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This article focuses on unilateral sovereignty referendums pursued by territorial autonomies. Due to their unilateral character, such referendums are unlikely to gain external recognition and, as a result, fail to effect or prevent any de jure change in sovereignty. However, they are still pursued despite these constraints, suggesting that they serve purposes other than formal changes in sovereignty. To explain this phenomenon, the article proposes a framework of seven potential motivations. The framework is examined through the case of Gagauzia’s 2014 referendums, which addressed two key issues: Moldova’s foreign alignment and Gagauzia’s deferred independence. The analysis follows three referendum stages — proposal, initiation, and implementation — focusing on the dual leadership of the executive and legislative branches. Drawing primarily on newspapers affiliated with these branches, the study finds empirical support for three key motivations: advancing the individual and collective political interests of autonomy leadership, strengthening Gagauzia’s ties with its patron (Russia), and empowering the territorial autonomy vis-à-vis the parent state (Moldova). This article contributes a framework of motivations for unilateral sovereignty referendums tailored specifically to territorial autonomies, going beyond existing explanations developed for all polities. It also provides a detailed account of one of the most significant political events in Gagauzia’s history.
For much of imperial Chinese history, chroniclers and explorers understood a maritime land called Liuqiu to be the Ryūkyūs. In the early twentieth century, however, a new dynastic history claimed that Liuqiu was in fact Taiwan. This article explores how and why an uncontested and unambiguous understanding of Chinese maritime history was suddenly rewritten in the modern world, becoming the accepted interpretation and shaping twenty-first century geopolitics. While scholars have weighed the veracity of Liuqiu as either Taiwan or Ryūkyū, this article focuses on how the Liuqiu–Taiwan thesis was produced and transmitted, showing how scientific methodology, imperialism, and nationalism worked to reshape geographical history. The article further contributes to an understanding of the shaping of the borders and claims of the modern Chinese nation: whereas scholars have investigated late Qing and early Republican debates over the western frontier and ethnicities, this article shows that questions over Taiwan were just as important.
The European praying mantis, Mantis religiosa (Linnaeus, 1758) (Mantodea: Mantidae), is an introduced predatory insect established in southwestern and southeastern Canada and much of the United States of America. Despite over a century of records, the geographic origins of North American populations have remained unclear. We analysed 807-bp fragments of the mitochondrial CO1 gene from 17 sequences from southern Quebec and Ontario, Canada, comparing them to 175 sequences from western, eastern, and southern Europe. Population genetics analyses revealed that Canadian samples carry haplotypes from two divergent lineages that co-occur in a localised region of western France. These haplotypes showed the closest affinities to others also found in France, strongly supporting a French origin. Historical records from Rochester, New York, United States of America, where M. religiosa was first documented in 1899, suggest introduction via the 19th-century horticultural trade. The low haplotype diversity in Canada may reflect founder effects or environmental filtering, though additional, undetected introductions remain possible. This study clarifies the likely French source of M. religiosa in southeastern Canada and underscores the value of combining molecular data and historical accounts to track invasion pathways.
Let $f \in \mathbb{Q}[x]$ be a square-free polynomial of degree at least $3$, $m_i$, $i=1,2,3$, odd positive integers, and $a_i$, $i=1,2,3$, non-zero rational numbers. We show the existence of a rational function $D\in \mathbb{Q}(v_1,v_2,v_3,v_4)$ such that the Jacobian of the quadratic twist of $y^2=f(x)$ and the Jacobian of the $m_i$-twist, respectively, $2m_i$-twist, of $y^2=x^{m_i}+a_i^2$, $i=1,2,3$, by $D$ are all of positive Mordell–Weil ranks. As an application, we present families of hyperelliptic curves with large Mordell–Weil rank.
