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.
Receiving a dementia diagnosis is a complex experience that can provide clarity about symptoms but often creates uncertainty. Support during and after diagnosis is essential to help individuals navigate living with dementia. This qualitative descriptive study examined experiences during and after diagnosis among people with dementia and care partners in New Brunswick, Ontario, and Quebec.
Methods
Interviews with 5 people with dementia and 15 care partners were conducted and then analysed using qualitative content analysis to identify barriers, facilitators, and contextual influences related to a positive experience.
Results
Barriers included limited resources, poorly coordinated care, disorganized diagnostic pathways, and stigma. Facilitators included access to information, person-centred care, support networks, recognition of personhood, and structured care navigation. The COVID-19 pandemic further shaped experiences.
Conclusion
Findings highlight the importance of compassionate care, accessible information, and coordinated services while underscoring systemic gaps, stigma, and the impact of the pandemic.
This work experimentally investigates the natural ventilation of an emptying filling box under stochastic forcing in an opposing wind. A point buoyancy source on the floor generates a turbulent plume that rises towards the ceiling, producing a buoyant layer. The resulting stack effect induces a volume flux exiting through the high-level opening, equal to that entering through the low-level opening. The buoyancy-induced pressure is reduced by an opposing wind. If the wind velocity exceeds a critical threshold, two different states may occur: either the stratification is preserved although the buoyant layer thickens, or a well-mixed regime takes place. We find that if wind undergoes stochastic fluctuations, a noise-induced phenomenon occurs: when the stratification persists, the height of the interface fluctuates around a mean value significantly lower than that exhibited in the constant-wind scenario. The deviation from the constant-wind equilibrium increases as the mean wind velocity and the noise intensity grow. Moreover, the transition to the well-mixed regime may occur for wind velocity lower than the critical threshold under constant wind conditions. These results confirm the predictions given by a theoretical model, where the system is forced by stochastic wind fluctuations modelled with an Ornstein–Uhlenbeck process. This modelling choice is supported by the experimental characterisation of the pressure field. Lastly, we provide an approximate analytical solution for the system’s mean behaviour.
Since the mid-twentieth century, foreign-physician migration to the United States has challenged mainstream medicine. Facing simultaneous demands to address physician shortages and concerns about the quality of foreign-trained doctors, regulators struggled to create effective systems for evaluating international credentials. This essay traces three pivotal episodes reflecting the evolution of this regulatory landscape: the postwar incorporation of Jewish émigré doctors, the rise of Asian physician migration following the Hart-Celler Immigration and Nationality Act of 1965, and the contemporary role of global regulatory entities. Over the past sixty years, as physician migration from the global South has increased, the regulatory apparatuses to facilitate this mobility have grown in scale, size and number. The multiplication of these supranational bureaucracies and institutions is not a value-neutral endeavour. It reflects racialized assumptions coded through ‘competence’ discourses, geopolitical investments and a bias toward global North educational models, and raises broader questions about global health care equity. Despite these overlapping and sometimes redundant global-governance structures, however, foreign-physician integration continues to raise questions about trust, equivalency and the variability of human capital.
Drawing on textual, archaeological, and palaeoclimatic evidence, this article reconstructs the broad patterns of plague’s arrival in the southern Red Sea region during the 1430s. It contends that this initial introduction led to the formation of a medium-term reservoir that generated recurrent epidemic waves over the subsequent 150–200 years. This development is attributed to the interplay of environmental and human-driven factors acting together. The study adopts a dual approach: first, it examines how commercial networks across the Red Sea facilitated the spread of the plague; second, it investigates the environmental and topographical shifts in the southern Red Sea between 1370 and 1470 to understand how these conditions allowed the disease to become endemic to the region.
Data on thromboembolism treatment and outcomes in children with cardiac disease are limited. We sought to characterise thromboembolism treatment and outcomes in paediatric patients with cardiac disease.
