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China and Vietnam have outlined new steps to resolve their long-running territorial disputes in the South China Sea in an effort to avert further conflict and put their relations on a steadier footing for the future. Although both countries are ruled by Communist parties and share extensive land and sea borders, they have had a tense relationship. But they now face political challenges at home as their export-oriented economies and investment slow under the impact of global financial turmoil and deepening recession. They have evidently decided to give primacy to strengthening bilateral party, trade and investment ties to offset the wider economic downturn.
The Mekong, one of the world's major rivers, starting in Tibet and flowing through south China, Burma, Thailand, Laos, Cambodia, and Vietnam, provides sustenance through irrigation and fishing to those living in its basin. But it also provides hydroelectric power through dams, three of which were built in China, with more planned. And it is precisely these dams that are now threatening the water supply, the livelihood of those living downstream, and the relations between China and its southern neighbors. A fourth Chinese dam, Xiaowan, that should generate 4,200 megawatts of power, could affect the level of fish stocks in Cambodia and water supply for Vietnam's rice fields. But China contends controlling the water flow will prevent the adverse effects of erosion caused by the Mekong's flooding cycle and will supply renewable energy. Winning the debate or coming to a workable compromise is further complicated by China's refusal to join the Mekong River Commission, an inter-government agency whose members include the four of the downstream countries. And though the global financial crisis has put on hold other dams being planned by the downstream countries, China is moving ahead with its plans.
There is a mental geography that may find its explorers, but never its cartographers.
Annie Le Brun
The nature of the relationship between surrealism and anthropology has been a focus of recent anthropological debate. This relation has not been considered at the level of methodology and the aim of this article is to consider surrealism in specific methodological relation with anthropology, particularly about how the idea of travel has been conceptualized.
Research has demonstrated that implementation of Nocebo Hypothesis Cognitive Behavioural Therapy (NH-CBT) achieved full symptom remission in 93% of people with Functional Neurological Symptoms Disorder (FNSD), most of them exhibiting motor symptoms. The basis for NH-CBT is consistent with a predictive coding aetiological model of FNSD. This idea is transparently shared with people with FNSD in the form of telling them that their symptoms are caused by a nocebo effect, usually followed by some physical activity that aims to change the person’s belief about their body.
Aims:
To demonstrate that a version of NH-CBT can also be effective in eliminating or reducing non-epileptic seizures (assumed to be a sub-type of FNSD).
Method:
A consecutive case series design was employed. Participants were treated with NH-CBT over a 12-week period. The primary outcome measure was seizure frequency. Numerous secondary measures were employed, as well as a brief qualitative interview to explore participants’ subjective experience of treatment.
Results:
Seven out of the 10 participants became seizure free at least 2 weeks before their post-treatment assessment, and all stayed seizure-free for at least 5 months. Six of those seven remained seizure free at 6-month follow-up. There were large positive effect sizes for the majority of secondary measures assessed.
Conclusions:
This case series provides evidence of feasibility and likely utility of NH-CBT in reducing the frequency of non-epileptic seizures.
Prior trials suggest that intravenous racemic ketamine is a highly effective for treatment-resistant depression (TRD), but phase 3 trials of racemic ketamine are needed.
Aims
To assess the acute efficacy and safety of a 4-week course of subcutaneous racemic ketamine in participants with TRD. Trial registration: ACTRN12616001096448 at www.anzctr.org.au.
Method
This phase 3, double-blind, randomised, active-controlled multicentre trial was conducted at seven mood disorders centres in Australia and New Zealand. Participants received twice-weekly subcutaneous racemic ketamine or midazolam for 4 weeks. Initially, the trial tested fixed-dose ketamine 0.5 mg/kg versus midazolam 0.025 mg/kg (cohort 1). Dosing was revised, after a Data Safety Monitoring Board recommendation, to flexible-dose ketamine 0.5–0.9 mg/kg or midazolam 0.025–0.045 mg/kg, with response-guided dosing increments (cohort 2). The primary outcome was remission (Montgomery-Åsberg Rating Scale for Depression score ≤10) at the end of week 4.
Results
The final analysis (those who received at least one treatment) comprised 68 in cohort 1 (fixed-dose), 106 in cohort 2 (flexible-dose). Ketamine was more efficacious than midazolam in cohort 2 (remission rate 19.6% v. 2.0%; OR = 12.1, 95% CI 2.1–69.2, P = 0.005), but not different in cohort 1 (remission rate 6.3% v. 8.8%; OR = 1.3, 95% CI 0.2–8.2, P = 0.76). Ketamine was well tolerated. Acute adverse effects (psychotomimetic, blood pressure increases) resolved within 2 h.
