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Welfare governance in elder care has undergone significant changes, but we know less about the processes and actors of making welfare governance. This is problematic, as the concern for process is a key strength of the welfare governance perspective. Based on a case study of elder care in Denmark, and drawing on studies of professions, the aim is to analyse how welfare professions contribute to the making of welfare governance. Our analysis shows that welfare professions bring unique resources into play. They have strong professional agency, drawing on both broader institutional roles and more specific professional projects. The institutional work itself is highly complex and the welfare professions combine not only formal and informal coordination, but also do so in ways that are closely tailored to specific contexts. The analysis makes important empirical and theoretical contributions to the study of welfare governance in elder care.
In Malaysia, a Muslim-majority country in Southeast Asia, a dynamic market for Muslim fashion has evolved over the past decade, especially concerning the abaya, a female Muslim dress. Malay Malaysian designers, producers and consumers focus on this garment because it represents a style of female Islamic clothing that is perceived as ‘authentic’. The abaya originates from the Arabian Peninsula and is generally worn by Arabic Muslim women with a syariah-compliant design that is commonly simple, loose and opaque. Embedded into the broader marketising processes of a halal industry in Malaysia, Malay women started to adopt this material object and transformed it into a distinct expression of Malaysian Muslim style. The original abaya that follows Islamic rules became a colourful and decorated dress. This transformative process is not only an expression of variation in fashion and style but profoundly transcends powerful social, placial and spatial orders within the Muslim world. The Malaysian fashion market for abayas is embedded in wider dynamics of sacred landscaping in which the Arabian Peninsula is considered to be the ‘centre of Islam’ while Malaysia is positioned and positions itself at the margins. However, Malay Malaysian social actors have shifted this constellation towards a Malaysia that has pushed itself to the forefront of a commercialising Islam through the development of the related Muslim fashion market, among other things. Thus, within a Muslim world order, transregional connections lead to an entangled web of meaning-making regarding power structures, Islamic principles and social practices.
Dietary lipids (omega-3 polyunsaturated fatty acids (n-3) PUFAs) and saturated fatty acids (SFA) seem to play an important role in brain health. (n-3) PUFAs have been shown to improve cerebral perfusion and to promote synaptogenesis. In this study, we investigated the relationship between dietary fat composition, cognitive performance and brain morphology in cognitively healthy individuals.
A total of 101 cognitively healthy participants (age: 42.3 ± 21.3 years, 62 females) were included in this study. Verbal memory was assessed using the California Verbal Learning Test (CVLT). Intake of (n-3) PUFA and SFA was calculated from food-frequency questionnaire-derived data (EPIC-FFQ). Magnetic resonance imaging (MRI) data were obtained (Siemens Trio 3T scanner) and grey matter volumes (GMV) were assessed by voxel-based morphometry (VBM/SPM8). We examined the association of SFA/(n-3) PUFA ratio and memory performance as well as GMV using regression models adjusted for age, sex, education, body mass index, apolipoprotein E (APOE) status and alcohol consumption. For VBM data, a multiple regression analysis was performed using the same covariates as mentioned before with intracranial volume as an additional covariate.
A high SFA/(n-3) PUFA ratio was significantly (p < 0.05) correlated with poorer verbal memory performance and with lower GMV in areas of the left prefrontal cortex that support memory processes.
These findings suggest that a diet rich in PUFAs is likely to exert favourable effects on brain morphology in brain areas important for memory and executive functions. This could constitute a possible mechanism for maintaining cognitive health in older age.
