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This chapter analyzes the Republic’s theory of the tripartite soul regarding the question of self-rule and autonomy. Only when the soul is in the ideal position of having reason positioned as sovereign ruler can a person be seen as acting autonomously. But it is not clear that when reason rules, it also motivates actions. Christine M. Korsgaard has argued that personal decision-making should be seen as analogous to political decision-making. She conceives of political decisions as a process where requests for action spring from the people, while rulers suffice to say yes or no. This chapter claims that this analysis is inadequate as a theory of how Plato portrays the relationship between the parts of the soul and of decision-making in general, and offers an alterantive interpreation in terms of what is called the Complex Model of Decision-Making.
This paper presents a study focusing on the morphological variations in Southwestern Norwegian preschool children’s role-play register. Within this register, the children switch between their local Southwestern Norwegian dialect and a Central Eastern Norwegian variety similar to the Oslo dialect. Although the majority of the children (with the exception of two) employ this Central Eastern Norwegian variety in role-play, two children exhibited a significantly greater degree of usage compared to the others. Consequently, these two children were selected for an in-depth analysis. The detailed analysis reveals that while the Central Eastern Norwegian variety is used for most variables by both children, the extent to which they code-switch depends on the individual child and the specific variable in question. The observed variation across variables and between the children is examined and discussed in the paper.
The world is facing multiple interconnected crises, from climate change and economic instability to social inequalities and geopolitical tensions. These crises do not occur in isolation; instead, they interact, reinforce each other, and create unexpected ripple effects – forming what is known as a polycrisis. Traditional ways of analysing problems often fail to grasp these interdependencies, making it difficult to find effective responses. We draw on system archetypes to describe and exemplify three polycrisis patterns. These provide a structured way to analyse how multiple crises unfold and interact, as well as insights into how to navigate such complexity.
Technical summary:
The concept of a polycrisis describes the complex interconnections between global issues, which can lead to unexpected emergent behaviours and the possible convergence of undesirable impacts. Understanding these dynamics is crucial for anticipating compounded effects and for identifying leverage points for effective intervention. We propose that system archetypes – generic structures in system dynamics that capture recurring patterns of behaviour – can serve as a useful analytical tool to study polycrises. Specifically, we reinterpret three key system archetypes in this context: Converging Constraints (based on the Limits to Growth system archetype), Deepening Divides (based on Success to the Successful system archetype), and Crisis Deferral (drawing from the Policy Resistance system archetype). These patterns illustrate how resource limitations, structural inequalities, and short-term solutions can sustain or worsen crisis dynamics. Using real-world examples, we show how polycrisis patterns can be employed to map feedback structures between interacting crises and to guide effective interventions. Our work contributes to a more structured and systemic understanding of polycrises, by providing a tool to help researchers and policymakers better anticipate, navigate, and mitigate their effects.
Social media summary:
‘Polycrisis patterns reveal how crises like climate change, economic instability, and inequality interact, amplifying their impacts’.
In July 2005, the United Nations special rapporteur on discrimination and racism, Doudou Diene, went on a nine-day tour of Japan and talked to minority groups, antidiscrimination campaigners and government and police officials around the country. After releasing his preliminary findings to the press last year, Diene handed the completed 23-page report based on his research to the UN Commission on Human Rights in January. [Doudou Diene Report]
Thursday, June 16, 2005 is a date that will be etched in memory as the day Japan's proposal for United Nations reform was dealt a fatal blow by the U.S. government.
The United States’ proposal on reform of the U.N. Security Council released that day calls for expansion of membership from the current 15 to 19 or 20, by adding “two or so” permanent members to the current five– Britain, China, France, Russia and the United States–as well as two or three additional nonpermanent members.
The Diene Report of 2005 represents an instance in which an international organization investigated Japanese official treatment of minority communities in Japan in relation to international standards, and their findings strongly supported the Ainu activists. The United Nations sent Doudou Diene, their Special Rapporteur, to Japan to look into discrimination and racism. Diene's report harshly criticized the racism that exists in Japan and suggested that improved measures are necessary to protect the Ainu and other minorities there. This article is a response to his report by five Japanese individuals who have long been committed to countering discrimination and racism in the country. Four of the five contributors agree with the overall content of the Diene report and provide further information. They see the report as a small but positive impetus that will help the 21st century activism that further counters discrimination and racism in Japan. On the other hand, William Wetherall criticizes the report as seriously flawed, because he thinks it misunderstands the main aspects of the issue.
