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In the 1990s, British writers began using “transparency” as a portmanteau word to describe that desirable state of organizational management and governance characterized by candor, openness, honesty, clarity, legal compliance, and full disclosure (Handy, 1990). At first, the word didn’t take hold on this side of the Atlantic, perhaps because it was too vague and philosophical for American tastes in managerial buzz words (which tend to run more to the precise and practical).
Civil War soldiers marched home in 1865 as changed men. No longer holiday soldiers, they were now seasoned veterans. In “The Return of the Heroes,” poet Walt Whitman celebrated the “worn, swart, handsome, strong” men who had been made from the “stock of homestead and workshop,” hardened by the “long campaign and sweaty march,” and inured to the “hard-fought, bloody field.” Disease or marching had enervated all; shot and shell had maimed some and shaken others. Whitman nevertheless projected a vision of regenerative masculinity. The immortal ranks tramping through the poem’s stanzas displayed a manliness grounded in the work of the antebellum era, transformed by the experiences in war, and redeemed by the agricultural pursuits of the postwar years. Whitman’s poem serves as a reminder that nineteenth-century Americans thought deeply about what made a man and recognized masculinity’s mutability.
The Fontan procedure is the final stage of surgical palliation for a single-ventricle circulation. Significant complications are common including rhythm disturbance necessitating implantation of a permanent pacemaker. This has been widely considered a negative prognostic indicator.
This single-centre, retrospective case control study involved all patients who underwent the Fontan procedure at the Leeds Congenital Heart Unit between 1990 and 2015 and have had regular follow-up in Yorkshire and Humber, United Kingdom. 167 Fontan patients were identified of which 2 were excluded for having a pre-procedure pacemaker. Of the remainder, 23 patients required a pacemaker. Outcomes were survival, early and late complications, need for further intervention and oxygen saturation in long-term follow-up.
There was no difference in survival (30-day survival pacemaker 92.6%, sinus rhythm 90.5%, p = 0.66, 1-year pacemaker 11.1%, sinus rhythm 10.1%, p = 1). The pacemaker group was more likely to have cerebral or renal complications in the first-year post-procedure (acute kidney injury: sinus rhythm 0.8%, pacemaker 19.1%, p = 0.002). No difference was observed in longer term complications including protein losing enteropathy (sinus rhythm 3.5%, pacemaker 0% p = 1). There was no difference in saturations between the two groups at follow-up. Paced patients were more likely to have required further intervention, with a higher incidence of cardiopulmonary bypass procedures (sinus rhythm 6.3%, pacemaker 35%, p < 0.001).
Despite an increase in early complications and the need for further interventions, pacemaker requirement does not appear to affect long-term survival following the Fontan procedure.
A piezoelectric biomedical microelectromechanical system (bioMEMS) cantilever device was designed and fabricated to act as either a sensing element for muscle tissue contraction or as an actuator to apply mechanical force to cells. The sensing ability of the piezoelectric cantilevers was shown by monitoring the electrical signal generated from the piezoelectric aluminum nitride in response to the contraction of iPSC-derived cardiomyocytes cultured on the piezoelectric cantilevers. Actuation was demonstrated by applying electrical pulses to the piezoelectric cantilever and observing bending via an optical detection method. This piezoelectric cantilever device was designed to be incorporated into body-on-a-chip systems.
Despite trends towards greater LGBTQ (lesbian, gay, bisexual, transgender, and queer) rights in industrialized democracies, the rights of sexual minorities have become increasingly politicized and restricted throughout Africa. Recognizing religion's central role in shaping attitudes toward gays and lesbians, we hypothesize that local religious diversity could expose individuals to alternative religious perspectives, engender tolerance toward marginalized communities, and therefore dislodge dogmatic beliefs about social issues. Employing cross-national Afrobarometer survey data from 33 countries with an index of district-level religious concentration, we find that respondents living in religiously pluralistic communities are 4–5 points more likely to express tolerance of homosexual neighbors (50% increase) compared to those in homogeneous locales. This effect is not driven by outlier countries, the existence of specific religious affiliations within diverse communities, respondents' religiosity, or other observable and latent factors at the country, sub-national, district, and individual level. Further robustness checks address potential threats to validity. We conclude that religious diversity can foster inclusion of sexual minorities in Africa.
There is now a strong body of literature showing that bullying victimisation during childhood and adolescence precedes the later development of anxiety and depressive disorders. This study aimed to quantify the burden of anxiety and depressive disorders attributable to experiences of bullying victimisation for the Australian population.
