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Faced with rising levels of cross-border migration, many countries have extended local voting rights to non-citizen residents. However, empirical evidence indicates that voter turnout among non-naturalized immigrants is lower when compared to citizens. This raises the question of how to explain this difference. A common answer is that the low turnout rates of non-citizen residents are primarily due to the socio-economic composition of this group and the challenges involved in adapting to a new political system. An alternative but less discussed possibility is that the low turnout concerns the nature of the elections. Hence, we examine whether the turnout of non-citizens is hampered because they are only allowed to partake in local elections. Based on a regression discontinuity design (RDD) using Swedish administrative data, we find that turnout could increase by 10–20 percentage points if the voting rights of non-citizens were extended to the national level.
An online training package providing a concise synthesis of the scientific data underpinning EU legislation on enrichment and tail-docking of pigs was produced in seven languages, with the aim of improving consistency of professional judgements regarding legislation compliance on farms. In total, 158 participants who were official inspectors, certification scheme assessors and advisors from 16 EU countries completed an initial test and an online training package. Control group participants completed a second identical test before, and Training group participants after, viewing the training. In Section 1 of the test participants rated the importance of modifying environmental enrichment defined in nine scenarios from 1 (not important) to 10 (very important). Training significantly increased participants’ overall perception of the need for change. Participants then rated nine risk factors for tail-biting from 1 (no risk) to 10 (high risk). After training scores were better correlated with risk rankings already described by scientists. Scenarios relating to tail-docking and management were then described. Training significantly increased the proportion of respondents correctly identifying that a farm without tail lesions should stop tail-docking. Finally, participants rated the importance of modifying enrichment in three further scenarios. Training increased ratings in all three. The pattern of results indicated that participants’ roles influenced scores but overall the training improved: i) recognition of enrichments that, by virtue of their type or use by pigs, may be insufficient to achieve legislation compliance; ii) knowledge on risk factors for tail-biting; and iii) recognition of when routine tail-docking was occurring.
Necrotising otitis externa is a severe ear infection for which there are no established diagnostic or treatment guidelines.
Method
This study described clinical characteristics, management and outcomes for patients managed as necrotising otitis externa cases at a UK tertiary referral centre.
Results
A total of 58 (63 per cent) patients were classified as definite necrotising otitis externa cases, 31 (34 per cent) as probable cases and 3 (3 per cent) as possible cases. Median duration of intravenous and oral antimicrobial therapy was 6.0 weeks (0.49–44.9 weeks). Six per cent of patients relapsed a median of 16.4 weeks (interquartile range, 23–121) after stopping antimicrobials. Twenty-eight per cent of cases had complex disease. These patients were older (p = 0.042), had a longer duration of symptoms prior to imaging (p < 0.0001) and higher C-reactive protein at diagnosis (p = 0.005). Despite longer courses of intravenous antimicrobials (23 vs 14 days; p = 0.032), complex cases were more likely to relapse (p = 0.016).
Conclusion
A standardised case-definition of necrotising otitis externa is needed to optimise diagnosis, management and research.
How does an increased presence of immigrants in the workplace affect anti-immigration voting behavior? While cooperative interactions between natives and immigrants can reduce intergroup prejudice, immigrant coworkers might be regarded as a threat to native-born workers’ labor market position. We combine detailed Swedish workplace data with precinct-level election outcomes for a large anti-immigration party (the Sweden Democrats) to study how the share of non-Europeans in the workplace affects opposition to immigration. We show that the share of non-Europeans in the workplace has a negative effect on support for the Sweden Democrats and that this effect is solely driven by same-skill contact in small workplaces. We interpret these results as supporting the so-called contact hypothesis: that increased interactions with minorities can reduce opposition to immigration among native-born voters, which, in turn, leads to lower support for anti-immigration parties.
The area of regenerative work is still close to unexplored. The aim was to explore the possibility for employees to gain energy at work.
Methods:
Questionnaire to all employees (n = 599) from different professions in public and private primary health care centers in one health care district in Sweden. The questionnaire, which had a salutogenic perspective, included information on self-rated health, psychosocial work environment and experiences, recovery, social climate, and energy. Having an energy-building experience was defined by a positive response to two combined questions regarding energy at work. Analyses were performed with bivariate correlation and multiple logistic regression.
