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In this chapter, the authors trace out the “natural history” of an intensely collaborative multisited comparison, which was distinct from many other comparative research projects because research at each site was carried out by a PhD-level anthropologist who was involved in the scientific development of the project rather than only in the implementation of a centrally directed project. It draws on their experiences with this once-in-a-lifetime opportunity, a large, US National Institutes of Health–funded multisite project, to discuss ways in which that comparative research could have been even more powerful, things that future comparative research should strive to avoid, recommended best practices, and what the authors would call “minimum adequate” approaches to comparative ethnography.
The northern lobe of the White River Ash (WRAn) is part of a bilobate distribution of tephras that originated from the Wrangell Volcanic Field near the border of Alaska, USA, and Yukon, Canada. It is distributed across northeastern Alaska and the northwestern portion of the Yukon. The timing of this eruption has seen little critical analysis relative to the younger and more extensive eastern lobe eruption of the White River Ash. We compiled 38 radiocarbon (14C) dates from above and below the WRAn, and employed several statistical approaches to identify and eliminate or down-weight outliers, combine dates, and different Bayesian models, to provide a revised age estimate for the timing of the WRAn tephra deposition. Our results indicate that the most accurate modeled age estimate for the northern lobe of the White River Ash deposition is between 1689 and 1560 cal BP, with a mean and median of 1625 and 1623 cal BP, respectively. This age range is 90 to 200 years younger than previous age estimates.
Clostridioides difficile infection (CDI) remains a significant public health concern, resulting in excess morbidity, mortality, and costs. Additional insight into the burden of CDI in adults aged <65 years is needed.
A 6-year retrospective cohort study was conducted using data extracted from United States Veterans Health Administration electronic medical records.
Patients aged 18–64 years on January 1, 2011, were followed until incident CDI, death, loss-to-follow-up, or December 31, 2016. CDI was identified by a diagnosis code accompanied by metronidazole, vancomycin, or fidaxomicin therapy, or positive laboratory test. The clinical setting of CDI onset was defined according to 2017 SHEA-IDSA guidelines.
Of 1,073,900 patients, 10,534 had a CDI during follow-up. The overall incidence rate was 177 CDIs per 100,000 person years, rising steadily from 164 per 100,000 person years in 2011 to 189 per 100,000 person years in 2016. Those with a CDI were slightly older (55 vs 51 years) and sicker, with a higher baseline Charlson comorbidity index score (1.4 vs 0.5) than those without an infection. Nearly half (48%) of all incident CDIs were community associated, and this proportion rose from 41% in 2011 to 56% in 2016.
The findings from this large retrospective study indicate that CDI incidence, driven primarily by increasing community-associated infection, is rising among young and middle-aged adult Veterans with high service-related disability. The increasing burden of community associated CDI in this vulnerable population warrants attention. Future studies quantifying the economic and societal burden of CDI will inform decisions surrounding prevention strategies.
The purpose of this study was to examine whether vehicle type based on size (car vs. other = truck/van/SUV) had an impact on the speeding, acceleration, and braking patterns of older male and female drivers (70 years and older) from a Canadian longitudinal study. The primary hypothesis was that older adults driving larger vehicles (e.g., trucks, SUVs, or vans) would be more likely to speed than those driving cars. Participants (n = 493) had a device installed in their vehicles that recorded their everyday driving. The findings suggest that the type of vehicle driven had little or no impact on per cent of time speeding or on the braking and accelerating patterns of older drivers. Given that the propensity for exceeding the speed limit was high among these older drivers, regardless of vehicle type, future research should examine what effect this behaviour has on older-driver road safety.
In his article “Carbon Emissions, Stratospheric Aerosol Injection, and Unintended Harms,” Christopher J. Preston compares the culpability of carbon emitters versus that of geoengineers deploying stratospheric aerosol injection (SAI). This comparison relies on a parallel between carbon emitters and SAI deployers that requires both to be agents. However, both are not. While the harms of geoengineering will be caused by culpable agents acting intentionally, the harms connected to climate change emerge out of the uncoordinated actions of billions of people. Taken as a large group, carbon emitters cause harm but do not constitute an agent. Taken individually, carbon emitters are agents but do not cause the harms of climate change. As a result, the parallel collapses, and Preston's “surprising” conclusion is one that he is not entitled to reach.