Fe-deficiency anaemia is considered an important public health problem both in wealthier countries and in those of medium and low income, especially in children under 5 years of age. The shortage of studies with national representativity in medium-income countries, such as Brazil, prevents the knowledge of the current situation and its associated factors. We conducted a systematic review and meta-analysis to estimate the pooled prevalence of Fe-deficiency anaemia in Brazilian children under 5 years of age and determined the factors involved in the variability of the estimates of prevalence. We collected fifty-seven studies from the databases MEDLINE, LILACS and Web of Science, along with the reference lists of included articles. We contacted authors for unpublished data. We did not restrict publication timespan and language. This systematic review and meta-analysis was reported according to the guidelines by PRISMA. The pooled prevalence of anaemia in Brazil was 40·2 (95 % CI 36·0, 44·8) %. The age range of the child and the period of data collection were associated with the anaemia prevalence. The pooled prevalence of anaemia was higher in children under 24 months of age (53·5 v. 30·7 %; P < 0·001) and in studies with data collected before 2004 (51·8 v. 32·6 %; P = 0·001). The efforts made by the Brazilian government were successful in the reduction of anaemia in children under 5 years of age in Brazil in the evaluated period. However, prevalence remains beyond acceptable levels for this population group.
Anthropogenic underwater noise has severely increased over the last century and a significant component of noise in marine environments is due to ship traffic. Every year at sea, we observe the continuous movement of more than 60,000 medium to very large commercial vessels, such as cargo ships, bulk carriers, container vessels, tankers, cruise ships and ferries (Equasis, 2015). The incredible increase in commercial maritime trade and the related increase in vessel speed of the last 40 years have raised the amount of noise that ship traffic is spreading throughout the oceans. From the 1960s, when the first measures of noise levels were reported (Wenz, 1962), until the 1990s, underwater noise has almost doubled every 10 years (Andrew et al., 2002; McDonald et al., 2006a; Merchant et al., 2012). While some recent studies describe slowly decreasing low-frequency ocean noise levels at different oceanic locations during the early 2000s (Andrew et al., 2011; Miksis-Olds et al., 2016), the typical and long-term trends for ship noise are still unknown in many regions of the world (Viola et al., 2017).
The aim of the study was to assess the inflammatory potential of the Brazilian population’s diet and its association with demographic, socio-economic and anthropometric characteristics. A cross-sectional study was performed with 34 003 individuals aged 10 years and older, evaluated by the National Diet and Nutrition Survey from the Consumer Expenditure Survey (POF 2008–2009). The Energy-adjusted Dietary Inflammatory Index (E-DII™) was determined using thirty-four dietary parameters calculated through non-consecutive 2-d dietary records. Positive scores indicate a pro-inflammatory diet, while negative scores indicate an anti-inflammatory diet. A bivariate and multivariate linear regression analysis based on a hierarchical theoretical model was performed to verify the factors associated with the E-DII. The mean of the E-DII was 1·04 (range of −4·77 to +5·98). The highest values of the pro-inflammatory E-DII were found among adolescents (1·42; P < 0·001) and individuals with higher income (1·10; P < 0·001) and level of education (1·18; P < 0·001). In the final model, the E-DII was associated with higher income quartiles and was higher in the Northeast and South regions, in white people, individuals with ≥9 years of education and adults and adolescents age group. The Brazilian population consumes a diet with high inflammatory potential, especially adolescents, white people and those with higher income and level of education. Thus, the index presented uneven distribution among the population, emphasising groups with higher dietary inflammatory potential. The socio-economic risk profile of a diet with higher inflammatory potential in medium-income countries is different from what is observed in high-income nations.
The goal of this commentary is to expose the situation of Food and Nutrition Security (FNS) in Brazil in the context of the COVID-19 pandemic by providing a critical analysis of this scenario and suggesting ways to move forward. When COVID-19 arrived in Brazil, a crisis scenario that incorporated economic, social and political aspects became highly visible. This scenario fostered unemployment, poverty and hunger. Besides that, it exposed multiple vulnerabilities that were getting worse over the past few years prior to the pandemic. In this context, COVID-19 found in Brazil a fertile ground for its dissemination and community transmission. The impacts of the suspension of many commercial activities and other economic sectors due to the pandemic were quickly felt socially and economically in Brazil. Some of the actions carried out by the Brazilian government included the emergency aid payment and exemption from payment of energy bills for vulnerable individuals, release of funds for programmes for the direct purchase of food from family farmers, delivery of school food kits directly to students despite the closure of schools and publication of sanitary rules for the operation of restaurants. However, these actions are still insufficient, slow and not sufficiently coordinated to contain the progress of the food and nutritional insecurity crisis in Brazil. The COVID-19 pandemic highlights the urgency for the Brazilian government to again prioritise the FNS agenda. This includes implementing mechanisms to ensure the Human Right to Adequate Food and expanding existing FNS programmes.
