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Linear stability studies are presented for a quasi-axisymmetric stellarator equilibrium which is unstable with respect to external kink and peeling-ballooning modes. Using the three-dimensional linear stability CASTOR3D code, the effects of parallel viscosity, gyro-viscosity, ion diamagnetic drift velocity, ExB velocity and an externally driven flow in direction of the quasi-symmetry are investigated with respect to their influence on growth rate, oscillation frequency and mode structure.
Adolescent suicidal behavior is a major global public health concern. Risks are often shaped not only by individual behaviors alone but also by broader constellations of health lifestyles. We aim to identify distinct adolescent health lifestyles and assess their associations with suicidal ideation and suicide attempts. Using data from the 2022 Luxembourg Health Behaviour in School-aged Children survey, latent class analysis identified five health lifestyle classes based on seven behaviors (diet, physical activity, substance use and problematic social media use). Hierarchical logistic regression was employed to assess associations with past-year suicidal ideation and suicide attempt. Compared to Class 1 (Healthy behaviors), adolescents in Class 2 (High substance use) had significantly higher odds of suicidal ideation (odds ratio [OR] = 2.5, 95% confidence interval [CI]: 2.0–3.1) and suicide attempt (OR = 2.9, 95% CI: 2.2–3.8). Class 3 (Digital vulnerabilities) also showed elevated odds of ideation (OR = 3.0, 95% CI: 2.2–4.0) and attempt (OR = 2.3, 95% CI: 1.6–3.4). Class 4 (High alcohol use) was associated with suicidal ideation only (OR = 1.4, 95% CI: 1.1–1.8). Class 5 (No substance use) showed no significant associations with either outcome. Our findings underscore the importance of considering multidimensional health lifestyles, including emerging risks such as vaping and problematic social media use in adolescent suicide prevention strategies.
This article traces the origins and evolution of the Shanghai Bund within a comparative framework of transimperial urban forms. Existing scholarship has offered divergent interpretations – imperial metropolitan precedents, cross-colonial transfers and local antecedents – which this article argues are complementary rather than contradictory. It further moves beyond broad regional claims through specifying concrete cases supported by new archival evidence. Drawing on records mainly from the Shanghai Municipal Archives, The National Archives in the UK and contemporary newspapers, the article shows how Singapore’s Boat Quay, Calcutta’s Strand Road and London’s Thames Embankment were selectively appropriated to meet shifting sanitary, political and economic needs. Localized over successive decades, these borrowings crystallized into a Bund form – landscaped, monumental, with a financial core and technologically modern – that became a model for other treaty ports and was reproduced across the imperial world and beyond. The Bund’s history is thus a microcosm of the circulation and remaking of ideas within the wider networks of the British Empire.
Depression screening in primary care has been widely discussed, but its economic implications have remained largely unexplored. The GET.FEEDBACK.GP randomised controlled trial evaluated feedback interventions after depression screening in primary care. The study arms were (a) feedback provided to the general practitioner; (b) feedback to both the patient and the treating general practitioner; and (c) a control group without feedback. Analysis of clinical effectiveness revealed that feedback interventions were not associated with decreased depression severity. Their economic implications were the subject of this study.
Aims
To evaluate the economic impact of general-practitioner- and patient-targeted feedback following depression screening for adults in German primary care.
Method
A cost-effectiveness analysis from a societal perspective of feedback interventions after depression screening with a time horizon of 12 months was conducted. Direct and indirect costs were estimated. Quality-adjusted life years were calculated on the basis of the EQ-5D-5L, and incremental cost-effectiveness ratios and cost-effectiveness acceptability curves based on the net monetary benefit were constructed. Sensitivity analyses and post hoc explorative subpopulation analyses were performed. Trial registration: ClinicalTrials.gov, NCT03988985.
Results
In total, 987 participants who screened positive for at least moderate depression were included. Feedback provision was not significantly associated with changes in costs or quality-adjusted life years during follow-up. Cost-effectiveness probabilities of feedback interventions were lower than 50% compared with no feedback. Higher cost-effectiveness probabilities were observed in patients whose suspected depression was confirmed 1 month post-screening and in those with previous depression.
Conclusions
The analysed feedback interventions cannot be considered to be cost-effective for the investigated population. Patient-targeted feedback was potentially cost-effective for subpopulations, particularly patients with a later confirmed depression diagnosis; this requires further research.
