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It is common for caregivers of the cognitively disabled to speak on behalf of their charges who cannot speak for themselves. Their testimony, however, is often dismissed either because of doubt about their having relevant expertise or because of worries that they are blinded by love. This paper is positioned against such dismissals. I argue that good caregivers are uniquely positioned to offer reliable and often insightful testimony about the well-being of their charges and so ought to be taken more seriously. I argue first for the reliability of caregiver testimony via a phenomenological account, which reveals that accuracy is constitutive of good caregiving. I then argue further that caregiver testimony can be especially insightful because the love that is characteristic of good caregiving may be semi-transformative, facilitating insight into cognitively disabled lives in a way that cannot be achieved through more detached forms of engagement.
Despite the decline in mortality rates among children in developing countries, disparities persist between countries, particularly between twins and singletons. This study employed data from nine Demographic and Health Surveys in the Dominican Republic and Haiti to estimate and compare mortality rates for twins and singletons in categories of the under-5 age group (neonatal, postneonatal, and child mortality) and examine the factors associated with excess mortality among twins. From 1996 to 2013, the under-5 mortality rate (U5MR) for singletons in the Dominican Republic declined from 56‰ (95% CI [47, 64) to 30‰ (22–39) and from 108‰ (53–164) to 53‰ (16–89) among twins. In Haiti, between 1994 and 2016, the U5MR declined from 121‰ (109–133) to 77‰ (68–80) for singletons and from 432‰ (327–538) to 204‰ (149–260) among twins. The adjusted risk of neonatal death for twins is 1.4 (1.0–1.9) times higher than for singletons in the Dominican Republic, compared to a risk of 4.3 (3.5–5.3) times higher in Haiti. In the post-neonatal period, the mortality risk for twins in the Dominican Republic was 1.8 (1.0–3.1) times higher than that for singletons, 2.9 (2.3–3.8) in Haiti. The risk of death for twins was not significantly different from that for singletons in both the Dominican Republic and Haiti at ages 1–4 years. Low birth weight, lack of breastfeeding, absence of, or inadequate, antenatal care, noncesarean section birth, and high birth order were associated with excess mortality among twins in both countries.
Recommended dietary fibre consumption is rarely met in high-income countries. Detailed analysis of fibre consumption patterns is essential to identify strategies for increasing intake. This study investigated the timing and sources of fibre intake in Switzerland, using data from the Swiss Nutrition Survey, menuCH (n = 2057, 18–75 years). Dietary characteristics were summarised for the adult population and for subgroups stratified by absolute (< 15 g/day, 15-<30 g/day, and >=30 g/day) and relative (< 10 g/1000 kcal/day, 10-<14 g/1000 kcal/day, and >=14 g/1000 kcal/day) fibre intake. Mean fibre intake of both 24 HDRs for each individual and contribution of food groups and timing (before breakfast, breakfast, during the morning, lunch, during the afternoon, dinner, after dinner/at night) was calculated. Fibre was mainly consumed at breakfast (4.1 g/day), lunch (6.0 g/day), and dinner (6.4 g/day). Intake at breakfast differed between the lowest and highest fibre intake groups by 6.4 g/day (absolute) and 4.3 g/day (relative). Breakfast skipping was more frequent among low-fibre intake groups (29% for absolute intake, 19% for relative intake) than in the overall population (15%). The main sources of dietary fibre were grain products (35.6%), followed by vegetables (18.3%) and fruits (18.2%), with whole grains accounting for 17.5% of grain intake. Legumes contributed only to 1% of total fibre intake. Public health efforts encouraging regular breakfast consumption, and intake of whole grains and legumes are recommended to improve fibre intake.
This study examined global trends in influenza-associated lower respiratory infections (LRIs) deaths from 1990 to 2019 using data from the GBD 2019. The annual percentage change (APC) and average annual percentage change (AAPC) were used to analyze age-standardized death rates (ASDR). Globally, the ASDR of influenza-associated LRIs was 3.29/100,000 in 2019, which was higher in the African region (6.57/100,000) and among adults aged 70 years and older (29.88/100,000). The ASDR of influenza-associated LRIs decreased significantly from 1990 to 2019 (AAPC = −1.88%, P < 0.05). However, it was significantly increased among adults aged 70 years and older during 2017–2019 (APC = 2.31%, P < 0.05), especially in Western Pacific Region and South-East Asia Regions. The ratio of death rates between adults aged 70 years and older and children aged under 5 years increased globally from 1.63 in 1990 to 5.34 in 2019, and the Western Pacific Region experienced the most substantial increase, with the ratio soaring from 1.83 in 1990 to 12.98 in 2019. Despite a decline in the global ASDR of influenza-associated LRIs, it continues to impose a significant burden, particularly in the African, Western Pacific regions and among the elderly population.