Background: Quantification of the magnitude of CRE both within a facility and regionally poses a challenge to healthcare institutions. Periodic point-prevalence surveys are recommended by the CDC CRE tool kit as a facility-level prevention strategy. A 2016 point-prevalence survey of 2 high-risk units at a tertiary-care center in the United States for CRE colonization found that all patients surveyed were negative for CRE. The infection prevention (IP) team repeated the study in 2019 to reassess the prevalence of CRE in the healthcare facility. Methods: A point-prevalence survey was performed in November 2019 on the same 2 high-risk units surveyed in 2016. A perirectal flocked swab was collected from all patients unless a patient refused and/or a contraindication to rectal swab was present. Swabs were inoculated onto HardyChrom TM CRE agar for incubation in ambient air at 35°C for 24 hours. Organism identification was performed using MALDI-TOF mass spectrometry on a MBT Smart by Bruker. Results: None of the patients on either high-risk unit was known to be colonized or infected with CRE at the time of the point-prevalence survey. Of 41 perirectal swabs collected, 4 (9.8%) were positive for CRE. None (0 of 20) were surgical ICU patients and 4 of 21 (19%) were medical ICU patients. All positive swabs revealed different organisms identified as follows: Escherichia coli, Enterobacter cloacae, Enterobacter kobai, and Enterobacter aerogenes. All 4 positive patients had had recent contact with multiple acute-care hospitals. Also, 2 had been transferred for liver transplant evaluation. None of these patients had received a carbapenem during their admission to the facility. Conclusion: CRE are increasingly identified in healthcare centers in the United States. Centers previously classified as low prevalence will need to maintain preventive strategies to limit transmission risks as colonized patients arrive in the facility for care. Adoption of a robust horizontal infection prevention program may be an effective strategy to avoid the spread of CRE.
Disclosures: Michelle Doll reports a research grant from Molnlycke Healthcare.
Numerous investigations have documented that age-related changes in the integrity of the corpus callosum are associated with age-related decline in the interhemispheric transfer of information. Conversely, there is accumulating evidence for more efficient white matter organization of the corpus callosum in individuals with extensive musical training. However, the relationship between making music and accuracy in interhemispheric transfer remains poorly explored.
To test the hypothesis that musicians show enhanced functional connectivity between the two hemispheres, 65 professional musicians (aged 56–90 years) and 65 age- and sex-matched non-musicians performed the fingertip cross-localization test. In this task, subjects must respond to a tactile stimulus presented to one hand using the ipsilateral (intra-hemispheric test) or contralateral (inter-hemispheric test) hand. Because the transfer of information from one hemisphere to another may imply a loss of accuracy, the value of the difference between the intrahemispheric and interhemispheric tests can be utilized as a reliable measure of the effectiveness of hemispheric interactions.
Older professional musicians show significantly greater accuracy in tactile interhemispheric transfer than non-musicians who suffer from age-related decline.
Musicians have more efficient interhemispheric communication than age-matched non-musicians. This finding is in keeping with studies showing that individuals with extensive musical training have a larger corpus callosum. The results are discussed in relation to relevant data suggesting that music positively influences aging brain plasticity.
Once upon a time… If a text starts like this, you will immediately have specific expectations as to how it will continue. While Once upon a time is a typical beginning for a fairy tale or children’s story, it would not normally work as an opener for a chapter in a textbook. The phrase is an example of how linguistic features are associated with particular texts, and how language creates effects and expectations in the reader. There are many ways in which the choice of words shapes a text. Stylistics is the study of linguistic features that make a text distinctive. And style, as Wales (2001, p. 371) puts it, is “the set or sum of features that seem to be characteristic: whether of register, genre, or period, etc.” Which linguistic features we select in a stylistic analysis depends on what we want to capture. The Tale of Peter Rabbit by Beatrix Potter starts: “Once upon a time there were four little Rabbits…” The Tale of Two Bad Mice starts in a similar way: “Once upon a time there was a very beautiful doll’s-house…” Both are stories for children and begin in a conventional way. Although both texts are by Beatrix Potter, and she begins several of her tales with once upon a time, this is not the only characteristic of her style. To describe the style of an author it is important to compare their writing to that of other authors.