The purpose of this study was to determine if season or weather affected the objectively measured trip distances of older drivers (≥ 70 years; n = 279) at seven Canadian sites. During winter, for all trips taken, trip distance was 7 per cent shorter when controlling for site and whether the trip occurred during the day. In addition, for trips taken within city limits, trip distance was 1 per cent shorter during winter and 5 per cent longer during rain when compared to no precipitation when controlling for weather (or season respectively), time of day, and site. At night, trip distance was about 30 per cent longer when controlling for season and site (and weather), contrary to expectations. Together, these results suggest that older Canadian drivers alter their trip distances based on season, weather conditions, and time of day, although not always in the expected direction.
Individuals have various kinds of obligations: keep promises, don’t cause harm, return benefits received from injustices, be partial to loved ones, help the needy and so on. How does this work for group agents? There are two questions here. The first is whether groups can bear the same kinds of obligations as individuals. The second is whether groups’ pro tanto obligations plug into what they all-things-considered ought to do to the same degree that individuals’ pro tanto obligations plug into what they all-things-considered ought to do. We argue for parity on both counts.
To understand perspectives of stakeholders during initial district-wide implementation of a Breakfast in the Classroom (BIC) model of the School Breakfast Program.
Qualitative data were collected from twenty-nine focus groups and twenty interviews with stakeholders in a school district early in the process of implementing a BIC model of the School Breakfast Program.
Ten elementary schools within a large, urban school district in the USA that served predominantly low-income, racial/ethnic minority students.
Purposively selected stakeholders in elementary schools that had implemented BIC for 3–6 months: students (n 85), parents/guardians (n 86), classroom teachers (n 44), cafeteria managers (n 10) and principals (n 10).
Four primary themes emerged, which were interpreted based on the Diffusion of Innovations model. School staff had changed their perceptions of both the relative disadvantages and costs related to time and effort of BIC over time; the majority of each stakeholder group expressed an appreciation for BIC; student breakfast consumption varied from day to day, related to compatibility of foods with child preferences; and stakeholders held mixed and various impressions of BIC’s potential impacts.
The study underscores the importance of engaging school staff and parents in discussions of BIC programming prior to its initiation to pre-emptively address concerns related to cost, relative disadvantages and compatibility with child preferences and school routines/workflow. Effectively communicating with stakeholders about positive impacts and nutritional value of the meals may improve support for BIC. These findings provide new information to policy makers, districts and practitioners that can be used to improve implementation efforts, model delivery and outcomes.
The enhancement of photovoltaic efficiency by incorporation of down-shifting phosphor materials in optically active and inactive regions of solar modules is presented. Thin film photovoltaic modules suffer from various optical losses, including front glass reflectance, thermalization loss of absorbed high energy photons, window layer absorption, and the loss of photons to scribe regions. There have been various efforts to improve the performance of solar modules by application of down-shifting (DS), down-converting, and up-converting materials systems. Here we show results towards the development of a low-cost phosphor film system tuned to the solar spectrum and specifically designed for CdTe thin film modules.
To assess the nutritional quality of food packages offered in the Food Distribution Program on Indian Reservations (FDPIR) using the Healthy Eating Index 2010 (HEI-2010).
Data were collected from the list of the food products provided by the US Department of Agriculture’s Food and Nutrition Handbook 501 for FDPIR. Nutritional quality was measured through a cross-sectional analysis of five randomly selected food packages offered through FDPIR. HEI-2010 component and total scores were calculated for each food package. ANOVA and t tests assessed significant differences between food packages and HEI-2010 maximum scores, respectively.
This study took place in the USA.
Study units included food products offered through FDPIR.
The mean total HEI-2010 score for the combined FDPIR food packages was significantly lower than the total HEI-2010 maximum score of 100 (66·38 (sd 11·60); P<0·01). Mean scores for total fruit (3·52 (sd 0·73); P<0·05), total vegetables (2·58 (sd 0·15); P<0·001), greens and beans (0·92 (sd 1·00); P<0·001), dairy (5·12 (sd 0·63); P<0·001), total protein foods (4·14 (sd 0·56); P<0·05) and refined grains (3·04 (sd 2·90); P<0·001) were all significantly lower than the maximum values.
The FDPIR food package HEI-2010 score was notably higher than other federal food assistance and nutrition programmes. Study findings highlight opportunities for the FDPIR to modify its offerings to best support lifestyles towards prevention of diet-related chronic disease.