Conclusions
Adequately dosed subcutaneous racemic ketamine was efficacious and safe in treating TRD over a 4-week treatment period. The subcutaneous route is practical and feasible.
OBJECTIVES/GOALS: As hospitals across the nation respond to the need to address community violence, there is a dearth of Hospital-based Violence Intervention Programs (HVIPs) in the South despite having disproportionate rates. This research aims to identify key factors and strategies for implementation of an HVIP among rural patient populations in a southern state. METHODS/STUDY POPULATION: Semi-structured interviews will be conducted with medical providers, social service organizations, and patients transferred from four high-risk rural areas in Arkansas. Data will be analyzed using Framework Analysis, a rapid analysis approach involving framework development, code application, impactful statement identification, and content analysis. Evidence- Based Quality Improvement (EBQI), a group consensus making process, will be conducted to identify key implementation strategies and factors to adapt based interview findings. Priority areas for adaptation will be identified via systematic rating. The EBQI team, including researchers and key rural stakeholders will engage in a series of discussion, vote on final strategies, and develop a guide for future HVIP implementation and pilot testing. RESULTS/ANTICIPATED RESULTS: Findings from this study will result in a prioritized list of barriers and facilitators across sample groups. Factors will be rated by level of importance. Cluster maps will display the relationships among factors. Go and no-go zones will be identified based on importance and feasibility. Implementation strategies will be mapped to barriers and facilitators. DISCUSSION/SIGNIFICANCE: The findings will result in a culturally and geographically relevant HVIP model and package of implementation strategies to test in future hybrid trials (feasibility pilot & multi-site RCT); and shape the future of violence prevention efforts in healthcare settings across the rural South.
Recent Holocaust scholarship has investigated the relationship between Holocaust memory and Holocaust tourism, particularly as it pertains to questions of what constitutes appropriate behavior at memorial sites. Sergei Loznitsa's 2016 documentary, Austerlitz, which focuses on the actions and reactions of masses of visitors who stream through the Sachsenhausen and Dachau concentration camps, raises provocative questions about the tension between these camps’ commemorative intentions and tourists’ experiences. This essay examines Losznita's film in several overlapping contexts, including: the shift in memorial practice in the last few decades defined largely by an emphasis on subjective sensory experience; the rise of “dark tourism” and its relationship to historical memory; and the continued shift toward understanding not just history but also the present through images, whereby even lived experience appears to require visual mediation for its affirmation.
Ukrainian filmmaker Sergei Loznitsa's 2016 observational documentary, Austerlitz, chronicles the behavior of crowds of tourists as they wander through German concentration camps—primarily Sachsenhausen and Dachau—on what appears to be a midsummer day. Consisting entirely of a series of black-and-white long takes from fixed camera positions throughout the camp and lacking any narration, captions, or on-screen text, Loznitsa's film focuses not on the history of the camps or the events that took place within them but on the actions and reactions of the masses of visitors who stream through the camps: tourists whose demeanor and dress, whose incessant use of cameras and cell phones to snap pictures of details of the camps and pose for selfies, conveys a manner perhaps more suited to a theme park than to visits to places where the systematic torture, dehumanization, and murder of hundreds of thousands took place. In doing so, the film raises provocative questions about the tension between these camps’ commemorative intention and what the tourists actually experience.
In a brief director's statement, Loznitsa frames the increasing popularity of visiting concentration camps and death camps as a tourist experience as a mystery to be solved. Describing his own experience at Buchenwald while researching an upcoming film on Babi Yar, he explains how he came to make the film: “This is the place where people were exterminated; this is the place of suffering and grief. And now, I am here. A tourist. With all the typical curiosities of a tourist.
In light of government and healthcare system commitments to reducing the carbon footprint of healthcare, health technology assessment (HTA) agencies are increasingly motivated to investigate how to consider environmental sustainability in their assessments and guidance. This constitutes a major departure from the existing remits and objectives of most agencies, which typically focus on improving population health outcomes. This presentation seeks to identify options for incorporating environmental impact data into HTA and to examine the main challenges, focusing on the National Institute for Health and Care Excellence (NICE) as a case study.
Methods
We present four broad approaches that could be pursued, informed by policy analysis undertaken by NICE. The strengths, weaknesses and implications of each approach are assessed.