The COVID-19 pandemic negatively affected students’ mental health, increasing pre-existing psychosocial vulnerabilities. University students worldwide have presented differences in their mental health status; however, cross-country studies comparing students’ mental health during the pandemic are lacking.
Aims
To investigate potential differences between university students from Brazil and those from Germany with respect to (a) depressive symptoms and alcohol and drug consumption, (b) social and emotional aspects (loneliness, self-efficacy, perceived stress, social support and resilience) and (c) attitudes towards vaccination.
Method
Two online cross-sectional studies were conducted with university students during the COVID-19 pandemic in Brazil (November 2021 to March 2022) and in Germany (April to May 2022). Depressive symptoms, alcohol consumption, loneliness, self-efficacy, perceived stress, social support, resilience, sociodemographic information and attitudes towards vaccination were assessed. Data were analysed using univariate and bivariate models.
Results
The total sample comprised N = 7911 university students, with n = 2437 from Brazil and n = 5474 from Germany. Brazilian students presented significantly more depressive symptoms and suicidal thoughts, higher levels of perceived stress, higher frequency of drug or substance consumption, and lower levels of perceived social support and resilience than German students, whereas German students presented higher levels of loneliness than Brazilian students. A more favourable opinion towards vaccinations in general was found among Brazilian students compared with German students.
Conclusions
In both countries, low-threshold (online) counselling targeting university students is needed. The differences between the samples could indicate country and/or cultural differences which justify further research in this area.
Days of antibiotic spectrum coverage (days of ASC: DASC) is a metric for antibiotic usage calculated by ASC scores for spectrum and addresses limitations of days of therapy (DOT), which does not include spectrum. This study aims to investigate whether ASC-related metrics offer different aspects compared to aggregated DOT for all antibiotics (DOTtotal) and to assess their correlation in evaluating the impact of antimicrobial stewardship team (AST) programs.
Design:
Retrospective.
Setting:
A single center within an 845-bed hospital.
Methods:
Trends in DOTtotal, DASC, and the DASC/DOT ratio, representing the average spectrum coverage per therapy day, were analyzed pre- and post-AST programs (April 2018) from January 2015 to December 2023, using interrupted time series analysis. Independent of the DASC/DOT, we also advocated ASC-stratified DOT (ASDOT), which facilitates comprehensive evaluation of DOT across ASC scores of <6, 6–10, and >10, representing narrow-, intermediate-, and broad-spectrum antibiotics.
Results:
Among inpatients, AST programs significantly moderated the increasing trends of these metrics. Specifically, although the rates of increase in DOTtotal and DASC were slowed or plateaued, the DASC/DOT ratio decreased (P < 0.001). ASDOT metrics revealed a decrease and subsequent plateau in DOTtotal for the broad- and intermediate-spectrum antibiotics, with an increase observed for the narrow-spectrum antibiotics (P < 0.001 for each). DASC did not provide additional insights in the outpatient’s population.
Conclusions:
The study demonstrates that ASC-related metrics may yield different and useful conclusions about the effectiveness of AST programs for inpatients.
This systematic review aimed to quantify the prevalence of substance use among female sex workers (FSWs) in low- and middle-income countries (LMICs).
Methods
Design: The review protocol was registered with PROSPERO (CRD42021242048). We searched Ovid, PubMed and Web of Science databases for peer-reviewed, quantitative studies from inception to 6th March 2023. Study designs included: cross-sectional, case–control, cohort study, case series analysis, or experimental studies. Study quality was assessed using the Centre for Evidence-Based Management (CEBM) Critical Appraisal Tool.
Setting: FSWs in LMICs.
Participants/Inclusion criteria: any measure of prevalence or incidence of substance use (not alcohol or tobacco) among FSWs aged 18+ years.