Methods:
A single-centre, retrospective cohort study of children, aged < 21 years, with cardiac disease admitted to a paediatric cardiac ICU from October 2020 to September 2024, diagnosed with acute symptomatic thromboembolism (radiologically confirmed first episode). We analysed demographics, thromboembolism characteristics, antithrombotic drug regimens, and outcomes (recurrent thromboembolism, clinically relevant bleeding).
Results:
Of 865 eligible patients, 75 (8.7%) developed acute symptomatic thromboembolism: 48 (64%) venous; 16 (21.3%) arterial; 9 (12%) intracardiac; 2 (2.7%) venous+arterial. Of 50 patients with venous or venous+arterial, 33 (66%) received anticoagulation in the acute phase. Of 18 patients with arterial or arterial+venous, 12 (66.7%) received anticoagulation in the acute phase. Recurrent thromboembolism occurred in 28 (37.3%) patients, more likely among single ventricle vs. biventricular physiology [OR 3.2 (95% CI 1.1 to 9.4), p = 0.04]. Clinically relevant bleeding occurred in 10 (13.3%) patients, mostly with concomitant antithrombotics (anticoagulation + antiplatelet) vs. monotherapy [6 (9.2%) vs. 4 (40.0%), p = 0.02] in the subacute phase of treatment. The literature review revealed limited data on treatment strategies.
Conclusion:
There is variation in the treatment strategy for thromboembolism in children with cardiac disease, with risk for thromboembolism, recurrent thromboembolism, and bleeding. Prospective multicentre studies are needed to extend preliminary findings on treatment strategies and risk factors.
Chapter 1 considers the evolving significance of a putative ideal of religious uniformity for the makeup of political institutions in late antiquity. It suggests that we have the chronology of the Christianisation of late ancient bureaucracies back to front. It was only when those elites became predominantly Christian that religious uniformity within the state became a feasible goal for individual regimes. In that sense, for the Christianisation of the Roman state, the conversion of the Roman aristocracy only represents the beginning of the story. This chapter thus pursues the question of religious uniformity further into late antiquity, by considering the developing understanding of what was required to ensure an appropriately (orthodox) Christian state in the fifth and sixth centuries. It argues that requirements for (orthodox) Christian administrators were not simply an axiomatic assumption of late (and post-)Roman regimes, but a product of shifts in institutional norms and wider cultural assumptions across the fourth to sixth centuries.
Part III of this book reconstructs expectations of official churchgoing and entanglements with churchmen and Christian institutions in select political environments across the fifth and sixth centuries. Ch. 6 pursues this problem in the best attested of these: the Eastern imperial capital of Constantinople. It begins by charting norms of imperial religious observance. Eastern emperors seem to have attended public churches at major festivals and special occasions. Various reports suggest that when the emperor went to church, those who served them (and the senatorial aristocracy as a collective) were supposed to go too. Within these politics of church attendance, the bishop of Constantinople represents a surprisingly peripheral figure. Although some courtiers and bureaucrats were regular attendees at Hagia Sophia, they seem to have kept themselves at a critical distance from the bishop’s pastoral authority. As with other members of the Constantinopolitan elite, many imperial officials focused their Christian identities on activities within their own households, whether these were dynastic commemorations, building projects, patronage arrangements for clerics, monastic start-ups, or their own ascetic practices. This chapter shows how the religious practices and affiliations of these ‘over-mighty congregants’ were also shaped by the corporate Christianity of the imperial palace, consistory, and Senate.
This article examines the reality of “let the adjudicator judge” by investigating how Chinese judges are held accountable for their judgments under the expanded ex post case review system. We examine the first three years of the implementation of this headline initiative in a grassroots court (Court T) located in a major city in China. Our data include the internal quarterly reports produced by the court’s case review committee and interviews with judges. The assessments went beyond legal analysis, commenting on matters such as work ethic, diligence and moral sensibilities. Frontline judges view the review system as subjective and arbitrary. The new mechanism, however, alters the power dynamics between senior judges and their subordinates. While frontline judges no longer require pre-approval from senior judges, they rely on the goodwill of those same seniors to navigate the review process. Within this ostensibly freer framework, frontline judges are subjected to a more diffuse but pervasive form of discipline. Our analysis reveals how the adjudication committee, far from being sidelined, has shifted its role, concentrating ex ante supervision on a minority of difficult cases while holding judges accountable through ex post reviews of flawed judgments. The article further underscores the challenges of disentangling legal analysis from political supervision in a framework of authoritative legality.
