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In fragile contexts, the state is sometimes unable to effectively perform some of its fundamental functions, such as the provision of public services, law-making, or territorial governance. Multinational corporations sometimes step in to perform these functions by leveraging their political power. On the one hand, this facilitates the enjoyment of fundamental rights for the affected citizens; on the other hand, it risks undermining the relationship between citizens and the state itself, further weakening its foundations. This paper aims to identify a normative criterion to navigate this phenomenon, drawing on theory of positive constitutionalism to do so.
Design creativity is an inherently complex and recursive cognitive process involving nonlinear transitions between distinct cognitive states. This experimental neurocognitive study provides empirical support for theoretical nonlinear and recursive models of design creativity by examining neurocognitive processes across design creativity cognitive states, including idea generation (IDG), idea evolution (IDE), rating process (IDR), and rest mode (RST). EEG signals were recorded during loosely controlled design creativity tasks, and 13 well-established features were extracted from recurrence quantification analysis (RQA). A feature selection pipeline identified the most significant features for distinguishing between the cognitive states. Statistical analyses of the features provided deeper insights into brain dynamics and confirmed the significance of the selected features, supported by EEG topography maps. The findings revealed distinct and complex recursive dynamics across cognitive states, primarily involving the frontal, parietal and central regions, offering novel insights complementary to prior EEG studies. We also classified the cognitive states using the selected significant features through six classification models: k-Nearest Neighbor, Support Vector Machine, Naïve Bayes, Multi-Layer Perceptron, Linear Discriminant Analysis and Random Forest. To ensure robust evaluation, we applied three cross-validation strategies – hold-out, k-fold and one-subject-out – and combined the classifiers using majority voting fusion. Classification results (10-fold cross-validation) demonstrated high performance, with an average accuracy (96.23%), kappa (93.56%), recall (96.58%), precision (98.08%), F1-score (97.29%) and specificity (98.43%). The study provides findings that are consistent with theoretical expectations. Consistent with theoretical expectations, the findings deepen understanding of recursive and nonlinear neural dynamics in design creativity cognition and guide future research.
The ability of urban centres to grow and persist through crises is often assessed qualitatively in archaeology but quantitative assessment is more elusive. Here, the authors explore urban resilience in ancient Mesopotamia by applying an adaptive cycle framework to the settlement dynamics of the Bronze and Iron Age Khabur Valley (c. 3000–600 BC). Using an integrated dataset of settlements and hollow ways, they identify patterns of growth, conservation, release and reorganisation across six periods, demonstrating the value of coupling archaeological data with resilience theory and network analysis to understand the adaptive capacities of complex archaeological societies.
New technologies are being developed in a context of scarcity. Health technology assessment (HTA) aims to support decision makers in providing equitable and affordable access to effective innovations. This study aims to summarize the policy-related findings of a Horizon2020 project on innovating HTA methods and discuss their implications for the governance of HTA in Europe.
Methods
A thematic analysis of policy-oriented papers (n = 18) from the Next Generation Health Technology Assessment (HTx) project was carried out to summarize challenges and solutions. Subsequently, via an online survey and in a 2-day meeting, European and global stakeholders (n = 21) were invited to comment on these solutions and to prioritize future strategies.
Results
Reported challenges included a lack of access to standardized data, differences in evidentiary needs, existing policy structures, and a lack of capacity and knowledge. Suggested solutions were capacity building, national and international dialogues, standardization, and increased European collaboration. Stakeholders had different expectations with respect to the likely success of these solutions.
Conclusion
Innovation of HTA requires alignment of evidentiary needs through dialogues, standardization through increased European collaboration, and capacity building. However, without additional investments in personnel capacity, HTA agencies must still prioritize some activities at the expense of others. Furthermore, although European collaboration is important, global alignment might be required to enforce standardization.
