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Religious life in late medieval Latin Christendom was intense. A turn toward pastoral theology and increasing lay literacy and activism led to criticism of and rising expectations for clergy (more preaching, better morals), multiplication of devotions (e.g., prayer books promising indulgences, elaborate church decoration, new saints’ shrines, and pilgrimages), and anxieties about means of salvation and good works (e.g., chantries and Mass foundations, practices of charity in face of the “undeserving poor”). Among the responses were reformulations of the understanding and practice of worship and the roles and characters of ministries.
Syrian refugees may have increased mental health needs due to the frequent exposure to potentially traumatic events and violence experienced during the flight from their home country, breakdown of supportive social networks and daily life stressors related to refugee life. The aim of this study is to report evidence on mental health needs and access to mental health and psychosocial support (MHPSS) among Syrians refugees living in Sultanbeyli-Istanbul, Turkey.
A cross-sectional survey was conducted among Syrian refugees aged 18 years or over in Sultanbeyli between February and May 2018. We used random sampling to select respondents by using the registration system of the municipality. Data among 1678 Syrian refugees were collected on mental health outcomes using the Posttraumatic Stress Disorder (PTSD) Checklist (PCL-5) and the Hopkins Symptoms Checklist (HSCL-25) for depression and anxiety. We also collected data on health care utilisation, barriers to seeking and continuing care as well as knowledge and attitudes towards mental health. Descriptive analyses were used.
The estimated prevalence of symptoms of PTSD, depression and anxiety was 19.6, 34.7 and 36.1%, respectively. In total, 249 respondents (15%) screened positive for either PTSD, depression or anxiety in our survey and self-reported emotional/behavioural problems since arriving in Sultanbeyli. The treatment gap (the proportion of these 249 people who did not seek care) was 89% for PTSD, 90% for anxiety and 88% for depression. Several structural and attitudinal barriers for not seeking care were reported, including the cost of mental health care, the belief that time would improve symptoms, fear of being stigmatised and lack of knowledge on where and how to get help. Some negative attitudes towards people with mental health problems were reported by respondents.
Syrian refugees hardly access MHPSS services despite high mental health needs, and despite formally having access to the public mental health system in Turkey. To overcome the treatment gap, MHPSS programmes need to be implemented in the community and need to overcome the barriers to seeking care which were identified in this study. Mental health awareness raising activities should be provided in the community alongside the delivery of psychological interventions. This is to increase help-seeking and to tackle negative attitudes towards mental health and people with mental health problems.
We reviewed published evidence on quality improvement in hospitals in the Russian Federation since 2000. We used three data sources: MEDLINE, ‘Rossiiskaia Meditsina’ (Central Scientific Medical Library), and elibrary.ru using specific search terms. No language or study design restrictions were imposed. In total, 1717 articles were identified; 51 met the inclusion criteria and were thematically analysed. Russian legislation, government acts and grey literature were sourced to contextualise identified themes. Since 2010, the Federal Ministry of Health has increasingly sought to improve quality of care, providing additional resources and new initiatives across the health system. These include clinical practice guidelines, pay for performance schemes, electronic medical records, more specialist care, paraclinical care, and quality control systems. Quality of care, increasingly a concern of the Russian government, is said to be improving. Yet most initiatives have rarely been evaluated. This reflects the limited capacity for health services research in Russia. It seems likely that the full potential for improvements in quality of care in Russia is still to be realised.
Although injuries have been linked to worse mental health, little is known about this association among the general population in low- and middle-income countries (LAMICs). This study examined the association between injuries and depression in 40 LAMICs that participated in the World Health Survey.
Cross-sectional information was obtained from 212 039 community-based adults on the past 12-month experience of road traffic and other (non-traffic) injuries and depression, which was assessed using questions based on the World Mental Health Survey version of the Composite International Diagnostic Interview. Multivariable logistic regression analysis and meta-analysis were used to examine associations.
The overall prevalence (95% CI) of past 12-month traffic injury, other injury, and depression was 2.8% (2.6–3.0%), 4.8% (4.6–5.0%) and 7.4% (7.1–7.8%), respectively. The prevalence of traffic injuries [range 0.1% (Ethiopia) to 5.1% (Bangladesh)], and other (non-traffic) injuries [range 0.9% (Myanmar) to 12.1% (Kenya)] varied widely across countries. After adjusting for demographic variables, alcohol consumption and smoking, the pooled OR (95%CI) for depression among individuals experiencing traffic injury based on a meta-analysis was 1.72 (1.48–1.99), and 2.04 (1.85–2.24) for those with other injuries. There was little between-country heterogeneity in the association between either form of injury and depression, although for traffic injuries, significant heterogeneity was observed between groups by country-income level (p = 0.043) where the pooled association was strongest in upper middle-income countries (OR = 2.37) and weakest in low-income countries (OR = 1.46).
Alerting health care providers in LAMICs to the increased risk of worse mental health among injury survivors and establishing effective trauma treatment systems to reduce the detrimental effects of injury should now be prioritised.
