reporting agreement with CTs in March reported disagreement in May. Conspiracy believers’ responses did not change between two measurements in March but were different in May, suggesting that the low temporal stability was due to situational factors rather than erroneous or random answers. Poor temporal stability of responses endorsing CTs may problematize interpretation of survey data. Respondents’ endorsement of CTs may be affected by situational factors, inflating agreement with CTs, and correlations with other survey-based measures.
Chemical, biological, radiological, and nuclear (CBRN) incidents require meticulous preparedness, particularly in the Middle East and North Africa (MENA) region. This study evaluated CBRN response operational flowcharts, tabletop training scenarios methods, and a health sector preparedness assessment tool specific to the MENA region.
Methods
An online Delphi survey engaging international disaster medicine experts was conducted. Content validity indices (CVIs) were used to validate the items. Consensus metrics, including interquartile ranges (IQRs) and Kendall’s W coefficient, were utilized to assess the panelists’ agreement levels. Advanced artificial intelligence computing methods, including sentiment analysis and machine-learning methods (t-distributed stochastic neighbor embedding [t-SNE] and k-means), were used to cluster the consensus data.
Results
Forty experts participated in this study. The item-level CVIs for the CBRN response flowcharts, preparedness assessment tool, and tabletop scenarios were 0.96, 0.85, and 0.84, respectively, indicating strong content validity. Consensus analysis demonstrated an IQR of 0 for most items and a strong Kendall’s W coefficient, indicating a high level of agreement among the panelists. The t-SNE and k-means identified four clusters with greater European response engagement.
Conclusions
This study validated essential CBRN preparedness and response tools using broad expert consensus, demonstrating their applicability across different geographic areas.