Results
The first option is to act as an ‘information conduit’, aggregating and distributing in a standardized format environmental impact information that is provided voluntarily by health technology manufacturers. The second is to present complementary analyses of environmental impact data, separately but alongside results from established health economic analyses (‘parallel evaluation’ model). The third is to incorporate environmental impact data into health economic analyses, for example by monetizing environmental outcomes, so that quantitative estimates of treatment value are directly affected by environmental benefits and costs (‘integrated evaluation’ model). The fourth is to create new decision-making frameworks for evaluating healthcare interventions that are not expected to improve health-related outcomes, but claim to have relative environmental benefits.
Conclusions
We conclude that these approaches are not mutually exclusive, and all involve some degree of benefit and risk. We explain why the parallel evaluation model may be the most appropriate approach for NICE as a first response to the increased demand for guidance on the environmental impact of health technologies. We also outline activities being undertaken by NICE and other agencies such as the Canadian Agency for Drugs and Technologies in Health to develop new methodologies for incorporating environmental impact data into their HTAs.
The COVID-19 pandemic has shone a spotlight on how health outcomes are unequally distributed among different population groups, with disadvantaged communities and individuals being disproportionality affected in terms of infection, morbidity and mortality, as well as vaccine access. Recently, there has been considerable debate about how social disadvantage and inequality intersect with developmental processes to result in a heightened susceptibility to environmental stressors, economic shocks and large-scale health emergencies. We argue that DOHaD Society members can make important contributions to addressing issues of inequality and improving community resilience in response to COVID-19. In order to do so, it is beneficial to engage with and adopt a social justice framework. We detail how DOHaD can align its research and policy recommendations with a social justice perspective to ensure that we contribute to improving the health of present and future generations in an equitable and socially just way.
In studies of Holocaust representation and memory, scholars of literature and culture traditionally have focused on particular national contexts. At the same time, recent work has brought the Holocaust into the arena of the transnational, leading to a crossroads between localized and global understandings of Holocaust memory. Further complicating the issue are generational shifts that occur with the passage of time, and which render memory and representations of the Holocaust ever more mediated, commodified, and departicularized. Nowhere is the inquiry into Holocaust memory more fraught or potentially more productive than in German Studies, where scholars have struggled to address German guilt and responsibility while doing justice to the global impact of the Holocaust, and are increasingly facing the challenge of engaging with the broader, interdisciplinary, transnational field. Persistent Legacy connects the present, critical scholarly moment with this long disciplinary tradition, probing the relationship between German Studies and Holocaust Studies today. Fifteen prominent scholars explore how German Studies engages with Holocaust memory and representation, pursuingcritical questions concerning the borders between the two fields and how they are impacted by emerging scholarly methods, new areas of inquiry, and the changing place of Holocaust memory in contemporary Germany.
Contributors: David Bathrick, Stephan Braese, William Collins Donahue, Tobias Ebbrecht-Hartmann, Katja Garloff, Andreas Huyssen, Irene Kacandes, Jennifer M. Kapczynski, Sven Kramer, Erin McGlothlin, Leslie Morris, Brad Prager, Karen Remmler, Michael D. Richardson, Liliane Weissberg.
Erin McGlothlin and Jennifer M. Kapczynski are both Associate Professors in the Department of Germanic Languages and Literatures at Washington University in St. Louis.
Evidence about the impact of the COVID-19 pandemic on the mental health of specific subpopulations, such as university students, is needed as communities prepare for future waves.
Aims
To study the association of proximity of COVID-19 with symptoms of anxiety and depression in university students.
Method
This trend study analysed weekly cross-sectional surveys of probabilistic samples of students from the University of British Columbia for 13 weeks, through the first wave of COVID-19. The main variable assessed was propinquity of COVID-19, defined as ‘knowing someone who tested positive for COVID-19’, which was specified at different levels: knowing someone anywhere globally, in Canada, in Vancouver, in their course or at home. Proximity was included in multivariable linear regressions to assess its association with primary outcomes, including 30-day symptoms of anxiety and/or depression.
Results
Of 1388 respondents (adjusted response rate of 50%), 5.6% knew someone with COVID-19 in Vancouver, 0.8% in their course and 0.3% at home. Ten percent were overwhelmed and unable to access help. Knowing someone in Vancouver was associated with an 11-percentage-point increase in the probability of 30-day anxiety symptoms (s.e. 0.05, P ≤ 0.05), moderated by gender, with a significant interaction of the exposure and being female (coefficient −20, s.e. 0.09, P ≤ 0.05). No association was found with depressive symptoms.
