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.
Childhood obesity represents a significant global health concern and identifying its risk factors is crucial for developing intervention programs. Many “omics” factors associated with the risk of developing obesity have been identified, including genomic, microbiomic, and epigenomic factors. Here, using a sample of 48 infants, we investigated how the methylation profiles in cord blood and placenta at birth were associated with weight outcomes (specifically, conditional weight gain, body mass index, and weight-for-length ratio) at age six months. We characterized genome-wide DNA methylation profiles using the Illumina Infinium MethylationEpic chip, and incorporated information on child and maternal health, and various environmental factors into the analysis. We used regression analysis to identify genes with methylation profiles most predictive of infant weight outcomes, finding a total of 23 relevant genes in cord blood and 10 in placenta. Notably, in cord blood, the methylation profiles of three genes (PLIN4, UBE2F, and PPP1R16B) were associated with all three weight outcomes, which are also associated with weight outcomes in an independent cohort suggesting a strong relationship with weight trajectories in the first six months after birth. Additionally, we developed a Methylation Risk Score (MRS) that could be used to identify children most at risk for developing childhood obesity. While many of the genes identified by our analysis have been associated with weight-related traits (e.g., glucose metabolism, BMI, or hip-to-waist ratio) in previous genome-wide association and variant studies, our analysis implicated several others, whose involvement in the obesity phenotype should be evaluated in future functional investigations.
Flavonoids have shown anti-hypertensive and anti-atherosclerotic properties: the impact of habitual flavonoid intake on vascular function, central haemodynamics and arterial stiffness may be important. We investigated the relationship between habitual flavonoid consumption and measures of central blood pressure and arterial stiffness. We performed cross-sectional analysis of 381 non-smoking healthy older adults (mean age 66·0 (sd 4·1) years; BMI, 26·4 (sd 4·41) kg/m2; 41 % male) recruited as part of the Australian Research Council Longevity Intervention study. Flavonoid intake (i.e. flavonols, flavones, flavanones, anthocyanins, isoflavones, flavan-3-ol monomers, proanthocyanidins, theaflavins/thearubigins and total consumption) was estimated from FFQ using the US Department of Agriculture food composition databases. Measures of central haemodynamics and arterial stiffness included systolic blood pressure (cSBP), diastolic blood pressure (cDBP), mean arterial pressure (cMAP) and augmentation index (cAIx). After adjusting for demographic and lifestyle confounders, each sd/d higher intake of anthocyanins ((sd 44·3) mg/d) was associated with significantly lower cDBP (−1·56 mmHg, 95 % CI −2·65, −0·48) and cMAP (−1·62 mmHg, 95 % CI −2·82, −0·41). Similarly, each sd/d higher intake of flavanones ((sd 19·5) mg/d) was associated with ~1 % lower cAIx (−0·93 %, 95 % CI −1·77, −0·09). These associations remained significant after additional adjustment for (1) a dietary quality score and (2) other major nutrients that may affect blood pressure or arterial stiffness (i.e. Na, K, Ca, Mg, n-3, total protein and fibre). This study suggests a possible benefit of dietary anthocyanin and flavanone intake on central haemodynamics and arterial stiffness; these findings require corroboration in further research.
Every government engages in budgeting and public financial management to run the affairs of state. Effective budgeting empowers states to prioritize policies, allocate resources, and discipline bureaucracies, and it contributes to efficacious fiscal and macroeconomic policies. Budgeting can be transparent, participatory, and promote democratic decision-making, or it can be opaque, hierarchical, and encourage authoritarian rule. This book compares budgetary systems around the world by examining the economic, political, cultural, and institutional contexts in which they are formulated, adopted, and executed. The second edition has been updated with new data to offer a more expansive set of national case studies, with examples of budgeting in China, India, Indonesia, Iraq, and Nigeria. Chapters also discuss Brexit and the European Union's struggle to require balances budgets during the Euro Debt Crisis. Additionally, the authors provide a deeper analysis of developments in US budgetary policies from the Revolutionary War through the Trump presidency.
Appreciating how government budgeting systems and policies vary is best understood by comparing and analyzing the political cultural, historic, economic, and institutional contexts in which they are formulated, adopted, and executed. This book argues that even similar-appearing institutions and budgetary procedures may very well differ in practice due to the influence of a government’s political cultural and historical experiences.
The great budgetary transformation of central Eastern Europe and the former Soviet Union demonstrates the critical importance of economic context, political culture, history, and institutions in the recreation of public financial management systems. Since the collapse of the USSR, countries in this region have served as fiscal laboratories that experiment with budgetary reforms. This includes countries like Hungary and Poland that joined the European Union.
