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Drawing upon findings from a qualitative project exploring welfare stigma in the lives of women in Merseyside, this article examines experiences of stigma and resistance strategies among the mothers interviewed. The article provides insights into how gendered stigma manifests in the lives of mothers reliant on social security benefits in the present era of continued welfare reform. The mothers’ experiences of stigma are argued to revolve around the devaluation of caring labour, the perception that benefits are undeserved and the notion of ‘bad motherhood’. Furthermore, the article contributes to knowledge about stigma resistance strategies, including acknowledging the value of care and rejecting blaming narratives. Nonetheless, it is argued that owing to the power and pervasiveness of structurally-imposed stigma, individualised resistance strategies are limited and mothers must also engage in everyday stigma management techniques.
To estimate population-based rates and to describe clinical characteristics of hospital-acquired (HA) influenza.
Design:
Cross-sectional study.
Setting:
US Influenza Hospitalization Surveillance Network (FluSurv-NET) during 2011–2012 through 2018–2019 seasons.
Methods:
Patients were identified through provider-initiated or facility-based testing. HA influenza was defined as a positive influenza test date and respiratory symptom onset >3 days after admission. Patients with positive test date >3 days after admission but missing respiratory symptom onset date were classified as possible HA influenza.
Results:
Among 94,158 influenza-associated hospitalizations, 353 (0.4%) had HA influenza. The overall adjusted rate of HA influenza was 0.4 per 100,000 persons. Among HA influenza cases, 50.7% were 65 years of age or older, and 52.0% of children and 95.7% of adults had underlying conditions; 44.9% overall had received influenza vaccine prior to hospitalization. Overall, 34.5% of HA cases received ICU care during hospitalization, 19.8% required mechanical ventilation, and 6.7% died. After including possible HA cases, prevalence among all influenza-associated hospitalizations increased to 1.3% and the adjusted rate increased to 1.5 per 100,000 persons.
Conclusions:
Over 8 seasons, rates of HA influenza were low but were likely underestimated because testing was not systematic. A high proportion of patients with HA influenza were unvaccinated and had severe outcomes. Annual influenza vaccination and implementation of robust hospital infection control measures may help to prevent HA influenza and its impacts on patient outcomes and the healthcare system.
Major depressive disorder (MDD) is a leading cause of disability worldwide.
Aims
To examine the: (a) 12-month prevalence of DSM-IV MDD; (b) proportion aware that they have a problem needing treatment and who want care; (c) proportion of the latter receiving treatment; and (d) proportion of such treatment meeting minimal standards.
Method
Representative community household surveys from 21 countries as part of the World Health Organization World Mental Health Surveys.
Results
Of 51 547 respondents, 4.6% met 12-month criteria for DSM-IV MDD and of these 56.7% reported needing treatment. Among those who recognised their need for treatment, most (71.1%) made at least one visit to a service provider. Among those who received treatment, only 41.0% received treatment that met minimal standards. This resulted in only 16.5% of all individuals with 12-month MDD receiving minimally adequate treatment.
Conclusions
Only a minority of participants with MDD received minimally adequate treatment: 1 in 5 people in high-income and 1 in 27 in low-/lower-middle-income countries. Scaling up care for MDD requires fundamental transformations in community education and outreach, supply of treatment and quality of services.
Fundamental mode classical Cepheids have light curves which repeat accurately enough that we can watch them evolve (change period). The new level of accuracy and quantity of data with the Kepler and MOST satellites probes this further. An intriguing result was found in the long time-series of Kepler data for V1154 Cyg the one classical Cepheid (fundamental mode, P = 4.9 d) in the field, which has short term changes in period (≃20 minutes), correlated for ≃10 cycles (period jitter). To follow this up, we obtained a month long series of observations of the fundamental mode Cepheid RT Aur and the first overtone pulsator SZ Tau. RT Aur shows the traditional strict repetition of the light curve, with the Fourier amplitude ratio R1/R2 remaining nearly constant. The light curve of SZ Tau, on the other hand, fluctuates in amplitude ratio at the level of approximately 50%. Furthermore prewhitening the RT Aur data with 10 frequencies reduces the Fourier spectrum to noise. For SZ Tau, considerable power is left after this prewhitening in a complicated variety of frequencies.