Current explanations of Sino–American relations are dominated by realist and liberal understandings of world politics, neglecting crucial transnational actors that complexify Sino–American relations. In contrast and drawing from internationally informed Gramscian hegemony theory, and on extensive archival work, we offer an alternative complex multidimensional transnational account. By researching the Ford Foundation’s activities in China and the United States, specifically its contribution to the development of the international relations (IR) discipline in China, we break new ground and show that Ford was key in profoundly shaping Sino–American relations, especially by developing transnational knowledge networks. These transnational elite networks simultaneously integrated China into the LIO and had unintended consequences, particularly in encouraging Chinese counter-hegemonic dynamics that challenge the LIO from within. Our approach indicates a richer complexity of Sino–US relations than extant theories, suggesting that the future trajectories of this strategic relationship are uncertain and do not fall neatly into an inevitable war or peaceful interdependence binary.
Backers of nuclear deterrence are thought to use strategic logic, while nuclear disarmament advocates are believed to embrace moral reasoning. Yet policy makers and diverse publics may hold both—ostensibly contradictory—preferences. Recent studies find that publics in Western democratic countries support the nuclear strikes underpinning long-standing conceptions of deterrence policy. But other scholarship indicates that these very same publics want to abolish nuclear arsenals. A lack of comparative analyses across the Global North and the Global South limits the generalizability of these claims. Does a categorical dichotomy between nuclear deterrence and disarmament really reflect global public views on the bomb? What explains a multitude of seemingly inconsistent scholarly results? In this reflection essay, we argue that deterrence and disarmament are not necessarily incompatible tools for reducing nuclear dangers. We point to several ways that individuals might simultaneously accommodate both pro- and antinuclear weapons policy positions. To investigate this proposition, we offer a new observational dataset on global nuclear attitudes from a survey we conducted in 24 countries on six continents (N = 27,250). Unlike isolated studies of these phenomena, our data strongly confirm that publics do not subscribe to categorical views of nuclear weapons. This headline finding and novel dataset open new possibilities for studying nuclear politics.
Building on untapped archival documents and press reports, I explore a seeming contradiction underpinning the Israeli authorities’ War on Drugs from the late 1950s to the early 1980s. While the state authorities clamped down on local cannabis users, it was heavily invested in covert cannabis trafficking operations into Egypt, its main enemy at the time. The primary targets of the domestic clampdown were the country’s Jewish consumers of the drug, mainly first- and second-generation Jewish immigrants from the Middle East and North Africa (collectively known as Mizrahim). Provoking latent class, racial, and gendered anxieties, the state authorities used hashish to further marginalize and criminalize Mizrahim in Israel. However, while the state cracked down on Mizrahi hashish dealers and users, the Israeli military was directly involved in large-scale hashish trafficking operations to Egypt. This enterprise aimed to immerse and immobilize the Egyptian population generally—and the Egyptian armed forces specifically—with hashish.
Whereas some prehispanic societies across North America pursued monumentality, hierarchy, and regional integration, others adopted inward-oriented strategies that fostered cohesion through symbolic containment and household autonomy. Mimbres Classic period (AD 1000–1130) communities in southwestern New Mexico exemplify this alternative trajectory. By situating Mimbres insularity within broader regional developments, this study examines how material practices were mobilized to construct and maintain a culturally bounded world. Drawing on theories of boundary maintenance and ritual sovereignty, I argue that distinctive forms of architecture, painted ceramics, mortuary practices, and regulated interaction localized sacred authority and deliberately limited external connectivity. In contrast to Chaco Canyon’s investments in monumentality and social hierarchy, Mimbres society sustained social coherence through practices rooted in household ritual and symbolic regulation. Crucially, this insularity was neither fixed nor absolute—it emerged in the AD 900s, peaked during the Classic period, and receded after AD 1130 as communities relocated and engaged with new material traditions and regional networks. By tracing this historical arc, this study challenges models that equate social organization with scale or connectivity, demonstrating instead how inward-oriented strategies can produce resilient, if historically contingent, cultural frameworks.
This study analyses the relationship between fear of stigma and bypassing primary ART facilities by ART clients in the Upper East Region of Ghana.
Methodology:
Methodology: The study employed an exploratory case study design, involving 52 participants of: ART clients (n = 37), nurses (n = 7), a counsellor (n = 1), cadres (n = 2), pharmacists (n = 2) and data managers (n = 3) through convenient and purposive sampling techniques. Data was collected using semi-structured interview guides and analysed using a thematic framework.