There are many different ways to try to bring about an end to the harms involved in the production of consumer goods. In this article I will start at the bottom, with the individual whose ordinary choices about how to travel, what to eat, what to wear, where to shop, and which policies to support all cause her to confront the possibility of involvement in these harms to the environment, nonhuman animals, and persons.
Having dismissed the claim that an individual has a straightforward duty of justice not to consume unethically produced goods, in the second section I map out a few different approaches, all of which I take to be promising avenues for generating duties in individuals to consume ethically. I argue that the last approach is the most promising and spend the third section of this article developing it. Specifically, I argue that as a first step in collectivizing to act against unjust global labor practices, an individual ought to signal to others her commitments to ethical consumption. In section four I ask whether some signals are too cheap to function as a step toward collectivization, and defend the deliberate consumption of only ethically produced goods as a moderately costly and therefore reliable signal. In the last section I consider a challenge to the proposal in terms of whether it imposes unacceptable costs on consumers.
The current study sought to examine the utility of intra-individual variability (IIV) in distinguishing participants with prodromal Huntington disease (HD) from nongene-expanded controls. IIV across 15 neuropsychological tasks and within-task IIV using a self-paced timing task were compared as a single measure of processing speed (Symbol Digit Modalities Test [SDMT]) in 693 gene-expanded and 191 nongene-expanded participants from the PREDICT-HD study. After adjusting for depressive symptoms and motor functioning, individuals estimated to be closest to HD diagnosis displayed higher levels of across- and within-task variability when compared to controls and those prodromal HD participants far from disease onset (FICV(3,877)=11.25; p<.0001; FPacedTiming(3,877)=22.89; p<.0001). When prodromal HD participants closest to HD diagnosis were compared to controls, Cohen’s d effect sizes were larger in magnitude for the within-task variability measure, paced timing (−1.01), and the SDMT (−0.79) and paced tapping coefficient of variation (CV) (−0.79) compared to the measures of across-task variability [CV (0.55); intra-individual standard deviation (0.26)]. Across-task variability may be a sensitive marker of cognitive decline in individuals with prodromal HD approaching disease onset. However, individual neuropsychological tasks, including a measure of within-task variability, produced larger effect sizes than an index of across-task IIV in this sample. (JINS, 2015, 21, 8–21)
Western Australia has an extensive coastline extending 12889 km (excluding islands) from latitude 35 degrees in the south to 14 degrees in the north. The extensive coastline intersects the distribution of many species of beaked whale. A total of 74 Ziphiidae were recorded as stranded along the Western Australian coast between 1940 and 2010 (70 years). Ten of the 21 species of beaked whales currently recognized taxonomically worldwide have been observed in Western Australia with True's beaked whale Mesoplodon mirus and Shepherd's beaked whale Tasmacetus shepherdi recorded more than elsewhere in Australia. Western Australia has the highest species diversity (10) of beaked whale strandings compared to other Australian states and regions. Gray's beaked whale, Mesoplodon grayi, was the most commonly reported species (33 records) and had the largest mass stranding group size (seven) of the beaked whales stranded in Western Australia. The records presented in this paper confirm the distribution of Arnoux's beaked whale Berardius arnuxii, strap-toothed beaked whale Mesoplodon layardii, Shepherd's beaked whale, Blainville's beaked whale Mesoplodon densirostris in Western Australian waters. The records presented of True's beaked whale confirm its presence in Australian waters, with Western Australia a possible key location for this species. Factors causing strandings and death should be investigated in future wherever possible, particularly the rostral injuries reported for six beaked whales. Beaked whale species identification should be confirmed through genetic analysis in future to maximize certainty of species identification.
Two dominant arguments within international political theory, arguments from humanity and arguments from justice, can be distinguished along the lines of the well-known distinction between omissions and actions, respectively. The discussion in this paper shows that people in general are psychologically biased towards thinking that omissions producing harm are less morally grave than actions producing equivalent harm. It also canvasses evidence suggesting that greater moral gravity correlates with heightened guilt, and that heightened guilt is more likely to lead to action that would alleviate it, i.e. remedial or compensatory action. For those reasons, it is suggested that we should expect arguments from justice, which track actions, to be a more feasible means to the desired outcome of (local commitment to) global justice than arguments from humanity, which track omissions.
