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This article examines the impact of informal intergovernmental relations on the Kenyan government’s handling of the COVID-19 pandemic. It argues that although informality in governance has been perceived negatively by many governance scholars, it nevertheless has the capacity to enhance the effectiveness and legitimacy of government. By virtue of informality’s adaptability and recognition of the centrality of context, it can enhance efficacy particularly in unpredictable circumstances as occurred in the pandemic. Notwithstanding this reality, until recently, literature on informality, mainly informed by Eurocentric colonial perspectives on governance, has focussed on its negative elements, criticizing it for diverse governance ailments. Through the prism of the negotiated order theory, this article challenges this dominant narrative using an analysis of informal intergovernmental relations during the COVID-19 pandemic in Kenya. It argues that though informality was at times applied negatively, overall, it ensured vibrant intergovernmental relations, thus positively impacting health service delivery and enhancing the government’s legitimacy in the management of the pandemic.
We show that dualising transfer maps in Hochschild cohomology of symmetric algebras over complete discrete valuations rings commutes with Tate duality. This is analogous to a similar result for Tate cohomology of symmetric algebras over fields. We interpret both results in the broader context of Calabi–Yau triangulated categories.
Mobile-based trading apps have made investing easier than ever before, but this includes enabling access to risky investments that many investors may not be able to trade safely. The UK financial regulator thereby requires Contract for Difference (CFD) trading apps to make disclosures such as, ‘89% of retail investor accounts lose money when trading CFDs with this provider’. However, these disclosures might be counteracted by either their suboptimal implementation, or by other aspects of these apps’ deceptive choice architecture. Therefore, the present study audited choice architecture characteristics of demo-modes of the 14 most-popular CFD trading apps in the UK. A content analysis found for example that 31.6% of risk warnings did not comply with the regulator’s standards, and that only 35.7%% of apps contained risk warnings within the app’s main tabs. A thematic analysis suggested that apps’ educational resources could instil users with the hope of winning, by emphasising practice, strategies and psychological mindset – instead of acknowledging luck as the predominant factor underlying CFD trading profitability. Overall, this study added to previous research highlighting the similarities between certain high-risk investments and gambling, and added to the behavioural public policy literature on deceptive choice architecture.
Invasive group A Streptococcal (iGAS) outbreaks have been linked to Community Healthcare Services Delivered at Home (CHSDH). There is, however, very limited evidence describing the epidemiology and mortality of iGAS cases associated with CHSDH. We used routine data to describe iGAS cases in adults who had received CHSDH prior to onset and compare characteristics between CHSDH-outbreak and non-outbreak CHSDH cases, in South East England between December 2021 and December 2023. There were 80/898 (8.9%) iGAS case episodes with CHSDH prior to onset; cases were in elderly people (50% aged 85 and over), and had primarily received wound or ulcer care (93.8%), with almost all care delivered by community nurses (98.8%). The 30-day all-cause case fatality was 26.3%. Emm 1.0 was the most common type (17.5%). In this period, 5/11 iGAS outbreaks (45.4%) were CHSDH-associated, and 25 cases with receipt of CHSDH prior to onset (31.3%, Confidence Interval [CI] 21.3–42.6%) were linked to these outbreaks. On univariate analysis, CHSDH-outbreak case episodes were more likely to be associated with emm pattern genotype E (OR 6.1 95% CI 1.8–20.9), and skin or soft tissue infection clinical presentation (OR 3.6, 95% CI 1.1–12.0) than non-outbreak CHSDH cases. There may be an increased risk of propagation of iGAS outbreaks in patients receiving CHSDH, emphasizing the need for rigorous early infection prevention and control, and outbreak surveillance.
Knowledge-first epistemology places knowledge at the normative core of epistemological affairs: on this approach, central epistemic phenomena are to be analyzed in terms of knowledge. This Element offers a defence of an integrated, naturalistic knowledge-first account of justified belief, reasons, evidence and defeat, permissible assertion and action, and the epistemic normativity of practical and theoretical reasoning. On this account, the epistemic is an independent normative domain organized around one central etiological epistemic function: generating knowledge. In turn, this epistemic function generates epistemic norms of proper functioning that constitute the epistemic domain, and govern moves in our epistemic practice, such as forming beliefs, asserting, and reasoning. This title is also available as Open Access on Cambridge Core.
We study the rationality properties of the moduli space ${\mathcal{A}}_g$ of principally polarised abelian $g$-folds over $\mathbb{Q}$ and apply the results to arithmetic questions. In particular, we show that any principally polarised abelian 3-fold over ${\mathbb{F}}_p$ may be lifted to an abelian variety over $\mathbb{Q}$. This is a phenomenon of low dimension: assuming the Bombieri–Lang conjecture, we also show that this is not the case for abelian varieties of dimension at least 7. Concerning moduli spaces, we show that ${\mathcal{A}}_g$ is unirational over $\mathbb{Q}$ for $g\le 5$ and stably rational for $g=3$. This also allows us to make unconditional one of the results of Masser and Zannier about the existence of abelian varieties over $\mathbb{Q}$ that are not isogenous to Jacobians.
