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This study aimed to develop and validate a questionnaire assessing the nutrition knowledge (NK) of Italian adult women regarding the relationship between diet, lifestyle, and bone health.
Design:
A 30-item questionnaire in Italian was developed by experts based on a literature review. Participants completed the questionnaire twice, with a 2-4 week gap between the two administrations. During the initial administration, weight and height were recorded using a mechanical scale and a stadiometer, while bone mineral density (BMD) of the lumbar spine (L1-L4), femoral neck, and total femur were assessed via dual-energy X-ray absorptiometry (DXA).
Setting:
Centre for Metabolic Bone Diseases at the Parma University Hospital, from January 2022 to June 2024.
Participants:
Women aged 45 to 75 years old, native Italian speakers, undergoing DXA at the Centre participated.
Results:
The sample included 295 women with a median age of 63 years (interquartile range 11.5). The questionnaire demonstrated good internal consistency (Cronbach’s alpha = 0.698) and high temporal stability (R = 0.810, p = 0.002), effectively differentiating between individuals with and without a nutritional background. Regression analysis indicated negative associations between NK score and age (β1 = -0.130, p < 0.001), and BMI (β1 = -0.193, p < 0.001).
Conclusions:
The NutriBone questionnaire is a valid and reliable tool for evaluating NK related to bone health in Italian adult women undergoing DXA, with potential for future research applications.
This study investigates convection in a non-isothermal spherical Taylor–Couette flow (sTC) under the influence of the dielectrophoretic (DEP) force. The convective flow is driven by differential rotation of the inner and outer boundaries rotating with $\varOmega$ and $\Delta {\varOmega }$ in combination of an electric tension applied between both shells to induce thermo-electrohydrodynamic (TEHD) convection. To understand the interaction between DEP force-driven and rotation-driven mechanisms, we first analysed TEHD convection and non-isothermal sTC flow independently. For the TEHD case, we establish scaling relations for heat transport by expressing the Nusselt number, ${\textit{Nu}}$, as a function of the electric Rayleigh number, ${\textit{Ra}}_{{E}}$, and the kinetic energy density, $\tilde {E}_k$. These relations are evaluated against classical models of convection to assess consistency and deviations. A similar approach was applied to the non-isothermal sTC flow in the absence of the DEP force, where we identified axisymmetric and non-axisymmetric flow regimes which were classified by ${\textit{Nu}}$, $\tilde {E}_k$ and $\Delta {\varOmega }$, and developed corresponding scaling relations. When both mechanisms were active, ${\textit{Nu}}$ generally increased, however, the DEP force locally suppressed angular momentum transport, especially near the equator. This interplay revealed three distinct regimes: (A) DEP force-dominated TEHD convection, (C) rotation-dominated non-isothermal sTC flow and (B) a transitional regime with reduced heat transport. A decomposition of a derived inflow Nusselt number, ${\textit{Nu}}^q$, based on conductive and convective contributions, further elucidated the underlying heat transport mechanism.
The libretto and score of Richard Wagner’s famous tetralogy, Der Ring des Nibelungen, were influenced by various philosophers, including Ludwig Feuerbach and Arthur Schopenhauer. Several themes within these Gesamtkunstwerke, including authenticity, compassion, idealism, and love, have subsequently received detailed philosophical attention. Lacking, however, is a systematic philosophical interpretation of legal symbolism within The Ring Cycle. Providing such an interpretation helps illuminate the legal-philosophical richness of Wagner’s thought, which has, perhaps understandably, been overlooked not only within Wagner studies but also within contemporary jurisprudence. Moreover, elucidating legal symbolism within the tetralogy brings to light an underappreciated form of legal-philosophical cognition: the fundamentally aesthetic exercise of finding and appreciating legal meaning through layered harmony. I begin this task by examining six such symbols within Das Rheingold. My interpretive method is self-consciously “creative”: Although I draw extensively upon Wagner’s libretto and score, I present Rheingold as a living cultural artefact of contemporary jurisprudential relevance. It explores, to a high level of sophistication, several issues currently debated within general jurisprudence, including the nature of law, and its relationship with authority, domination, and violence. Viewed from this perspective, Rheingold discloses, both on stage and within its soundworld, a discrete and troubling Wagnerian conception of legality that both challenges existing jurisprudential debates and renders them more visceral.
This study explores associations between clusters characterizing urban Canadians' retail food environments and their acceptability levels of three policies aimed at promoting healthier restaurant food environments.
Design:
The three examined policies related to 1) proposing healthier menu default options, 2) restricting the establishment of fast-food restaurants near schools, and 3) eliminating unhealthy foods from municipal buildings’ food outlets. Retail food environment clusters were available for 1-and 3-kilometer (km) buffer zones from the centroid of participants’ residential dissemination area. Retail food environment data were extracted from Can-FED, whereas acceptability data were provided by the THEPA dataset.