This chapter examines budgeting in the United States, its budgetary institutions, culture, and policies, from the founding of the republic in the 1700s through the Trump administration. The US Constitution is the world’s oldest functioning government document, and its budgetary rules reflect the country’s ongoing debate about fiscal federalism, and how the federal goverment should manage its fiscal and macroeconomic policies.
Merze Tate, a graduate of both Oxford and Harvard, was one of the few African-American women who secured a professorship at an American university in the 1940s. This chapter analyses Tate’s early intellectual formation in interwar Anglo-American academic internationalism, augmented by her global travels and her time teaching in the segregated south. At Howard University, she continued her analysis of American racism and imperialism and developed a distinctive ‘anti-racist geopolitics.’ She regarded herself first and foremost as a diplomatic historian, with a realist bent. This did not mean that Tate embraced a restrictive view on the public’s say in foreign policy formation, particularly when this public was African-American. But Tate insisted that to hold U.S. power to account, one had to understand what power was and how it was wielded internationally.
Latin America has stignificantly improved its budgetary effectiveness during the past thirty years, despite a widespread variation in political, demographic, and income levels. Bureaucratic authoritarian regimes have evolved into contribute to public finance stabilization. Significant problems remain in the financing of such basic services as education and health care. Expenditure control weakenesses remain at the managerial and operational levels of government.
Though geographically diverse, China, Indonesia, Nigeria, and Iraq share some interesting commonalities. All have been heavily influenced by external, primarily European, budgetary models and practices. After the 1949 Revolution, China turned to the Soviet Union for five-year planning and budgetary models and guidelines. Iraq, a former British colony also turned to the Soviet Union for guidance during the Cold War, and more recently its budgetary processes have been influenced by the American occupation. Like Iraq, Nigeria was a British colony, and Indonesia a former Dutch colony, and both these countries were influenced by their colonial histories.
The EU member states engage in budgeting through a set of supranational fiscal procedures outlined in EU treaties and supporting legislation. The EU itself is a suprnational government with its own budget and budgetary institutions, procedures, and programs. It enforces these macrobudgetary rules that significantly constrain the policy decisions of the individual member states.
This chapter examines the budgetary behavior of the former countries of the British Empire, now known as Commonwealth countries. Orginally created by the 1931 Statute of Westminister that recast the British Empire as a “Commonwealth of nations,” the modern Commonwealth consists of a fifty-four-country network of disparate people created in 1949. The chapter in particular examines the budgetary practices of the United Kingdom and India.
All governments have budgets. Budgeting is a core state function. Effective budgeting empowers the state to prioritize policies, allocate resources, and discipline the bureaucracy. Proficient budgeting contributes to efficient fiscal and macroeconomic policies. This book offers a comparative framework that identifies eight categores called cultural clusters that help identify the budgetary institutions and policies adopted by different governments.
Introduction: Most emergency departments (ED) in Canada have a population of high frequency users that present to the ED on a regular basis. These patients are well described in the literature and typically defined by a frequency of 8-10 visits/year. In Thunder Bay, Ontario we have a significant population of patients that present more often that we have termed “super-users”. These patients often are typically from a vulnerable population with multiple co-morbidities and a high mortality rate. Although their risk for poor health outcomes is well recognized, both the chronicity and complexity of their symptoms often contributes to diagnostic dilemmas. The decision to order a computed tomography (CT) scan can be a difficult balance between ruling out life threatening diagnoses and exposing the patient to excessive radiation. Our objective was to describe how often these super-users of the ED received a CT scan and what types of imaging were completed. Methods: The Thunder Bay Regional Health Sciences Centre is a geographically isolated hospital in Northwestern Ontario with the next closest hospital based CT scanner greater than 300 km away. Based on previous literature and our preliminary scoping of the super-user group, we have identified a minimum of 25 visits as the threshold. A retrospective chart review was conducted for the year 2017 using our electronic medical record. Patient demographic data was collected along with the type and number of CT scans into a standardized collection tool. Results: Our preliminary results showed that our total population of super-users was 75 patients with an average of 32 visits to the ED per year. A total of 76% of the patients had a CT scan completed at least once. On average these patients have a CT during 10% of their visits with head CT comprising 50% of the imaging and abdominal/pelvis imaging comprising another 45%. For 20% of these super-users, they had CTs on 20% of their visits. From this population, only 10% of the patients had surgery in 2017 while 7% of visits required admission to hospital. The most common diagnoses for these patient visits relate to mental health/addictions, gastrointestinal complaints and infection. Conclusion: This study has shown that a significant number of our super-user population are receiving multiple CTs. Our next step is collect data on individual radiation doses and calculate exposure risks. We hope to inform policy and decision-makers who are developing programs to treat the underlying cause of their high resource use.