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This study aims to contribute to enhanced food security in Haiti through proposing targeted local interventions. Employing a spatially explicit tool, the research supports decision-making by relating undernutrition to socio-economic conditions and biophysical factors.
Design:
Georeferenced Demographic and Health Survey (DHS) conducted in 2016-2017 combined with spatial environmental information were used for a multivariate linear regression model to identify factors associated with stunting prevalence. Missing data were imputed through kernel density regression. We converted the structural relationship estimated for the territory of Haiti into a decision support tool by adding fixed effects at communal level. Various policy scenarios were analysed.
Setting:
Haiti, with spatial data across the 134 communes.
Participants:
The analysis included 5623 children under five and their mothers, sourced from DHS data.
Results:
Approximately 22% of all children were stunted. Implementation of the LimitedIntervention development scenario led to a 2.5% reduction in stunting, while the ModerateIntervention and FullIntervention scenarios achieved more significant reductions of 6% and 10%, respectively. Areas with highest stunting incidence benefit most from interventions.
Conclusions:
This tool supports decision makers by assessing the impact of interventions at commune level and selecting areas where interventions exert the most significant effects. The study suggests to apply a strategy that starts in relatively safe communes and then scales to other areas. The flexible approach adopted in this study allows applications in other countries or regions to assess the prevalence of undernutrition among children under five.
Recent years have seen increased interest in Aquinas’s account of perception, its connection to other aspects of his thought and its relation to other theories, such as Kantian and empiricist ones. The present essay begins by discussing contributions to the understanding of Thomas’s position advanced by David Hamlyn and Anthony Lisska and later engages with Aquinas’s writings directly. It poses the question, ‘What sort of a theory does Aquinas offer?’ and suggests it is akin in type if not in substance to Quine’s ‘naturalised epistemology’. Aquinas holds that all human knowledge derives from experience, but I argue that this does not imply (as it would with a strict empiricism) that it is reducible, directly or indirectly, to the contents of immediate sense experience. This is because of the role of two capacities: the cogitative power and the active intellect in constructing contents that transcend immediate experience but which are expressed in perception. Also, some concepts are non-empirical. This leads to a consideration of the sense in which Aquinas is or is not a metaphysical and epistemological realist.
We propose a novel approach to classifying inflation-targeting (IT) economies using fractionally integrated processes. Motivated by the rising prevalence and diversity of IT, we leverage variation in the persistence of inflation rates to identify four de facto strategies, or “shades” of IT. Moving from negative orders of fractional integration, indicating anti-persistent behaviour, to more persistent long-memory processes, often associated with less credible policy frameworks, we classify countries into average, strict, flexible, and uncommitted IT. This framework sheds light on differences between declarative and actual strategies across 36 advanced and emerging economies. Most countries fall into the flexible IT category, though extreme cases, including uncommitted IT, occur quite frequently. Furthermore, we link our classification to institutional features of national frameworks using ordinal probit models. The results suggest differences across categories are related to variations in the maturity and stability of IT frameworks, with weaker connections to central bank independence and transparency.
The outsourcing of traditionally military functions in Africa to private military companies (PMCs) such as the Wagner Group and the Africa Corps has been accompanied by violations of international humanitarian law and international human rights law. According to the International Law Commission’s Articles on Responsibility of States for Internationally Wrongful Acts, state responsibility for these violations can be imputed to the states that employ PMCs to function as their agents, to exercise government authority or to act in the vacuum left by official authorities. States that do not intervene to prevent these abuses fail their obligations of due diligence through persistent non-action and should not be excused from demanding accountability by immunity agreements between the host and hiring states. We explore the possibility of the communitarian invocation of state responsibility by third-party states, on behalf of victims, in order to end impunity, drive accountability and secure effective redress for victims.
This cluster of short essays discusses Kathy Psomiades’s Primitive Marriage: Victorian Anthropology, the Novel and Sexual Modernity (Oxford University Press, 2023), winner of the North American Victorian Studies Association’s 2023 Subsequent Book Prize, along with a response from the author.
