We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The 2007 adoption of the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) marked a critical juncture in the area of Indigenous rights. As a nonbinding agreement, its adoption is at the discretion of each state, resulting in significant state-level variation. Importantly, within-state variations remain underexplored. These differences are potentially significant in federal, decentralized countries such as Canada. This article examines why some provinces and territories lead in implementing the key principles embedded in UNDRIP, whereas others have dragged their feet. We collected 230 Canadian regulations introduced at the subnational level between 2007 and 2023, and assessed the impact of three key variables (i.e. political ideology, resource politics and issue voting). We found that none of these variables explained within-state variations on their own. To further explore the role of these variables, we subsequently compared two provinces at different stages of the UNDRIP implementation spectrum (Québec and British Columbia).
This study investigates screening practices for antimicrobial-resistant organisms (AROs) in seventy-five hospitals participating in the Canadian Nosocomial Infection Surveillance Program (CNISP). Screening practices varied with widespread MRSA screening, selective carbapenemase-producing organisms (CPO) screening, and limited vancomycin-resistant Enterococcus (VRE) screening. These findings may help interpret ARO rates within CNISP hospitals and inform screening practices.
Older adults with treatment-resistant depression (TRD) benefit more from treatment augmentation than switching. It is useful to identify moderators that influence these treatment strategies for personalised medicine.
Aims
Our objective was to test whether age, executive dysfunction, comorbid medical burden, comorbid anxiety or the number of previous adequate antidepressant trials could moderate the superiority of augmentation over switching. A significant moderator would influence the differential effect of augmentation versus switching on treatment outcomes.
Method
We performed a preplanned moderation analysis of data from the Optimizing Outcomes of Treatment-Resistant Depression in Older Adults (OPTIMUM) randomised controlled trial (N = 742). Participants were 60 years old or older with TRD. Participants were either (a) randomised to antidepressant augmentation with aripiprazole (2.5–15 mg), bupropion (150–450 mg) or lithium (target serum drug level 0.6 mmol/L) or (b) switched to bupropion (150–450 mg) or nortriptyline (target serum drug level 80–120 ng/mL). Treatment duration was 10 weeks. The two main outcomes of this analysis were (a) symptom improvement, defined as change in Montgomery–Asberg Depression Rating Scale (MADRS) scores from baseline to week 10 and (b) remission, defined as MADRS score of 10 or less at week 10.
Results
Of the 742 participants, 480 were randomised to augmentation and 262 to switching. The number of adequate previous antidepressant trials was a significant moderator of depression symptom improvement (b = −1.6, t = −2.1, P = 0.033, 95% CI [−3.0, −0.1], where b is the coefficient of the relationship (i.e. effect size), and t is the t-statistic for that coefficient associated with the P-value). The effect was similar across all augmentation strategies. No other putative moderators were significant.
Conclusions
Augmenting was superior to switching antidepressants only in older patients with fewer than three previous antidepressant trials. This suggests that other intervention strategies should be considered following three or more trials.
Antibiotics are essential to combating infections; however, misuse and overuse has contributed to antimicrobial resistance (AMR). Antimicrobial stewardship programs (ASPs) are a strategy to combat AMR and are mandatory in Canadian hospitals for accreditation. The Canadian Nosocomial Infection Surveillance Program (CNISP) sought to capture a snapshot of ASP practices within the network of Canadian acute care hospitals. Objectives of the survey were to describe the status, practices, and process indicators of ASPs across acute care hospitals participating in CNISP.
Design:
The survey explored the following items related to ASP programs: 1) program structure and leadership, 2) human, technical and financial resources allocated, 3) inventory of interventions carried and implemented, 4) tracking antimicrobial use; and 5) educational and promotional components.
Methods:
CNISP developed a 34-item survey in both English and French. The survey was administered to 109 participating CNISP hospitals from June to August 2024, responses were analyzed descriptively.
Results:
Ninety-seven percent (106/109) of CNISP hospitals responded to the survey. Eighty-four percent (89/106) reported having a formal ASP in place at the time of the study. Ninety percent (80/89) of acute care hospitals with an ASP performed prospective audit and feedback for antibiotic agents and 85% (76/89) had formal surveillance of quantitative antimicrobial use. Additionally, just over 80% (74/89) provided education to their prescribers and other healthcare staff.