Measurements: A narrative synthesis was conducted across all studies meeting the inclusion criteria. Pooled prevalence estimates for ‘ever’ and ‘recent’ drug use were calculated using a random effects model.
Results
3135 papers were identified; 161 papers reporting on 102 studies with 167,333 FSWs from 39 LMICs met the inclusion criteria. 26 studies scored high, 61 scored moderate, and 15 scored in the lower quality range. Only 4/102 studies used a validated measurement tool to assess levels of substance use dependence. The mean age of study participants was 28.9 years (SD 7.7). The pooled prevalence for recent (past month to past year) substance use among FSWs in LMICs is: illicit drug use 29% (95% CI: 14–34%), cannabis 20% (95% CI: 8–30%), cocaine 21% (95% CI: 9–32%), amphetamine type stimulants 19% (95% CI: 12–26%), opioids 8% (95% CI: 4–12%), sedatives and sleeping pills 6% (95% CI: 0–12%), inhalants 4% (95% CI: –4–12%), hallucinogens 0% (95% CI: 0–0%), and recent drug use during sex work 42% (95% CI: 15%–68%). Only 5/102 studies reported a substance use intervention. Key study limitations include the lack of a validated measurement tool by most studies (96%) meaning it was not possible to distinguish between any drug use vs. harmful drug use. The criminalisation of drug use may have led to under-reporting and an underestimate of true substance use prevalences.
Conclusion
FSWs in LMICs report a high prevalence of recent drug use – including during sex work – with cannabis, cocaine and amphetamine type stimulants the most commonly used. There is an urgent need for effective low-cost substance use interventions. Future studies should use validated substance-use measurement tools to assess the burden of substance use disorders.
Analysis of the chronological data and observation of a lagoonal sediment core reveal sand washover events between around 2.4 to 2.5 cal. ky BP in the Isumi River lowland. We conducted radiocarbon dating with AMS and constructed an age-depth model using the latest calibration curve and appropriate model routine. In the middle to lower part of the core, dark-gray sand layers are repeatedly deposited. Sand layers may exhibit an erosional surface at the base with fining upward grading. The overwash layers are composed of well-rounded sand with occasional gravel, indicative of transportation. overwash sediment characteristics are consistent with proximal marine deposits, suggesting an ocean origin (though riverine sediment is also similar in character). The age-depth model indicates very high sediment accumulation rates associated with overwash deposits. Based on the amount of accumulated sediment, relatively large-scale redeposition events occurred during this period but more information is needed to constrain the mechanism(s) causing the events. We also present a local reservoir age correction compatible with the Marine20 calibration curve.
Even as education becomes increasingly important for functioning in society, and many welfare states have taken responsibility for providing education, many individuals have insufficient skill levels to fully participate in society. This paper investigates the relationship between literacy skills and basic functioning and participation in society, focusing on the role of the welfare state, and whether individuals with low literacy skills are better off in terms of labour market outcomes, quality of life, digital participation and adult learning in countries with higher investments in active labour market policies (ALMPs), and three underlying spending categories: 1) public employment services, 2) training and 3) private sector employment incentives. Through multi-level analysis of 25 Economic Co-operation and Development (OECD) countries and 139,449 individuals, using individual-level data from the Programme for the International Assessment of Adult Competencies (PIAAC) and country-level data from the OECD, our results show that while low literacy is associated with less favourable conditions related to all outcome variables investigated, ALMPs do not always moderate these negative associations. This is especially true for labour market participation, health and on-the-job training. However, higher ALMP spending is associated with more favourable conditions among low-literate individuals when it comes to job satisfaction, digital participation and life-long learning.