Mylonite textures in granodiorite boulders are responsible for higher rates of surface denudation of host rocks and the progressive development of unusual rock weathering features, termed weathering posts. These textures are characterized by smaller grain sizes, higher biotite content, and a higher biotite axial ratio in host rocks relative to weathering posts. Elemental concentrations do not show a significant difference between weathering posts and the host rocks in which they are found, and this reflects the absence of a weathering residue on the rock surfaces. Chemical weathering loosens the bonds between mineral grains through the expansion of biotite, and the loosened grains fall off or are blown off the boulder surface and continue their chemical alteration in the surrounding soil. The height of weathering posts on late Quaternary moraines increases at a linear rate of ~ 1.45±0.45 cm (1000 yr)– 1 until post heights reach the diameter of host rocks. Such a rate of boulder denudation, if unrecognized, would generate significant errors (> 20%) in cosmogenic exposure ages for Pleistocene moraines. Given the paucity of boulders with diameters that significantly exceed 1.5 m, the maximum age of utility of weathering posts as a numeric age indicator is ~ 100 ka.
Recently two distinct forms of rule-utilitarianism have been introduced that differ on how to measure the consequences of rules. Brad Hooker advocates fixed-rate rule-utilitarianism (which measures the expected value of the rule's consequences at a 90 percent acceptance rate), while Michael Ridge advocates variable-rate rule-utilitarianism (which measures the average expected value of the rule's consequences for all different levels of social acceptance). I argue that both of these are inferior to a new proposal, optimum-rate rule-utilitarianism. According to optimum-rate rule-utilitarianism, an ideal code is the code whose optimum acceptance level is no lower than that of any alternative code. I then argue that all three forms of rule-utilitarianism fall prey to two fatal problems that leave us without any viable form of rule-utilitarianism.
Twentieth century philosophers introduced the distinction between “objective rightness” and “subjective rightness” to achieve two primary goals. The first goal is to reduce the paradoxical tension between our judgments of (i) what is best for an agent to do in light of the actual circumstances in which she acts and (ii) what is wisest for her to do in light of her mistaken or uncertain beliefs about her circumstances. The second goal is to provide moral guidance to an agent who may be uncertain about the circumstances in which she acts, and hence is unable to use her standard moral principle directly in deciding what to do. This paper distinguishes two important senses of “moral guidance”; proposes criteria of adequacy for accounts of subjective rightness; canvasses existing definitions for “subjective rightness”; finds them all deficient; and proposes a new and more successful account. It argues that each comprehensive moral theory must include multiple principles of subjective rightness to address the epistemic situations of the full range of moral decision-makers, and shows that accounts of subjective rightness formulated in terms of what it would reasonable for the agent to believe cannot provide that guidance.
Holly A. Muir, Vice Chair, Clinical Operations Department of Anesthesiology, Duke University, Medical Center, Durham, North Carolina, USA; Chief, Division of Women's Anesthesia,
Michael Smith, Chief Resident in Anesthesiology, Department of Anaesthesiology, University of Kansas, School of Medicine – Wichita, Wichita, KS, USA,
David R. Gambling, Clinical Associate Professor, Department Anesthesiology, University of California, San Diego, CA USA; Staff Anesthesiologist, Sharp Mary Birch Hospital for Women
Malignancy complicates between 0.02% and 0.10% of all pregnancies and in one study cancer diagnosis was associated with 1 in 1000 deliveries. Pregnancy does not affect the frequency of cancers seen in women of childbearing age. Melanoma may be the most frequent malignancy seen during pregnancy (1:350), followed by cervical cancer (1:2250), Hodgkin lymphoma (1:3000), breast cancer (1:7500), ovarian cancer (1:18,000), and leukemia (1:75,000). However, the National Cancer Institute maintains that breast cancer is the most common cancer seen in pregnant and postpartum women at 1:3000 pregnancies (www.cancer.gov/cancertopics/pdq/treatment/breast-cancer-and-pregnancy).
In general, the prognosis for pregnant women with malignant lesions is the same, stage for stage, as for nonpregnant women. However, for many reasons, diagnosis of cancer during pregnancy occurs at more advanced stages of the disease.
Typically, during pregnancy, what benefits the mother also benefits the fetus. However, that is not true in the case of the pregnant woman with cancer as treating the cancer often means compromising the pregnancy. Depending on the type of cancer and gestational age at diagnosis, treatment can sometimes be delayed until the fetus is either viable or mature. In some cases, protection of maternal and fetal health are congruent, but when care of the mother imposes iatrogenic risk to the fetus, the mother may decide to delay or alter her treatment for the good of the fetus, potentially to her own detriment.
Fetal and uterine monitoring during cancer surgery is controversial.