Classical Cepheids form one of the foundations of modern cosmology and the extragalactic distance scale; however, cosmic microwave background observations measure cosmological parameters and indirectly the Hubble Constant, H0, to unparalleled precision. The coming decade will provide opportunities to measure H0 to 2% uncertainty thanks to the Gaia satellite, JWST, ELTs and other telescopes using Cepheids and other standard candles. In this work, we discuss the upcoming role for variable stars and asteroseismology in calibrating the distance scale and measuring H0 and what problems exist in understanding these stars that will feed back on these measurements.
Despite the decline in coronary heart disease in many European countries, the disease remains an enormous public health problem. Although we know a great deal about environmental risk factors for coronary heart disease, a heritable component was recognized a long time ago. The earliest and best known examples of how our genetic constitution may determine cardiovascular risk relate to lipoprotein(a), familial hypercholesterolaemia and apolipoprotein E. In the past 20 years a fair number of polymorphisms assessed singly have shown strong associations with the disease but most are subject to poor repeatability. Twins constitute a compelling natural experiment to establish the genetic contribution to coronary heart disease and its risk factors. GenomEUtwin, a recently funded Framework 5 Programme of the European Community, affords the opportunity of comparing the heritability of risk factors in different European Twin Registries. As an illustration we present the heritabilities of systolic and diastolic blood pressure, based on data from over 4000 twin pairs from six different European countries and Australia. Heritabilities for systolic blood pressure are between 52 and 66% and for diastolic blood pressure between 44 and 66%. There is no evidence of sex differences in heritability estimates and very little to no evidence for a significant contribution of shared family environment. A non-twin based prospective case/cohort study of coronary heart disease and stroke (MORGAM) will allow hypotheses relating to cardiovascular disease, generated in the twin cohorts, to be tested prospectively in adult populations. Twin studies have also contributed to our understanding of the life course hypothesis, and GenomEUtwin has the potential to add to this.
Binary/multiple status can affect stars at all stages of their lifetimes: evolution onto the main sequence, properties on the main sequence, and subsequent evolution. 5 M⊙ stars have provided a wealth of information about the binary properties fairly massive stars. The combination of cool evolved primaries and hot secondaries in Cepheids (geriatric B stars) have yielded detailed information about the distribution of mass ratios. and have also provided a surprisingly high fraction of triple systems. Ground-based radial velocity orbits combined with satellite data from Hubble, FUSE, IUE, and Chandra are needed to provide full information about the systems, including the masses. As a recent example, X-ray observations can identify low mass companions which are young enough to be physical companions. Typically binary status and properties (separation, eccentricity, mass ratio) determine whether any stage of evolution takes an exotic form.
Objectives: This study describes the development of a framework for health technology decisions, for Ontario Health Technology Advisory Committee (OHTAC) in Ontario, Canada.
Methods: OHTAC convened a “Decision Determinants Sub-Committee” in January 2007, which undertook a systematic literature review and conducted key informant interviews to develop an explicit decision-making framework.
Results: The “Decision Determinants Sub-Committee” offered recommendations about decision criteria, and the process by which decisions are made. Decision criteria include (i) overall clinical benefit, (ii) consistency with societal and ethical values, (iii) value for money, and (iv) feasibility of adoption into the health system. The decision process should be transparent and fair and should use a deliberative process in delivering recommendations.
Conclusions: This methodology is currently being pilot tested in a live environment: OHTAC. It will be evaluated and revised according to its feasibility, acceptability, and perceived usefulness.
