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 examines the challenges Indigenous communities face in safeguarding their intangible cultural heritage (ICH) in the digital age, using two case studies. Referring to the Te Hiku Media case, it analyzes the threat of data colonialism posed by corporate digitization projects. The article argues that existing legal frameworks provide limited protection for Indigenous ICH, prompting Indigenous communities to develop the innovative theory of Indigenous data sovereignty (ID-SOV). The Government of Nunavut–Microsoft partnership case highlights the benefits and drawbacks of public–private partnerships (PPPs) for Indigenous ICH. Key takeaways from both cases’ analysis lead to our proposal of integrating ID-SOV principles into PPPs to limit data colonialism risks and improve the sustainability of Indigenous ICH digitization projects. The article contends that implementing ID-SOV principles by design and by default in PPPs can empower Indigenous communities while leveraging the oversight of public actors and resources of private partners to safeguard Indigenous ICH through digital tools.
The efficient integration of outpatient (OPD) and inpatient (IPD) care is a critical challenge in modern healthcare, essential for maximising patient-centred care and resource utilisation. OPD, encompassing preventive services, routine check-ups, and chronic disease management, aims to minimise the need for hospitalisations. Conversely, IPD remains crucial for acute interventions and complex medical needs. This paper investigates the nuanced relationship between OPD and IPD: specifically, we seek to determine if increased OPD utilisation while improving overall health, leads to a reduction or increase in subsequent IPD utilisation, duration, and associated costs. We analyse anonymised data from Indian organisations providing company-sponsored OPD and IPD insurance to their employees between 2021 and 2024. By examining the correlation between OPD utilisation patterns and IPD outcomes, we aim to provide data-driven insights for effective healthcare integration strategies. Furthermore, we explore the feasibility of developing a personalised “Wellbeing Rating” derived from longitudinal OPD insurance utilisation data. This automated methodology aims to provide a continuous, dynamic health assessment, moving beyond the limitations of traditional, sporadic medical examinations by leveraging the comprehensive data inherent within insured OPD coverage.
When unexploded ordnance (UXO) is embedded in the body, the effect of explosive weapons used in conflict is amplified. Though relatively rare, such events present potentially devastating consequences for the patient and medical providers as routine diagnostic and therapeutic procedures hold potential to initiate detonation of the embedded UXO (eUXO). The objective is to identify and synthesize available literature relating to the management of eUXO in low resource settings.
Methods
A scoping review was conducted using PRISMA-ScR methodology to evaluate literature in all languages from all date ranges until January 31, 2024, discussing the management of casualties with eUXO, including types of ordnance, injury patterns, diagnostics, resource utilization, surgical interventions, and outcomes.
Results
Search strings identified 3,425 records. After title and abstract screening 3,397 were excluded yielding 18 for full text screening of which 5 were excluded. Therefore 13 reports were included in analysis. Data variable reporting was heterogeneous but themes and subthemes regarding safety, planning and communication emerged.
Conclusions
A scoping review was conducted to identify gaps in existing literature on the management of eUXO in low resource settings. Coordinated engagement from personnel representing a variety of clinical and non-clinical specialties is required to safely manage eUXO.
The Rapid Acceleration of Diagnostics–Underserved Populations’ COVID-19 Equity Evidence Academy (RADx-UP EA) was a series of virtual conferences hosted between 2021 and 2023 that assembled community members, researchers, and governmental leaders from across the US to discuss and devise ways to promote equity in COVID-19 testing and vaccination. Using community-engaged methodologies in its design and implementation, this series provided a framework and forum for community and academic partners to engage in collaborative idea generation and consensus building during a public health emergency. The ideas and strategies gained during the EAs were disseminated to inform future research and action related to COVID-19. This conference paper highlights the specific engagement approaches used and the themes and recommendations generated. This model and its findings have broad utility beyond RADx-UP and can be used by researchers and practitioners to inform and advance community-engaged research and practice in diverse public health settings.