Setting:
Retail food environments present across Canada’s seventeen most populated census metropolitan areas.
Participants:
Urban-dwelling Canadians (N=27,162).
Results:
Results from multivariate multilevel logistic regression analyses showed that those who were surrounded by the greatest relative density of both healthy food outlets (HFOs) and fast-food outlets (FFOs) within a 3 km buffer zone were less likely to be in complete agreement with the fast-food zoning policy than the reference category. Findings also indicated that, within a 1 km buffer zone, those whose retail food environment was categorized as being the least healthy (no HFO and highest relative density of FFOs) were less likely to be in complete agreement with the unhealthy food elimination policy than the reference category.
Conclusions:
This study provides new evidence of associations between retail food environments and restaurant food environment policy acceptability, which may help orient the implementation of these policies.
When Thomas Ellwood repeatedly flouted his father’s command in 1659 to stay away from the Quakers, his behaviour provoked bitter family quarrels and a beating, until his father eventually found a surprising solution: he confiscated all his son’s hats. Thomas became in effect a prisoner in the house, accepting that it would be unthinkable to go outside without a hat. However strange to us today, this made perfect sense to contemporaries, and such episodes remind us that the multifaceted conventions surrounding dress played an important role in early modern culture. When, where, and how hats were worn, and the gestures in which they featured, conveyed signals about identity and status, could sustain, display, or defy social hierarchies and relationships, and asserted political or religious loyalties.
To investigate food consumption behavior and self-perceived nutrition knowledge among university students and derive implications for nutrition education in countries with limited formal nutrition education.
Design:
A mixed-methods approach was adopted. A survey was first conducted to examine participants’ food consumption behavior and self-perceived nutrition knowledge. One-third of the participants were then selected by stratified random sampling for semi-structured interviews to gain more in-depth insights into their self-declared knowledge and related behaviors.
Setting:
Universities in China, representing a context of limited formal nutrition education in pre-university schooling.
Participants:
190 university students.
Analysis:
Interview transcripts were reviewed to verify participants’ self-declared nutrition knowledge and identify misconceptions or gaps in understanding. Questionnaire data were analyzed using descriptive statistics.
Results:
Students with higher education levels reported paying more attention to nutrition labels and selecting healthier snacks. However, interviews revealed that students who claimed to read nutritional claims during food purchases often misunderstood the meaning of sugar and fat content information. A significant “illusion of knowing” was observed, and participants generally lacked awareness of authoritative food standards.
Conclusion and Implications:
Illusion of knowing is common among students who have not received formal systematic nutrition education. Nutrition education programs should prioritize raising students’ understanding of basic food concepts and improving their ability to interpret nutrition information accurately, as part of broader health promotion efforts.
Episodic memory decline is among the earliest and most prominent cognitive changes observed in both normal aging and Alzheimer’s disease. The Free and Cued Selective Reminding Test (FCSRT) enhances differentiation of memory deficits through controlled semantic encoding and cue-based retrieval. However, culturally appropriate normative data for Mandarin-speaking adult populations have been lacking. This study aimed to establish normative data for the Taiwan version of the FCSRT (T-FCSRT), examine demographic effects on test performance, and evaluate its psychometric properties and clinical applicability.
Method:
A total of 372 cognitively healthy adults aged 45–86 years were recruited using stratified sampling to reflect the Taiwanese population across sex, age, and education levels. Participants completed the T-FCSRT, and regression-based analyses were used to adjust for demographic effects. Reliability and validity were assessed using test–retest data and correlations with established neuropsychological measures.
Results:
All T-FCSRT core indices were significantly influenced by age and education level, whereas sex effects were confined to immediate and delayed free-recall measures. The T-FCSRT demonstrated good test–retest reliability, criterion-related and construct validity, and regression-based percentile norms that provide population-representative benchmarks.
Conclusion:
The T-FCSRT demonstrates strong psychometric properties and provides culturally appropriate normative data for Mandarin-speaking adults in Taiwan. These findings support its utility for clinical assessment and research on episodic memory, enabling more accurate differentiation between normal and pathological aging.
Winning the battle against weeds is crucial for sustainable rice (Oryza sativa L.) production in sub-Saharan Africa (SSA), where weeds remain a leading cause of yield losses and continue to threaten the livelihoods of millions of smallholder farmers, with farms below one hectare. This review evaluates the dynamic landscape of weed control strategies by examining weed ecology, the limitations of traditional hand weeding, and the growing risks associated with overreliance on herbicides including escalating health concerns, environmental impacts, and the rapid rise of herbicide resistance. The central finding advanced in this review is that, despite the proven potential of integrated weed management (IWM) to provide sustainable and resilient weed control, its widespread adoption remains considerably low. Key barriers include weak extension services, low farmer awareness, and insufficient policy support which collectively prevent timely and effective uptake of diversified weed control strategies. While approaches such as biological control, cover cropping, crop rotation, and precision tools old promise, they remain underutilized without strong institutional backing. Drawing from case studies across the region, the review argues that IWM could deliver the most resilient and context appropriate results if embedded within robust advisory systems and supportive incentives. The paper concludes with recommendations to strengthen extension capacity, promote farmer centered innovation, and align policies to accelerate sustainable, scalable adoption of IWM across SSA.
