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How are images, emotions, and international politics connected? This article develops a theoretical framework contributing to visuality and emotions research in International Relations. Correcting the understanding that images cause particular emotional responses, this article claims that emotionally laden responses to images should be seen as performed in foreign policy discourses. We theorise images as objects of interpretation and contestation, and emotions as socially constituted rather than as individual ‘inner states’. Emotional bundling – the coupling of different emotions in discourse – helps constitute political subjectivities that both politicise and depoliticise. Through emotional bundling political leaders express their experiences of feelings shared by all humans, and simultaneously articulate themselves in authoritative and gendered subject positions such as ‘the father’. We illustrate the value of our framework by analysing the photographs of Alan Kurdi, a three-year-old Syrian-Kurdish boy who drowned in September 2015. ‘Kurdi’ became an instant global icon of the Syrian refugee crisis. World leaders expressed their personal grief and determination to act, but within a year, policies adopted with direct reference to Kurdi's tragic death changed from an open-door approach to attempts to stop refugees from arriving. A discursive-performative approach opens up new avenues for research on visuality, emotionality, and world politics.
Although extrafloral nectar (EFN) is a key food resource for arboreal ants, its role in structuring ground-nesting ant communities has received little attention, despite these ants also being frequent EFN-attendants. We investigated the role of EFN as a driver of the spatial structure of ground-nesting ant communities occurring in dry forest in north-eastern Brazil. We examined the effects on this relationship of two global drivers of biodiversity decline, chronic anthropogenic disturbance and climate change (through decreasing rainfall). We mapped EFN-producing plants and ant nests in 20 plots distributed along independent gradients of disturbance and rainfall. We categorized ant species into three types according to their dependence on EFN: heavy users, occasional users and non-users. We found a strong relationship between ant dependence on EFN and nest proximity to EFN-producing plants: heavy-users (mean distance 1.1 m) nested closer to EFN-producing plants than did occasional users (1.7 m), which in turn nested closer to EFN-producing plants than did non-users (2.3 m). Neither disturbance nor rainfall affected the proximity of heavy-user nests to EFN-producing plants. Our study shows for the first time that EFN is a key driver of the spatial structure of entire communities of ground-nesting ants.
Iron deficiency (ID) defined as plasma ferritin <12 µg/L is associated with delayed cognitive development in early childhood and increased incidence of infections, however the longitudinal association between early life factors and ID in 18-month-old children in Denmark is unknown. This study aimed to determine the prevalence of ID and to describe risk factors associated with ID in healthy 18-month-old Danish children. Blood samples, anthropometric measurements and self-reported questionnaire data had been obtained in the birth cohort, Odense Child Cohort (OCC). The questionnaires were modified from those used in the DNBC, Danish National Birth Cohort. Plasma ferritin and C-reactive protein in venous, non-fasting samples were analysed in the final sample size of 370 children after exclusion of 79 children due to chronic disease, acute infection, C-reactive protein >10 mg/L, twin birth or prematurity. Associations with ID were analysed by logistic regression, adjusting for sex, maternal education, duration of partial breastfeeding and current intake of milk, fish and meat. Overall, 56 children had ID (15.1%). Factors associated with increased risk were exclusive breastfeeding beyond 4 months (OR 5.97, 95%CI [1.63; 21.86]) and no intake of oral iron supplements from 6-12 months (OR 3.99, 95%CI [1.33; 11.97]. Duration of partial breastfeeding and current diet were not associated with ID. In conclusion, the ID prevalence was 15.1%, and both exclusive breastfeeding beyond 4 months and no intake of oral iron supplements from 6-12 months were associated with increased risk for ID in 18-month-old children.