Behind the black boxes of algorithms promoting or adding friction to posts, technical design decisions made to affect behavior, and institutions stood up to make decisions about content online, it can be easy to lose track of the heteromation involved, the humans spreading disinformation and, on the other side, moderating or choosing not to moderate it. This can be aptly shown in the case of the spread of misinformation on WhatsApp during Brazil’s 2018 general elections. Since WhatsApp runs on a peer-to-peer architecture, there was no algorithm curating content according to the characteristics or demographics of the users, which is how filter bubbles work on Facebook. Instead, a human infrastructure was assembled to create a pro-Bolsonaro environment on WhatsApp and spread misinformation to bolster his candidacy. In this paper, we articulate the labor executed by the human infrastructure of misinformation as hetoromation.
What explains the geography and timing of contestation in civil war? We propose a theory of opportunistic rebel tactics, in which insurgent commanders react to temporary shifts in the local balance of power to attack the state. We argue that these opportunistic strikes are enabled by two jointly necessary factors: (1) negative fluctuations in local repressive state capacity and (2) the expectation of civilian compliance with rebel incursions. We evaluate this argument on data from the Colombian civil war. Leveraging exogenous variation in local state capacity caused by landslide-induced road closures, we find that short-term negative shocks to repressive capacity increase the likelihood of insurgent-state clashes. However, this effect does not hold when local communities harbor strongly anti-insurgent attitudes, suggesting that state capacity and civilian behavior jointly shape rebel strategy and that popular opposition can substitute for state strength.
We present a chemo-dynamical study conducted with 2dF$+$AAOmega of $\sim 6\,000$Gaia DR3 non-variable candidate metal-poor stars that lie in the direction of the Galactic plane. Our spectral analysis reveals 15 new extremely metal-poor (EMP) stars, with the lowest metallicity at $\left[\text{Fe/H}\right] = -4.0 \pm 0.2$ dex. Two of the EMP stars are also carbon enhanced, with the largest enhancement of $\left[\text{C/Fe}\right] = 1.3 \pm 0.1$ occurring in a dwarf. Using our $\left[\text{C/Fe}\right]$ results, we demonstrate that the number of carbon-depleted stars decreases with lower metallicities, and the fraction of carbon-enhanced stars increases, in agreement with previous studies. Our dynamical analysis reveals that the fraction of prograde and retrograde disk stars, defined as $z_{\mathrm{max}} \lt 3$ kpc, with $J_{\phi}/J_{\mathrm{tot}} \gt 0.75$ and $J_{\phi}/J_{\mathrm{tot}} \lt -0.75$, respectively, changes as metallicities decrease. Disk stars on retrograde orbits make up $\sim 10$% of all the stars in our sample with metallicities below $-2.1$ dex. Interestingly, the portion of retrograde disk stars compared with the number of kinematically classified halo stars is approximately constant at $4.6$% for all metallicities below $-1.5$ dex. We also see that $J_{\phi}$ increases from $380 \pm 50$ to $1320 \pm 90$ km s$^{-1}$ kpc across metallicity range $-1.5$ to $-1.1$, consistent with the spin-up of the Galactic disk. Over the metallicity range $-3.0 \lt \left[\text{Fe/H}\right] \lt -2.0$, the slopes of the metallicity distribution functions for the prograde and retrograde disk stars are similar and comparable to that for the halo population. However, detailed chemical analyses based on high-resolution spectra are needed to distinguish the accreted versus in situ contributions. Finally, we show that our spectroscopic parameters reveal serious systematics in the metallicities published in recent studies that apply various machine learning techniques to Gaia XP spectra.
This study investigated the differences in the expression of numerical motion metaphors in English and Spanish. We evaluated 1472 English-to-Spanish translations in which a manner of motion verb (e.g., skyrocket, plummet) was used to metaphorically express numerical change (e.g., unemployment is skyrocketing). For each of the translations, we annotated (1) the type of metaphor used in Spanish, (2) whether the manner of motion and path information was present in Spanish, and (3) whether the path and manner information in Spanish were conflated in a single word or indicated via adjuncts. There were three main findings. First, Spanish translations shifted from the motion domain to a quantity domain in almost half of the translations (e.g., skyrocket translated as aumentar, Eng. increase). Second, Spanish translations omitted manner of motion in half of the cases (e.g., prices surging translated as alza de los precios, Eng. rise in prices). Third, the path of motion was always present in the Spanish translations. This translation analysis provides evidence that the typological differences reported for the encoding of literal motion are also observed in the expression of numerical, metaphorical motion and that the choice of metaphorical mappings depends on language typology.