This chapter develops the closure thesis—a theoretical framework for understanding the inter-related dynamics of political equality and inequality in the international system based on joining the neo-Weberian concept of social closure and the economic idea of club goods. The closure thesis consists of a constitutive and a causal logic that together contribute an explanation for the reproduction and transformation of political inequalities, understood as the distribution of participatory and procedural rights. The closure thesis makes a constitutive and a causal argument: first, that institutions create rules of closure that over time have narrowed—rather than expanded—the type of political actors considered legitimate participants, thereby constituting members as categorical equals and non-members as categorical unequals; second, that as institutions respond to normative or functional pressures to be include more, and more diverse, states, incumbents face strong incentives to respond by protecting their privileges through institutional designs—such as assimilative multilateralism, hierarchical multilateralism, and exclusive multilateralism—that distribute procedural rights unequally. The closure thesis thus contests the view that the globalization of the international system has been a process of greater inclusiveness of formerly marginalized actors accompanied by a more egalitarian and even democratic multilateral institutional order.
This chapter argues that the emergence of what we recognize as the modern international system develops through evolving practices of diplomacy. IR literature has increasingly paid attention to the early modern development of diplomacy to understand the origins of the system. This chapter offers a distinct interpretation of the importance of diplomacy from the perspective of the closure thesis. In contrast to the typical account of diplomacy as mediating the political fractures that resulted from the breakdown of Christendom, it argues that the adoption and diffusion of specific diplomatic practices, such as the permanent resident ambassador, facilitated closure and boundary-drawing by narrowing the types of actors invested with rights of political representation. Diplomatic practices emerged in part as a means of producing common goods and securing privileged access to those goods for some political actors, while facilitating the political exclusion and subordination of others. The chapter concludes with a discussion of the argument’s contemporary relevance. In reflecting on an historical age in which the sovereign state was not yet the only legitimate political agent, the contemporary question is whether today’s legal and representational rights at the global level can or should be emancipated from the state.
The international relations (IR) literature appears to be divided into two fundamentally different views about the basic structure of the international system and its institutions. On one view, the expansion and opening of international institutions in the 20th Century to include more actors and greater geographical reach, combined with strengthening democracy norms, are driving the democratization of international institutions. At the same time, a more critical literature is emerging that instead views the system as permeated by multiple forms of hierarchy and deep structures of domination. This chapter, in contrast, argues that political equality and inequality obstinately co-exist in international institutions because of their very role in regulating access to collective goods. It develops what I call the closure thesis to explain how institutional designs reflect an ongoing struggle between the assertion of equal rights and the preservation of unequal privileges. This argument requires re-thinking three premises: that equality and inequality are antagonistic; that greater inclusiveness typically promotes a move towards greater equality; and that international institutions provide global public goods. This chapter elaborates on these points, situates them in the literature, introduces the closure thesis, and outlines the rest of the book.
International law makes a claim to universality; it is supposed to be the law that applies to the relations among all peoples. This chapter argues that international law, instead, serves as a mechanism of closure; it provides a restrictive articulation of the rules that define which actors have a capacity for international rights. The chapter offers a reading of two of the most influential figures in early international law, Grotius and Vattel, in terms of the closure thesis. It traces the principle mechanism of closure to a notion of property rights that invests the territorial state with the capacity for rights based on possession and ownership. It then details how the combination of property and natural rights as the basis for sovereignty would justify the equal treatment of some and the domination and exploitation of others. Rules of closure served to accelerate the formation of property monopolies, first in the form of colonial extraction and later in the form of market neoliberalization. The chapter considers the contemporary implications of the international-law-as-closure argument. At stake is whether universalism is understood as a project of homogenizing differences and protecting privileges, or of making space for pluralism and diversity.