Emotion regulation, while closely linked to depressive symptoms, has seldom been examined together with them in studies of the relationship between chronotype and suicidality. We therefore examined whether chronotype predicts suicidality through the sequential mediation of poor emotion regulation and depressive symptoms. In addition, we examined whether these mediation pathways differ between morningness and eveningness groups.
Methods:
This study included 3,109 Korean adults from the general population. Chronotype, depressive symptoms, emotion regulation, and suicidality were assessed using the Composite Scale of Morningness, Self-Rating Depression Scale, Emotion Regulation Skills Questionnaire, and the Suicidality module of the Mini International Neuropsychiatric Interview, respectively.
Results:
Chronotype did not have a direct effect on suicidality. Instead, eveningness was indirectly linked to higher suicidality. Specifically, individuals with stronger eveningness tendencies reported poorer emotion regulation, which increased depressive symptoms; depression, in turn, predicted suicidal ideation, which emerged as a significant predictor of suicide attempts. Subgroup analyses revealed that the same sequential pathway was significant only among evening-types, but not among morning-types.
Conclusions:
Chronotype appears to play a role in suicide risk in the general population. Screening for chronotype and focusing on emotion regulation and depression may enhance prevention efforts tailored to chronotype, especially for evening-type individuals.
The Southern Baptist “conservative resurgence” of the 1980s and 1990s is one of the defining events in the alignment of US evangelicals with the Republican Party. Lacking information about internal decision-making processes, existing studies have tended to exaggerate the cohesiveness of the activist network that ultimately captured the denomination. This paper takes a micro-historical approach to trace how movement leaders responded when one of the movement’s stars, evangelist James Robison, began using his ministry to promote charismatic theology that many in the movement viewed as heretical. Focusing on how Southern Baptist conservatives worked out the boundaries of legitimate cooperation in real time, I show that key conservatives initially tried to convince Robison to walk back his charismatic turn and rejoin the Southern Baptist mainstream. Their ultimate failure set the pattern for the movement’s subsequent opposition to charismatics and clarifies the relationship between the Southern Baptist Convention and the broader Christian Right coalition.
The dual burden of tuberculosis (TB) and diabetes mellitus (DM) presents a growing challenge for health systems in low- and middle-income countries (LMICs), including Pakistan. Despite global and national policies advocating for integrated care, evidence on health facility readiness to operationalize integration remains scarce. This study assessed the readiness of TB basic management units (BMUs) to deliver integrated TB-DM care and explored implementation barriers using the Consolidated Framework for Implementation Research (CFIR).
Methods:
We conducted an explanatory sequential mixed-methods study from September 2024 to February 2025 across 13 TB BMUs in five districts of Pakistan. Quantitative readiness data were collected using a structured tool adapted from the WHO Service Availability and Readiness Assessment (SARA), generating a composite score across four domains. Subsequently, qualitative data were gathered through multi-stakeholder focus group discussions with healthcare providers, facility managers, patients, caregivers, and policymakers. Reflexive thematic analysis was conducted and mapped to CFIR Inner Setting constructs to contextualize quantitative findings.
Results:
Only one facility demonstrated high readiness, while 12 showed low readiness. Facilities lacked routine comorbidity screening, trained staff, diagnostic capacity, and essential medicines. Key barriers included inadequate infrastructure, workforce shortages, fragmented information systems, and low prioritisation of integrated care. Financial constraints and limited coordination further hindered implementation.
Conclusion:
This study highlights critically low readiness among TB facilities in different districts of Pakistan to deliver integrated TB-DM care, reflecting systemic weaknesses across core domains. Strengthening systems, building capacity, and improving integration strategies are essential to bridge gaps between policy and practice.