The concepts of ‘dangerous’, ‘celebratory’, and ‘hegemonic’ multilingualism provide a valuable heuristic to explore language ideologies within supranational organizations like the United Nations. Adopting a critical stance in relation to the functions and values assigned to multilingualism and applying corpus-assisted discourse analysis, this study examines three ideological manifestations: verbalizations, metapragmatic acts, and linguistic practices in United Nations debates on the 1995 multilingualism resolution. The study analyses how member state representatives index their ideological stance: metadiscursively via verbalizations within the context of language policy debates, via acts of voting, and via their use of multilingualism as positioning devices within these debates. Unlike previous investigations of language ideology which have predominantly and exclusively focussed on discursive analyses of texts, this article forwards a tripartite analytic framework. We argue that this model serves to afford a holistic examination of practised and stated attitudes towards multilingualism, which in turn have consequences for language policy outcomes. (Language ideology, language policy, multilingualism, United Nations)
Anorexia nervosa (AN) is a complex psychiatric illness with severe and life-threatening medical sequelae, including death. Existing evidence-based treatments are linked to good prognosis and full recovery in many. For a small minority of critically ill patients, treatment decisions extend beyond voluntary engagement. Severe cases may involve involuntary hospitalisation, nasogastric feeding, physical restraint, and other coercive measures. While these interventions are sometimes necessary to prevent death, they raise profound ethical concerns. This article explores the ethical tensions in treatment of individuals with AN through the lens of the four principles of biomedical ethics, respect for autonomy, beneficence, non-maleficence, and justice, examining the implications for clinical practice. It also outlines the legal mechanisms in Ireland governing involuntary treatment for AN. It considers treatment principles in children and adolescents as well as adults.
Existing evidence suggests a potential association between coffee consumption and Non-alcoholic fatty liver disease (NAFLD,now known as MASLD), yet the nature of this relationship remains ambiguous. The primary objective of this study was to comprehensively investigate and clarify the association between coffee intake and the occurrence of NAFLD.
Design:
A cross-sectional study design was employed, analyzing data from NHANES(National Health and Nutrition Examination Survey,NHANES) spanning from 2013 to 2018. Weighted univariate and multivariate logistic regression models were utilized to assess the relationship between coffee consumption and NAFLD. RCS analysis was conducted to explore any potential nonlinear associations. Forest plots were generated to visualize the impact of coffee consumption on NAFLD across different subgroups, and threshold effect analysis was performed to evaluate the nonlinear relationship between coffee consumption and NAFLD prevalence specifically in women.
Setting:
Data were from the US - representative NHANES.
Participants:
8062 subjects aged ≥20 years were included.
Results:
The weighted prevalence of NAFLD among the participants was 44.18%. After controlling for confounding variables, coffee consumption was found to be negatively associated with the risk of NAFLD (OR = 0.96, 95%CI: 0.94, 0.99). The association between coffee consumption and NAFLD was observed to vary by gender and education level. For the prevention of NAFLD in women, the optimal coffee intake was determined to be 2 cups.
Conclusions:
Increasing coffee intake emerges as a potentially effective non-pharmacological strategy for the prevention and management of NAFLD. Notably, for women, consuming 2 cups of coffee appears to represent the optimal threshold for maximizing this beneficial effect.
Extensive evidence links air pollution exposure to cognitive decline; however, it remains unclear whether cognitive reserve and brain reserve modify this association. We examined the moderating roles of cognitive reserve contributors and brain reserve in the association between air pollution and cognitive function in dementia-free adults.
Methods
Cross-sectional data were obtained from 650 participants who underwent 3T brain magnetic resonance imaging and completed the Montreal Cognitive Assessment (MoCA). Cognitive reserve contributors were assessed based on education, occupation, and social engagement. Brain reserve was quantified using the ventricle-to-brain ratio derived from brain scans. Five-year average concentrations of particulate matter with diameters ≤10 and ≤2.5 μm and nitrogen dioxide were estimated based on residential addresses. Partial least squares structural equation modeling was applied to construct latent variables representing the air pollution mixture and composite cognitive reserve (contributors). Analyses examined whether cognitive reserve contributors and brain reserve modified associations of air pollution with MoCA scores and suspected mild cognitive impairment.
Results
In individuals with an average level of cognitive reserve, a 1–standard deviation increase in air pollution mixture was associated with a 0.24-point decrease in MoCA scores (95% confidence interval [CI]: −0.31 to −0.16). This association was attenuated in individuals with higher cognitive reserve (β = −0.12; 95% CI: −0.25 to 0.02) and intensified in those with lower cognitive reserve (β = −0.36; 95% CI: −0.37 to −0.35). The moderating effect of brain reserve was not significant.
Conclusions
Higher cognitive reserve may mitigate the effects of air pollution on cognitive function.
Within resource-limited health care, it is important to demonstrate the value and impact of neuropsychological assessment (NPA) services. However, the most suitable methods for capturing these outcomes are yet to be established. We aimed to identify key potential outcomes of NPA, existing measures of these outcomes, and issues and challenges associated with outcome measurement.
