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In a global society experiencing an increasing shortage of qualified workers and the recognition that individuals with autism spectrum disorder (ASD) can be effective employees, there is an uptick in private sector initiatives to address employment needs through the recruitment of workers with ASD. A case study methodology with consensual qualitative research analysis was used to gain a rich understanding of employment of people with ASD at a medium-sized clothier in collaboration with a service provider for people with ASD. Perceptions of implementation and effectiveness were collected. Results suggest the hiring of people with ASD was positively perceived by employees. Components of this success included changes to the physical work environment, diversity training specific to individuals with disabilities, and a company climate of engaging and supporting employees with ASD. This research suggests that the collaborative initiative may prove a meaningful model for other companies interested in employing people with ASD.
To draw lessons from Fiji regarding the challenges and opportunities for policy initiatives to restrict (i) food marketing to children and (ii) marketing of breast milk substitutes, to inform policy for the double burden of malnutrition.
Qualitative political economy analysis of two policy case studies.
Eleven key informants from relevant sectors, representing public health, economic and consumer interests.
This study used two policy initiatives as case studies to examine factors influencing decision-making: Marketing Controls (Foods for Infants and Young Children) Regulations 2010, amended in 2016 to remove guidelines and restrictions on marketing in the form of labelling, and the draft Advertising and Promotion of Unhealthy Foods and Non-Alcoholic Beverages to Children Regulation developed in 2014 but awaiting review by the Solicitor General’s Office. Factors identified included: a policy paradigm in which regulation of business activity contradicts economic policy goals; limited perception by key policy actors of links between nutrition and marketing of breast milk substitutes, foods and beverages; and a power imbalance between industry and public health stakeholders in policymaking. Regulation of marketing for health purposes sits within the health sector’s interest but not its legislative remit, while within the economic sector’s remit but not interest. Opportunities to strengthen restrictions on marketing to improve nutrition and health include reframing the policy issue, strategic advocacy and community engagement.
Restricting marketing should be recognised by public health actors as a public health and an industry policy issue, to support strategic engagement with economic policy actors.
This paper examines the stability of egocentric networks as reported over time using a novel touchscreen-based participant-aided sociogram. Past work has noted the instability of nominated network alters, with a large proportion leaving and reappearing between interview observations. To explain this instability of networks over time, researchers often look to structural embeddedness, namely the notion that alters are connected to other alters within egocentric networks. Recent research has also asked whether the interview situation itself may play a role in conditioning respondents to what might be the appropriate size and shape of a social network, and thereby which alters ought to be nominated or not. We report on change in these networks across three waves and assess whether this change appears to be the result of natural churn in the network or whether changes might be the result of factors in the interview itself, particularly anchoring and motivated underreporting. Our results indicate little change in average network size across waves, particularly for indirect tie nominations. Slight, significant changes were noted between waves one and two particularly among those with the largest networks. Almost no significant differences were observed between waves two and three, either in terms of network size, composition, or density. Data come from three waves of a Chicago-based panel study of young men who have sex with men.
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.
Maximising synergies and minimising conflicts (i.e. building policy coherence) between trade and nutrition policy is an important objective. One understudied driver of policy coherence is the alignment in the frames, discourses and values of actors involved in the respective sectors. In the present analysis, we aim to understand how such actors interpret (i.e. ‘frame’) nutrition and the implications for building trade–nutrition policy coherence.
We adopted a qualitative single case study design, drawing on key informant interviews with those involved in trade policy.
We focused on the Australian trade policy sub-system, which has historically emphasised achieving market growth and export opportunities for Australian food producers.
Nineteen key informants involved in trade policy spanning the government, civil society, business and academic sectors.
Nutrition had low ‘salience’ in Australian trade policy for several reasons. First, it was not a domestic political priority in Australia nor among its trading partners; few advocacy groups were advocating for nutrition in trade policy. Second, a ‘productivist’ policy paradigm in the food and trade policy sectors strongly emphasised market growth, export opportunities and deregulation over nutrition and other social objectives. Third, few opportunities existed for health advocates to influence trade policy, largely because of limited consultation processes. Fourth, the complexity of nutrition and its inter-linkages with trade presented difficulties for developing a ‘broader discourse’ for engaging the public and political leaders on the topic.
Overcoming these ‘ideational challenges’ is likely to be important to building greater coherence between trade and nutrition policy going forward.
Biomimetic hierarchical surface structures that exhibit features having multiple length scales have been used in many technological and engineering applications. Their surface topographies are most commonly analyzed using scanning electron microscopy (SEM), which only allows for qualitative visual assessments. Here we introduce fractal and lacunarity analyses as a method of characterizing the SEM images of hierarchical surface structures in a quantitative manner. Taking femtosecond laser-irradiated metals as an example, our results illustrate that, while the fractal dimension is a poor descriptor of surface complexity, lacunarity analysis can successfully quantify the spatial texture of an SEM image; this, in turn, provides a convenient means of reporting changes in surface topography with respect to changes in processing parameters. Furthermore, lacunarity plots are shown to be sensitive to the different length scales present within a hierarchical structure due to the reversal of lacunarity trends at specific magnifications where new features become resolvable. Finally, we have established a consistent method of detecting pattern sizes in an image from the oscillation of lacunarity plots. Therefore, we promote the adoption of lacunarity analysis as a powerful tool for quantitative characterization of, but not limited to, multi-scale hierarchical surface topographies.