This article examines the dynamics of youth identity formation at a boarding school for “at-risk” children. The school prepares its young boarders for adulthood through systematic intervention in their everyday cultural practices. By inducing a state of social liminality, or felt in-betweenness, the school seeks to guide its students—mainly youth of color—towards particular social roles, norms, and beliefs. However, children respond and adapt to this ambivalence, which leads to lasting effects as they transition into young adulthood. Utilizing extensive fieldwork and longitudinal data, the analysis employs an interpretive approach to provide context-specific insights into these dynamics. The study details the cultural interventions observed in 2013-14 and revisits the children, now young adults, a decade later, to understand the policy and ethical implications of those interventions. In so doing, this study contributes to understanding the complex interaction between authority, conformity, and identity management within institutions devoted to transforming the lives of children at the social margins.
Fast radio bursts (FRBs) are short, intense radio signals from distant astrophysical sources, and their accurate localisation is crucial for probing their origins and utilising them as cosmological tools. This study focuses on improving the astrometric precision of FRBs discovered by the Australian Square Kilometre Array Pathfinder (ASKAP) by correcting systematic positional errors in the Rapid ASKAP Continuum Survey (RACS), which is used as a primary reference for ASKAP FRB localisation. We present a detailed methodology for refining astrometry in two RACS epochs (RACS-Low1 and RACS-Low3) through crossmatching with the Wide-field Infrared Survey Explorer (WISE) catalogue. The uncorrected RACS-Low1 and RACS-Low3 catalogues had significant astrometric offsets, with all-sky median values of $0.58''$ in RA and $-0.26''$ in Dec. (RACS-Low1) and $0.29''$ in RA and $1.24''$ in Dec. (RACS-Low3), with a substantial and direction-dependent scatter around these values. After correction, the median offset was completely eliminated, and the 68% confidence interval in the all-sky residuals was reduced to $0.2''$ or better for both surveys. By validating the corrected catalogues against other, independent radio surveys, we conclude that the individual corrected RACS source positions are accurate to a 1-$\sigma$ confidence level of $0.3''$ over the bulk of the survey area, degrading slightly to $0.4''$ near the Galactic plane. This work lays the groundwork to extend our corrections to the full RACS catalogue that will enhance future radio observations, particularly for FRB studies.
Este texto tiene un carácter exploratorio a partir de la experiencia etnográfica del levantamiento indígena y popular que paralizó Ecuador en el mes de junio de 2022. Con epicentro en Quito, la capital del país, dicha movilización fue la más larga de todas las que ha protagonizado el movimiento indígena ecuatoriano desde la década de 1990. El artículo reflexiona sobre las características de esta última protesta; señala sus diferencias con respecto a las movilizaciones de los años noventa y de los primeros años de este siglo XXI; y plantea algunas hipótesis sobre la nueva generación de líderes que están al frente de la organización indígena más importante del país, la CONAIE (Confederación de Nacionalidades Indígenas del Ecuador). El argumento principal que se explora es que la adopción de discursos y repertorios de protesta más orientados hacia una dimensión clasista que hacia una puramente etnoidentitaria ha sido la clave en la mayor capacidad de convocatoria del movimiento. Esto se reflejó en el masivo respaldo al llamado de la CONAIE contra las medidas neoliberales adoptadas por el Gobierno nacional.
Here we examine interactions between centralised and devolved employment policy and welfare in Scotland, Wales and England, taking a qualitative approach to gain a street-level perspective. This paper’s twin aims are to challenge the privileging of methodological nationalism in the study of welfare regimes and to offer a substate alternative through a street-level perspective. In the context of prevailing trends towards activation measures and mixed economies of welfare across Western Europe, the UK’s work first approach and categorisation as a Liberal welfare regime of minimal provision is complexified using a devolved policy context.
Our findings on cross-jurisdictional interactions show devolved employment programmes in Scotland and Wales actively reshaping welfare delivery in ways that resist the UK’s historically centralised approach. We contribute to a growing body of literature on substate welfare regimes with significant implications for the privileging of methodological nationalism in the study of work and welfare.