Method:
Focus groups of experienced Australian neuropsychologists discussed possible NPA outcomes, existing measures, and challenges of outcome measurement, analyzed using thematic analysis. The Delphi method of expert consensus was then used to identify the most important set of NPA outcomes, using iterative survey rounds with expert panelists. Panelists also rated the top three outcomes most likely to demonstrate the impact of NPA in trials.
Results:
There were 50 potential NPA outcomes generated by the focus groups, spanning proximal and distal patient, caregiver, health service, and societal domains. Numerous issues and challenges were identified associated with meaningfully measuring NPA outcomes. After three Delphi survey rounds (n = 46), a total of 16 outcomes achieved consensus agreement. Few existing validated measures were identified. The top three rated outcomes were 1) better patient and/or caregiver understanding of presenting problems, 2) better patient and/or caregiver understanding of how to manage and cope with cognitive symptoms, and 3) diagnostic clarification.
Conclusions:
Psychoeducational benefits of NPA were considered by Australian experts as key outcomes relevant across contexts; however, there are no existing measures of these outcomes. Future research should develop valid outcome measures to be used in clinical trials evaluating NPA impacts.
Golden Dawn (GD), Greece’s most prominent far-right political organization, strategically utilized antisemitism as its core ideological principle rather than a marginal prejudice or rhetorical device. This article argues that antisemitism served primarily as an epistemological conspiratorial framework central to GD’s ideological worldview, providing a coherent interpretive lens through which all political, economic, and social phenomena were explained as elements of a singular Jewish-orchestrated plot. Drawing on qualitative discourse analysis of over 10,300 GD publications spanning 1993 to 2020, the study illustrates how this epistemological master frame enabled the party to unify diverse domestic and international issues, from foreign policy tensions and immigration debates to economic crises, under a consistent antisemitic narrative. Additionally, by explicitly employing Holocaust denial, endorsing Nazi symbolism, and openly propagating antisemitic conspiracies, GD deliberately violated post-Holocaust European norms. This normative transgression was integral to the party’s identity, positioning it in overt defiance of mainstream moral and political boundaries. The article thus demonstrates how GD’s antisemitism functioned not merely as a rhetorical provocation but as the foundation of a comprehensive ideological system that consciously challenged established European taboos. These findings also suggest broader implications for understanding the role and adaptability of conspiratorial antisemitism and normative transgression in other extremist ideologies beyond the Greek context.
We consider a generalization of the forest fire model on $\mathbb{Z}_+$ with ignition at zero only, studied by Volkov (2009 ALEA6, 399–414). Unlike that model, we allow delays in the spread of the fires and the non-zero burning time of individual ‘trees’. We obtain some general properties for this model, which cover, among others, the phenomenon of an ‘infinite fire’, not present in the original model.
The urban authorities of early modern Dutch cities employed a broad variety of public servants to manage the urban administration and provide public services relating to health, security, education, and entertainment. Neither part of the governing elite nor members of the guilds, these urban officials are of interest to historians of both work and governance. This article demonstrates that studying these public servants might yield valuable insights into premodern attitudes to work, especially public work. Using applications for employment in public office as well as petitions for improved remuneration, we analyse the value public servants of early modern Dutch cities attached to their professional activities. The town of Zwolle (c.1550–1700) serves as a case study, shedding light on the conditions under which people decided to work in urban public services. In their competition for the town’s salaried offices, candidates demonstrated considerable individual initiative, ranging from unsolicited applications to proposals concerning their personal value for the civic community. Similarly, officeholders demanded proper remuneration befitting the value of their work and their services for the town’s common good.
Investment facilitation is an increasingly important policy tool to promote foreign investment. However, we know very little about its prevalence. This paper introduces a new dataset for measuring the adoption of investment facilitation measures at country level. The Investment Facilitation Index (IFI) covers 101 measures, grouped into six policy areas, and maps adoption across 142 economies. The paper outlines the conceptual and methodological framework of the IFI, analyses the current levels of adoption, and demonstrates the index’s robustness. The data show that economies with lower adoption rates typically belong to the low-income or lower-middle-income groups, often located in Sub-Saharan Africa, Latin America and the Caribbean. This dataset serves as a benchmark for assessing the design and impact of international agreements, such as the Investment Facilitation for Development Agreement (IFDA). It can also support the IFDA implementation by guiding domestic assessments of technical assistance needs and capacity development.