Trace analysis of quartz at the <0.1 wt% level can be routinely accomplished by x-ray diffraction using rotating pressed-powder briquettes and a peak deconvolution strategy due to Wiedemann, et al. (1937a, b) which permits reproducible determination of background and enhances peak resolution without changing the integrated intensity.
Four calibration methods were tested: (1) calibration with perlites microscopically analyzed by Hamilton and Peletls (1988), (2) with artificial mixtures of quartz and glass, (3) with chemical analysis and massbalance calculation of quartz in glass mixtures, and (4) with a new method of additions for XRD.
Methods (2) and (4) gave the best results. Method (2) has a precision of 16.9 pet at the 0.1 wt% level and a LLD of 0.05 wt% at 3σ. Method (4) is particularly attractive because large spikes can be used which minimize homogenization errors and permit preparation of standards which have properties very similar to run-of-the-mill samples; the problem of non-zero intercepts is avoided.
Federal laws require that urban redevelopment projects characterize the Pb hazard of old painted surfaces. In large metropolitan surveys, the Pb analyses are commonly obtained with a portable XRF unit; however, for small surveys, capital investments in such instrumentation may be unwarranted. In 1988, the city of Las Cruces, NM, requested our help in providing needed Pb in paint analyses. We developed an economical XRF method for Pb analysis suitable for small scale urban surveys and the requirements of individual home owners, it is described below.
1) A standard wavelength dispersive XRF spectrometer is used to determine the CI countrate from a 3.6 cm KCl disk and the countrate per square cm is computed. 2) The paint chip is weighed to the nearest 0.1 mg and cemented onto the disk. 3) The prepared disk is counted for CI, Pb, and Rb using the same spectrometer. 4) The CI countrate deficit is used to compute the area of the paint chip. 5) The mass of Pb corrected for Rb interference is determined from an appropriate calibration curve, and the results are reported in mg Pb/cm2.
The Pb analysis is calibrated against geochemical standards. Spex Mix containing Pb is sprinkled on double faced mylar tape of known area and used as an independent check on the calibration curve. We present the results of our calibration curves and our analytical experience over the last 5 years.
This article presents previously unpublished data from the Archives of the Duke of Candia (Crete) pertaining to the economic activities of Greek, Latin, and Jewish women in the Venetian colony of the fourteenth century. While trends over time are difficult to discern in the notarial registers examined for this study, they are none the less suggestive of a lively participation by women in moneylending, investment, and production, as well as in the local distribution of the island's products.
The surprise outcome of the 2016 presidential election continues to raise more questions as experts grapple with the evidence for why most prognosticators considered a Hillary Clinton victory almost certain. This article uses the 2016 Cooperative Congressional Election Study data to show that a primary explanation for why the election of Donald Trump was difficult to predict is that the bulk of his support did not materialize until Election Day, in the battleground states that he had to carry to win the Electoral College.
In this study of the early US Congress (First through Nineteenth: 1789–1827), we assess the impact of slavery on the electoral competitiveness of House elections. Slavery and other forms of labor repressive agriculture have long been known to undermine democracy. Using district-level measures of electoral competitiveness and slavery, we find that a higher percentage of slaves in a district negatively impacts competition, even when we limit our models to Southern elections. Our findings indicate that from the nation's founding up to the age of Andrew Jackson, slavery strongly accounts for a pronounced disparity in the competitiveness of House elections.
As activists frame campaigns, their region's broader cultural and political context intercedes. In Israel and Palestine attempts to work across national lines and undertake activism that links ecological, economic, and social issues have long been stymied. This article examines how the fraught historical and contemporary relationships of Israelis and Palestinians with land bestow both flexibility and limitations on their framing of campaigns. In particular, it ethnographically analyzes the framing of two projects—the building of an “eco-mosque” and a Jordan River restoration effort—to examine how activists grapple with frame flexibility and its limits. It finds that an Israeli tendency to deterritorialize environmental issues and curb environmental campaigns that are “too political” conflicts with Palestinian criticism of apolitical frames because they euphemize violence and domination. These cases demonstrate how local connotations can make or break environmental campaigns. The eco-adage, “Think global, act local” is not enough. One must think local, too.
We present dark-matter minihalo models for the Ultra-Compact High Velocity HI Clouds (UCHVCs) recently discovered in the 21 cm ALFALFA survey. We assume gravitational confinement of ~104 K HI gas by flat-cored dark-matter subhalos within the Local Group. For the UCHVCs we calculate the photoionization-limited hydrostatic gas profiles for any distance-dependent total observed HI mass and predict the associated (projected) HI half-mass radii. The observed 21 cm fluxes and half-mass angular radii then constrain the source distances or DM halo parameters. As a consistency check we model the gas-rich dwarf galaxy Leo T, for which the distance is known (420 kpc) and there is a well-resolved HI column density profile. We derive an upper limit for the pressure of any enveloping hot IGM gas at the distance of Leo T. Our analysis supports the scenario that some of the UCHVCs may constitute a population of 21-cm-selected but optically-faint dwarf galaxies in the Local Volume.