Subcutaneous adipose tissue (scAT) and peripheral blood mononuclear cells (PBMCs) play a significant role in obesity-associated systemic low-grade inflammation. High-fat diet (HFD) is known to induce inflammatory changes in both scAT and PBMCs. However, the time course of the effect of HFD on these systems is still unknown. The aim of the current study was to determine the time course of the effect of high fat diet (HFD) on PBMCs and scAT. New Zealand white rabbits were fed HFD for 5 or 10 weeks (i.e., HFD-5 and HFD-10), or regular chow (i.e., CNT-5 and CNT-10). Thereafter, metabolic and inflammatory parameters of PBMCs and scAT were quantitated. HFD induced hyperfattyacidemia in HFD-5 and HFD-10 groups, with the development of insulin resistance (IR) in HFD-10, while no changes were observed in scAT lipid metabolism and inflammatory status. HFD activated the inflammatory pathways in PBMCs of HFD-5 group, and induced modified autophagy in that of HFD-10. The rate of fat oxidation in PBMCs was directly associated with the expression of inflammatory markers; and tended to inversely associate with autophagosome formation markers in PBMCs. HFD affected systemic substrate metabolism, and the metabolic, inflammatory, and autophagy pathways in PBMCs in the absence of metabolic and inflammatory changes in scAT. Dietary approaches or interventions to avert HFD-induced changes in PBMCs could be essential in prevention of metabolic and inflammatory complications of obesity, and promote healthier living.
Norway authorised out-patient commitment in 1961, but there is a lack of representative and complete data on the use of out-patient commitment orders.
To establish the incidence and prevalence rates on the use of out-patient commitment in Norway, and how these vary across service areas. Further, to study variations in out-patient commitment across service areas, and use of in-patient services before and after implementation of out-patient commitment orders. Finally, to identify determinants for the duration of out-patient commitment orders and time to readmission.
Retrospective case register study based on medical files of all patients with an out-patient commitment order in 2008–2012 in six catchment areas in Norway, covering one-third of the Norwegian population aged 18 years or more. For a subsample of patients, we recorded use of in-patient care 3 years before and after their first-ever out-patient commitment.
Annual incidence varied between 20.7 and 28.4, and prevalence between 36.5 and 48.9, per 100 000 population aged 18 years or above. Rates differed significantly between catchment areas. Mean out-patient commitment duration was 727 days (s.d. = 889). Use of in-patient care decreased significantly in the 3 years after out-patient commitment compared with the 3 years before. Use of antipsychotic medication through the whole out-patient commitment period and fewer in-patient episodes in the 3 years before out-patient commitment predicted longer time to readmission.
Mechanisms behind the pronounced variations in use of out-patient commitment between sites call for further studies. Use of in-patient care was significantly reduced in the 3 years after a first-ever out-patient commitment order was made.
To determine the risk of dementia in patients with type 1 or type 2 diabetes and in individuals with glycosylated haemoglobin, type A1C (HbA1c) of ⩾48 mmol/mol, which is the diagnostic limit for diabetes.
We included the following cohorts: all incident diabetes cases aged 15 or above registered in the National Diabetes Registry (NDR) from January 2000 through December 2012 (n = 148 036) and a reference population, adult participants from the Glostrup cohort (n = 16 801), the ADDITION Study (n = 26 586) and Copenhagen Aging and Midlife Biobank (CAMB) (n = 5408). Using these cohorts, we analysed if a diagnosis of type 1 or type 2 diabetes in the NDR or HbA1c level of ⩾ 6.5% (48 mmol/mol) in the cohorts increased risk of dementia in the Danish National Patient Registry or cognitive performance assessed by the Intelligenz-Struktur-Test 2000R (IST2000R).
A diagnosis of type 1 or type 2 diabetes in the NDR was associated with increased risk of dementia diagnosed both before or after age 65 as well as across different subtypes of dementia. Self-reported diabetes or high HbA1c levels were associated with lower cognitive performance (p = 0.004), while high HbA1c was associated with increased risk of dementia (HR 1.94 (1.10–3.44) in the Glostrup cohort but not in the ADDITION Study (HR 0.96 (0.57–1.61)).
Both type 1 and type 2 diabetes are associated with an increased risk of dementia, while the importance of screening-detected elevated HbA1c remains less clear.