In this article I look at the collaboration between Dickens and his greatest illustrator, Hablot K. Browne (Phiz), in Dombey and Son, David Copperfield, and especially Bleak House. In these works, text and image cluster around themes of fallen sexuality, feminine transgression, and the problematic identity of woman as both protagonist and narrator or author. I argue that Browne’s illustrations offer not a counternarrative to Dickens’s but a submerged one, especially in relation to controversial or taboo material. The text and plates work in unison to make manifest what might be present but only subtly telegraphed by Dickens’s words. My piece culminates in speculation about Dickens’s creation of the first-person narrator, Esther Summerson, in Bleak House: was Dickens responding to the proliferation of women-authored texts and women narrators? And were Dickens and Browne signaling in repeated depictions of a faceless Esther that the sex and identity of authorship were mysterious and unsettlingly mutable?
Engaging residents of long-term care homes (LTCHs) in their home’s environment, programs, and operations is required in some jurisdictions and could improve resident quality of life and other outcomes. This scoping review summarized existing research on resident engagement in LTCH organizational design and governance, including associated enablers, barriers, approaches, and outcomes. The database search yielded 5,580 records (after deduplication), and 62 articles covering 59 studies were included. These studies predominantly described Residents’ Councils (n = 38; 64%) and enablers or barriers pertaining to resident and home perspectives, as well as implementation and sustainability infrastructure. Few studies described approaches to considerations of resident diversity (n = 8; 14%) or the presence of dementia and/or cognitive impairment (n = 12; 20%). Ten studies reported quantitative data evaluating resident engagement, and only four with resident-reported outcomes. Robust, evidence-informed frameworks that are co-designed with residents, staff, and others in the LTCH sector are needed to engage residents in their LTCHs.
This article charts the intellectual development and application of communication theology, centering two church-led communication training programs in Nyegezi (Tanzania) and Nairobi (Kenya), from their founding amid East African decolonization in the 1960s through to the challenges of Africanization in the 1970s–1980s. This has implications for two growing bodies of scholarship. First, speaking to histories of Christian thought—particularly on ecumenism, secularization, and localization in the context of decolonization—I show that these training centers, their African staff, and their students enabled the elaboration of communication theology, and revealed its contradictions. Second, speaking to intellectual histories of attempts to decolonize information and communications, I reinsert theology into an often state-centric narrative, suggesting how these training programs informed debates about relevance and self-reliance in the media. I thus make the case for locating intellectual histories of both communications and Christianity in regions of the decolonizing world.
En el recinto sagrado de Mexico-Tenochtitlan, capital del imperio mexica (Azteca), se han recuperado 18 vasijas trípodes con aletas al interior de diversos contextos rituales. El estudio cuidadoso de sus atributos iconográficos, formales y contextuales revela que estos objetos estaban vinculados directamente con el pulque (una bebida alcohólica producida con la savia fermentada del maguey) y sus deidades, además de descifrar su función ritual dentro del discurso simbólico de este importante espacio de la ciudad. Se concluye que estas vasijas reflejan dos aspectos simbólicos del pulque, los cuales están determinados por la materia prima con la que fueron elaboradas. Las vasijas de cerámica se vinculan con la fertilidad, la vida, la música y los juegos; mientras que las de piedra verde están relacionadas con la noche, la muerte, el sacrificio y la guerra. Estas vasijas fueron un símbolo estandarizado entre la sociedad mexica, además que fueron ampliamente reproducidas en manuscritos y otros objetos arqueológicos, resaltando su importancia y el vínculo constante con las deidades del pulque.
The touchstone of judicial review in Lesotho for a long time has preeminently been the ultra vires principle. The modern conception of the doctrine of legality as a constitutional device to control the exercise of public power has not been a prominent feature of Lesotho’s public law. It has only gained traction recently. The superior courts in Lesotho – the High Court and the Court of Appeal – have ruled that the expansive doctrine of legality is now the cornerstone of constitutionalism in the country. In this new trajectory, they rely mainly on the well-developed South African legality jurisprudence. This development of constitutional law in Lesotho is laudable. However, the extent to which South African jurisprudence can inform Lesotho on this subject remains a matter of controversy. This article examines the “importation” of South African jurisprudence on legality into Lesotho, the lessons that Lesotho can derive and the future development pathways for legality in the country.
The present article provides a diachronic analysis of the negation and contraction patterns of will and would in British and American English. It contrasts nineteenth- and twentieth-century data from British and American fiction, comparing the collocational preferences of negated versus non-negated and contracted versus non-contracted modals. Utilising Configural Frequency Analysis, we explore frequency differences as well as variety-specific association patterns. Results reveal predominantly commonalities. The spread of the modal contractions ’ll and ’d as well as the spread of the contracted negator n’t proceeded at similar speeds in both varieties. The analysis at the level of cotextual configurations shows the emergence of several emancipated subschemas that are each differentially entrenched and conventionalised.