We report diffuse extended radio-continuum emission spatially coinciding with the IR source WISEA J094409.17–751012.8, and a semi-variable star, V687 Carinae. We use 944 MHz radio data from the large-scale Evolutionary Map of the Universe (EMU) survey to analyse this diffuse emission (EMU J094412–751016), which we nickname “Anglerfish”. We investigate if the spatially correlated infrared (IR) source, WISEA J094409.17–751012.8, is physically related to Anglerfish. The IR colours of WISEA J094409.17–751012.8 are indicative of an elliptical galaxy, raising the possibility that Anglerfish may belong to the newly-discovered class of extragalactic radio sources known as Odd Radio Circles (ORCs) with WISEA J094409.17–751012.8 as the host galaxy. We also investigate the possibility that Anglerfish is physically related to the star, V687 Carinae, and whether it may be a remnant from a previous epoch of stellar mass-loss. We determine that a physical association between the radio emission and the star is unlikely due to the star’s weak stellar winds compared to the theoretical expansion velocity of the ‘shell’. It is possible that Anglerfish may be a Galactic high-latitude supernova remnant (SNR); however, we find that the observed size and luminosity are not consistent with this scenario. We also investigate the ORC scenario, which we deem the most likely scenario based on the Anglerfish’s observed properties such as size, brightness, lack of other frequency detections, and possible host galaxy identification. We therefore propose Anglerfish as an ORC candidate, but note that additional radio and optical observations are vital to further constrain the properties and confirm this classification.
This research was conducted to determine if and how Australian and Canadian dietetic regulatory bodies incorporate social justice into regulatory documents, and how this compares between two otherwise demographically and politically similar countries.
Design:
Quantitative and qualitative content analysis of Australian and Canadian dietetic regulatory documents was performed to determine how often and in what context social justice terms were incorporated into dietetics regulation.
Setting:
Australia and Canada
Participants:
Regulatory documents in Australia and Canada
Results:
Findings reveal that social justice is framed differently between the two countries, particularly related to working with people who experience marginalization. Regulatory documents seldom addressed issues of systemic injustice, focusing instead on self-awareness, and individualistic approaches to care.
Conclusions:
Social justice is currently framed in nutrition and dietetics regulatory documents in ways that do not align with core principles of social justice. Social justice should be re-framed in regulatory documents to shift attention away from awareness, towards action, and should be done in a way that addresses systemic injustices in healthcare. Developing a clear and consistent definition of what social justice is, is a critical first step in achieving this goal, to overcome the challenges identified in this research study.
To optimize school food baskets in Ghana to meet newly proposed food and nutrition targets while considering cultural acceptability and cost.
Design:
Modeling study. Data on existing school meal menus was collected from various regions to provide baseline inputs. Linear programming (LP) was used to model school meal baskets that satisfied minimum nutrient and food targets for school meals while meeting cost and acceptability constraints. Five LP models were tested, each varying in budget constraints and acceptability/food-based parameters.
Setting:
Ghana
Participants:
NA
Results:
Baseline school food baskets were significantly deficient in energy, protein, iron, zinc, vitamin A, folate, vitamin B12 and vitamin C compared to food and nutrient standards for school meals in Ghana. Optimization resulted in school food baskets that met cost, nutrient and food-based/acceptability targets but with substantial deviations from baseline. Achieving nutritional adequacy within cost limits increased reliance on animal-source foods and led to higher environmental impacts, indicating trade-offs between nutrition, affordability, and environmental sustainability.
Conclusion:
The study underscores LP’s potential for enhancing school meals in Ghana but highlights the need for increased financial investment for reaching dietary goals. Addressing local realities and cultural preferences is essential for implementing effective, sustainable school meal strategies and improving child health.
Histories of American water have tended to flow in two dimensions, tracing surface waters across horizontal space and only rarely descending into the earth below. Rivers, wetlands, dams, and canals have defined how we understand our relationship with this vital resource, and with the diverse human and more-than-human actors who share it. Foundational works by Donald Worster and Norris Hundley traced the rise of hydraulic societies in the American West, showing how rivers, dams, and aqueducts enabled both state formation and capitalist expansion, while Joel Tarr and Martin Melosi foregrounded water infrastructure in the field of urban environmental history.1 More recent scholarship has explored cultural and social histories of water, including more-than-human perspectives, environmental justice, Indigenous water rights, and the political ecologies of urban and rural water systems, expanding the field well beyond its earlier focus on engineering and state-building.2
This article provides an overview of the professional roles of audiologists and speech-language pathologists (S-LPs) in interprofessional primary care.
Background:
Current published literature considering primary care delivery within comprehensive interprofessional teams contains little representation of professionals from the fields of audiology and speech-language pathology.
Methods:
An illustrative case scenario highlights the key roles of audiologists and S-LPs in primary care, and how collaborative relationships within an interprofessional primary care team structure can enhance the overall quality of care provided to patients and to their families.
Findings:
As experts in the prevention, diagnosis, and rehabilitation of communication disorders, with S-LPs supporting speech and swallowing disorders and audiologists supporting hearing and vestibular disorders, S-LPs and audiologists are well-positioned to support meaningful participation in primary care across the lifespan and in collaboration with different healthcare professionals, including patients experiencing cognitive decline.