Ageism, defined as stereotypes, prejudices, and discrimination based on age, is a pervasive phenomenon across individuals, settings, historical periods, and cultures. To address the universality of ageism, we explore three main questions: (a) Does ageism happen throughout the course of a person's life? (b) Does ageism permeate all spheres of life? (c) Does ageism exist all around the world? We conclude that although ageism is universal, there are substantial variations in its definition, manifestations, and impact over time and in different sociocultural contexts. The variability identified suggests that we cannot use a one-size-fits-all approach to conceptualize or target ageism, but instead we should adopt a personalized approach, which considers the sociocultural context, the personal attributes of the targets and agents of ageism, and the normative framework concerning ageism at the global and local levels. This title is also available as Open Access on Cambridge Core.
This study aimed to adapt and validate the FOODLIT-Tool in Turkish to assess sustainable food literacy among Turkish adults. The adaptation addresses a lack of psychometrically validated instruments for measuring food literacy and sustainability-oriented eating behaviours in Turkey.
Design:
A psychometric evaluation was conducted, including forward-translation, back-translation and cultural adaptation steps, followed by expert review for content validation. Construct validity was assessed using confirmatory factor analysis (CFA), and internal consistency was evaluated to ensure reliability.
Setting:
Data collection was conducted online via Google Forms between July and August 2024.
Participants:
A total of 482 participants aged 18 to 65 years residing in Turkey voluntarily completed the Turkish version of the FOODLIT-Tool, along with a general information form and the Sustainable and Healthy Eating Behavior Scale.
Results:
CFA results demonstrated an acceptable model fit (χ2/df = 3·67, CFI = 0·91, RMSEA = 0·07). Cronbach’s α values ranged from 0·60 to 0·91 across the sub-dimensions, indicating adequate to excellent internal consistency. Significant positive correlations were found between FOODLIT subscales and sustainable eating behaviours. Women scored significantly higher in culinary competence, production quality and environmental awareness.
Conclusions:
The adapted Turkish version of the FOODLIT-Tool demonstrates satisfactory validity and reliability for evaluating food literacy and sustainable dietary practices among Turkish adults. The scale serves as a useful assessment tool for future research and intervention studies focusing on sustainable nutrition. Further validation using representative samples and longitudinal designs is warranted before its application in public health or policy-making contexts.
Safety behaviors are a common response to persecutory ideation in psychosis. They potentially contribute to the maintenance and exacerbation of symptoms and emotional distress and are therefore a promising treatment target. However, empirical evidence for this hypothesized maintenance role is scarce. We therefore examined cross-sectional and micro-longitudinal associations between safety behaviors, negative affect, and persecutory ideation in the daily lives of individuals with psychotic disorders.
Methods
We assessed safety behaviors, persecutory ideation, and negative affect at baseline and 10 times/day during one week of Ecological Momentary Assessment (EMA) in N = 64 participants with persecutory ideation and a psychotic disorder.
Results
At baseline, safety behaviors were positively correlated with persecutory ideation (r = .47), depression (r = .67), and anxiety (r = .69). Safety behaviors assessed at baseline and safety behaviors assessed in daily life showed a moderate correlation (r = .56). Multilevel analyses of the longitudinal EMA data revealed persecutory ideation (β = .16) and negative affect (β = .11) to predict subsequent use of safety behaviors. Momentary use of safety behaviors predicted subsequent persecutory ideation (β = .13) and negative affect (β = .18).
Conclusions
Our results provide evidence for a vicious cycle of maintenance involving persecutory ideation, negative affect, and safety behaviors. Targeting safety behaviors with ecological momentary interventions in daily life could be a promising approach to interrupt this cycle.