This study aimed to investigate the abundance distribution of Quinella in yak rumen, a dominant microbe associated with low methane emissions and high propionate yield, and its modulation of microbial carbohydrate metabolism. A high-quality genomic database for rumen Quinella was constructed through the screening of 12 717 published metagenome-assembled genomes from 12 ruminant species. Genomic annotation indicated that Quinella possessed two distinct gene clusters for converting fumarate to propionate. The 16S rRNA sequencing data revealed that the ruminal Quinella abundance is host-dependent, with a markedly higher prevalence in yaks (56.3%) than in cattle (3.01%). In yaks, higher rumen Quinella abundance was accompanied by the lower abundances of enoyl-CoA hydratase and acetate CoA transferase, encoding two butyrate synthetases but higher abundances of key genes involved in propionate synthesis. In vivo analyses found that yaks carrying more Quinella abundance (high or low groups, n = 9 per group) exhibited higher total volatile fatty acids and lower butyrate percentage in their ruminal contents. Additionally, comparative metagenomic analysis indicated that microbial genes from yaks with higher Quinella were enriched in critical metabolic pathways, including glycolysis, the reductive Krebs cycle, and the conversion of acetyl-CoA to acetate. However, no significant differences in methane production (prediction based) were observed between yaks with higher or lower Quinella (n = 9 per group). In summary, this study provided a valuable genomic resource for further research on Quinella and partially verified its potential in microbial carbohydrate metabolism, specifically enhancing volatile fatty acid production. However, its role in yak methane emission requires further validation.
School refusal among neurodivergent students underscores systemic failures in traditional educational systems. This qualitative study, informed by the neurodiversity paradigm, examines how Flexible Learning Options (FLOs) in South Australia address drivers of disengagement, such as sensory overload, punitive discipline, and identity erasure, while fostering reengagement through autonomy, relational safety, and identity empowerment. Drawing on interviews conducted with a subsample of 18 students aged 13–19, reflexive thematic analysis resulted in the development of three themes: (1) autonomy and its limits, (2) relational safety as harm reduction, and (3) identity empowerment through neuroaffirmation. The findings reported in this paper advocate for educational models that transform flexibility from a temporary solution into a blueprint for equity, ensuring schools become spaces of support rather than harm for neurodivergent learners.
This study aimed: 1) to characterize the use and prevalence of nutrition and health claims (NHC), and 2) to examine the association between NHC and the potential presence of Health Canada’s front-of-pack (FOP) nutrition symbol indicating high saturated fats, sugars and/or sodium on a sample of Canadian prepackaged food products.
Design
A cross-sectional analysis was conducted on five categories of prepackaged food products. Label components were classified using the INFORMAS labelling taxonomy. Products’ nutritional profile was evaluated using Health Canada’s FOP symbol nutrient thresholds for saturated fats, sugars and sodium.
Setting
Data were obtained from the Food Quality Observatory database, collected between 2018 and 2022 from food retailers in Québec City and the Greater Montreal Area or online.
Participants
A total of 2,937 food products were evaluated from five food categories: Breakfast cereals (n=392), Cookies and granola bars (n=983), Flavoured milks and plant-based alternative beverages (n=202), Salty snacks and crackers (n=1063) and Yogurts and plant-based yogurt alternatives (n=297).
Results
Overall, 74.2% of food products had a NHC and 28.9% had a NHC and would require to display the FOP symbol. Food products that would require the FOP symbol were less likely to carry a NHC.
Conclusions
The results demonstrate substantial use of marketing techniques highlighting positive product attributes. Given the potential for inconsistent messaging on food products carrying NHC and the FOP symbol, these results highlight an opportunity to improve Canadian labelling regulations by restricting the use of NHC on products high in saturated fats, sugars and/or sodium.
This article deals with the domestic politics of Estonia and Latvia after the Russian invasion of Ukraine on 24 February 2022. It studies the cases of the Estonian Conservative People’s Party (EKRE) and Latvia’s National Alliance (NA). This piece concentrates on the cases of EKRE and NA with an interest in these parties’ formation processes, outlooks on identity politics, their stances vis-à-vis the EU and developments in international politics, and their relations with other political actors in Estonia and Latvia.
EKRE and NA anchor their ideological prerogatives in the longer trajectories of ethno-nationalism in Estonia and Latvia. However, whereas NA transformed into a party of the national conservative right, open to cooperation with centrist and centre-right partners, EKRE has remained a party of the radical right with a staunchly anti-systemic rhetoric and agenda. This particularity is largely to account for NA’s convergence with Latvia’s major parties on the increased securitisation of relations with Russia and EKRE’s divergence towards a rhetoric that urges a prioritisation of the national interest and a “pro-peace” stance vis-à-vis the war in Ukraine.
Healthcare personnel (HCP) are at risk for occupational exposure to tuberculosis. Current guidelines for managing exposed HCP are broad and resource intensive. Based on review of our internal data, we propose a risk-based stratification approach to streamline exposure follow-up testing and optimize resource utilization.