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This letter explores language politics as it concerns gender, and investigates the adoption of amendments that introduce gender-neutral language to subnational constitutions via popular initiative. Embracing theories of female empowerment based on resource acquisition and shrinking gender differentials in economic resources, the authors argue that popular support for these initiatives will be higher in contexts where female and male incomes are closer to parity. The study tests this expectation using city-level historical administrative data in California on Proposition 11 in 1974 – the first American state to hold a popular vote on amending its constitution to include only gender-neutral language. It finds that greater parity in income between women and men is associated with greater voter support for the initiative. This result holds after controlling for conceivable confounders, fails to emerge when analyzing gender-irrelevant ballot measures, and replicates when analyzing similar measures held in three jurisdictions in other states.
Major surgery carried out in low- and middle-income countries is associated with a high risk of surgical site infections (SSI), but knowledge is limited regarding contributory factors to such infections. This study explores factors related to patients developing an SSI in a teaching hospital in Ghana. A prospective cohort study of patients undergoing abdominal surgical procedures was conducted at Korle Bu Teaching Hospital. Patient characteristics, procedures and environmental characteristics were recorded. A 30-day daily surveillance was used to diagnose SSI, and Poisson regression analysis was used to test for association of SSI and risk factors; survival was determined by proportional hazard regression methods. We included 358 patients of which 58 (16.2%; 95% CI 12.7–20.4%) developed an SSI. The median number of door openings during an operation was 79, with 81% being unnecessary. Door openings greater than 100 during an operation (P = 0.028) significantly increased a patient's risk of developing an SSI. Such patients tended to have an elevated mortality risk (hazard ratio 2.67; 95% CI 0.75–9.45, P = 0.128). We conclude that changing behaviour and practices in operating rooms is a key strategy to reduce SSI risk.
To determine whether optic disc hemorrhages (ODH) and cotton wool spots (CWS) at presentation are associated with worse visual outcomes in pediatric patients with idiopathic intracranial hypertension (IIH).
Retrospective institutional review of 100 eyes of 50 consecutive pediatric IIH patients (aged 16 years or less) who had baseline optic disc photographs before or within 30 days of their diagnostic lumbar puncture and initiation of medical treatment. Optic disc photographs were independently graded by three ophthalmologists in a standardized manner. Visual function was assessed using visual acuity (VA) and visual field grade (VFG).
At least one ODH was found in 41% of eyes, at least one CWS was found in 27% of eyes, and 20% of eyes had both ODH and CWS. At presentation, Frisén grade was associated with the presence of CWS (p = 0.013) and showed no association with ODH (p = 0.060). When controlling for Frisén grade, ODH and CWS were not associated with worse VA or VFG at final follow-up. Severe ODH were associated with worse VA and VFG at presentation (p < 0.03), but not at final follow-up. Severe CWS at presentation was strongly associated with a worse Humphrey mean deviation of 5.0 dB (95% confidence interval 1.6–8.3) at final follow-up (p = 0.002).
When controlling for the severity of papilledema, ODH do not provide any additional prognostic value in pediatric IIH patients. Frisén grade and severe CWS at presentation were independently associated with worse visual outcomes at the final follow-up.
Four placoderm fishes are described from the Lepel Beds of the Vitebsk Regional Stage of the Lower Devonian (upper Emsian) of Belarus. Two forms are new (Stipatosteus svidunovitchi new genus, new species and Actinolepis zaikai new species) and the other two taxa are left in open nomenclature (Coccosteidae gen. indet. sp. indet.; Placodermi indet. 1). Specimens of all four forms consist of disarticulated, mostly well-preserved plates (some are worn at the edges) originating from the cores of six boreholes. Additionally, the paper presents data on organic remains with the placoderms. A detailed lithological description of the enclosing rocks and a taphonomic description of the ichthyofauna are also provided. The 2010 Stratigraphic Chart of the Devonian deposits of Belarus was used as the stratigraphic basis. The presence of the genus Actinolepis Agassiz, 1844 in these deposits as well as in the Emsian of the Baltic region and Spitsbergen suggests a regional paleogeographic connection at this time.