Conclusions:
CNISP acute care hospitals employ multiple key aspects of ASP including implementing interventions and monitoring/tracking antimicrobial use. There were acute care hospitals without an ASP, highlighting areas for investigation and improvement.
It remains unclear which individuals with subthreshold depression benefit most from psychological intervention, and what long-term effects this has on symptom deterioration, response and remission.
Aims
To synthesise psychological intervention benefits in adults with subthreshold depression up to 2 years, and explore participant-level effect-modifiers.
Method
Randomised trials comparing psychological intervention with inactive control were identified via systematic search. Authors were contacted to obtain individual participant data (IPD), analysed using Bayesian one-stage meta-analysis. Treatment–covariate interactions were added to examine moderators. Hierarchical-additive models were used to explore treatment benefits conditional on baseline Patient Health Questionnaire 9 (PHQ-9) values.
Results
IPD of 10 671 individuals (50 studies) could be included. We found significant effects on depressive symptom severity up to 12 months (standardised mean-difference [s.m.d.] = −0.48 to −0.27). Effects could not be ascertained up to 24 months (s.m.d. = −0.18). Similar findings emerged for 50% symptom reduction (relative risk = 1.27–2.79), reliable improvement (relative risk = 1.38–3.17), deterioration (relative risk = 0.67–0.54) and close-to-symptom-free status (relative risk = 1.41–2.80). Among participant-level moderators, only initial depression and anxiety severity were highly credible (P > 0.99). Predicted treatment benefits decreased with lower symptom severity but remained minimally important even for very mild symptoms (s.m.d. = −0.33 for PHQ-9 = 5).
Conclusions
Psychological intervention reduces the symptom burden in individuals with subthreshold depression up to 1 year, and protects against symptom deterioration. Benefits up to 2 years are less certain. We find strong support for intervention in subthreshold depression, particularly with PHQ-9 scores ≥ 10. For very mild symptoms, scalable treatments could be an attractive option.
This is the first of a multi-part article on the South Korean massacres of 1950, the US direct and indirect involvement in those massacres, and the subsequent cover up of the events in South Korea and the United States.
2004 is the fiftieth anniversary of the Hydrogen Bomb test at Bikini that has rendered the island and nearby atolls uninhabitable ever since. Two earlier Japan Focus articles (http://japanfocus.org/094.html and http://japanfocus.org/097.html) portrayed the impact of the blast on the crew of the Japanese fishing boat Lucky Dragon, and the subsequent course of the anti-nuclear movement. The two articles presented here detail the consequences of atomic and hydrogen bomb testing on Bikini and neighboring atolls, including the consequences for displaced people, the continued failure of the U.S. government to clean up the radioactive islands, and the long stalled negotiations with the U.S. government to compensate the people of Bikini.
Six years after declaring the U.S. killing of Korean War refugees at No Gun Ri was “not deliberate,” the Army has acknowledged it found but did not divulge that a high-level document said the U.S. military had a policy of shooting approaching civilians in South Korea.
Seoul—Government investigators digging into the grim hidden history of mass political executions in South Korea have confirmed that dozens of children were among many thousands shot by their own government early in the Korean War.
The ubiquity of social media platforms allows individuals to easily share and curate their personal lives with friends, family, and the world. The selective nature of sharing one’s personal life may reinforce the memories and details of the shared experiences while simultaneously inducing the forgetting of related, unshared memories/experiences. This is a well-established psychological phenomenon known as retrieval-induced forgetting (RIF, Anderson et al.). To examine this phenomenon in the context of social media, two experiments were conducted using an adapted version of the RIF paradigm in which participants either shared experimenter-contrived (Study 1) or personal photographs (Study 2) on social media platforms. Study 1 revealed that participants had more accurate recall of the details surrounding the shared photographs as well as enhanced recognition of the shared photographs. Study 2 revealed that participants had more consistent recall of event details captured in the shared photographs than details captured or uncaptured in the unshared photographs. These results suggest that selectively sharing photographs on social media may specifically enhance the recollection of event details associated with the shared photographs. The novel and ecologically embedded methods provide fodder for future research to better understand the important role of social media in shaping how individuals remember their personal experiences.
