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Increasing consumer demand for sustainably-sourced products has created a need to benchmark sustainability at the field level. To address this issue, some companies are offering incentives to producers, but are still lacking participation. This study estimated producers’ willingness to accept for participating in sustainability programs and implementing sustainable practices at the field level using a double-bounded dichotomous-choice framework. The results revealed preferences for longer contracts in length of time, industry as the verification party, supplemental benefits that yield an economic incentive, and a per-bale payment. This project will give new insights to the value and importance of documenting, verification, and traceability throughout the supply chain.
Evaluate impact of COVID-19 prevention training with video-based feedback on nursing home (NH) staff safety behaviors.
Design:
Public health intervention
Setting & Participants:
Twelve NHs in Orange County, California, 6/2020-4/2022
Methods:
NHs received direct-to-staff COVID-19 prevention training and weekly feedback reports with video montages about hand hygiene, mask-wearing, and mask/face-touching. One-hour periods of recorded streaming video from common areas (breakroom, hallway, nursing station, entryway) were sampled randomly across days of the week and nursing shifts for safe behavior. Multivariable models assessed the intervention impact.
Results:
Video auditing encompassed 182,803 staff opportunities for safe behavior. Hand hygiene errors improved from first (67.0%) to last (35.7%) months of the intervention, decreasing 7.6% per month (OR = 0.92, 95% CI = 0.92–0.93, P < 0.001); masking errors improved from first (10.3 %) to last (6.6%) months of the intervention, decreasing 2.3% per month (OR = 0.98, 95% CI = 0.97–0.99, P < 0.001); face/mask touching improved from first (30.0%) to last (10.6%) months of the intervention, decreasing 2.5% per month (OR = 0.98, 95% CI = 0.97–0.98, P < 0.001). Hand hygiene errors were most common in entryways and on weekends, with similar rates across shifts. Masking errors and face/mask touching errors were most common in breakrooms, with the latter occurring most commonly during the day (7A.M.–3P.M.) shift, with similar rates across weekdays/weekends. Error reductions were seen across camera locations, days of the week, and nursing shifts, suggesting a widespread benefit within participating NHs.
Conclusion:
Direct-to-staff training with video-based feedback was temporally associated with improved hand hygiene, masking, and face/mask-touching behaviors among NH staff during the COVID-19 pandemic.
In recent years, scholars worldwide have begun organising and developing a coherent framework and research agenda focused on the emerging field of ‘global administrative law’. This nascent body of law, unlike domestic or national forms of administrative law, does not operate within the bounds of unitary nation states, and unlike traditional accounts of public international law, it does not arise exclusively between nation states. Instead it operates in a transnational or global space occupied by a vast variety of administrative actors responsible for trans-governmental regulation and administration; the field of ‘global governance’. To combat growing concerns that there are crucial legitimacy, accountability and democratic deficiencies inherent in this system of global governance, numerous administrative law type mechanisms and principles have been developed by global administrative bodies. Global administrative law embodies the totality of these various mechanisms and principles.
Soldiers must be treated in the first instance with humanity but kept under control by means of iron discipline.
In the past fifty years the High Court of Australia has scrutinised the constitutional validity of military service tribunals on several occasions. Each time, the validity of service tribunals to conduct trials and impose punishment in relation to the particular offence has been upheld on the basis that it derives from a proper exercise by the legislature of its power under s 51(vi) of the Constitution. On no occasion has this been considered by the Court as a whole to involve a breach of the separation of powers doctrine. However, while it is generally accepted that service tribunals exercise what would ordinarily be seen as falling within the definition of “judicial power”, there has been no unifying and satisfactory explanation as to why this does not breach the separation of powers doctrine.
Recent theories have implicated inflammatory biology in the development of psychopathology and maladaptive behaviors in adolescence, including suicidal thoughts and behaviors (STB). Examining specific biological markers related to inflammation is thus warranted to better understand risk for STB in adolescents, for whom suicide is a leading cause of death.
Method:
Participants were 211 adolescent females (ages 9–14 years; Mage = 11.8 years, SD = 1.8 years) at increased risk for STB. This study examined the prospective association between basal levels of inflammatory gene expression (average of 15 proinflammatory mRNA transcripts) and subsequent risk for suicidal ideation and suicidal behavior over a 12-month follow-up period.
Results:
Controlling for past levels of STB, greater proinflammatory gene expression was associated with prospective risk for STB in these youth. Similar effects were observed for CD14 mRNA level, a marker of monocyte abundance within the blood sample. Sensitivity analyses controlling for other relevant covariates, including history of trauma, depressive symptoms, and STB prior to data collection, yielded similar patterns of results.