In a game with costly information acquisition, the ability of one player to acquire information directly affects her opponent’s incentives for gathering information. Rational inattention theory then posits the opponent’s information-acquisition strategy is a direct function of these incentives. This paper argues that people are cognitively limited in predicting their opponent’s level of information, and hence lack the strategic sophistication that the theory requires. In an experiment involving a real-effort attention task and a simple two-player trading game, I study the ability of subjects to (1) anticipate the information acquisition of opponents in this strategic game, and (2) best respond to this information acquisition when acquiring their own costly information. I study this by exogenously manipulating the difficulty of the attention task for both the player and their opponent. Predictions of behavior are generated by a novel theoretical model in which Level-K agents can acquire information à la rational inattention. I find an out-sized lack of strategic sophistication, driven largely by the cognitive difficulties of predicting opponent information. These results suggest a necessary integration of the theories of rational inattention and costly sophistication in strategic settings.
A particular fashion and lifestyle aesthetic called kankokuppo (Koreaish) has gained popularity among young Japanese women in the early 2020s, who increasingly admire what they perceive to embody the “atmosphere (fun’iki)” of South Korea. This article examines the semiotic rendering of a sensuous perception of Korea identified as “Koreaish” through aesthetically embodied practices and mediatized discourses. The analysis reveals the centrality of what I call a “soft unity”: softness that arises from ambiguated boundaries, taken up across discrete objects, practices, and social value regimes. Alongside growing calls to change Japanese society from a divisive to a borderless one, this softness is valorized as the quality of idealized sociality despite its association with highly normative femininity. The emergent “Koreaish” is emblematic of the postfeminist reformulation of the feminine ideal in neoliberal Japan, which manifests as a nexus of the demanifestation of differences and the reversion to conservative feminine values.
Human papillomavirus (HPV) infection has a negative impact on quality of life (QoL) and sexual function, mainly owing to increased levels of anxiety and distress.
Aims
To examine the potentially moderating effects of general psychological health on the relationships between (a) HPV-related psychosocial burden and QoL and (b) HPV-related psychosocial burden and sexual function.
Method
The HPV Impact Profile, Female Sexual Function Index, General Health Questionnaire-28 and Life Satisfaction Inventory questionnaires were completed by 151 women.
Results
HPV-related psychosocial burden and general psychological health accounted for 23.2% of QoL variability. There was not strong evidence for a moderating effect of general psychological health on the relationship between HPV-related psychosocial burden and QoL. Higher HPV-related psychosocial burden predicted worse sexual function on average. However, HPV-related psychosocial burden accounted for only 4.1% of sexual function variability.
Conclusions
Higher HPV-related psychosocial burden is associated with lower QoL as well as worse sexual function. General psychological health predicts changes in QoL over and above HPV-related psychosocial burden; thus, a deep understanding of emerging mental health issues soon after diagnosis is crucial to improve counselling and enhance women’s mental empowerment to achieve a better psychological response.
To assess the feasibility of using large language models (LLM) to develop research questions about changes to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food packages.
Design:
We conducted a controlled experiment using ChatGPT-4 and its plugin, MixerBox Scholarly, to generate research questions based on a section of the U.S. Department of Agriculture (USDA) summary of the final public comments on the WIC revision. Five questions weekly for 3 weeks were generated using LLM under two conditions: fed with or without relevant literature. The experiment generated ninety questions, which were evaluated using the Feasibility, Innovation, Novelty, Ethics and Relevance criteria. t tests and multivariate regression examined the difference by feeding status, artificial intelligence model, evaluator and criterion.
Setting:
The United States.
Participants:
Six WIC expert evaluators from academia, government, industry and non-profit sectors.
Results:
Five themes were identified: administrative barriers, nutrition outcomes, participant preferences, economics and other topics. Feeding and non-feeding groups had no significant differences (Coeff. = 0·03, P = 0·52). MixerBox-generated questions received significantly lower scores than ChatGPT (Coeff. = –0·11, P = 0·02). Ethics scores were significantly higher than feasibility scores (Coeff. = 0·65, P < 0·001). Significant differences were found between the evaluators (P < 0·001).