A third nationally representative serosurvey was performed to study the changes in Toxoplasma gondii (T. gondii) seroprevalence in the Netherlands over a 20-year time span and to identify and confirm risk factors for acquired toxoplasmosis. This cross-sectional study (conducted in 2016/2017) was designed similarly to the previous two studies (1995/1996 and 2006/2007) and included a questionnaire and serum sampling among Dutch residents. Factors associated with seropositivity for T. gondii were determined using multivariable analysis of the questionnaire-derived data. The earlier observed decrease in T. gondii seroprevalence between 1995/1996 and 2006/2007 (from 40.5% to 26.0%) did not continue into 2016/2017 (29.9%). Similarly to the previous studies, the seroprevalence increased with age and varied among regions. In all studies, higher T. gondii seropositivity was associated with increasing age, lower educational level, not living in the Southeast, and eating raw or semi-cooked pork. The incidence of congenital toxoplasmosis was estimated at 1.3/1000 (95% CI 0.9–1.8) live-born children in 2017. As the seroprevalence of T. gondii in the Netherlands did not decrease over the last decade, an increase in public health awareness is needed and prevention measures may need to be taken to achieve a further reduction in T. gondii infections in the Netherlands.
Due to its widespread use in the sex work industry, female sex workers (FSWs) in low- and middle-income countries (LMICs) are at high risk of harmful alcohol use and associated adverse health outcomes. This systematic review and meta-analysis aims to provide an estimate of the prevalence of harmful alcohol use among FSWs in LMICs and to examine associations with common health and social concerns.
Methods
The review protocol was registered with PROSPERO, number CRD42021237438. We searched three electronic databases for peer-reviewed, quantitative studies from inception to 24th February 2021.
Inclusion criteria:
• Any measure of prevalence or incidence of alcohol use among FSWs aged 18 years or older.
• Countries defined as LMIC in accordance with the World Bank income groups 2019.
• Study designs: cross-sectional survey, case–control study, cohort study, case series analysis, or experimental study with baseline measures for alcohol use.
Pooled prevalence estimates were calculated for:
1. Any hazardous/harmful/dependent alcohol use
2. Harmful/dependent alcohol use only, both overall and by region
3. Daily alcohol use.
4. Meta-analyses examined associations between harmful alcohol use and violence, condom use, HIV/STIs, mental health problems and other drug use.
Results
In total, 435 papers were identified. After screening, 99 papers reporting on 87 unique studies with 51,904 participants from 32 LMICs met the inclusion criteria. Study designs included cross-sectional (n = 89), cohort (n = 6) and experimental (n = 4). Overall, 5 scored as high quality, 79 studies scored as moderate and 15 scored as weak quality. Twenty-nine papers reporting on 22 unique studies used validated alcohol use tools including AUDIT, CAGE and WHO CIDI. The pooled prevalence of any hazardous/harmful/dependent alcohol use was 41% (95% CI: 31–51%), and of daily alcohol use was 26% (95% CI: 17–36%). There was variation in harmful alcohol use by global region (Sub-Saharan Africa: 38%; South Asia/Central Asia/ East Asia and Pacific: 47% and Latin America and the Caribbean:44%). Harmful alcohol use was significantly associated with inconsistent condom use (pooled unadjusted RR: 1.65; 95% CI: 1.01–2.67), STIs (pooled unadjusted OR: 1.29; 95% CI 1.15–1.46); and other drug use (pooled unadjusted OR of 2.44; 95% CI 1.24–4.80), but not with HIV, violence or mental health problems.
Conclusion
We found a high burden of problem alcohol use and daily alcohol use among FSWs in LMICs. Harmful drinking was associated with HIV risk factors such as inconsistent condom use, STIs and other drug use. There is an urgent need for tailored interventions for FSWs in LMICs that address alcohol use as well as the associated sex work risk environment
We sought to examine the effects of daily consumption of macadamia nuts on body weight and composition, plasma lipids and glycaemic parameters in a free-living environment in overweight and obese adults at elevated cardiometabolic risk. Utilising a randomised cross-over design, thirty-five adults with abdominal obesity consumed their usual diet plus macadamia nuts (~15 % of daily calories) for 8 weeks (intervention) and their usual diet without nuts for 8 weeks (control), with a 2-week washout. Body composition was determined by bioelectrical impedance; dietary intake was assessed with 24-h dietary recalls. Consumption of macadamia nuts led to increased total fat and MUFA intake while SFA intake was unaltered. With mixed model regression analysis, no significant changes in mean weight, BMI, waist circumference, percent body fat or glycaemic parameters, and non-significant reductions in plasma total cholesterol of 2⋅1 % (−4⋅3 mg/dl; 95 % CI −14⋅8, 6⋅1) and low-density lipoprotein (LDL-C) of 4 % (−4⋅7 mg/dl; 95 % CI −14⋅3, 4⋅8) were observed. Cholesterol-lowering effects were modified by adiposity: greater lipid lowering occurred in those with overweight v. obesity, and in those with less than the median percent body fat. Daily consumption of macadamia nuts does not lead to gains in weight or body fat under free-living conditions in overweight or obese adults; non-significant cholesterol lowering occurred without altering saturated fat intake of similar magnitude to cholesterol lowering seen with other nuts.