Conclusions:
Upregulated inflammatory signaling in the immune system is prospectively associated with STB among at-risk adolescent females, even after controlling for history of trauma, depressive symptoms, and STB prior to data collection. Additional research is needed to identify the sources of inflammatory up-regulation in adolescents (e.g., stress psychobiology, physiological development, microbial exposures) and strategies for mitigating such effects to reduce STB.
The purpose of this study is to analyze agricultural producers’ willingness to adopt regenerative cover crop practices in their operation and the effects of producer and farm characteristics on willingness to accept (WTA) values. The paper utilizes the double-bounded contingent valuation method to analyze survey responses submitted by producers and non-operating landowners in the Texas and Oklahoma portions of the Southern Great Plains. Results showed an average WTA of $26.38/acre for producers to adopt cover crops and that programs aimed at increasing adoption rates may require more substantial investment compared to those focused on continuity with current adopters.
The term ‘natural theology’ provokes a variety of reactions, spanning from whole-hearted endorsement to passionate rejection. Charged as it is with polemical and pejorative undertones, this debate begs for an intervention. If the scholarly community is to engage constructively with the concept and practice of natural theology – either by way of acceptance, rejection, or something in between – clarity in its definition and identification is imperative. The aim of this paper is to try to shed some light on three of the most common definitions of ‘natural theology’ in contemporary scholarship, to provide clarity about the ways in which they differ, and to propose some conceptual refinements in the hope that, if adopted, more fruitful discourse may take place in relation to this much-debated and interdisciplinary phrase.
The aim of this study is to estimate the minimum prevalence of intestinal parasites in the population of Roman London through analysis of pelvic sediment from 29 third- to fourth-century burials from the 1989 excavations of the western cemetery at 24–30 West Smithfield, 18–20 Cock Lane and 1–4 Giltspur Street (WES89). Microscopy was used to identify roundworm eggs in 10.3 per cent of burials. We integrate these results with past palaeoparasitological work in the province of Britannia to explore disease, hygiene and diet. The most commonly found parasites (whipworm and roundworm) were spread by poor sanitation, but other species caught from animals were also present (fish tapeworm, beef/pork tapeworm and liver flukes). Parasite diversity was highest in urban sites. The health impacts of these infections range from asymptomatic to severe.
This article examines shifts towards onshoring pharmaceutical manufacturing, a response to the vulnerabilities exposed by the COVID-19 pandemic in global supply chains. It delves into how globalization, public policy, and geopolitical tensions have shaped pharmaceutical markets, compelling nations to seek solutions that ensure reliable medicine access and reduce dependency on foreign supplies. The study highlights disparities in regulatory oversight and geographic concentration of production, which contribute to frequent shortages, particularly of generic medicines. The pandemic intensified these issues, prompting increased state interventions and heightening concerns over geopolitical risks. As a result, onshoring efforts, often encapsulated in local content measures, have expanded, and are now driven by both economic motives and imperatives of national security and public health.
In the absence of written records, disease and parasite loads are often used as indicators of sanitation in past populations. Here, the authors adopt the novel approach of integrating the bioarchaeological analysis of cesspits in an area of medieval Leiden (the Netherlands) with historical property records to explore living conditions. Using light microscopy and enzyme-linked immunosorbent assays (ELISA) they identify evidence of parasites associated with ineffective sanitation (whipworm, roundworm and the protozoan Giardia duodenalis)—at residences of all social levels—and the consumption of infected livestock and freshwater fish (Diphyllobothriidae, cf. Echinostoma sp., cf. Fasciola hepatica and Dicrocoelium sp.).
The question posed is how deep-time perspectives contribute to tackling contemporary One Health challenges, improving understanding and disease mitigation. Using evidence from the field of paleopathology, it is possible to explore this question and highlight key learning points from the past to focus the minds of those making healthcare policy decisions today. In previous centuries urbanization led to poorer health for a wide range of indicators, including life expectancy, sanitation and intestinal parasites, airway disorders such as maxillary sinusitis, metabolic diseases such as rickets, and even conditions resulting from clothing fashions such as bunions. Modern concerns regarding the quality of urban air and rivers show we have still to incorporate these lessons. When we consider major infectious diseases affecting past societies such as bubonic plague, tuberculosis and leprosy, interaction between humans and wild mammal reservoirs was key. Wild red squirrels in Britain today remain infected by the medieval strain of leprosy that affected people 1,500 years ago. It is clear that the One Health focus on the interaction between humans, animals and their environment is important. Eradicating zoonotic infectious diseases from humans but not these reservoirs leaves the door open to their spread back to people in the future.
