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To explore the formal and informal ways in which different actors involved in shaping trade agreements pursue their interests and understand the interactions with nutrition, in order to improve coherence between trade and nutrition policy goals.
The paper draws on empirical evidence from Australian key informant interviews that explore the underlying political dimensions of trade agreements that act as barriers or facilitators to getting nutrition objectives on trade agendas.
Countries experiencing greater availability and access to diets full of energy-dense and nutrient-poor foods through increased imports, greater foreign direct investment and increasing constraints on national health policy space as a result of trade agreements.
Interviews took place with Australian government officials, industry, public-interest non-government organizations and academics.
The analysis reveals the formal and informal mechanisms and structures that different policy actors use both inside and outside trade negotiations to pursue their interests. The analysis also identifies the discourses used by the different actors, as they attempt to influence trade agreements in ways that support or undermine nutrition-related goals.
Moving forward requires policy makers, researchers and health advocates to use various strategies including: reframing the role of trade agreements to include health outcomes; reforming the process to allow greater access and voice to health arguments and stakeholders; establishing cross-government partners through accountable committees; and building circles of consensus and coalitions of sympathetic public-interest actors.
The prisoner population is ageing, and consideration is needed for how to best support those with age-related health conditions in the system. Existing work practices and organizational structures often fail to meet the needs of prisoners with dementia, and prison staff experience high levels of burden because of the increased needs of these prisoners. Little is known about the best method of responding to the needs of this growing subpopulation of prisoners.
A scoping review was conducted to answer the question: what are the perceived best care options for prisoners with dementia? To be included, publications had to be publicly available, reported on research findings, or viewed opinions and commentaries on care practices relevant to older prisoners with dementia. Searches were conducted in 11 databases to identify relevant publications. Data from the included publications were extracted and summarized into themes.
Eight themes were identified that could support better care practices for prisoners with dementia: (1) early and ongoing screening for older prisoners; (2) specialized services; (3) specialized units; (4) programs or activities; (5) adaptations to current contexts; (6) early release or parole for older prisoners with dementia deemed at low risk of reoffending; and (7) training younger prisoners (8) as well as staff to assist older prisoners with dementia. Besides practical strategies improving care practice, costs, prison-specific resources, and staff skills were highlighted as care barriers across all themes. A lack of empirical evidence supported these findings.
One of the implications of the international ageing prison population is the higher number of people living with dementia being incarcerated. Suggestions for best care approaches for prisoners with dementia now need to move from opinion to empirical approaches to guide practice.
Guidelines for palliative and spiritual care emphasize the importance of screening patients for spiritual suffering. The aim of this review was to synthesize the research evidence of the accuracy of measures used to screen adults for spiritual suffering.
A systematic review of the literature. We searched five scientific databases to identify relevant articles. Two independent reviewers screened, extracted data, and assessed study methodological quality.
We identified five articles that yielded information on 24 spiritual screening measures. Among all identified measures, the two-item Meaning/Joy & Self-Described Struggle has the highest sensitivity (82–87%), and the revised Rush protocol had the highest specificity (81–90%). The methodological quality of all included studies was low.
Significance of Results
While most of the identified spiritual screening measures are brief (comprised 1 to 12 items), few had sufficient accuracy to effectively screen patients for spiritual suffering. We advise clinicians to use their critical appraisal skills and clinical judgment when selecting and using any of the identified measures to screen for spiritual suffering.
The residual closure of a subgroup H of a group G is the intersection of all virtually normal subgroups of G containing H. We show that if G is generated by finitely many cosets of H and if H is commensurated, then the residual closure of H in G is virtually normal. This implies that separable commensurated subgroups of finitely generated groups are virtually normal. A stream of applications to separable subgroups, polycyclic groups, residually finite groups, groups acting on trees, lattices in products of trees and just-infinite groups then flows from this main result.
We assessed the appropriateness of intravenous antimicrobial starts (IVASs) in Philadelphia County hemodialysis facilities using only National Healthcare Safety Network data. We classified 57.5% of IVASs as inappropriate. These findings warrant further investigation into the determinants of inappropriate IVASs in hemodialysis facilities to enhance antimicrobial stewardship.
Pictorial representation is a key human behaviour. Cultures around the world have made images to convey information about living kinds, objects and ideas for at least 75,000 years, in forms as diverse as cave paintings, religious icons and emojis. However, styles of pictorial representation vary greatly between cultures and historical periods. In particular, they can differ in figurativeness, i.e. varying from detailed depictions of subjects to stylised abstract forms. Here we show that pictorial styles can be shaped by intergroup contact. We use data from experimental microsocieties to show that drawings produced by groups in contact tended to become more figurative and transparent to outsiders, whereas in isolated groups drawings tended to become abstract and opaque. These results indicate that intergroup contact is likely to be an important factor in the cultural evolution of pictorial representation, because the need to communicate with outsiders ensures that some figurativeness is retained over time. We discuss the implications of this finding for understanding the history and anthropology of art, and the parallels with sociolinguistics and language evolution.