High workforce turbulence has plagued clinical research, becoming intensified during the COVID-19 pandemic, especially for patient-facing workers. In a time of great uncertainty and risk among healthcare workers, researchers included, the pandemic also brought increased demand for research studies in volume, speed, and complexity, triggering elevated staff turnover. This has posed significant hurdles for employers, especially research sites, where retaining skilled patient-facing clinical research professionals (CRPs) is pivotal for sustaining medical innovation. Lack of job standardization and advancement pathways has been noted to play an important role both in turnover and contributes to the inability to accurately measure workforce trends. To address these factors, Duke University adopted a competency-based job classification system for CRPs in 2016.
Methods:
Since that adoption of competency-based jobs, employee-level staffing data for all CRPs have been tracked monthly, creating a master data file from September 2016 through June 2024. This study updates previous analyses, evaluating turnover and turbulence rates, and demographic changes in the CRP workforce over this period.
Results:
Over the last six years, the Duke CRP workforce remained relatively stable. Voluntary turnover rates fluctuated, peaking at 19.1% in FY 2021 during the COVID-19 pandemic, and have steadily declined each year since then.
Conclusions:
Despite national workforce challenges exacerbated by the pandemic, our data indicate that proactive measures to standardize clinical research jobs and assess the resultant well-defined site-based employee data may have mitigated extremes in workforce turnover at Duke University. Turbulence rates, while stabilizing, signal areas for further study.
Vegetable consumption in many countries is less than recommended and even lower in low-income households. This study explored the determinants of current vegetable food choice in households with limited food budgets to inform the implementation of a national vegetable promotion programme. Five focus groups and one individual interview were conducted with twenty-nine parents who self-identified as ‘shopping on a budget’ in an area of multiple deprivation in the southeast of England. Transcripts of audio recordings were coded in NVivo and analysed using inductive thematic analysis. Four main themes which shaped the range of vegetables brought into the home were identified: (1) attributes of vegetables, (2) attributes of parents including their vegetable norms, knowledge and skills (veg-literacy), and interest and opportunity to invest time and effort in vegetables, (3) family food dynamics, and (4) influence of retailers. Overarching this was parents’ capacity to absorb the risk of wasting food, money, time, and effort on vegetables and damaging trust in the parent–child food relationship. The data suggest there is a common set of ‘core vegetables’, which are routinely bought. When money is tight, parents only buy vegetables they know their children will eat and are generally not persuaded to buy ‘off-list’ in response to price discounts or promotions. Cost is not always the main barrier to increased vegetable purchase. To avoid unintentionally widening dietary inequalities, supply-side interventions to promote vegetable consumption need to be designed alongside targeted actions that enhance the capacity of low-income households to respond.
Older adults are more likely to develop delirium with COVID-19 infection. This cross-sectional cohort study was designed to explore the risk factors of delirium in hospitalized older adults with COVID-19 and to evaluate whether delirium is an independent predictor of mortality in this cohort of patients.
Methods:
Data were collected through a retrospective clinical chart review of patients aged 65 years or older who were admitted to St. James’s Hospital between March 2020 and 2021 who tested positive for SARS-CoV-2 infection.
Results:
A total of 261 patients (2.8 % of total admissions 65 years or older) were included in this study. Patients who developed delirium were older (80.8 v. 75.8 years, p < 0.001), more likely to have pre-existing cognitive impairment (OR = 3.97 [95% CI 2.11–7.46], p < 0.001), and were more likely to be nursing home residents (OR = 12.32 [95% CI 2.54–59.62], p = 0.0018). Patients who developed delirium had a higher Clinical Frailty score (mean 5.31 v. 3.67, p < 0.001) and higher Charlson Co-morbidity index (mean 2.38 v. 1.82, p = .046). There was no significant association between in-hospital mortality and delirium in the patient cohort (p = 0.13). Delirium was associated with longer hospital stay (40.5 days v. 21 days, P = 0.001) and patients with delirium were more likely to be discharged to nursing homes or convalescence instead of home (OR = 8.46 [95% CI 3.60–19.88], p < 0.001).
Conclusions:
Delirium is more likely to occur in COVID-19 patients with pre-existing risk factors for delirium, resulting in prolonged admission and functional decline requiring increased support for discharge.