Conclusions:
The LLM applications can assist in developing research questions with acceptable qualities related to the WIC food package revisions. Future research is needed to compare the development of research questions between LLM and human researchers.
The focus of existing research on perceived organizational support (POS) has largely been concentrated at the individual-level, leaving an understudied gap at a higher unit-level of analysis. This study aims to fill this gap by examining the multilevel relationship between employee POS and job satisfaction, emphasizing the moderating role of unit-level POS. We hypothesize, based on POS theory and social comparison theory, that unit-level POS serves as a contextual moderator for the relationship between individual-level POS and job satisfaction. Additionally, at the unit-level, we identify clan culture values and unit-satisfaction as correlates of unit-POS. We test our hypotheses using a Bayesian Multilevel Structural Modeling approach on 45 work units and 317 employees. The results show that at low levels of unit-level POS, individual-level POS is more important for employees’ job satisfaction. We furthermore found support for a positive association between unit-level POS, unit-clan culture, and unit satisfaction. Our results, and their notable theoretical and practical implications, are discussed.
In March 2019, flooding of the Missouri River and its tributaries destroyed infrastructure and farmland and affected communities, including those in the state of Nebraska. The objective of this study was to assess emergency preparedness and satisfaction with flood response, recovery, and relief efforts 5 years following the 2019 floods in rural eastern Nebraska.
Methods
Using stratified simple random sampling, this study surveyed 13 Nebraska communities to assess emergency preparedness and satisfaction with flood response, recovery, and relief efforts 5 years following the 2019 Missouri River Flood. Descriptive statistics are reported.
Results
Households impacted by the 2019 Nebraska flood reported worsening physical and mental health symptoms and identified major gaps in communication, long-term mental health support, and infrastructure resilience. Self-reported preparedness improved post-flood. Inadequate early warnings and poor information dissemination eroded trust.
Conclusions
There are persistent mental and physical health impacts resulting from exposure to the 2019 Missouri River floods that can impact communities’ ability to respond and recover from subsequent hazards. Evaluating the impacts of previous disasters is a critical component of increasing community resiliency and local public health and emergency preparedness capacity to serve these populations.
To investigate the decision-making processes of nurse prescribers in general practice when managing acute episodes of illness in patients with multimorbidity.
Background:
Nurse independent prescribers in UK general practice are facing increasing complex clinical decision-making when assessing patients presenting acutely with undifferentiated and undiagnosed conditions as multimorbidity and polypharmacy becomes increasingly common. This qualitative study investigated the decision-making processes of nurse prescribers in general practice when managing acute episodes of illness in patients with multimorbidity.
Methods:
Fourteen general practice nurse prescribers were recruited through purposive sampling. Think aloud in response to staged vignettes was used followed by semi-structured interviews. Thematic analysis was used to analyse think aloud and interview data.
Findings:
Participants were experienced nurses with a range of clinical exposure and training who mostly made appropriate diagnostic and prescribing decisions. Pockets of expertise were revealed which reflected participants’ clinical experience, but there was a high rate of referral to the GP for some vignettes. Participants’ decision-making was underpinned by both analytical and intuitive processes, the quality of which was dependent on their individual knowledge and experience. A reliance on pattern recognition, aligned to intuitive decision-making, to determine the content of the consultations was identified as an area of risk and showed all participants to be inconsistent in their identification of complex factors. Omission of these factors could have important implications for prescribing decision-making. Organizational issues such as time-limited clinics also shaped the content of participants’ consultations, encouraged a limited, problem-focused approach, and reduced the opportunity for mentorship. Comprehensive knowledge, clinical experience, and mentorship are critical to ensure nurse prescribers make optimal decisions in the context of patients with multimorbidity. A team approach to the management of acute presentations in these patients is recommended to improve patient experience and maximize nurse prescribers’ contribution to the general practice workforce.
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)