Outdoor music festivals (OMFs) attract large numbers of guests and benefit from the help of large numbers of volunteers. Studies have previously described the injury patterns at OMFs, but no studies have described the use of medication and sales from on-site pharmacies at a large OMF.
The usage of medication and prescriptions in the Medical Health Care Organization (MHCO), including sales from the on-site pharmacy, at the Roskilde (Denmark) Festival 2015 were prospectively recorded.
In excess of 130,000 attendees (guests and volunteers) participated in the Roskilde Festival 2015. The number of attendees contacting the MHCO was 15,133, of which 3,723 (25%) had a consultation with a doctor. Of all attendees evaluated by a doctor, 669 attendees received some form of medication in relation to the consultation. The MHCO administered and/or handed out a total of 6,494 units of prescription and over-the-counter medication, of which analgesics represented nearly 51%. Asthma was the condition with the highest proportion of attendees requiring pharmaceutical treatment, as 28 out of 48 (58%) received medication during the consultation. Sixty-five attendees received both medicine and a prescription. The MHCO handed out 562 prescriptions. In total, 609 prescriptions were redeemed at the on-site pharmacy. Antibiotics represented more than 78% of all redeemed prescriptions at the on-site pharmacy.
The most utilized medications were analgesics and antibiotics. The data indicate a need for on-site prophylaxis using tetanus toxoid in combination with diphtheria toxoid vaccine and an on-site pharmacy. The content of the formulary at a mass-gathering event should be based on: evacuation time by ambulance/helicopter to hospitals with the level of competence needed; types of conditions to be treated on-site; level of competencies of festival medical staff; expected incidence and type of illness and injuries; and treatment of acute, life-threatening illnesses and or injuries.
The COllaborative project of Development of Anthropometrical measures in Twins (CODATwins) project is a large international collaborative effort to analyze individual-level phenotype data from twins in multiple cohorts from different environments. The main objective is to study factors that modify genetic and environmental variation of height, body mass index (BMI, kg/m2) and size at birth, and additionally to address other research questions such as long-term consequences of birth size. The project started in 2013 and is open to all twin projects in the world having height and weight measures on twins with information on zygosity. Thus far, 54 twin projects from 24 countries have provided individual-level data. The CODATwins database includes 489,981 twin individuals (228,635 complete twin pairs). Since many twin cohorts have collected longitudinal data, there is a total of 1,049,785 height and weight observations. For many cohorts, we also have information on birth weight and length, own smoking behavior and own or parental education. We found that the heritability estimates of height and BMI systematically changed from infancy to old age. Remarkably, only minor differences in the heritability estimates were found across cultural–geographic regions, measurement time and birth cohort for height and BMI. In addition to genetic epidemiological studies, we looked at associations of height and BMI with education, birth weight and smoking status. Within-family analyses examined differences within same-sex and opposite-sex dizygotic twins in birth size and later development. The CODATwins project demonstrates the feasibility and value of international collaboration to address gene-by-exposure interactions that require large sample sizes and address the effects of different exposures across time, geographical regions and socioeconomic status.
Lake Untersee is one of the largest perennially ice-covered lakes in Dronning Maud Land. We investigated the energy and water mass balance of Lake Untersee to understand its state of equilibrium. The thickness of the ice cover is strongly correlated with sublimation rates; variations in sublimation rates across the ice cover are largely determined by wind-driven turbulent heat fluxes and the number of snow-covered days. Lake extent and water level have remained stable for the past 20 years, indicating that the water mass balance is in equilibrium. The lake is damned by the Anuchin Glacier and mass balance calculation suggest that subaqueous melting of terminus ice contributes 40–45% of the annual water budget; since there is no evidence of streams flowing into the lake, the lake must be connected to a groundwater system that contributes 55–60% in order to maintain the lake budget in balance. The groundwater likely flows at a rate of ~8.8 × 10−2 m3 s−1, a reasonable estimate given the range of subglacial water flux in the region. The fate of its well-sealed ice cover is likely tied to changes in wind regime, whereas changes in water budget are more closely linked to the response of surrounding glaciers to climate change.