Results:
The study provides ample evidence of the occurrence of stigma-driven bypassing of primary ART facilities by clients. The analysis shows entrenched cultural norms and values and the population’s low awareness of the efficacy of ART fuel the processes of stigma and discrimination towards ART clients.
Strengths and limitations:
We acknowledge the following limitations and strengths: convenient and purposive sampling procedures may not represent the views of all ART clients on bypassing primary facilities. Sensitive nature of HIV and the location of ART centres, coupled with time constraints in probing into all ART bypassing issues. Yet, given the depth of the issues presented and the scope of participants and ART facilities, we believe relevant data was generated to address the research question.
Conclusion:
An integrated approach could be used to address the drivers of stigma and discrimination focusing on awareness creation to undo the entrenched negative cultural beliefs around HIV transmission, and implement anti-HIV stigma legislation to eliminate prejudice towards PLHIV.
We examine whether different information frames affect how people perceive the domestic costs of sanctions and support sanctions. Using data from an information provision experiment in Germany and Poland, we demonstrate that people overestimate the costs of sanctions (Gross Domestic Product loss due to an energy embargo) in sending countries. Yet, this perception can be corrected through the provision of actual information, which in turn enhances the support for the sanction. Contrasting sanctions’ costs with other costs – Covid-19 costs and costs imposed on target countries – has no additional effect.
Within the recent glut of philosophical work on hope, relatively little attention has been devoted to the circumstantial conditions that frustrate or accommodate hoping. In this article, I show how an individual’s spatial environment can constrain their capacity to sustain determinate hopes for the future via an extended case study: long-term refugee detention. Taking seriously refugees’ claims that a central cause of widespread hopelessness is the feeling of being in limbo, and drawing on recent work on the role of the imagination in hoping, I demonstrate how an individual’s spatial environment can limit imaginative access to the interim steps between their present circumstances and a desired future, making it difficult to see any way their hope could be realized.
This paper surveys the literature on gender differences in religiosity and on how religion shapes gender-related economic and social outcomes. Part I examines why women tend to be more religious than men, reviewing leading explanations from sociology, economics, and psychology. Part II analyzes how religion affects gender norms and attitudes, education, labor market participation, fertility, health, legal institutions, and discrimination. Across domains, we distinguish between effects driven by individual religiosity—such as beliefs and religious practice—and those driven by religious denomination. We emphasize studies that employ credible causal identification strategies, including natural experiments, instrumental variables, and policy reforms, while also reviewing correlational evidence for context. Overall, the literature suggests that religious teachings and participation often reinforce traditional gender roles, influencing women’s education, labor supply, and fertility decisions, though important heterogeneity and exceptions exist. We also highlight instances in which secular reforms or religious movements have altered these outcomes. The survey concludes by identifying gaps in the literature and outlining priorities for future empirical research.
Neurodevelopmental disorders have been associated with hearing problems (HP) later in life, but there is limited information regarding their shared biology.
Methods
We leveraged large-scale genome-wide datasets to estimate genetic correlation (global and local), polygenic overlap, and locus-specific pleiotropy among HP, autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and Tourette syndrome (TS). Then, we investigated shared molecular functions, biological processes, and cellular components, and performed a drug-repurposing analysis to identify compounds that may target the pathogenic processes linking neurodevelopmental disorders to HP.
Results
We observed high genetic correlation of HP with ASD (rg = 0.22) and TS (rg = 0.22). With respect to HP-ADHD polygenic overlap, 34% of the causal variants were shared between these conditions, with only 74% of them showing concordant effect directions. We also identified nine chromosomal regions with evidence of ADHD-HP local genetic correlations with pleiotropic effects on other outcomes, such as smoking initiation, brain-imaging phenotypes, and bilirubin levels. With respect to HP-ASD, we observed an inverse local genetic correlation within CD33 chromosomal region. Pleiotropy among HP, ASD, and ADHD was also identified in two variants (rs325485 and rs2207286) included within 95% credible sets related to neuropsychiatric conditions, altered hearing function, and other traits such as risk taking and insomnia. Drug-repurposing analyses identified anisomycin for HP-ASD shared biological mechanisms and five compounds related to HP-ADHD pleiotropy.