Amblyopia is a developmental disorder that affects the spatial vision of one or both eyes in the absence of an obvious organic cause; it is associated with a history of abnormal visual experience during childhood. Subtypes have been defined based on the purported etiology, namely, strabismus (misaligned eyes) and/or anisometropia (unequal refractive error). Here we consider the usefulness of these subclassifications.
Health technology assessment (HTA) is not simply a mechanistic technical exercise as it takes place within a specific institutional context. Yet, we know little about how this context influences the operation of HTA and its ability to influence policy and practice. We seek to demonstrate the importance of considering institutional context, using a case study of Hungary, a country that has pioneered HTA in Central and Eastern Europe. We conducted 26 in-depth, semi-structured interviews with public- and private-sector stakeholders. We found that while the HTA Department, the Hungarian HTA organisation, fulfilled its formal role envisaged in the legislation, its potential for supporting evidence-based decision-making was not fully realised given the low levels of transparency and stakeholder engagement. Further, the Department’s practical influence throughout the reimbursement process was perceived as being constrained by the payer and policy-makers, as well as its own limited organisational capacity. There was also scepticism as to whether the current operational form of the HTA process delivered ‘good value for money’. Nevertheless, it still had a positive impact on the development of a broader institutional HTA infrastructure in Hungary. Our findings highlight the importance of considering institutional context in analysing the HTA function within health systems.
To (i) evaluate the extent to which Coca-Cola’s ‘Transparency Lists’ of 218 researchers that it funds are comprehensive; (ii) map all scientific research acknowledging funding from Coca-Cola; (iii) identify those institutions, authors and research topics funded by Coca-Cola; and (iv) use Coca-Cola’s disclosure to gauge whether its funded researchers acknowledge the source of funding.
Using Web of Science Core Collection database, we retrieved all studies declaring receipt of direct funding from the Coca-Cola brand, published between 2008 and 2016. Using conservative eligibility criteria, we iteratively removed studies and recreated Coca-Cola’s transparency lists using our data. We used network analysis and structural topic modelling to assess the structure, organization and thematic focus of Coca-Cola’s research enterprise, and string matching to evaluate the completeness of Coca-Cola’s transparency lists.
Three hundred and eighty-nine articles, published in 169 different journals, and authored by 907 researchers, cite funding from The Coca-Cola Company. Of these, Coca-Cola acknowledges funding forty-two authors (<5 %). We observed that the funded research focuses mostly on nutrition and emphasizes the importance of physical activity and the concept of ‘energy balance’.
The Coca-Cola Company appears to have failed to declare a comprehensive list of its research activities. Further, several funded authors appear to have failed to declare receipt of funding. Most of Coca-Cola’s research support is directed towards physical activity and disregards the role of diet in obesity. Despite initiatives for greater transparency of research funding, the full scale of Coca-Cola’s involvement is still not known.
Measles eradication efforts have been successful at achieving elimination in many countries worldwide. Such countries actively work to maintain this elimination by continuing to improve coverage of two routine doses of measles vaccine following measles elimination. While improving measles vaccine coverage is always beneficial, we show, using a steady-state analysis of a dynamical model, that the correlation between populations receiving the first and second routine dose also has a significant impact on the population immunity achieved by a specified combination of first and second dose coverage. If the second dose is administered to people independently of whether they had the first dose, high second-dose coverage improves the proportion of the population receiving at least one dose, and will have a large effect on population immunity. If the second dose is administered only to people who have had the first dose, high second-dose coverage reduces the rate of primary vaccine failure, but does not reach people who missed the first dose; this will therefore have a relatively small effect on population immunity. When doses are administered dependently, and assuming the first dose has higher coverage, increasing the coverage of the first dose has a larger impact on population immunity than does increasing the coverage of the second. Correlation between vaccine doses has a significant impact on the level of population immunity maintained by current vaccination coverage, potentially outweighing the effects of age structure and, in some cases, recent improvements in vaccine coverage. It is therefore important to understand the correlation between vaccine doses as such correlation may have a large impact on the effectiveness of measles vaccination strategies.
In January 2017, the UK Government made public a Memorandum of Understanding (MoU) between the Department of Health, National Health Service (NHS) Digital and the Home Office. This Memorandum allows for the more expedited sharing of a patient’s non-clinical data, specifically from the NHS England to the Home Office. The Government justified the MoU as in the ‘public interest to support effective immigration enforcement’. In this review, we seek to unpack this justification by providing, first, a background to the MoU, placing it in the context of creating a ‘hostile environment’ for migrants – a project initially sought by Theresa May in her time as Home Secretary. We then explore the potential impact of data sharing on individual health, public health and on health professionals. We conclude that the MoU could threaten both individual and public health, while placing health professionals in an unworkable position both practically and in terms of their duties to patients around confidentiality. As such, we agree with colleagues’ position that it should be suspended, at least until a full consultation and health impact assessment can be carried out.