Management of infants with hypoplastic left heart syndrome is resource-intensive. Trends in initial Stage 1 palliation choice and associated hospital cost and outcomes over time are unclear.
Using a retrospective cohort of infants <30 days of age (2004–22) from the Paediatric Health Information Systems database, we analysed the annual prevalence of Stage 1 palliation choice, as well as the association between palliation choice and outcomes and resource use. Prevalence of palliation choice was calculated, and Mann–Kendall tests evaluated linear trends. Study outcomes were pooled across years and compared by palliation choice. Associations over time between palliation choice and outcomes and resource use were evaluated with generalised linear mixed models.
Of 7701 patients, 67.45% (n = 5194) underwent a Norwood with modified Blalock-Taussig shunt, (NmBT) 22.06% (n = 1699) underwent a Norwood with right ventricle to pulmonary artery conduit (NRVPA), and 10.49% (n = 808) underwent a hybrid procedure. The annual prevalence of NRVPA surpassed that of NBT in 2017. In the pooled analysis, infants undergoing NRV-PA had the lowest in-hospital mortality (11.2%, P < 0.0001) and lowest cost at $335,406 (IQR: $208,624 to $583,322 (P = 0.001). A trend for increased median estimated hospitalisation cost was observed across time for all procedure choices (P for trend <0.0001 for all).
These data suggest that the NRV-PA is the preferred palliation choice, has the lowest in-hospital mortality, and is the most cost-effective option. Our findings suggest that all Stage 1 palliation options have become more expensive with no observed change in mortality.
The digital and sustainable transitions represent two strategic drivers of growth and innovation for micro-, small-, and medium-sized enterprises. This is especially relevant for micro-firms, which significantly lag behind larger firms in these areas. Financial literacy can play a key role in guiding small entrepreneurs to make sound financial choices and make the so-called twin transition successful. We exploit a survey conducted by the Bank of Italy in 2021 – involving about 2,000 non-financial firms with less than 10 employees – to investigate whether financial literacy acts as a driver for the twin transition. Through instrumental variable estimation, we find evidence of a causal link between financial literacy and both digitalisation and engagement in sustainable activities.
This paper focuses on a type of underdetermination that has barely received any philosophical attention: underdetermination of data. I show how one particular type of data—RNA sequencing data, arguably one of the most important data types in contemporary biology and medicine—is underdetermined, because RNA sequencing experiments often do not determine a unique data set. Instead, different ways of generating usable data can result in vastly different, and even incompatible, data sets. But, since it is often impossible to adjudicate among these different ways of generating data, ‘the data’ coming out of such experiments is underdetermined.
End-of-life care in the Emergency Department (ED) can be a challenge. Defining goals of care in dementia patients may be more complex. The quality of ED medical records is relevant for better care in the last hours or days of life. In this article, we explore the identification of last days of life recognition in ED records of dementia patients.
Methods
Retrospective qualitative review of ED medical records of patients with dementia in the last 7 days of life using reflexive thematic analysis. This study was conducted at a university tertiary hospital, with a 24 h/7 days polyvalent ED. All 2021 ED medical records of dementia patients who presented to the ED within the last 7 days of their lives were included.
Results
More than 1 in 4 patient’s medical records (n = 55, 27,4%) made no explicit reference to the identification of last days of life and only 2 medical records contained this specific designation. Most relevant issues presented under three broader themes: (I) diagnosis and prognosis concerning the last days or hours of life; (II) goals of care, medical decisions and communication about care in the last days or hours of life; and (III) comfort and needs assessment in the last days of life of patients with dementia in the ED.
Significance of results
There is limited identification of the last days or hours of life in ED medical records and clinical notes are of poor-quality regarding communication and shared decision making.
Indigenous archaeology and archaeology of Indigeneity are paramount in the contemporary world. We certainly need more of it across the archaeological scale and across the archaeological globe. Archaeology’s unhealthy attachment to colonialism, colonial administration and imperialism keeps on affecting our discipline on all levels. It is therefore encouraging to read Felix Acuto’s call for an engaged and activist Indigenous archaeology of Latin America. It is certainly needed, but depressing to learn about the recurrent atrocities against Indigenous peoples in Argentina.