This systematic review aims to evaluate the effectiveness of various physical environmental enrichment items such as brushes, ropes, teats, chains, balls, cowhides/blocks, at improving the welfare of indoor-housed calves, heifers, and cattle. This review of 33 peer-reviewed papers and one industry report evaluated different welfare-related outcomes following physical environmental enrichment, including feed intake, lying time, play and exploratory behaviour, aggression, stereotypic behaviour and cross-sucking behaviour. The results of the meta-analysis revealed that calves and heifers enrolled in experimental studies using enrichment items had significantly improved growth rates, and increased locomotor play, but the overall reduction in cross-sucking behaviour was small and non-significant. The effect of enrichment on feed intake, aggression/stereotypic behaviour, play behaviour, cleanliness score contrasted between studies, with some reporting improvements while others showed no effect of environmental enrichment in these parameters. The risk of bias assessment revealed limitations in researcher blinding, sequence generation, and allocation concealment across the literature assessing the effectiveness of environmental enrichment on animal welfare. Overall, this review underscores the significant positive impact of physical enrichment on the welfare and behaviour of indoor-housed cattle, while highlighting the need for further research to optimise enrichment strategies across different cattle age groups and housing conditions.
Colonization and ongoing colonial policies and practices are contributing to increased dementia rates in Indigenous populations. This health inequity could be addressed by implementing culturally safe dementia interventions specifically designed for Indigenous people. We conducted a scoping review of culturally safe dementia care interventions for Indigenous populations. Databases searched included OVID (Medline, PsycINFO, Embase, Healthstar), Informit Indigenous Collection, JBI EBP, Scopus/Elsevier and PubMed. Eligibility criteria included studies in English, interventions designed specifically for Indigenous persons living with dementia and evaluative outcomes of the intervention. In total, 2,259 articles were identified. After removing duplicates, 1,394 titles and abstracts were screened and 54 studies were screened for eligibility. Of these, no studies were eligible for inclusion. This empty review reveals a massive and inexcusable gap in knowledge around developing, implementing and evaluating culturally safe Indigenous-specific dementia care interventions. Future directions for research include working with Indigenous peoples to determine what culturally safe interventions for dementia look like, implementing high-quality studies with evidence-based measures and outcomes, and improving efforts to get this important work published to inform future studies.
This paper presents a novel simplification calculus for propositional logic derived from Peirce’s existential graphs’ rules of inference and implication graphs. Our rules can be applied to propositional logic formulae in nested form, are equivalence-preserving, guarantee a monotonically decreasing number of variables, clauses and literals, and maximise the preservation of structural problem information. Our techniques can also be seen as higher-level SAT preprocessing, and we show how one of our rules (TWSR) generalises and streamlines most of the known equivalence-preserving SAT preprocessing methods. In addition, we propose a simplification procedure based on the systematic application of two of our rules (EPR and TWSR) which is solver-agnostic and can be used to simplify large Boolean satisfiability problems and propositional formulae in arbitrary form, and we provide a formal analysis of its algorithmic complexity in terms of space and time. Finally, we show how our rules can be further extended with a novel n-ary implication graph to capture all known equivalence-preserving preprocessing procedures.
The nonlinear disturbance caused by either a localised pressure distribution moving at constant speed on the free surface of a liquid of finite depth or a flow over a topographic obstacle, is investigated using (i) the weakly nonlinear forced Kadomtsev–Petviashvili equation which is valid for depth-based Froude numbers near unity and (ii) the fully nonlinear free-surface Euler system. The presence of a steady v-shaped Kelvin wave pattern downstream of the forcing is established for this model equation, and the wedge angle is characterised as a function of the depth-based Froude number. Inspired by this analysis, it is shown that the wake can be eliminated via a careful choice of the forcing distribution and that, significantly, the corresponding nonlinear wave-free solution is stable so that it could potentially be seen in a physical experiment. The stability is demonstrated via the numerical solution of an initial value problem for both the model equation and the fully nonlinear Euler system in which the steady wave-free state is attained in the long-time limit.