Results:
The response rate was 84%. Health and energy correlated positively (r = 0.54). In total, 44.5% of the employees reported having an energy-building experience. Predictors for having an energy-building experience were recovery [positive odds ratio (POR) = 2.78], autonomy (POR = 2.26), positive workplace characteristics (POR = 2.09), and internal work experiences (POR = 1.88).
Conclusions:
The results support the hypothesis that it is possible to gain energy at work, an area that is still close to unexplored. There is a high correlation between energy and health. Employees’ energy-building experiences relate to well-being at work and correlates to recovery, autonomy, positive workplace characteristics, and positive internal work experiences. This knowledge can help in improving future work environment development.
Blood was drawn from 18 inpatients fullfilling the DSMIII criteria for schizophrenia and their 15 age- and sex-matched clinically infection-free controls before and after neuroleptic treatment. Blood films were stained with MGG solution, mixed, and subsequently read in random order by one observer. The lymphocytes were examined by light microscopy and classified into six types: normal lymphocytes, Downey type I atypical lymphocytes, Downey type III atypical lymphocytes, stress lymphocytes, plasmocytoid lymphocytes, and large granular lymphocytes. Downey type I and III atypical lymphocytes were classified into small, medium, and large lymphocytes. Schizophrenic patients had significantly more Downey type III medium size cells before treatment (p = 0.019 before treatment and p = 0.056 after treatment) and less Downey type I small size cells (p = 0.113 before treatment and p = 0.026 after treatment). Our study supports the idea of a possible subgroup of schizophrenia exhibiting immunological aberrations. In the present study, we found morphologically more specified cells which could be involved in this alteration.
Atopic disorders, including asthma, dermatitis and rhinoconjunctivitis are the most common chronic diseases of childhood. Numerous studies have investigated the relationship between immune dysregulation and prenatal factors, including psychological stress. The association between prenatal maternal stress and atopy, however, has never been systematically reviewed.
Aims
To systematically review all observational studies on the association between prenatal maternal stress and atopic disorders or predisposition in childhood.
Objectives
To identify all observational studies in humans that compared the prevalence of one or more atopic disorders or predispositions in children of exposed and unexposed mothers. To critically evaluate the quality and validity of the published literature.
Methods
PubMed, EMBASE, PSYCInfo and Scopus databases were searched and relevant studies were identified and assessed accordingly to the PRISMA-criteria.
Results
Fifteen studies met the inclusion criteria, many of which examined the association between prenatal stress and multiple disorders. Preliminary results suggest that children of mothers who experienced stress during pregnancy have a higher risk of developing asthma, dermatitis and rhinoconjunctivitis than children of unexposed mothers.
Conclusion
The impact of psychological stress on immune function appears consistent regardless of stress-definition. The varying stress- and outcomes measures make it difficult to compare results from the studies. Future research should focus on whether certain disorders are more susceptible than others, as well as if certain stressor-types or times during pregnancy are more critical.
Elevation of prolactin level is a known adverse effect of antipsychotics. Long-standing hyperprolactinaemia may inhibit reproductive function by impairing gonadal steroidogenesis and is associated with a number of adverse effects such as galactorrhoea, amenorrhoea, gynecomastia, impotence and decreased bone mineral density. Lurasidone is a recently approved atypical antipsychotic agent for the treatment of schizophrenia.
Aims/Objectives
To compare the incidence of treatment-emergent adverse events (TEAEs) related to hyperprolactinaemia in patients treated with lurasidone or active comparators.
Methods
Pooled data from two 52-week studies that evaluated the long-term safety and efficacy of lurasidone compared with quetiapine XR or risperidone in patients with schizophrenia were reviewed post-hoc for prolactin levels and TEAEs considered to be related to hyperprolactinaemia.