Infections cause morbidity and mortality in neonatal intensive care units (NICUs). The association between nursery design and nosocomial infections is unclear.
To determine whether rates of colonization by methicillin-resistant Staphylococcus aureus (MRSA), late-onset sepsis, and mortality are reduced in single-patient rooms.
Retrospective cohort study.
NICU in a tertiary referral center.
Our NICU is organized into single-patient and open-unit rooms. Clinical data sets including bed location and microbiology results were examined over 29 months. Differences in outcomes between bed configurations were determined by χ2 and Cox regression.
All NICU patients.
Among 1,823 patients representing 55,166 patient-days, single-patient and open-unit models had similar incidences of MRSA colonization and MRSA colonization-free survival times. Average daily census was associated with MRSA colonization rates only in single-patient rooms (hazard ratio, 1.31; P=.039), whereas hand hygiene compliance on room entry and exit was associated with lower colonization rates independent of bed configuration (hazard ratios, 0.834 and 0.719 per 1% higher compliance, respectively). Late-onset sepsis rates were similar in single-patient and open-unit models as were sepsis-free survival and the combined outcome of sepsis or death. After controlling for demographic, clinical, and unit-based variables, multivariate Cox regression demonstrated that bed configuration had no effect on MRSA colonization, late-onset sepsis, or mortality.
MRSA colonization rate was impacted by hand hygiene compliance, regardless of room configuration, whereas average daily census affected only infants in single-patient rooms. Single-patient rooms did not reduce the rates of MRSA colonization, late-onset sepsis, or death.
Infect Control Hosp Epidemiol 2015;36(10):1173–1182
This article reflects on issues of Indigenous creativity in Māori arts education, along with what we see as problematic tensions of the assessment of intangible elements. Our writing is motivated by a desire to start a global dialogue on Indigenous/Māori epistemologies, pedagogies and ontologies, and the contradictions and tensions that threaten these through global assessment drives within schools. We argue that current student assessment regimes are being increasingly influenced by international neoliberal agendas, which focus on universal, measurable outcomes. By critically exploring the assessment of creativity in the arts from a Māori perspective, we reflect on several contradictions and tensions in current assessment drives within schools. In particular, the intangible dimensions of being and flow and their connection to creativity are examined, and we conclude with recommendations for further work in this area.
In major depressive disorder (MDD), single nucleotide polymorphisms (SNPs) in monoaminergic genes may impact disease susceptibility, treatment response, and brain volume. The objective of this study was to examine the effect of such polymorphisms on hippocampal volume in patients with treatment-resistant MDD and healthy controls. Candidate gene risk alleles were hypothesised to be associated with reductions in hippocampal volume.
A total of 26 outpatients with treatment-resistant MDD and 27 matched healthy controls underwent magnetic resonance imaging and genotyping for six SNPs in monoaminergic genes [serotonin transporter (SLC6A4), norepinephrine transporter (SLC6A2), serotonin 1A and 2A receptors (HTR1A and HTR2A), catechol-O-methyltransferase (COMT), and brain-derived neurotrophic factor (BDNF)]. Hippocampal volume was estimated using an automated segmentation algorithm (FreeSurfer).
Hippocampal volume did not differ between patients and controls. Within the entire study sample irrespective of diagnosis, C allele-carriers for both the NET−182 T/C [rs2242446] and 5-HT1A−1019C/G [rs6295] polymorphisms had smaller hippocampal volumes relative to other genotypes. For the 5-HTTLPR (rs25531) polymorphism, there was a significant diagnosis by genotype interaction effect on hippocampal volume. Among patients only, homozygosity for the 5-HTTLPR short (S) allele was associated with smaller hippocampal volume. There was no association between the 5-HT2A, COMT, and BDNF SNPs and hippocampal volume.
The results indicate that the volume of the hippocampus may be influenced by serotonin- and norepinephrine-related gene polymorphisms. The NET and 5-HT1A polymorphisms appear to have similar effects on hippocampal volume in patients and controls while the 5-HTTLPR polymorphism differentially affects hippocampal volume in the presence of depression.
We do not need substantive accounts of the human in order to justify treating one another as equals, nor – given the exclusionary risks attached – should we want such accounts. In this chapter, I address one key challenge to this position, which comes via the idea of human dignity. Dignity per se poses no problem for my argument. Nothing in what I have so far argued stops me valuing dignified behaviour, admiring the dignity of a Nelson Mandela, or advising a friend not to participate in an undignified slanging match. I may feel some ambivalence towards dignity, sometimes admiring it, sometimes wishing people would not stand so much upon it, but there is no inconsistency in me regarding dignity as a mostly desirable quality. Nor, indeed, is it incompatible with my arguments for me to regard dignified behaviour as to some extent species specific, to think that it would be odd to talk of ants as behaving in a dignified manner, though not especially strange to say this of cats. My problem arises when we start talking more specifically of ‘the dignity of the human’. At this point we seem to be indicating some substantive ideal of what it is to be human, and what therefore counts as diminishing or degrading that humanness. Many consider this ‘dignity of the human’ a necessary underpinning for claims about human rights, but there is no good reason why the commitment to human equality should have to be underpinned in this way, nor why it should have to come as a second stage. Most of what people find useful in ideas about human dignity can be adequately provided for by going straight to equality instead.