The number of novel psychoactive substances (NPS) available is increasing. Synthetic cannabinoids (SC) are one of many NPS sold. SC aim to emulate the effects of natural cannabis by acting on cannabinoid receptors. Despite much research into pharmacology, there is limited data on the user experience of SC.
It is useful for psychiatrists, to understand what experiences people have whilst on illicit substances. The aim of this qualitative study is to gain an initial understanding of what characterizes the experiences of those who use SC.
Fourty anonymously written online reports were collected from the “Erowid experience vaults” and analysed using the Empirical Phenomenological Psychological Method.
The analysis yielded 488 meaning units (MU). These were grouped into 36 categories revealing 5 broad themes: (1) physical affects; (2) sensory distortions and distortions of perception; (3) emotional and psychological effects; (4) re-dosing, addiction and comedown effects; (5) similarities to other substances.
Synthetic cannabinoids have a mixed effect on users with a myriad of experiences reported. Some experienced positive results from their usage such as euphoria and relaxation, however these were counter balanced by those who experienced some serious negative emotional and physical side effects such as anxiety, paranoia, palpitations and convulsions. SC appear to often emulate that of their natural counterpart, yet there is an unpredictability to them which can end with serious consequences. Online forum content gives us a strong base understanding of users experiences of SC. Further research is required to elucidate a more nuanced understanding.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The mechanism through which developmental programming of offspring overweight/obesity following in utero exposure to maternal overweight/obesity operates is unknown but may operate through biologic pathways involving offspring anthropometry at birth. Thus, we sought to examine to what extent the association between in utero exposure to maternal overweight/obesity and childhood overweight/obesity is mediated by birth anthropometry. Analyses were conducted on a retrospective cohort with data obtained from one hospital system. A natural effects model framework was used to estimate the natural direct effect and natural indirect effect of birth anthropometry (weight, length, head circumference, ponderal index, and small-for-gestational age [SGA] or large-for-gestational age [LGA]) for the association between pre-pregnancy maternal body mass index (BMI) category (overweight/obese vs normal weight) and offspring overweight/obesity in childhood. Models were adjusted for maternal and child socio-demographics. Three thousand nine hundred and fifty mother–child dyads were included in analyses (1467 [57.8%] of mothers and 913 [34.4%] of children were overweight/obese). Results suggest that a small percentage of the effect of maternal pre-pregnancy BMI overweight/obesity on offspring overweight/obesity operated through offspring anthropometry at birth (weight: 15.5%, length: 5.2%, head circumference: 8.5%, ponderal index: 2.2%, SGA: 2.9%, and LGA: 4.2%). There was a small increase in the percentage mediated when gestational diabetes or hypertensive disorders were added to the models. Our study suggests that some measures of birth anthropometry mediate the association between maternal pre-pregnancy overweight/obesity and offspring overweight/obesity in childhood and that the size of this mediated effect is small.
Globba sect. Nudae subsect. Mediocalcaratae (K.Schum.) K.J.Williams is revised. Nineteen species are recognised. Eight names are lectotypified, three names are newly placed in synonymy, and two names are neotypified. A key to the species and descriptions are provided. Nine new species are described and illustrated: Globba argyrocycnos Sangvir. & M.F.Newman, G. cataractarum Sangvir. & M.F.Newman, G. chrysochila Sangvir. & M.F.Newman, G. decora Sangvir. & M.F.Newman, G. lilacina Sangvir. & M.F.Newman, G. newmanii Sangvir., G. nitens Sangvir. & M.F.Newman, G. pycnostachys Sangvir. & M.F.Newman and G. pyrrhopoikila Sangvir. & M.F.Newman. Six names based on five types from Thailand and the Philippines remain doubtful. Andromonoecy in this subsection is defined. Provisional IUCN conservation assessments of all species are supplied.