Results
Prolactin levels decreased marginally in the lurasidone group (median -8.00 pmol/L, N=624) and quetiapine XR group (median -17.39 pmol/L, N=85), and increased in the risperidone group (median 385.00 pmol/L, N=199) (LOCF). The incidence of markedly abnormally high prolactin values (≥5× upper limit of normal) was 2.0%, 1.4% and 4.0% in the three groups, respectively. The hyperprolactinaemia-related TEAEs breast mass, gynecomastia, breast enlargement, breast tenderness, hypogonadism, infertility, pituitary tumors and mammary gland tumors were absent from all groups. Low rates (≤2.5%) of galactorrhoea, amenorrhoea and erectile dysfunction were seen in the lurasidone and risperidone groups, while no TEAEs were recorded in the quetiapine XR group.
Conclusions
This post-hoc review shows that long-term treatment with lurasidone was not associated with a clinically significant increase in prolactin levels and the incidence of associated TEAEs was low.
Antipsychotic-induced hyperprolactinaemia is associated with sexual dysfunction.1 In pivotal schizophrenia studies, lurasidone was associated with limited elevation of prolactin.2 This post-hoc analysis substantiates the clinical relevance by evaluating the incidence of treatment-emergent adverse events related to sexual dysfunction (SD-TEAEs) in patients with schizophrenia treated with lurasidone compared with active controls or placebo.
Methods
22 clinical studies were stratified into short-term, long-term and all Phase 2/3 lurasidone study pools. SD-TEAEs were defined as any adverse events related to sexual dysfunction starting on/after the first dose date and within 7 days of treatment discontinuation.
Results
All reported SD-TEAEs were mild or moderate in severity.
The incidence of SD-TEAEs with lurasidone treatment was comparable to placebo in short-term studies and lower than for risperidone in both short-term and long-term trials. Future studies utilising formal sexual functioning rating scales on a prospective basis should be considered to further examine this issue.
The complex wake behind two side-by-side flat plates placed normal to the inflow direction has been explored in a direct numerical simulation study. Two gaps, $g=0.5d$ and $1.0d$, were considered, both at a Reynolds number of 1000 based on the plate width $d$ and the inflow velocity. For gap ratio $g/d=0.5$, the biased gap flow resulted in an asymmetric flow configuration consisting of a narrow wake with strong vortex shedding and a wide wake with no periodic near-wake shedding. Shear-layer transition vortices were observed in the wide wake, with characteristic frequency 0.6. For $g/d=1.0$, two simulations were performed, started from a symmetric and an asymmetric initial flow field. A symmetric configuration of Kármán vortices resulted from the first simulation. Surprisingly, however, two different three-dimensional instability features were observed simultaneously along the span of the upper and lower plates. The spanwise wavelengths of these secondary streamwise vortices, formed in the braid regions of the primary Kármán vortices, were approximately $1d$ and $2d$, respectively. The wake bursts into turbulence some $5d$–$10d$ downstream. The second simulation resulted in an asymmetric wake configuration similar to the asymmetric wake found for the narrow gap $0.5d$, with the appearance of shear-layer instabilities in the wide wake. The analogy between a plane mixing layer and the separated shear layer in the wide wake was examined. The shear-layer frequencies obtained were in close agreement with the frequency of the most amplified wave based on linear stability analysis of a plane mixing layer.
As the IAU heads towards its second century, many changes have simultaneously transformed Astronomy and the human condition world-wide. Amid the amazing recent discoveries of exoplanets, primeval galaxies, and gravitational radiation, the human condition on Earth has become blazingly interconnected, yet beset with ever-increasing problems of over-population, pollution, and never-ending wars. Fossil-fueled global climate change has begun to yield perilous consequences. And the displacement of people from war-torn nations has reached levels not seen since World War II.