Conclusions
Our findings provide evidence that the comorbidity between neurodevelopmental disorders and HP is at least partially due to shared pathogenic processes acting through intrinsic and extrinsic factors.
Recent surveys have suggested that over half of UK households own a pet. One important aspect to this ownership is ensuring that access to appropriate veterinary care is available for their pets. To measure the ease of accessibility to such care, three aspects are important, the local demand for veterinary care, the supply of care, and the ease of travel to obtain the care. For the first element, in this study estimates were made of the household pet population for all neighbourhoods in England and Wales (36,672 neighbourhoods each containing approximately 700 households). Information regarding the location and number of veterinarians working in local practices was then used, with vehicle journey times, to provide a measure of accessibility to veterinary care. It was found that the more affluent and rural locations have better accessibility to veterinary care than deprived and urban locations. The detailed geography of the estimates provided by this study enabled the location of potential ‘veterinary deserts’ to be identified. With this knowledge additional provision can be prioritised to such locations with a view to improving the welfare of companion animals. Not only will this improve the accessibility of veterinary care but, through competition, this also has the potential to reduce care costs. Thus, the likelihood of pets receiving the care they need will improve. Whilst this study focuses upon England and Wales, the methodology presented would be equally valid in other settings where appropriate data exist.
For the Palestinian people, psychic life is just as much a site of struggle for liberation as social life. Palestinians are persistently refused psychological amplitude, characteristics easily granted to those who are never worried they might fall out of what is constituted as the category of the human. Abdaljawad Omar’s writings in English published since October 7, 2023 (as well as writings by other Palestinians, other Arabs, and those of Palestinian descent) offer means of understanding material resistance in relation to the terrain of the psyche. Omar offers distinctive accounts of mourning, loss, and ruins, as well as of how settler colonialism reorganizes experiences of time and relations between past, present, and future. The article reads Omar’s writings against other accounts of mourning and of psychic phenomena that are indebted to psychoanalysis. Omar’s analyses of Palestinians’ resistance to unfreedom and annihilation open up other ways of understanding the psychic vicissitudes of those who suffer, grieve, and struggle to exit a colonial condition characterized by the colonizer’s repeated attempts to break psychic worlds as well as erase bodily life. Understandings of psychic life that do justice to how Palestine is redrawing the world are central to the work of ‘cracking history open’.
Effective antibiotic stewardship programing in clinical settings necessitates a good understanding of local prevalences of antimicrobial resistance and important patient and community risk factors. However, most studies are limited in sample size and geographic coverage.
Methods:
This study utilized phenotypic resistance data of Escherichia coli from the Veteran’s Health Administration of the United States (U.S.), incorporating 126,777 unique cultures from veteran outpatients from seven Midwest states from 2010 to 2023, to examine the spatial pattern and important individual- and county-level risk factors for resistance to four important classes of antibiotics. We utilized Bayesian conditional autoregressive zero-inflated Poisson regression models to generate smoothed rates of resistance in each county and multilevel logistic regression models to detect risk factors for resistance.
Results:
High overall rates of resistance were seen for fluoroquinolone (29%) and TMP-SMX (22%). Geographic variation was seen among and between antibiotic classes. Certain urban regions in the southern parts of Illinois, Indiana, and Ohio had higher local resistance rates for fluoroquinolone and TMP-SMX. Being male, having diabetes, and previous exposure to antibiotics are significant risk factors for all classes of antibiotics while the significance of other risk factors varied across classes.
Conclusion:
Diverse geographic patterns of resistance level may reflect differences in local prescribing practices, while the differential correlations with risk factors likely reflect their clinical indications and prescribing patterns in clinical settings. The local resistance rates and risk factors for different classes of antibiotics should provide important guidance in practicing empirical prescribing and antibiotic stewardship in clinical settings.