The developmental environment can have an especially large impact on life history plasticity in animals, influencing body size, reproductive success, and longevity. This is because developmental processes interact with environmental factors to determine phenotypes such as body size, sexual investment, and metabolic rate, which in turn can influence longevity and senescence. We investigated how natural differences in the larval environment (discarded moose antlers) influenced development time, survival, and mating success of wild male antler flies, Protopiophila litigata Bonduriansky (Diptera: Piophilidae). Antlers become depleted of resources from year to year, as multiple generations of larvae feed within them. We collected larvae that grew inside nine different shed moose antlers, and we individually tracked them in the field as adults. Moose antlers that were more attractive to adult P. litigata also supported a greater number of larvae, suggesting they are of higher quality. Flies that developed in more attractive antlers completed metamorphosis more quickly but did not differ in body size, longevity, or lifetime mating success. This suggests that the observed differences in larval density may, in part, balance the variation in resource availability among antlers. Regardless of natal antler, large male P. litigata tended to live longer and have higher mating success, as found in previous studies of this species.
Laueite/stewartite epitaxy was studied using single-crystal diffraction applied to a composite crystal from Hagendorf-Süd, Bavaria. The orientation relationships between the crystals of the two minerals was facilitated by using a non-conventional B$\bar {1}$ space group setting for stewartite, giving unit cells with parallel axes and with as = 2al, bs = bl and cs = 2cl. Face indexing of the crystals of the two minerals confirmed the epitaxial relationship, with the {100} and {010} faces parallel. The plane of epitaxy is {010}. Refinement of laueite and stewartite datasets extracted from the composite-crystal data collection showed a significant decrease in the mean Mn-site bond distances in laueite, consistent with chemical analyses of the crystals that gave site compositions of Mn0.92Fe3+0.08 for stewartite and Mn0.66Mg0.17Fe3+0.17 for laueite. The epitaxial growth of laueite on {010} planes of stewartite appears to have been initiated by a change in solution chemistry. Possible paragenesis of the secondary phosphate minerals from primary triphylite is discussed.
Corteva Agriscience recently registered a premix of tolpyralate and bromoxynil in the United States and Canada for weed control in cereal fields. Limited information exists on weed control efficacy and crop safety with this new herbicide premixture. Greenhouse trials were conducted for 2 yr to test the efficacy of tolpyralate and bromoxynil combinations on 14 broadleaf and four grass weeds and its safety to wheat and barley. Four combinations of tolpyralate and bromoxynil at a 1:10 ratio (3.75 + 37.5, 7.5+ 75, 11.25 + 112.5, and 15 + 150 g ai ha−1) as a tank mix and premix were tested. Stand-alone treatments of tolpyralate and bromoxynil were also included in this study. The lowest tested rate of tolpyralate (3.75 g ha−1) provided 10% to 98% control of broadleaf weeds and 27% to 77% control of grass weeds. Bromoxynil at the lowest tested rate (37.5 g ha−1) provided 16% to 80% control of broadleaf weeds and 0% to 30% control of grass weeds. Tank mixing these two herbicides at the same rates resulted in improved broadleaf (60% to 100%) and grass (45% to 94%) weed control. The minimum recommended field use rate of tolpyralate + bromoxynil (15 + 150 g ha−1) controlled all the broadleaf weeds by >95%. That combination also controlled green foxtail, barnyardgrass, and large crabgrass by >90%. An additive or synergistic effect between the two herbicides was observed against several broadleaf and grass weed species. Among all the tested weeds, a greater synergistic effect was observed when the herbicides were used on kochia, chickweed, wild mustard, corn poppy, barnyardgrass, green foxtail, and fall panicum. The premix of the two herbicides provided similar control of broadleaf weeds, but better control of grass weeds than the tank-mix combinations. The premix can be used safely on wheat and barley.
Beliefs about the future shape attitudes, experiences, and priorities in the present. This article explores the relationship between democracy and the expected world to come. As it argues, visions of the future are an important resource for democratic politics, putting the present in critical perspective, aiding in the formation of a collective agent, and consolidating commitment in adversity. Indirectly, they contribute also to the legitimacy of democratic institutions, shaping the exercise of citizenship and the capacity to contend with the flaws of representation. The democratic significance of the imagined future becomes even more visible in today’s age of skepticism toward future-regarding politics, in which speculative modes of thinking run up against the desire for certainty and precision.