Despite the high-grade diagenesis experienced by the Skoorsteenberg Formation mudstones, Tanqua Karoo basin, South Africa, geochemical data have been interpreted to reveal primary mineralogy and so help understand provenance evolution. The geochemical signatures show systematic variations related to stratigraphy. The main changes in mudstones from the lower to the upper part of the section include: (1) an increase in the feldspar content of the primary sediment and a decrease in the content of Al-rich clay (probably dioctahedral smectite); (2) a decrease in the degree of chemical weathering of the sediment, representing a change to a dryer and/or cooler climate; (3) an increase in TiO2/Al2O3 representing increasing mafic sources; (4) an increase in CaO/(K2O+CaO) also possibly representing increasing mafic sources. Mass flux and differential diagenesis are unlikely to be responsible for the depth-related changes since the rocks have undergone the same degree of high-grade diagenesis and the mudstones are interrupted by other lithologies, so disturbing any sort of diffusion gradient. These variations could plausibly be the result of one or more of differential weathering, evolving provenance characteristics or variable hydrodynamic fractionation of the sediment. The ratio of Zr/Y, a possible indicator of hydrodynamic fractionation, increases only slightly and irregularly up-section. There is no relationship between the silica content, representative of the quartz-silt content of the sediment, and TiO2/Al2O3 showing that the amount of quartz, and so the degree of hydrodynamic fractionation, has not controlled mudstone geochemistry. The stratigraphic increase in feldspar content, the decrease in Al-rich clay content and increase of both TiO2/Al2O3 and CaO/(K2O+CaO) must be due to a combination of marginally evolving provenance characteristics (more mafic and felsic rocks exposed to weathering with time) and changes in the degree of rock weathering (less chemical weathering with time).
Little is known about potential harmful effects as a consequence of self-guided internet-based cognitive behaviour therapy (iCBT), such as symptom deterioration rates. Thus, safety concerns remain and hamper the implementation of self-guided iCBT into clinical practice. We aimed to conduct an individual participant data (IPD) meta-analysis to determine the prevalence of clinically significant deterioration (symptom worsening) in adults with depressive symptoms who received self-guided iCBT compared with control conditions. Several socio-demographic, clinical and study-level variables were tested as potential moderators of deterioration.
Methods
Randomised controlled trials that reported results of self-guided iCBT compared with control conditions in adults with symptoms of depression were selected. Mixed effects models with participants nested within studies were used to examine possible clinically significant deterioration rates.
Results
Thirteen out of 16 eligible trials were included in the present IPD meta-analysis. Of the 3805 participants analysed, 7.2% showed clinically significant deterioration (5.8% and 9.1% of participants in the intervention and control groups, respectively). Participants in self-guided iCBT were less likely to deteriorate (OR 0.62, p < 0.001) compared with control conditions. None of the examined participant- and study-level moderators were significantly associated with deterioration rates.
Conclusions
Self-guided iCBT has a lower rate of negative outcomes on symptoms than control conditions and could be a first step treatment approach for adult depression as well as an alternative to watchful waiting in general practice.
Controlled traffic farming (CTF) systems aim to reduce soil compaction by restricting machinery field traffic to permanent traffic lanes. Grass-clover silage production is generally associated with intensive field traffic, resulting in reduced silage clover content. If CTF can increase yield and clover content in grass-clover leys, this would reduce the need for grain and expensive protein concentrate in dairy cow feed rations. A mixed integer programming model was developed to evaluate the potential profitability of CTF in a dairy farm context. Existing field trial data were used to calculate the expected yield outcome of CTF, based on reductions in trafficked area. The results revealed that CTF increased profitability by up to €50/ha. Total machinery costs are likely to increase on converting to CTF, but variable machinery costs are likely to decrease.
We reanalyzed data from a previously published randomized component study that aimed to test the incremental effect of systematic exposure in an internet-delivered cognitive behavioral treatment (ICBT) for irritable bowel syndrome (IBS).
Methods
Three hundred and nine individuals with IBS were randomly assigned to either the full treatment protocol (experimental condition) or the same treatment protocol without systematic exposure (control). Participants were assessed weekly for IBS symptoms over the active treatment phase. We used a complier average causal effect (CACE) analysis, in the growth mixture modeling framework, to (1) examine the specific effect of exposure among those who received the intervention (i.e. compliers), and (2) explore the associations of pre-treatment patient characteristics with compliance status and outcome changes.
Results
Fifty-five per cent of those assigned to the experimental condition were classified as compliers. The CACE analysis that took into account compliance status demonstrated that the magnitude of the incremental effect of systematic exposure on IBS symptoms was larger than the effect observed in an intention-to-treat analysis that ignored compliance status (d = 0.81 v. d = 0.44). Patients with university education showed more improvement during the exposure phase of the treatment. Pre-treatment patient characteristics did not predict compliance status.