The democratic justification of academic freedom – Academic freedom and Article 2 TEU values (democracy, the rule of law) – Potential implications for the application of the EU rule of law toolbox – Complementary protection of academic freedom – Preliminary remarks on future proposals
Over the decades, research has demonstrated that Conditional Release Programs (CONREP) and Compulsory community treatment can reduce recidivism among forensic patients discharged from inpatient commitment. This study synthesizes current knowledge—including findings from a 2024 California Department of State Hospitals report—to evaluate the impact of involuntary community treatment on recidivism and patient outcomes.
Methods
We retrospectively analyzed 2613 patients discharged from California state hospitals between 2012 and 2017. Patients were either directly discharged to the community (N = 2011) or referred to CONREP (N = 602). Data on rearrests for general and violent offenses were obtained through 2018. Variables with established relationships to recidivism (e.g., commitment category, mental health diagnoses, lengths of stay) were included. Statistical analyses, including chi-square tests, Cox regression, and logistic regression, were conducted to compare recidivism rates and identify significant predictors.
Results
CONREP-treated patients demonstrated dramatically lower fixed recidivism rates at 1, 3, and 5 years compared with directly discharged patients. Direct discharge was associated with up to a sevenfold increased likelihood of rearrest within 1 year. The median time to rearrest was 400 days for directly discharged patients versus 500 days for CONREP patients (p < .004). Logistic regression revealed that direct discharge, younger age, and a higher number of state hospital commitments were significant predictors of rearrest.
Conclusions
Structured, court-supervised community treatment via CONREP substantially reduces recidivism among forensic patients, promoting safer community reintegration and improved outcomes. These findings support expanding CONREP services to enhance public safety and patient rehabilitation.
Over the past two decades, English has become a key medium of instruction in higher education in non-native English contexts, especially Asian countries. Extant research highlights the rapid expansion of English-medium instruction (EMI) and challenges in policy implementation, revealing tensions between different language policy levels (i.e., macro, meso and micro). Thus, a multilevel analysis is needed to understand these tensions. This review examines factors influencing EMI adoption in China, Japan, Malaysia, and Nepal, focusing on policy implementation by educators and students. Findings show that EMI adoption is driven by English's role as a global lingua franca and the permeation of neoliberal ideologies at the macro policymaking level. Such a macro-level endorsement of monolingual EMI has resulted in micro-level inequalities for students, with resistance manifested through multilingual practices, such as translanguaging, in the classroom. The discrepancies between language policies and practices highlight the necessity of reassessing the adequacy of monolingual EMI policies and the importance of adopting a multilingual policy framework. The article concludes with a critical discussion of the trends observed in these contexts and recommends several policy directions for the future.
The scandal of the Cuban Missile Crisis lies in the fact that it brought the United States and the Soviet Union to the brink of nuclear war for actions associated with relatively minor strategic and political gains. In this article I will treat this crisis as a diagnostic event to identify two significant interinstitutional dynamics that drove Nikita Khrushchev and President John F. Kennedy to this rationality-defying precipice. The first of these dynamics explores the consequences of transitioning military units from peacetime routines to crisis-level field deployment, which quickly created considerable command-and-control problems for both political leaders. Yet each believed that the other side remained in control of its forces, erroneously understanding local action by the other side as strategic moves ordered by central command. This created the potential for uncontrollable escalation. The second dynamic resulted from the interaction of two institutional arrangements in the United States. American presidents are simultaneously the country’s highest decision makers in foreign affairs and political campaigners interested in their own reelection. Foreign policy decisions thus become potential campaign moves. After World War II, a campaigning tradition emerged in which both parties felt compelled to outdo each other with anticommunist rhetoric and policies. This strategy built on deeply instituted anticommunism in the electorate, which politicians felt compelled to further cultivate. This dynamic significantly limited Kennedy’s response options, making it more likely than not that he would have called for an invasion of Cuba if Khrushchev had not backed down. The consequences would have been disastrous. The article concludes with tentative lessons to learn from these two dynamics.