Conclusions
Propinquity of COVID-19 cases may increase the likelihood of anxiety symptoms in students, particularly among men. Most students reported coping well, but additional support is needed for an emotionally overwhelmed minority who report being unable to access help.
This chapter examines the implications of theories of affect and embodiment for posthumanism. It argues that the recognition of bodies as fluid, co-composed, material and relational constitutes a crucial site for the emergence of the posthumanities. After examining the impact of Spinoza on Western ontologies of the body via Gilles Deleuze, the chapter addresses the affective turn in the humanities and social sciences and its consequences for how we understand affect, embodiment and the human. From affect as autonomous intensity to the cultural politics of affect to queer theories of embodiment in, this chapter shows how theories of affect and embodiment leads to the limits of the human and humanist knowledge production. This question of bodies, however, also exposes problems in the desire to move ‘beyond the human,’ when many racialized bodies were never fully counted as human. Scholars discussed include Brian Massumi, Sarah Ahmed, Anna Gibbs, Erin Manning, Judith Butler, Lauren Berlant, Dana Luciano, Mel Chen, Eliza Steinbock, Zakkiyah Jackson and Jasbir Puar.
The disease burden of surgical site infection (SSI) following total knee (TKA) replacement is considerable and is expected to grow with increased demand for the procedure. Diagnosing and treating SSI utilizes both inpatient and outpatient services, and the timing of diagnosis can affect health service requirements. The purpose of this study was to estimate the health system costs of infection and to compare them across time-to-diagnosis categories.
Methods:
Administrative data from 2005–2016 were used to identify cases diagnosed with SSI up to 1 year following primary TKA. Uninfected controls were selected matched on age, sex and comorbidities. Costs and utilization were measured over the 2-year period following surgery using hospital and out-of-hospital data. Costs and utilization were compared for those diagnosed within 30, 90, 180, and 365 days. A subsample of cases and controls without comorbidities were also compared.
Results:
We identified 238 SSI cases over the study period. On average, SSI cases cost 8 times more than noninfected controls over the 2-year follow-up period (CaD$41,938 [US$29,965] vs CaD$5,158 [US$3,685]) for a net difference of CaD$36,780 (US$26,279). The case-to-control ratio for costs was lowest for those diagnosed within 30 days compared to those diagnosed later. When only patients without comorbidities were included, costs were >7 times higher.
Conclusion:
Our results suggest that considerable costs result from SSI following TKA and that those costs vary depending on the time of diagnosis. A 2-year follow-up period provided a more complete estimate of cost and utilization.
This chapter examines the affective dimension of the unsaid. It proposes an affective approach to understanding, researching, and writing the unsaid by outlining and utilizing two distinct yet resonate methodologies, grounded in the research practices of each author. In doing so, the chapter shows how different methodological approaches to the challenge of writing the unsaid offer an unfolding of potentials for how silence might speak without words. The chapter begins with a brief account of affect studies in the humanities before detailing a methodology of affective witnessing to the silence of political violence, followed by an examination of the relations between silence and the body in the unsaid of sexual abuse and the problem of writing in the face of blockages to speaking. In closing, it considers in more general terms what affective methodologies might bring to qualitative research into the unsaid.
Field trials were conducted to compare on-site visual evaluations with color-infrared photography (CIR), and near-infrared (NIR) videography (video) and hand-held radiometry (HHR) for detecting and mapping dicamba injury in cotton. CIR, video, and HHR detected 48%, 42% and 36%, respectively, of the injured crop area as defined by visual evaluation (injury ratings >0 on a scale of 0 to 9). The remote techniques were unable to differentiate crop injury that did not involve the entire plant canopy. Reflectance measurements in the visible red (R) (630–690 nm) and NIR (760–900 nm) wavelengths were taken and used in herbicide dosage prediction equations. Predicted herbicide dosages were significantly, positively correlated (P≤0.01) with physical measures of herbicide present. These studies suggest that remote detection and mapping of moderate and severe herbicide injury is possible. Further, NIR videography, with near-real-time capability and low cost may be the system of choice for this type of application.