The ‘dignity of man’ (sic) has figured as one of the bases for claiming rights for centuries, but it was mainly with the Universal Declaration of Human Rights in 1948 that the ‘inviolable’ dignity of the human became such a central reference point for human rights documents and legislation.
When we speak the language of the human, we engage in a politics of inclusion; yet in offering our definitions of this human, we endorse something that serves to exclude. In any definition, the characteristics named as essential may be highly idealised, sometimes verging on the imaginary, but even when they capture something real the selections made are a matter of history and politics. As Ian Hacking has put it, we ‘make up people’. We do not make them up in the sense of conjuring them physically into existence, but when we decide that the crucial distinction is that between man and woman, or human and animal, or heterosexual and gay, we settle on definitions and boundaries that then mark our ways of thinking and living. The idea, for example, that humans divide into two sexes, male and female, is so much taken for granted that we tend to think of it as just a fact of nature – and it does indeed capture something ‘real’: a difference in our reproductive organs. But differentiating between humans on this basis was never the only possibility. We could, in principle, have decided that the key ‘natural’ distinction was between the short and the tall. Through much of history, people have claimed variations in skin colour and physiognomy as the key distinctions. So far as male and female is concerned, there may be no great mystery about why reproductive organs came to be viewed as such an important mode of differentiation – societies have to reproduce themselves, after all – but it is worth bearing in mind that this is not just ‘natural fact’. We should also bear this in mind when considering the human/non-human distinction.
As Felipe Fernandez-Armesto observes in So You Think You're Human?, St Francis of Assisi preached to ravens, St Antony of Padua reportedly administered communion to his horse, and in the – to most of us extraordinary – accounts of the animal trials of fifteenth-, sixteenth-, and seventeenth century Europe, we glimpse a very different division of the world in which animals seemed to have legal rights ‘practically on a par with humans’.
To think of oneself primarily as a human being is to discount, in some way, the significance of the divisions we otherwise maintain between people. It will be an important part of my argument, however, that it does not mean setting all those divisions aside. I argue that the politics of the human requires us precisely to address the divisions. It is not that one is human instead of being male or female, boss or worker, Ashanti or Fante, Christian, Muslim, or Jew, and that we can therefore ignore the salience of those more specific identifiers in order to focus on our shared humanity. The point, rather, is that none of the distinctions and divisions should prevent us from claiming our equality and being accepted as full equals. Where they do – where the other identifiers get in the way of equality – this points to urgent political tasks. Being human is not a matter of imaginatively discounting the significance of the barriers that have been erected between us, but then leaving those barriers in place. It is not the warm feeling one might get when discovering that people unlike us in every conceivable way nonetheless do things in a characteristically human manner. If those people still have power over us or we over them, we are not yet engaging fully with what it means for us both to be human beings. I do not mean by this that it is meaningless or dishonest to talk of us all being human so long as societies fall short of equality in power. If that were my argument, I would have to postpone the use of the term indefinitely, and probably for ever. My concern is with the tricky way in which notions of the human do indeed call on us to discount the significance of the divisions we maintain between us, and the danger that in doing so they encourage us to set those divisions entirely to one side.
In my opening comments, I indicated that I did not intend this book as either an endorsement of humanism or an anti or posthumanism. What do I mean by this claim? Peter Sloterdijk says of humanism that ‘as a word and as a movement [it] always has a goal, a purpose, a rationale: it is the commitment to save men from barbarism’. His description nicely captures the association between humanism and the humanities, linking it back to the ‘civilising’ scholarship of the Renaissance and its Greek and Roman forebears. It also captures some of humanism's political naivety: its belief that good men and good books can save us from the abyss. That naivety remains one of the charges against humanism, though many of today's critics read this in a more sinister light, variously identifying humanism's hypocrisy, anthropocentrism, Westerncentrism, exaggerated confidence in scientific progress, and misguided belief that humans can (eventually) control their world. My own preoccupation is that, in steering us away from the particularities that shape and define us – and through which we shape and define ourselves – humanism renders these of lesser significance, and thereby makes it harder to address the power relations invested in them. My objection then reflects a longstanding commitment to conceptualising equality through rather than despite difference. As applied to humanism, this becomes a concern that diverting attention from difference to what, as humans, we have in common can encourage an empty sentimentalism that wishes away the realities of power. This is a harsh depiction, and no self-defined humanist would recognise herself in the description, but it is hard to see how humanism can entirely avoid the charge. The force of the tradition lies precisely in that movement away from what is seen as an excessive and destructive focus on the differences that divide us, and towards our common humanity: this movement is the very basis of its ethical appeal.