Evaluation of adult antibiotic order sets (AOSs) on antibiotic stewardship metrics has been limited. The primary outcome was to evaluate the standardized antimicrobial administration ratio (SAAR). Secondary outcomes included antibiotic days of therapy (DOT) per 1,000 patient days (PD); selected antibiotic use; AOS utilization; Clostridioides difficile infection (CDI) cases; and clinicians’ perceptions of the AOS via a survey following the final study phase.
Design:
This 5-year, single-center, quasi-experimental study comprised 5 phases from 2017 to 2022 over 10-month periods between August 1 and May 31.
Setting:
The study was conducted in a 752-bed tertiary care, academic medical center.
Intervention:
Our institution implemented AOSs in the electronic medical record (EMR) for common infections among hospitalized adults.
Results:
For the primary outcome, a statistically significant decreases in SAAR were detected from phase 1 to phase 5 (1.0 vs 0.90; P < .001). A statistically significant decreases were detected in DOT per 1,000 PD (4,884 vs 3,939; P = .001), fluoroquinolone orders (407 vs 175; P < .001), carbapenem orders (147 vs 106; P = .024), and clindamycin orders (113 vs 73; P = .01). No statistically significant change in mean vancomycin orders was detected (991 vs 902; P = .221). A statistically significant decrease in CDI cases was also detected (7.8, vs 2.4; P = .002) but may have been attributable to changes in CDI case diagnosis. Clinicians indicated that the AOSs were easy to use overall and that they helped them select the appropriate antibiotics.
Conclusions:
Implementing AOS into the EMR was associated with a statistically significant reduction in SAAR, antibiotic DOT per 1,000 PD, selected antibiotic orders, and CDI cases.
Bentonites are readily available clays used in the livestock industry as feed additives to reduce aflatoxin (AF) exposure; their potential interaction with nutrients is the main concern limiting their use, however. The objective of the present study was to determine the safety of a dietary sodium-bentonite (Na-bentonite) supplement as a potential AF adsorbent, using juvenile Sprague Dawley (SD) rats as a research model. Animals were fed either a control diet or a diet containing Na-bentonite at 0.25% and 2% (w/w) inclusion rate. Growth, serum, and blood biochemical parameters, including selected serum vitamins (A and E) and elements such as calcium (Ca), potassium (K), iron (Fe), and zinc (Zn) were measured. The mineral characteristics and the aflatoxin B1 sorption capacity of Na-bentonite were also determined. By the end of the study, males gained more weight than females in control and Na-bentonite groups (p ≤ 0.0001); the interaction between treatment and sex was not significant (p = 0.6780), however. Some significant differences between the control group and bentonite treatments were observed in serum biochemistry and vitamin and minerals measurements; however, parameters fell within reference clinical values reported for SD rats and no evidence of dose-dependency was found. Serum Na and Na/K ratios were increased, while K levels were decreased in males and females from Na-bentonite groups. Serum Zn levels were decreased only in males from Na-bentonite treatments. Overall, results showed that inclusion of Na-bentonite at 0.25% and 2% did not cause any observable toxicity in a 3-month rodent study.
On several key issues we agree with the commentators. Perhaps most importantly, everyone seems to agree that psychology has an important role to play in building better models of human vision, and (most) everyone agrees (including us) that deep neural networks (DNNs) will play an important role in modelling human vision going forward. But there are also disagreements about what models are for, how DNN–human correspondences should be evaluated, the value of alternative modelling approaches, and impact of marketing hype in the literature. In our view, these latter issues are contributing to many unjustified claims regarding DNN–human correspondences in vision and other domains of cognition. We explore all these issues in this response.
Medieval hospitals were founded to provide charity, but poverty and infirmity were broad and socially determined categories and little is known about the residents of these institutions and the pathways that led them there. Combining skeletal, isotopic and genetic data, the authors weave a collective biography of individuals buried at the Hospital of St John the Evangelist, Cambridge. By starting with the physical remains, rather than historical expectations, they demonstrate the varied life courses of those who were ultimately buried in the hospital's cemetery, illustrating the diverse faces of medieval poverty and institutional notions of charity. The findings highlight the value of collective osteobiography when reconstructing the social landscapes of the past.
The cardiovascular adaptations associated with structured exercise training in Fontan patients remain unknown. We hypothesised that short-term training causes cardiac remodelling and parallel improvement in maximal exercise capacity (VO2 max) in these patients.