Objectives/Goals: Lung transplant is a life-saving surgery for patients with advanced lung diseases yet long-term survival remains poor. The clinical features and lung injury patterns of lung transplant recipients who die early versus those who survive longer term remain undefined. Here, we use cell-free DNA and rejection parameters to help elucidate this further. Methods/Study Population: Lung transplant candidacy prioritizes patients who have a high mortality risk within 2 years and will likely survive beyond 5 years. We stratified patients who died within 2 years of transplant as early death (n = 50) and those who survived past 5 years as long-term survivors (n = 53). Lung transplant recipients had serial blood collected as part of two prospective cohort studies. Cell-free DNA (cfDNA) was quantified using relative (% donor-derived cfDNA {%ddcfDNA}) and absolute (nuclear-derived {n-cfDNA}, mitochondrial-derived {mt-cfDNA}) measurements. As part of routine posttransplant clinical care, all patients underwent pulmonary function testing (PFT), surveillance bronchoscopy with bronchoalveolar lavage (BAL), transbronchial biopsy (TBBx), and donor-specific antibody testing (DSA). Results/Anticipated Results: Over the first 2 years after transplant, the number of episodes of antibody-mediated rejection (p) Discussion/Significance of Impact: Clinically, early-death patients perform worse on routine surveillance PFTs and experience a worse degree of CLAD. These patients also have higher levels of cfDNA as quantified by n-cfDNA and mt-cfDNA. These results provide preliminary evidence that early-death patients have worse allograft rejection, dysfunction, and molecular injury.
Why do we give to distant sufferers in need? Are we motivated primarily by altruism or opportunism? What, if anything, do givers expect in return for significant acts of generosity? This article explores these questions through an examination of corporate giving to Japan from America's industrial heartland following the Great Kantō Earthquake. Large corporate donations comprised a significant part of America's “tsunami of aid” to Japan in 1923. Why? What did corporate givers hope to accomplish or achieve? Recognition of Japan as an important commercial partner and expectations of expanded trade, my findings suggest, significantly influenced donations from key corporate actors.
This research builds on the work of D.K. Gode and Shyam Sunder who demonstrated the existence of a strong relationship between market institutions and the ability of markets to seek equilibrium—even when the agents themselves have limited intelligence and behave with substantial randomness. The question posed is whether or not market institutions account for the operation of the law of supply and demand in markets populated by humans with no role required of human rationality. Are institutions responsible for the operations of the law of supply and demand or are behavioral principles also at work? Experiments with humans and simulations with robots both conducted in conditions in which major institutional and structural aids to convergence were removed, produced clear answers. Human markets converge, while robot markets do not. The structural and institutional features certainly facilitate convergence under conditions of substantial irrationality, but they are not necessary for convergence in markets in which agents have the rationality of humans.
In this paper we propose and test a contracting mechanism, Multi-Contract Cost Sharing (MCCS), for use in the management of a sequence of projects. The mechanism is intended for situations where (1) the contractor knows more about the true costs of various projects than does the contracting agency (adverse selection), and (2) unobservable effort on the part of the contractor may lead to cost reductions (moral hazard). The proposed process is evaluated in an experimental environment that includes the essential economic features of the NASA process for the acquisition of Space Science Strategic missions. The environment is complex and the optimal mechanism is unknown. The design of the MCCS mechanism is based on the optimal contract for a simpler related environment. We compare the performance of the proposed process to theoretical benchmarks and to an implementation of the current NASA ‘cost cap’ procurement process. The data indicate that the proposed MCCS process generates significantly higher value per dollar spent than using cost caps, because it allocates resources more efficiently among projects and provides greater incentives to engage in cost-reducing innovations.