Conclusions
The effect of systematic exposure on IBS symptoms is of substantial magnitude among those individuals who actually receive the intervention (CACE). Studying the subsample of individuals who discontinue treatment prematurely and tailoring interventions to improve compliance may increase overall improvement rates in ICBT for IBS.
In this work, we study the class of mostly expanding partially hyperbolic diffeomorphisms. We prove that such a class is $C^{r}$-open, $r>1$, among the partially hyperbolic diffeomorphisms and we prove that the mostly expanding condition guarantees the existence of physical measures and provides more information about the statistics of the system. Mañé’s classical derived-from-Anosov diffeomorphism on $\mathbb{T}^{3}$ belongs to this set.
Almost nothing is known about the potential negative effects of Internet-based psychological treatments for depression. This study aims at investigating deterioration and its moderators within randomized trials on Internet-based guided self-help for adult depression, using an individual patient data meta-analyses (IPDMA) approach.
Method
Studies were identified through systematic searches (PubMed, PsycINFO, EMBASE, Cochrane Library). Deterioration in participants was defined as a significant symptom increase according to the reliable change index (i.e. 7.68 points in the CES-D; 7.63 points in the BDI). Two-step IPDMA procedures, with a random-effects model were used to pool data.
Results
A total of 18 studies (21 comparisons, 2079 participants) contributed data to the analysis. The risk for a reliable deterioration from baseline to post-treatment was significantly lower in the intervention v. control conditions (3.36 v. 7.60; relative risk 0.47, 95% confidence interval 0.29–0.75). Education moderated effects on deterioration, with patients with low education displaying a higher risk for deterioration than patients with higher education. Deterioration rates for patients with low education did not differ statistically significantly between intervention and control groups. The benefit–risk ratio for patients with low education indicated that 9.38 patients achieve a treatment response for each patient experiencing a symptom deterioration.
Conclusions
Internet-based guided self-help is associated with a mean reduced risk for a symptom deterioration compared to controls. Treatment and symptom progress of patients with low education should be closely monitored, as some patients might face an increased risk for symptom deterioration. Future studies should examine predictors of deterioration in patients with low education.
Adaptation to the consequences of climate change has developed into a growing field of concern for the insurance business. However, climate-related risk is not entirely a new field in insurance. Historically, a large number of insurance organisational choices and strategies have been used to mitigate the financial impact of extreme events and uncertainties associated with climate change. Taking the case of forests in Sweden, this article reviews the ways in which climate-related risks such as storm/wind and fire risks have been assured. The study shows that climate-related risks have generally increased over time and that major hazard events have been decisive for strategy and organisation choices. Twentieth-century developments show that corporate insurance coverage increased due to higher levels of anticipated risk, while self-insurance and public insurance were reduced. However, in more recent times the expansion of corporate insurance has stagnated. Increased premiums and tighter terms following historically extreme weather events have led government and forest owners to assume more climate risks.
The incidence of childhood respiratory infections in Greenland is among the highest globally. We performed a population-based study of 352 Greenlandic children aged 0–6 years aiming to describe rates and risk factors for carriage of four key bacteria associated with respiratory infections, their antimicrobial susceptibility and inter-bacterial associations. Nasopharyngeal swabs were tested for Streptococcus pneumoniae grouped by serotypes included (VT) or not included (NVT) in the 13-valent pneumococcal conjugate vaccine, non-typable Haemophilus influenzae (NTHi), Staphylococcus aureus and Moraxella catarrhalis. S. pneumoniae was detected from age 2 weeks with a peak carriage rate of 60% in 2-year-olds. Young age and having siblings attending a daycare institution were associated with pneumococcal carriage. Overall co-colonization with ⩾2 of the studied bacteria was 52%. NTHi showed a positive association with NVT pneumococci and M. catarrhalis, respectively, M. catarrhalis was positively associated with S. pneumoniae, particular VT pneumococci, whereas S. aureus were negatively associated with NTHi and M. catarrhalis. Nasopharyngeal bacterial carriage was present unusually early in life and with frequent co-colonization. Domestic crowding increased odds of carriage. Due to important bacterial associations we suggest future surveillance of pneumococcal conjugate vaccine's impact on carriage in Greenland to also include other pathogens.