Virginia creeper and wild grape are troublesome perennial vines that often infest Christmas tree plantations. Field studies were conducted to evaluate Fraser fir injury and Virginia creeper and wild grape control with directed applications of triclopyr (1,680 g ai/ha) alone and in combination with 2,4-D (1,120 g ai/ha), clopyralid (280 g ai/ha), and halosulfuron (36 g ai/ha). Additional treatments included 2,4-D, clopyralid, glyphosate (1,120 g ai/ha), halosulfuron, hexazinone (560 g ai/ha), mesotrione (105 g ai/ha), and sulfometuron (71 g ai/ha) applied alone; and a mixture of hexazinone plus mesotrione. In the triclopyr-containing treatments, Fraser fir injury ranged from 6 to 13% at 1 mo after treatment (MAT) and was 4 to 8% at 11 MAT. Leader growth was not impacted by the herbicide treatments. At 11 MAT, all triclopyr-containing treatments controlled Virginia creeper 93 to 98% and wild grape 98 to 100%, which was greater than the control observed with glyphosate at 63 and 59%, respectively. Virginia creeper and wild grape control with 2,4-D was 88 to 90%. Clopyralid, halosulfuron, hexazinone, hexazinone plus mesotrione, mesotrione, and sulfometuron provided less than 66% control of both perennial vines. Directed applications of triclopyr-containing treatments or 2,4-D were effective management tools for selective removal of wild grape and Virginia creeper from Fraser fir Christmas tree plantations. Additional research is needed on the potential sensitivity of other commonly grown Christmas tree species to triclopyr-containing treatments.
Bushkiller was evaluated under inter- and intraspecific competition. In
experiment 1, bushkiller, trumpetcreeper, and wild grape were
greenhouse-grown alone and in two or three species mixtures in pots. Of the
three species, bushkiller grew the tallest and had the greatest final
biomass when grown alone. When all three species were grown together,
bushkiller grew over twice the height of trumpetcreeper, over three times
the height of wild grape, and over four times the biomass of either
competing species. Plots of height over time showed that competition did not
affect bushkiller or wild grape growth rate, but trumpetcreeper growth was
reduced when grown with bushkiller. In experiment 2, bushkiller was grown in
cultures of one, two, and three plants per pot to determine intraspecific
competition effects on growth. Final height of bushkiller was not affected
by intraspecific competition; however, bushkiller biomass decreased with
increasing competition.
New arylpicolinate herbicide chemistry under development for rice, aquatic
weed management, and other uses was evaluated using five aquatic plants. The
herbicide
4-amino-3-chloro-6-(4-chloro-2-fluoro-3-methoxyphenyl)-5-fluoro-pyridine-2-benzyl
ester—also identified as XDE-848 BE or SX-1552 (proposed International
Organization for Standardization common name in review; active tradename
RinskorTM)—and its acid form (XDE-848 acid or SX-1552A) were
evaluated on three dicots: (1) Eurasian watermilfoil (EWM), (2) megalodonta,
and (3) crested floating heart (CFH), and two monocots: (1) hydrilla and (2)
elodea. A small-scale Organization for Economic Cooperation and Development
(OECD) protocol developed using EWM for registration studies was utilized.
EWM and megalodonta were also evaluated in larger-scale mesocosms for
comparison. In-water concentrations between 0.01 and 243 μg ai
L−1 as SX-1552 or SX-1552A were applied under static
conditions for 14 (growth chamber) or 28 d (mesocosm). EWM was susceptible
to both SX-1552 and SX-1552A, with dry-weight 50% effective concentration
(EC50) values of 0.11 and 0.23 μg ai L−1 under
growth chamber conditions. Megalodonta had EC50 values of 11.3
and 14.5 μg ai L−1 for the SX-1552 and SX-1552A. CFH was more
sensitive to SX-1552 (EC50 = 5.6 μg ai L−1) than to
SX-1552A (EC50 = 23.9 μg ai L−1). Hydrilla had
EC50 values of 1.4 and 2.5 μg ai L−1, whereas
elodea was more tolerant, with EC50 values of 6.9 and 13.1 μg ai
L−1 for SX-1552 and SX-1552A, respectively. For EWM mesocosm
trials, EC50 values for SX-1552 and 1552A were 0.12 μg ai
L−1 and 0.58 μg ai L−1, whereas the megalodonta
EC50 was 6.1 μg ai L−1. Activity of SX-1552 on EWM,
hydrilla, and CFH merits continued investigation for selective aquatic weed
control properties. Results suggest that the OECD protocol can be used to
screen activity of herbicides for multiple aquatic plant species.