Methods and Results:
Five patients, median age 19.5 (17.6–21.3) years, with a history of Fontan operation meeting inclusion/exclusion criteria, participated in a 3-month training programme designed to improve endurance. Magnetic resonance images for assessment of cardiac function, fibrosis, cardiac output, and liver elastography to assess stiffness were obtained at baseline and after training. Maximal exercise capacity (VO2 max) and cardiac output Qc (effective pulmonary blood flow) at rest and during exercise were measured (C2H2 rebreathing) at the same interval. VO2 max increased from median (IQR) 27.2 (26–28.7) to 29.6 (28.5–32.2) ml/min/kg (p = 0.04). There was an improvement in cardiac output (Qc) during maximal exercise testing from median (IQR) 10.3 (10.1–12.3) to 12.3 (10.9–14.9) l/min, but this change was variable (p = 0.14). Improvement in VO2 max correlated with an increase in ventricular mass (r = 0.95, p = 0.01), and improvement in Quality-of-life inventory (PedsQL) Cardiac scale scores for patient-reported symptoms (r = 0.90, p = 0.03) and cognitive problems (r = 0.89, p = 0.04). The correlation between VO2 max and Qc showed a positive trend but was not significant (r = 0.8, p = 0.08). No adverse cardiac or liver adaptations were noted.
Conclusion:
Short-term training improved exercise capacity in this Fontan pilot without any adverse cardiac or liver adaptations. These results warrant further study in a larger population and over a longer duration of time.
The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery (WCPCCS) will be held in Washington DC, USA, from Saturday, 26 August, 2023 to Friday, 1 September, 2023, inclusive. The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery will be the largest and most comprehensive scientific meeting dedicated to paediatric and congenital cardiac care ever held. At the time of the writing of this manuscript, The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery has 5,037 registered attendees (and rising) from 117 countries, a truly diverse and international faculty of over 925 individuals from 89 countries, over 2,000 individual abstracts and poster presenters from 101 countries, and a Best Abstract Competition featuring 153 oral abstracts from 34 countries. For information about the Eighth World Congress of Pediatric Cardiology and Cardiac Surgery, please visit the following website: [www.WCPCCS2023.org]. The purpose of this manuscript is to review the activities related to global health and advocacy that will occur at the Eighth World Congress of Pediatric Cardiology and Cardiac Surgery.
Acknowledging the need for urgent change, we wanted to take the opportunity to bring a common voice to the global community and issue the Washington DC WCPCCS Call to Action on Addressing the Global Burden of Pediatric and Congenital Heart Diseases. A copy of this Washington DC WCPCCS Call to Action is provided in the Appendix of this manuscript. This Washington DC WCPCCS Call to Action is an initiative aimed at increasing awareness of the global burden, promoting the development of sustainable care systems, and improving access to high quality and equitable healthcare for children with heart disease as well as adults with congenital heart disease worldwide.
This work describes the mineralogy of dolomite carbonatite occurring at the Newania carbonatite complex, Rajasthan, north-western India. The mineralogy records the textural and compositional features of magmatic and post-magmatic stages of carbonatite evolution. Ferroan dolomite is the principal constituent and displays variable degrees of deformation, ranging from brittle-to-ductile deformation regimes. Apatite exhibits textural and compositional evolutionary trends from early-to-late stages of carbonatite evolution. Two varieties of amphibole are reported for the first time from this complex, ferri-winchite and cummingtonite; the former is magmatic and the latter is metamorphic in origin. The columbite–tantalite-series minerals are columbite-(Fe), and their paragenesis evolves from composite grains with pyrochlore to individual crystals. Pyrochlore is magmatic with U–Ta–Ti-rich compositions and shows evolution from calciopyrochlore to kenopyrochlore, followed by alteration during late-stages of carbonatite evolution. Monazite and baryte constitute the post-magmatic mineral assemblage; the former is hydrothermal and crystallised after precursor apatite, whereas the latter is associated exclusively with columbite–pyrochlore composites. On the basis of the mineralogy of the carbonatite, it is concluded that the parent magma was generated by low-degree partial melting of magnesite–phlogopite-bearing peridotite.
Socioeconomic disadvantage is a major correlate of low political participation. This association is among the most robust findings in political science. However, it is based largely on observational data. The causal effects of early-life disadvantage in particular are even less understood, because long-term data on the political consequences of randomized early-life anti-poverty interventions is nearly nonexistent. We leverage the Moving to Opportunity (MTO) experiment to test the long-term effect of moving out of disadvantaged neighborhoods—and thus out of deep poverty—on turnout. MTO is one of the most ambitious anti-poverty experiments ever implemented in the United States. Although MTO ameliorated children’s poverty long term, we find that, contrary to expectations, the intervention did not increase children’s likelihood of voting later in life. Additional tests show the program did not ameliorate their poverty enough to affect turnout. These findings speak to the complex relationship between neighborhood disadvantage and low political participation.
Standardized observation of bed baths and showers for 100 residents in 8 nursing homes revealed inadequate cleansing of body sites (88%–100% failure) and >90% process failure involving lather, firm massage, changing dirty wipes or cloths, and following clean-to-dirty sequence. Insufficient water warmth affected 86% of bathing opportunities. Bathing training and adequate resources are needed.