We investigate the Reynolds analogy over riblets, namely the analogy between the fractional increase in Stanton number $C_h$ and the fractional increase in the skin-friction coefficient $C_f$, relative to a smooth surface. We investigate the direct numerical simulation data of Endrikat et al. (Flow Turbul. Combust., vol. 107, 2021, pp. 1–29). The riblet groove shapes are isosceles triangles with tip angles $\alpha = {30}^{\circ }, {60}^{\circ }, {90}^{\circ }$, a trapezoid, a rectangle and a right triangle. The viscous-scaled riblet spacing varies between $s^+ \approx 10$ to $60$. The global Reynolds analogy is primarily influenced by Kelvin–Helmholtz rollers and secondary flows. Kelvin–Helmholtz rollers locally break the Reynolds analogy favourably, i.e. cause a locally larger fractional increase in $C_h$ than in $C_f$. These rollers induce negative wall shear stress patches which have no analogue in wall heat fluxes. Secondary flows at the riblets’ crests are associated with local unfavourable breaking of the Reynolds analogy, i.e. locally larger fractional increase in $C_f$ than in $C_h$. Only the triangular riblets with $\alpha = {30}^{\circ }$ trigger strong Kelvin–Helmholtz rollers without appreciable secondary flows. This riblet shape globally preserves the Reynolds analogy from $s^+ = 21$ to $33$. However, the other riblet shapes have weak or non-existent Kelvin–Helmholtz rollers, yet persistent secondary flows. These riblet shapes behave similarly to rough surfaces. They unfavourably break the global Reynolds analogy, and do so to a greater extent as $s^+$ increases.
n-3 index, the erythrocyte proportion of the EPA + DHA fatty acids is a clinical marker of age-related disease risk. It is unclear whether regular intake of α-linolenic acid (ALA), a plant-derived n-3 polyunsaturated fatty acid, raises n-3 index in older adults. Of the 356 participants at the Loma Linda, CA centre from the original study, a randomly selected subset (n 192) was included for this secondary analysis (mostly Caucasian women, mean age 69 years). Participants were assigned to either the walnut (15 % of daily energy from walnuts) or the control group (usual diet, no walnuts) for 2 years. Erythrocyte fatty acids were determined at baseline and 1-year following intervention. No differences were observed for erythrocyte EPA, but erythrocyte DHA decreased albeit modestly in the walnut group (–0·125 %) and slightly improved in the control group (0·17 %). The change in n-3 index between the walnut and control groups was significantly different only among fish consumers (those who ate fish ≥ once/month). Longitudinal analyses combining both groups showed significant inverse association between the 1-year changes of the n-3 index and fasting plasma TAG (ß = −10), total cholesterol (ß = −5·59) and plasma glucose (ß = −0·27). Consuming ALA-rich walnuts failed to improve n-3 index in elders. A direct source of EPA/DHA may be needed to achieve desirable n-3 index, as it is inversely associated with cardiometabolic risk. Nevertheless, incorporating walnuts as part of heart healthy diets is still encouraged.
Extreme-high-speed communication exceeding 100 Gbps is one requirement for 6G. To satisfy extreme-high-speed-communication, one solution is to utilize terahertz bands above 100 GHz. To determine the new radio-interface technologies and service frequency bands for 6G, terahertz propagation characteristics above 100 GHz need to be understood. In this paper, we introduce our new radio-network topology for 6G and then show the frequency dependency of key propagation phenomena such as the characteristics of path loss in an urban environment, human blockage, and scattering from a rough building surface up to 150 GHz. Human blockage loss increases and the scattering is more diffused as the frequency increases. In the path-loss characteristics, it was found that path-loss frequency dependency is stronger than that given by conventional path-loss model because of scattering effects from a rough building surface.