Anti-Müllerian hormone (AMH) is a dimeric glycoprotein belonging to the superfamily of the transforming growth factor-β. Due to the discovery of AMH functions, relative to the ovarian function, it is being postulated as being a highly important marker in studies on mammalian reproduction. Therefore, the objective of this review was to describe the role of this hormone in different reproductive aspects of female mammals, taking women, cows, and mares as reference species. The relationship between ovarian reserve and AMH was analysed, and it has been verified that there is a relationship between the latter, the antral follicle count, and the number of primary follicles. AMH concentration has been associated with parameters like the age of the individual, fertility, superovulation treatments and embryo production, and to the reproductive hormone concentration. Also, an association between AMH and female reproduction system diseases, and the fact that AMH is a heritable feature in the cow have also been proven. Recent studies have analysed the role of AMH receptor type 2 since it appears that, together with gonadotropin-releasing hormone, it controls the secretion of gonadotropins. Despite the considerable amount of bibliography on AMH, more studies are needed to complete the information that we have on it, in order to reveal the unknown elements in its action mechanisms.
It is widely known that people with a severe and persistent mental illness (SPMI) are more at risk of poor physical health outcomes because of disparities in healthcare access and provision. Less is known about the quality of end-of-life (EoL) care in people with SPMI who have a life-limiting disease.
Methods
A comprehensive and systematic literature search in PubMed, Embase, Web of Science, Scopus, and CINAHL electronic databases (from inception to November 2023) was conducted, without language restriction, for reviews on EoL care and/or palliative sedation for people with SPMI and a life-limiting disease. A critical appraisal of the selected reviews was performed. Data were analyzed according to the four principles of biomedical ethics.
Results
Ten reviews were included. These show that people with SPMI are at risk of suboptimal EoL care. Stigma among healthcare professionals, lack of integrated care policies, absence of advanced care planning, and insufficient expertise and training in palliative care of psychiatrists have been identified as key challenges to the provision of adequate EoL care for people with SPMI. No data were found about palliative sedation.
Conclusions
To optimize palliative and EoL care for SPMI patients with a life-limiting disease, a policy of coordinated and integrated mental and physical healthcare is needed. Moreover, education and training initiatives to reduce stigma and discrimination among all healthcare workers and to enhance palliative care skills in psychiatrists should be offered. Finally, more research is needed on EoL particularly on palliative sedation for people with SPMI and a life-limiting disease.
Preventing neonatal calf diarrhea (NCD) and bovine respiratory disease (BRD) in cow–calf herds is essential to optimizing calfhood health. Disease control can prevent morbidity and mortality; however, evidence concerning the effectiveness of practices to achieve this is limited. The objective of this systematic review was to assess and summarize the evidence on the effectiveness of management practices to prevent calf morbidity and mortality from NCD and BRD in beef cow–calf herds. The population of interest was preweaned beef calves. The outcomes were calf morbidity and mortality caused by NCD and BRD. Only studies reporting naturally occurring diseases were included. Seventeen studies were deemed relevant, 6 studies of which were controlled trials or randomized controlled trials (RCTs), and 11 were observational studies. Most management practices had some evidence to support their use; however, the certainty of the findings was low to very low. Most of the practices were shown to impact both NCD and BRD. Yet, the different levels of consistency in the directionality of the findings suggest that some outcomes are more affected by some practices than others. More well-designed RCTs and cohort studies are required to provide reliable estimates to support recommended practices for cow–calf herds.
Up to 40% of seriously ill patients develop a (temporary) desire to die which can lead to requests for assisted dying. Health professionals often feel uncertain about addressing these topics, while informal caregivers may feel guilty and left out. Open and respectful communication proves beneficial. It remains unclear how this communication ideal realizes within the lived experience of all 3 parties. Therefore, we conducted in-depth analysis of communication strategies about desire to die from triangulated perspectives of patients, informal caregivers, and health professionals.
Methods
We conducted semi-structured interviews with purposefully sampled triads consisting of seriously ill patients, their respective informal caregivers and health professionals. Interviews were part of the qualitative evaluation of a 3-phase mixed-methods study on the effects of communication about desire to die on seriously ill patients. We followed a framework analysis approach to build communication types.
Results
From the N = 13 patients, 54% suffered from oncological diseases. Health professionals (N = 13) were multiprofessional. Informal caregivers (N = 13) were partners, children, or another relation. All in all, we conducted N = 14 interview triads (n = 3 incomplete; N = 39 individual interviews).
Four key themes emerged from analysis: (a) how open communication was perceived, (b) whether participants reported shared reality, (c) how they talked about death, and (d) their communication strategies.
Ultimately, 3 communication types were inductively derived at from these key themes. Type 1 “Between the Lines,” type 2 “Past each Other” and type 3 “Matter of Fact” show differing expressions on the key themes, especially on (b) shared reality. Specific type characteristics produce suggestions for health professionals’ communicative practice.