Sarcopenia (loss of muscle mass/strength) burdens many older adults – hospitalised older adults being particularly vulnerable. Treating the condition, protein supplementation (PrS) and resistance training (RT) may act synergistically. Therefore, this block-randomised, double-blind, multicentre intervention study, recruiting geriatric patients > 70 years from three medical departments, investigated the effect of PrS combined with RT during hospitalisation and 12 weeks after discharge. Participants were randomly allocated (1:1) to receive PrS (totally 27·5 g whey protein/d, about 2000 kJ/d) or isoenergetic placebo-products (< 1·5 g protein/d) divided into two servings per d to supplement the habitual diet. Both groups were engaged in a standardised, progressive low-intensity RT programme for the lower extremities (hospital: supervised daily/after discharge: self-training 4×/week). From April 2016 to September 2017, 2351 patients were screened, 462 were eligible, and 165 included. Fourteen were excluded and ten dropped out, leaving 141 participants in the intention-to-treat analysis. The average total protein intake during hospitalisation/after discharge was 1·0 (interquartile range (IQR) 0·8, 1·3)/1·1 (IQR 0·9, 1·3) g/kg per d (protein-group) and 0·6 (IQR 0·5, 0·8)/0·9 (IQR 0·6, 1·0) g/kg per d (placebo group). Both groups improved significantly for the primary and secondary endpoints of muscle mass/strength, functional measurements and quality of life, but no additional effect of PrS was seen for the primary endpoint (30-s chair stand test, repetitions, median changes from baseline: (standard test: 0 (IQR 0, 5) (protein group) v. 2 (IQR 0, 6) (placebo group) and modified test: 2 (IQR 0, 5) (protein group) v. 2 (IQR −1, 5) (placebo group)) or any secondary endpoints (Mann–Whitney U tests, P > 0·05). In conclusion, PrS increasing the total protein intake by 0·4 and 0·2 g/kg per d during hospitalisation and after discharge, respectively, does not seem to increase the adaptive response to low-intensity RT in geriatric medical patients.
Sub-Saharan Africa has the highest natural twinning rate in the world. Unfortunately, due to lack of adequate care during pregnancy, labor and postnatally, twin mortality in Sub-Saharan Africa also remains very high. Thus, it has been estimated that one in five twins dies during the childhood years. In spite of this, surprisingly few twin studies have been conducted in the region, making additional epidemiological data much needed. In 2009, we established one of the first twin registries in Sub-Saharan Africa at the Bandim Health Project in Guinea-Bissau. The registry had two main objectives. First, we wanted to describe the twinning rate and mortality patterns among newborn twins, including mortality risk factors and hospitalization patterns. Such studies can help the local clinicians improve twin health by identifying the most vulnerable children. Second, and in light of the rapidly increasing diabetes rates in Africa, we wanted to use the registry to particularly focus on metabolic disorders. Twins are often born with low birth weight, which according to the ‘thrifty phenotype hypothesis’ could predispose them to metabolic disorders later in life. Yet, no such ‘fetal programming’ data have previously been available from African twins despite the fact that nutritional patterns and influences from other factors (e.g., infections) could be markedly different here compared to high-income settings. In this article, we summarize the findings and current status of the Guinea-Bissau twin registry.