Meal timing is a key factor in synchronising the circadian clock in peripheral tissues. Circadian disorders are associated with the metabolic syndrome. Previously, we demonstrated that a skipping breakfast regimen (SBR) with a high-fat diet increased body weight gain in rats. In this study, we investigated whether SBR with a normal diet led to abnormal lipid metabolism and muscle metabolism in mice. Male C57BL/6 mice were fed during zeitgeber time (ZT) 12–24 in the control group and ZT 16–24 in the SBR group for 2 weeks. SBR mice showed increased body weight gain and perirenal adipose tissue weight. The plantar muscle weight was decreased in the SBR group compared with that in the control group. Furthermore, SBR delayed the circadian oscillations in clock gene expression in peripheral tissues, such as the liver, adipose tissue and muscle, as well as the oscillations in the expression of lipid metabolism-related genes in the liver and adipose tissue. These results suggest that skipping breakfast over a long period of time is associated with a risk of obesity, the metabolic syndrome and muscle loss, such as sarcopenia.
Eggs contain important compounds related to enhanced cognition, but it is not clear if egg consumption, as a whole, has a direct impact on memory decline in older adults. This study aimed to determine whether egg intake levels predict the rate of memory decline in healthy older adults after sociodemographic and dietary controls. We conducted a secondary analysis of data from 470 participants, age 50 and over, from the Biospsychosocial Religion and Health Study. Participants completed a food frequency questionnaire, which was used to calculate egg intake and divide participants into Low (<23 g/week, about half an egg), Intermediate (24–63 g/week, half to 1½ eggs) and High (≥63 g/week, about two or more eggs) tertiles. Participants were administered the California Verbal Learning Test – 2nd Edition (CVLT-II) Short Form in 2006–2007, and 294 of them were again tested in 2010–2011. Using linear mixed model analysis, no significant cross-sectional differences were observed in CVLT-II performance between egg intake levels after controlling for age, sex, race, education, body mass index, cardiovascular risk, depression and intake of meat, fish, dairy and fruits/vegetables. Longitudinally, the Intermediate egg group exhibited significantly slower rates of decline on the CVLT-II compared to the Low egg group. The High egg group also exhibited slower rates of decline, but not statistically significant. Thus, limited consumption of eggs (about 1 egg/week) was associated with slower memory decline in late life compared to consuming little to no eggs, but a dose-response effect was not clearly evident. This study may help explain discrepancies in previous research that did not control for other dietary intakes and risk factors.
The aim of the study was to investigate the effect of prebiotic fibres on appetite-regulating hormones, subjective feeling of appetite and energy intake in subjects with type 2 diabetes. Data presented are secondary outcomes of a study investigating the effect of prebiotics on glucagon-like peptide-1 and glycaemic regulation. We conducted a randomised and placebo-controlled crossover trial to evaluate the effects of 16 g/d of inulin-type fructans or a control supplement (maltodextrin) for 6 weeks in randomised order, with a 4-week washout period in-between, on appetite in thirty-five men and women with type 2 diabetes. Data were collected at visits before and after each treatment: plasma concentration of the satiety-related peptides ghrelin and peptide YY (PYY) were assessed during a standardised mixed meal. The subjective sensation of appetite was evaluated in response to an ad libitum lunch by rating the visual analogue scale. Twenty-nine individuals (twelve women) were included in the analyses. Compared to control treatment, the prebiotics did not affect ghrelin (P =0⋅71) or the ratings of hunger (P = 0⋅62), satiety (P = 0⋅56), fullness (P = 0⋅73) or prospective food consumption (P = 0⋅98). Energy intake also did not differ between the treatments. However, the response of PYY increased significantly after the control treatment with mean (sem) 11⋅1 (4⋅3) pg/ml when compared to the prebiotics −0⋅3 (4⋅3) pg/ml (P = 0⋅013). We observed no effect of inulin-type fructans on appetite hormones, subjective feeling of appetite or energy intake in patients with type 2 diabetes.