On the 70th anniversary of the division of the Korean peninsula, the Korea Policy Institute, in collaboration with The Asia-Pacific Journal, is pleased to publish a special series, “The 70th Anniversary of the U.S. Division of the Korean Peninsula: A People's History.” Multi-sited in geographic range, this series calls attention to the far-reaching repercussions and ongoing legacies of the fateful 1945 American decision, in the immediate wake of U.S. atomic bombings of Japan and with no Korean consultation, to divide Korea in two. Through scholarly essays, policy articles, interviews, journalistic investigation, survivor testimony, and creative performance, this series explores the human costs and ground-level realities of the division of Korea. In Part 1 of the series Hyun Lee interviews Shin Eun-mi on The Erosion of Democracy in South Korea.
We present four cases of male genital schistosomiasis (MGS) within children and adolescents opportunistically encountered as part of a wider screening programme for imported schistosomiasis in Germany and community outreach screening in Mali. Such genital manifestations in young children and adolescents are often overlooked but can include hydrocele, hypogonadism, varicocele, cutaneous granulomata on the penis and scrotum, echogenic spots in the prostate and the epididymis, alongside testicular masses. Though these cases appear sporadic, from our scoping literature review, they draw fresh attention on MGS in young children and highlight wider confusion with other congenital, neoplastic and infectious disease. These might include an insufficient closure of the tunica vaginalis, malignancies or lymphatic filariasis. Frequently haematuria is not present. One typical sign indicating MGS in adults, i.e. haematospermia is not present before puberty. Another reason of missing MGS cases may be that screening with scrotal or transabdominal ultrasonography are not easily accepted unless the reason for it is not extensively explained beforehand and that transabdominal ultrasonography is less sensitive for revealing prostatic lesions than transrectal ultrasonography.
Sudden cardiac death poses a significant risk in patients with surgically repaired tetralogy of Fallot. Despite extensive research, risk stratification practices vary. This study surveyed the Pediatric and Adult Congenital Electrophysiology Society to identify these differences. Results showed diverse practices in indications, methods, and interpretation of electrophysiology studies, highlighting a need for standardised algorithms to improve patient outcomes.
North Carolina growers have long struggled to control Italian ryegrass, and recent research has confirmed that some Italian ryegrass biotypes have become resistant to nicosulfuron, glyphosate, clethodim, and paraquat. Integrating alternative management strategies is crucial to effectively control such biotypes. The objectives of this study were to evaluate Italian ryegrass control with cover crops and fall-applied residual herbicides and investigate cover crop injury from residual herbicides. This study was conducted during the fall/winter of 2021–22 in Salisbury, NC, and fall/winter of 2021–22 and 2022–23 in Clayton, NC. The study was designed as a 3 × 5 split-plot in which the main plot consisted of three cover crop treatments (no-cover, cereal rye at 80 kg ha−1, and crimson clover at 18 kg ha−1), and the subplots consisted of five residual herbicide treatments (S-metolachlor, flumioxazin, metribuzin, pyroxasulfone, and nontreated). In the 2021–22 season at Clayton, metribuzin injured cereal rye and crimson clover 65% and 55%, respectively. However, metribuzin injured both cover crops ≤6% in 2022–23. Flumioxazin resulted in unacceptable crimson clover injury of 50% and 38% in 2021–22 and 2022–23 in Clayton and 40% in Salisbury, respectively. Without preemergence herbicides, cereal rye controlled Italian ryegrass by 85% and 61% at 24 wk after planting in 2021–22 and 2022–23 in Clayton and 82% in Salisbury, respectively. In 2021–22, Italian ryegrass seed production was lowest in cereal rye plots at both locations, except when it was treated with metribuzin. For example, in Salisbury, cereal rye plus metribuzin resulted in 39,324 seeds m–2, compared to ≤4,386 seeds m–2 from all other cereal rye treatments. In 2022–23, Italian ryegrass seed production in cereal rye was lower when either metribuzin or pyroxasulfone were used preemergence (2,670 and 1,299 seeds m–2, respectively) compared with cereal rye that did not receive an herbicide treatment (5,600 seeds m–2). cereal rye (Secale cereale L.) and crimson clover (Trifolium incarnatum L.)