A low-energy diet (LED) is an effective approach to induce a rapid weight loss in individuals with overweight. However, reported disproportionally large losses of fat-free mass (FFM) after an LED trigger the question of adequate protein content. Additionally, not all individuals have the same degree of weight loss success. After an 8-week LED providing 5020 kJ/d for men and 4184 kJ/d for women (84/70 g protein/d) among overweight and obese adults, we aimed to investigate the relationship between protein intake relative to initial FFM and proportion of weight lost as FFM as well as the individual characteristics associated with weight loss success. We assessed all outcomes baseline and after the LED. A total of 286 participants (sixty-four men and 222 women) initiated the LED of which 82 % completed and 70 % achieved a substantial weight loss (defined as ≥8 %). Protein intake in the range 1·0–1·6 g protein/d per kg FFM at baseline for men and 1·1–2·2 g protein/d per kg FFM at baseline for women was not associated with loss of FFM (P = 0·632). Higher Three-Factor Eating Questionnaire (TFEQ) hunger at baseline and reductions in TFEQ disinhibition and hunger during the LED were associated with larger weight loss (all P ≤ 0·020); whereas lower sleep quality at baseline predicted less successful weight loss using intention to treat analysis (P = 0·021), possibly driven by those dropping out (n 81, P = 0·067 v. completers: n 198, P = 0·659). Thus, the protein intakes relative to initial FFM were sufficient for maintenance of FFM and specific eating behaviour characteristics were associated with weight loss success.
In a 1973 letter to book reviewer Bruce Allen, Thomas Pynchon reflects on the simultaneous publication of the first edition of Gravity’s Rainbow (1973) in two different versions: a moderately priced paperback and a very expensive hardcover. Somewhat bitterly he writes that “nobody at Viking pays any attention to me – my feeling was that the whole fucking thing ought to be paperback. The idea was to get it to people who can’t afford $15. But They had their own ideas.” Unlike most other authors, Pynchon famously abstains from participating in the marketing of his work, but his comments to Allen indicate that the manner in which his books are presented to the public is important to him, and this is confirmed by additional evidence. In a 1962 letter to Faith Sale, he expresses his dissatisfaction with the dust jacket for V. (1963), and the designer of the dust jacket for Mason & Dixon (1997), Raquel Jaramillo, has revealed that he “worked closely with her on the design of the jacket, being very fussy about the look of the type.”
Depression and cardiovascular diseases (CVDs) are common diseases and associated in a bidirectional manner.
To examine whether a bidirectional association between CVD and depression could be explained by shared risk factors, misclassification of disease measures or non-response.
A total of 10 population-based cohorts including 93 076 men and women (mean age 54.4 years, s.d. = 9.2) and an additional 10 510 men (mean age 51.2 years, s.d. = 0.3) were followed for subsequent depression, ischaemic heart disease (IHD) and stroke in the Danish National Patient Registry from health examinations between 1982 and 2015 and until end of follow-up in 2017–2018. Exposures were physicians’ diagnoses of IHD, stroke, depression or self-reported chest pain, depression, use of antidepressant medication and the Major Depression Inventory at the time of study entry in the Metropolit study. Associations were analysed using Cox proportional hazard regression with disease as time-dependent variables.
IHD and stroke were associated with subsequent depression (hazard ratio (HR) for IHD: 1.79, 95% CI 1.43–2.23 and HR for stroke: 2.62, 95% CI 2.09–3.29) and the associations were present in both men and women. Adjustment for the shared risk factors socioeconomic status, lifestyle, body mass index, statin use and serum lipids did not change the risk estimates. Furthermore, depression was associated with higher risk of subsequent IHD (HR = 1.63, 95% CI 1.36–1.95) and stroke (HR = 1.94, 95% CI 1.63–2.30). The associations were also present when the analyses were based on self-reported disease measures or restricted to include non-responders.
The bidirectional association between CVD and depression was not explained by shared risk factors, misclassification or non-response.
Some of the most important decisions young people make are choices about education. Yet recent research shows that educational decisions are poorly explained by classical models of human capital investments: adolescents do not always choose what would best optimize their long-term net outcomes. Instead, students have been shown to be influenced by their current group of peers at the time when they make educational decisions. We expand on existing models by showing that students’ stated educational preferences can be influenced by simply priming them with their peers’ preferences. Further, we show that students are unaware of this peer influence in the sense that: (1) they claim that peers have no influence; (2) in a conjoint experiment, they do not select educations based on peers’ assessments; and (3) in a list experiment absent of any social desirability bias, they do not ascribe any influence to their peers either. All in all, the results show that young people are unwittingly influenced by their peers. These results have important implications for public policies aimed at encouraging young people to make more deliberate and informed educational choices.