Attention-deficit hyperactivity disorder (ADHD) is one of the most common mental disorders in adolescents, and a full syndrome diagnosis requires a combination of persistent symptoms. In a multicentre cross-sectional study from Italy using a non-clinical sample from a secondary school comprising 440 adolescents, published in this issue of BJPsych Open, Gostoli et al examined whether unhealthy lifestyle habits are linked to both clinical manifestation of ADHD and subclinical symptomatology. In line with the literature, the authors demonstrate an association between clinical ADHD diagnosis, unhealthy lifestyle behaviours and psychosocial impairments. Modifiable, adverse lifestyle behaviours are also prevalent in subclinical ADHD manifestations. This observation may be important for child and adolescent psychiatry when considering targeted health promotion approaches that delay or prevent progression from subclinical to clinical ADHD. In this article, we discuss from a clinical perspective the putative relevance of addressing subclinical ADHD symptoms in the context of the existing literature.
To explore current and potential upcoming legal provisions concerning advance healthcare directives in psychiatry in Ireland, with particular focus on clinical challenges and ethical issues (e.g., self-harm, suicide).
Methods:
Review and analysis of selected relevant sections of the Assisted Decision-Making (Capacity) Act 2015, Assisted Decision-Making (Capacity) (Amendment) Act 2022, Mental Health Act 2001, Mental Health Bill 2024, and Criminal Law (Suicide) Act 1993, and relevant publications from Ireland’s Medical Council and Decision Support Service.
Results:
The Assisted Decision-Making (Capacity) Act 2015 outlined new procedures for advance healthcare directives. The Assisted Decision-Making (Capacity) (Amendment) Act 2022 specified that advance healthcare directives relating to mental health are binding for involuntary patients unless involuntary status is based on Section 3(1)(a) of the Mental Health Act 2001 (i.e., the ‘risk’ criteria). The Mental Health Bill 2024 proposes making advance healthcare directives binding for all involuntary patients. In relation to suicide and self-harm, the Criminal Law (Suicide) Act 1993 states that ‘a person who aids, abets, counsels or procures the suicide of another, or an attempt by another to commit suicide, shall be guilty of an offence’, and the Decision Support Service advises that healthcare professionals are exempted from criminal liability if complying with a valid and applicable advance healthcare directive that refuses life-sustaining treatment, even where the directive-maker has attempted suicide.
Conclusions:
Considerable public and professional education are needed if advance healthcare directives are to be widely used. The ethical dimensions of certain advance directives require additional thought and, ideally, professional ethical guidance.
There is a longstanding belief amongst scholars of psychophysiology that activation is positively associated with attention. However, recent work on news avoidance suggests that activation from negative content is linked to decreased attention. The current study seeks to investigate these different expectations and suggests that both increased and decreased activation can be linked to both attention and avoidance. Using an experiment that employs skin conductance levels and heart rate to evaluate subjects’ media selection choices, the author finds that even as deactivation is most likely to precede the decision to turn away from content, roughly 30% of the time activation precedes turning away. These findings confirm prior conclusions from the psychophysiological communications literature, and in the news avoidance literature, but it also highlights the need for more nuanced expectations where activation and media selection are concerned.
Scalable assessment tools for precision psychiatry are of increasing clinical interest. One clinical risk assessment that might be improved by such approaches is assessment of violence perpetration risk. This is an important adverse outcome to reduce for some people presenting to services for first-episode psychosis. A prediction tool (Oxford Mental Illness and Violence (OxMIV)) has been externally validated in these services, but clinical acceptability and role need to be examined and developed.
Aims
This study aimed to understand clinical use of the OxMIV tool to support violence risk management in early intervention in psychosis services in terms of acceptability to clinicians, patients and carers, practical feasibility, perceived utility, impact and role.
Method
A mixed methods approach integrated quantitative data on utility and patterns of use of the OxMIV tool over 12 months in two services with qualitative data from interviews of 20 clinicians and 12 patients and carers.
Results
The OxMIV tool was used 141 times, mostly in new assessments. Required information was available, with only family history items scored unknown to any notable degree. The OxMIV tool was deemed helpful by clinicians in most cases, especially if there were previous risk concerns. It was acceptable practically, and broadly for the service, for which its concordance with clinical judgement was important. Patients and carers thought it could improve openness. There was some limited impact on plans for clinical support.
Conclusions
The OxMIV tool met an identified clinical need to support clinical assessment for violence risk. Linkage to intervention pathways is a research priority.