Significance of results
Awareness of typical communication strategies is necessary to foresee potential pitfalls such as loss of information or acting on unchecked assumptions. To reduce distress and increase information flow, health professionals should actively approach informal caregivers for desire to die conversations.
The presence of pesticide residues in food products, particularly milk, poses significant public health risks, especially in developing regions where agricultural practices often involve extensive pesticide use. This study aimed to assess the levels of pesticide contamination in milk collected from agro-pastoral cattle settlements in Niger State, Nigeria, and evaluate the associated health risks for both children and adults. Milk samples were systematically collected and analyzed using Gas Chromatography-Mass Spectrometry (GC-MS) to detect and quantify the concentrations of various pesticides, including organophosphates, organochlorines, and herbicides. The detected pesticides included Dichlorvos, β-Hexachlorocyclohexane, Malathion, DDT, and Dieldrin, among others, with Dichlorvos and β-Hexachlorocyclohexane showing the highest concentrations. Using the Estimated Daily Intake (EDI) model, we calculated the potential health risks associated with the consumption of contaminated milk for different age groups. The results indicated that children were particularly at risk, with EDI values exceeding the Acceptable Daily Intake (ADI) for certain pesticides, such as Dieldrin, leading to a risk ratio of 1.288. In contrast, adults showed a lower risk, with EDI values generally within safe limits. The findings underscore the urgent need for stricter pesticide regulation, enhanced monitoring of pesticide residues in livestock products, and the adoption of sustainable agricultural practices such as Integrated Pest Management (IPM) to mitigate the public health risks. This study highlights the vulnerability of children to pesticide exposure through dairy consumption and calls for immediate intervention to safeguard food safety and protect public health.
Reproductive health indicators in many developing countries including Nigeria are poor, and this is due to the less-than-optimum utilization of reproductive healthcare that has been linked to numerous factors including the educational attainment of women and their partners. In societies like Nigeria, marriage is nearly universal and upheld by patriarchal practices, while education is one of the determining factors for the choice of partner in the marriage market, as it also influences household power dynamics. Despite the plethora of studies investigating the link between education and utilization of these services, there is a paucity of research examining educational assortative mating (EAM) and its link to reproductive healthcare utilization. Hence, this study investigated EAM and explored its association with reproductive healthcare utilization from the perspective of family systems theory. Data from the 2018 Nigeria Demographic and Health Survey (n = 19,950) was analysed with frequencies presented and binary logistic regression models fitted. The result showed that high-education (34%) and low-education (46%) homogamy are the most prevalent types of EAM, while 40% of the partnered women reported facility delivery, 11% used modern contraceptives and 20% reported 8+ antenatal care visits. The multivariate analysis showed that compared to women in hypergamy, women in both high-education homogamy and hypogamy are more likely to deliver at a health facility but women in low-education are less likely. Women in both high-education homogamy and hypogamy are more likely, but those in low-education homogamy are less likely to use modern contraceptives. For antenatal care, only women in high-education homogamy are more likely to have 8 or more visits during pregnancy compared to women in hypergamy, while women in low-education homogamy and hypogamy are less likely. These findings provide evidence of the importance of an indicator of social stratification for important family decisions like healthcare utilization.
How does polarized politics affect electoral accountability? In this paper, I investigate the impact of political polarization on two channels through which voters can sanction incumbents for poor policy outcomes: voting for the opposition and abstaining. Using presidential election results at the county level, I show that, under polarized environments, the number of voters punishing the incumbent party for poor economic performances decreases in both channels. Survey analyses confirm that as the perceived ideological distance between parties increases, partisans are less likely to (i) negatively evaluate the economy when their party holds the Presidency and (ii) among those who have a negative view of the economy, they are less likely to penalize their party for negative economic assessments. These results show that polarization affects economic evaluation and clouds the responsibility for economic conditions, decreasing voters’ willingness to sanction the incumbent party.
The Lenin Memorial mass meeting, organized by the newly formed National Council of American–Soviet Friendship (NCASF) and featuring scenes from the Soviet play adapted and directed for the Theatre Guild, followed quickly on the heels of a similar mass meeting and rally, “Salute to Our Russian Ally,” staged at Madison Square Garden on 1 November 1942 and attended by twenty thousand supporters. Both events presented speeches by American political, military, and arts leaders and Soviet dignitaries, along with theatrical scenes and musical performances. The rallies concluded when the crowd had been effectively emotionally aroused and asked to stand for the playing of the national anthems of the United States and the USSR. The crowd was asked to approve statements on US–Soviet cooperation and peace to send to President Roosevelt and General Stalin, and it apparently roared back to the stage its approval.