Over recent decades, biomass gains in remaining old-growth Amazonia forests have declined due to environmental change. Amazonia’s huge size and complexity makes understanding these changes, drivers, and consequences very challenging. Here, using a network of permanent monitoring plots at the Amazon–Cerrado transition, we quantify recent biomass carbon changes and explore their environmental drivers. Our study area covers 30 plots of upland and riparian forests sampled at least twice between 1996 and 2016 and subject to various levels of fire and drought. Using these plots, we aimed to: (1) estimate the long-term biomass change rate; (2) determine the extent to which forest changes are influenced by forest type; and (3) assess the threat to forests from ongoing environmental change. Overall, there was no net change in biomass, but there was clear variation among different forest types. Burning occurred at least once in 8 of the 12 riparian forests, while only 1 of the 18 upland forests burned, resulting in losses of carbon in burned riparian forests. Net biomass gains prevailed among other riparian and upland forests throughout Amazonia. Our results reveal an unanticipated vulnerability of riparian forests to fire, likely aggravated by drought, and threatening ecosystem conservation at the Amazon southern margins.
The Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) cohort study of the Canadian Consortium on Neurodegeneration in Aging (CCNA) is a national initiative to catalyze research on dementia, set up to support the research agendas of CCNA teams. This cross-country longitudinal cohort of 2310 deeply phenotyped subjects with various forms of dementia and mild memory loss or concerns, along with cognitively intact elderly subjects, will test hypotheses generated by these teams.
The COMPASS-ND protocol, initial grant proposal for funding, fifth semi-annual CCNA Progress Report submitted to the Canadian Institutes of Health Research December 2017, and other documents supplemented by modifications made and lessons learned after implementation were used by the authors to create the description of the study provided here.
The CCNA COMPASS-ND cohort includes participants from across Canada with various cognitive conditions associated with or at risk of neurodegenerative diseases. They will undergo a wide range of experimental, clinical, imaging, and genetic investigation to specifically address the causes, diagnosis, treatment, and prevention of these conditions in the aging population. Data derived from clinical and cognitive assessments, biospecimens, brain imaging, genetics, and brain donations will be used to test hypotheses generated by CCNA research teams and other Canadian researchers. The study is the most comprehensive and ambitious Canadian study of dementia. Initial data posting occurred in 2018, with the full cohort to be accrued by 2020.
Availability of data from the COMPASS-ND study will provide a major stimulus for dementia research in Canada in the coming years.
Recent work on US policymaking argues that responsiveness to public opinion is distorted by money, in that the preferences of the rich matter much more than those of lower-income Americans. A second distortion—partisan biases in responsiveness—has been less well studied and is often ignored or downplayed in the literature on affluent influence. We are the first to evaluate, in tandem, these two potential distortions in representation. We do so using 49 Senate roll-call votes from 2001 to 2015. We find that affluent influence is overstated and itself contingent on partisanship—party trumps the purse when senators have to take sides. The poor get what they want more often from Democrats. The rich get what they want more often from Republicans, but only if Republican constituents side with the rich. Thus, partisanship induces, shapes, and constrains affluent influence.
When did kosmos come to mean ‘world-order’? This chapter ventures a new answer by examining evidence in late doxographies and commentaries often underutilized or dismissed by scholars. Two late doxographical accounts in which Pythagoras is said to be first to call the heavens kosmos (in the anonymous Life of Pythagoras and the fragments of Favorinus) exhibit heurematographical tendencies that place their claims in a dialectic with the early Peripatetics about the first discoverers of the mathematical structure of the universe. Xenophon and Plato refer to ‘wise men’ who nominate kosmos as the object of scientific inquiry into nature as a whole and the cosmic ‘communion’ (koinônia) between all living beings, respectively. But Empedocles is the earliest surviving source to use kosmos to refer to a harmonic ‘world-order’ and to illustrate cosmic ‘communities’ between oppositional pairs, realizing the mutual correspondence in the cycle of love and strife. Thus, if later figures posited Pythagoras as the first to refer to the universal ‘world-order’ as the kosmos, they did so because they believed Empedocles to have been a Pythagorean natural scientist, whose combined focus on cosmology and ethics was thought to exemplify a distinctively Pythagorean approach to philosophy.