We seek to explain how states govern big cities. Political scientists' accounts of urban politics either fail to treat the state systematically or place state hostility at the center of such an account. Accounts by historians, by contrast, offer tools political scientists can use to theorize urban politics in the state arena. We use those tools, and we find that cities can manage the legislative process. This power starts with bill introduction and carries through to the vote on the floor. This ability results from a central feature of American state politics: on bills about big cities, state legislators now and in the past find their primary voting cues in the unity of local delegations. The city delegation, then, has tremendous power to manage the state's involvement in city affairs. In many respects, ours is an account of a special kind of divided government, with two institutional arenas where urban government is carried out.
We examine the development of legislative capacity in U.S. state legislatures in the twentieth century. This capacity can be derived from the legislators themselves, or from institutions and practices. We consider both sources as we provide an account of the ragged and piecemeal development of legislative capacity in the states. We argue that most state legislatures have been neither entirely professional nor amateur, but rather have existed somewhere in between, in a place where pockets of expertise fill in for professional capacity.
Polaris, the nearest and brightest classical Cepheid, is a member of at least a triple system. It has a wide (18″) physical companion, the F-type dwarf Polaris B. Polaris itself is a single-lined spectroscopic binary with an orbital period of ∼30 years (Kamper 1996). By combining Hipparcos measurements of the instantaneous proper motion with long-term measurements and the Kamper radial-velocity orbit, Wielen et al (2000) have predicted the astrometric orbit of the close companion. Using the Hubble Space Telescope and the Advanced Camera for Surveys' High-Resolution Channel with an ultraviolet (F220W) filter, we have now directly detected the close companion. Based on the Wielen et al orbit, the Hipparcos parallax, and our measurement of the separation (0″.176 ± 0″.002), we find a preliminary mass of 5.0 ± 1.5 M⊙ for the Cepheid and 1.38 ± 0.61 M⊙ for the close companion. These values will be refined by additional HST observations scheduled for the next 3 years.
We have also obtained a Chandra ACIS-I image of the Polaris field. Two distant companions C and D are not X-rays sources and hence are not young enough to be physical companions of the Cepheid. There is one additional stellar X-ray source in the field, located 253″ from Polaris A, which is a possible companion. Further investigation of such a distant companion is valuable to confirm the full extent of the system.
Like the goddess Demeter, Diotima from Mantineia, the prophetess who teaches Socrates about eros and the “rites of love” in Plato's Symposium, was a mystagogue who initiated individuals into her mysteries, mediating to humans esoteric knowledge of the divine. The dialogue, including Diotima's speech, contains religious and mystical language, some of which specifically evokes the female-centered yearly celebrations of Demeter at Eleusis. In this essay, I contextualize the worship of Demeter within the larger system of classical Athenian practices, and propose that Plato borrowed Eleusinian language because it criticized conventional notions of the divine, thereby allowing him to reimagine the possibilities for the philosophical process among humans.
Bulk ZnO grown by the hydrothermal technique was investigated using electron paramagnetic resonance (EPR), photoluminescence (PL), and infrared absorption (FTIR) techniques. Isolated subsitutional lithium is the dominant acceptor and could be detected using EPR or PL. A large concentration of neutral Li+-OH− centers were observed using FTIR data. EPR spectra assigned to Mn, Co, Ni, Fe, and Group III (Al, Ga) donors were also observed. Photoinduced changes in the charge states of the different deep and shallow centers were produced using 325 nm light, and the stability of these changes were monitored with EPR during pulsed thermal anneals. The charge-state changes for some defects were persistent and remained up to 300 K. These impurities, when present in device structures, may act as stable charge trapping sites.
S Mus is the Cepheid with the hottest known companion. As a benefit, the large ultraviolet flux made it the only Cepheid companion for which the velocity amplitude could be measured with the echelle mode of the HST GHRS. Unfortunately, the high temperature is difficult to constrain at wavelengths longer than 1200 Å because of the degeneracy between temperature and reddening. We have now obtained a FUSE spectrum in order to determine the temperature of the companion better. We have identified two regions which are temperature sensitive near 16 000 K, but are relatively unaffected by H2 absorption (940 Å, and the Ly β wings). By comparing S Mus B with other FUSE spectra, we have determined a temperature of 17 000 K. The resultant Cepheid mass is 6.0 ± 0.4 M⊙