Recent advances in ancient DNA and isotope analysis have enabled archaeologists to detect migration events in the distant past. Yet, novel approaches evaluating the cultural impact of these migrations are lacking. As a result, archaeologists continue to debate problematic culture-historical scenarios in which migrants rapidly supplant passive indigenous communities. This study outlines a bottom-up, quantitative approach to prehistoric migrations. This approach uses Bayesian chronological modelling to investigate whether migrating and indigenous communities co-existed. In addition, a novel probabilistic comparison of ceramic technology traces whether cultural knowledge is exchanged between potters in these communities. This approach is applied to the emergence of Corded Ware communities in the Netherlands during the 3rd millennium BC. The outcomes demonstrate that this process was not a rapid replacement of indigenous groups by migrants, as sometimes stated. Instead, migrants likely co-existed with indigenous communities for centuries, learned ceramic production from them, and incorporated this knowledge into the production of characteristic Corded Ware ceramics. Furthermore, the outcomes suggest this scenario was likely commonplace for prehistoric migration in the 3rd and 4th millennia BC. As such, this study provides new approaches and insights which enable archaeologists to shed light on prehistoric migration, talk back to archaeogenetics on an equal footing, and contribute to broader societal debates on migration.
We argue that surveillance technologies, increasingly powered by artificial intelligence, translate print capitalism into data capitalism. We observe this transition as championed in Japan, a country favorable to its development given a strong techno-nationalism, by adopting Aurora Donzelli’s criticism of capitalism as a translation machine. Unlike traditional CCTV that simply records passersby in real-time, retail surveillance systems in Japan sense repeat customers and known offenders. These technologies are justified through Japanese techno-nationalism, recursively translating sociotechnical imaginaries of nationhood into databases. We observe that an epistemology of big data responsible for this transition paves the way for new technological infrastructures while maintaining old imaginaries of print capitalism. The goal of automating interpretation turns society into a closed system that interprets itself. Through this study, we also explore how semiotics can contribute to research on emergent technology, by eschewing the traditional analysis of discourse by differentiating “form” from “content.”
We systematically study the intersection flatness and Ohm-Rush properties for modules over a commutative ring, drawing inspiration from the work of Ohm and Rush and of Hochster and Jeffries. We establish new structural results for modules that are intersection flat/Ohm-Rush by exhibiting intimate connections between these notions and the seminal work of Raynaud and Gruson on Mittag-Leffler modules. In particular, we develop a theory of Ohm-Rush modules that is parallel to the theory of Mittag-Leffler modules. We also obtain descent and local-to-global results for intersection flat/Ohm-Rush modules. Our investigations reveal a particularly pleasing picture for flat modules over a complete local ring, in which case many otherwise distinct properties coincide.
Recent years have witnessed increased interest in everyday forms of heritage and the emergence of alternative terms designating cultural goods, monuments, and sites on the margins of official heritage (e.g., mundane, ordinary, informal). This paper systematically compares these terminologies to explore how their marginality challenges official discourses, offering insights into epistemic shifts within the Anglophone and Eurocentric heritage domain. Through a systematic literature review (SLR), we examined academic literature on heritage categories that fall outside official vocabularies, lists, and traditional preservation measures. Two questions guided this analysis: (1) How is each heritage term defined? (2) What values do authors attribute to these alternative designations? The research highlights tensions between traditional heritage frameworks and contemporary demands for adaptive, locally relevant approaches. In response to these emerging dynamics, and to facilitate future reflections on the issues raised by our SLR, we use the notion of liminality as a conceptual lens to reclaim the marginal status of these heritages while simultaneously emphasizing their capacity to serve as a fertile ground for critical and future-oriented heritage imaginaries. The study concludes by opening a reflection on how liminal heritage practices can inform more inclusive policymaking by challenging rigid age thresholds, reinterpreting continuity through adaptation, and expanding authenticity to include transformation.