This study updated a previous systematic review summarising the longitudinal association between bullying victimisation and anxiety and depressive disorders. Estimates from eligible studies published from inception until 18 August 2018 were included and meta-analyses were based on quality-effects models. Pooled relative risks were combined with a contemporary prevalence estimate for bullying victimisation for Australia in order to calculate population attributable fractions (PAFs) for the two mental disorder outcomes. PAFs were then applied to estimates of the burden of anxiety and depressive disorders in Australia expressed as disability-adjusted life years (DALYs).
The findings from this study suggest 7.8% of the burden of anxiety disorders and 10.8% of the burden of depressive disorders are attributable to bullying victimisation in Australia. An estimated 30 656 DALYs or 0.52% (95% uncertainty interval 0.33–0.72%) of all DALYs in both sexes and all ages in Australia were attributable to experiences of bullying victimisation in childhood or adolescence.
There is convincing evidence to demonstrate a causal relationship between bullying victimisation and mental disorders. This study showed that bullying victimisation contributes a significant proportion of the burden of anxiety and depressive disorders. The investment and implementation of evidence-based intervention programmes that reduce bullying victimisation in schools could reduce the burden of disease arising from common mental disorders and improve the health of Australians.
Turbulent structures in stably stratified shear layers are studied with direct numerical simulation. Flow visualization confirms the existence of hairpin vortices and highly elongated structures with positive and negative velocity fluctuations, whose streamwise lengths divided by the layer thickness are
, respectively. The flow at the wavelength related to these structures makes a large contribution to turbulent kinetic energy. These structures become prominent in late time, but with small buoyancy Reynolds numbers indicating suppression of turbulent mixing. Active turbulent mixing associated with the hairpin vortices, however, does occur. The structures and the vertical profile of the integral shear parameter show connections between stable stratified shear layers and wall-bounded shear flows.
Photonic crystal surfaces represent a class of resonant optical structures that are capable of supporting high intensity electromagnetic standing waves with near-field and far-field properties that can be exploited for high sensitivity detection of biomolecules and cells. While modulation of the resonant wavelength of a photonic crystal by the dielectric permittivity of adsorbed biomaterials enables label-free detection, the resonance can also be tuned to coincide with the excitation wavelength of common fluorescent tags - including organic molecules and semiconductor quantum dots. Photonic crystals are also capable of efficiently channeling fluorescent emission into a preferred direction for enhanced extraction efficiency. Photonic crystals can be designed to support multiple resonant modes that can perform label free detection, enhanced fluorescence excitation, and enhanced fluorescence extraction simultaneously on the same device. Because photonic crystal surfaces may be inexpensively produced over large surface areas by nanoreplica molding processes, they can be incorporated into disposable labware for applications such as pharmaceutical high throughput screening. In this talk, the optical properties of surface photonic crystals will be reviewed and several applications will be described, including results from screening a 200,000-member chemical compound library for inhibitors of protein-DNA interactions, gene expression microarrays, and high sensitivity of protein biomarkers.
Research participants want to receive results from studies in which they participate. However, health researchers rarely share the results of their studies beyond scientific publication. Little is known about the barriers researchers face in returning study results to participants.
Using a mixed-methods design, health researchers (N = 414) from more than 40 US universities were asked about barriers to providing results to participants. Respondents were recruited from universities with Clinical and Translational Science Award programs and Prevention Research Centers.
Respondents reported the percent of their research where they experienced each of the four barriers to disseminating results to participants: logistical/methodological, financial, systems, and regulatory. A fifth barrier, investigator capacity, emerged from data analysis. Training for research faculty and staff, promotion and tenure incentives, and funding agencies supporting dissemination of results to participants were solutions offered to overcoming barriers.
Study findings add to literature on research dissemination by documenting health researchers’ perceived barriers to sharing study results with participants. Implications for policy and practice suggest that additional resources and training could help reduce dissemination barriers and increase the return of results to participants.
CompStat emerged in the mid 1990s and quickly came to be seen as a major innovation in American policing. By the turn of the century it had received national awards from Harvard University and former Vice President Gore, and was featured prominently along with William Bratton (the police administrator who created the program) in the national news media. Its originators and proponents gave CompStat credit for impressive reductions in crime and improvements in neighborhood quality of life in a number of cities that had adopted the program (Silverman, 1996; Remnick, 1997; Gurwitt, 1998; Bratton, 1999). And while CompStat was first introduced only in 1994 in New York City, police departments around the country had begun to adopt it or variations of it by the first decade of the new century (Law Enforcement News, 1997; Maas, 1998; McDonald, 1998; Weisburd et al., 2003; Willis, Mastrofski & Kochel, 2010a). Indeed, in a Police Foundation survey conducted only six years after CompStat emerged on the scene in New York City, more than a third of American police agencies with 100 or more sworn officers claimed to have implemented a CompStat-like program (Weisburd et al., 2001). By 2006, Willis, Mastrofski, and Kochel (2010b) reported that about 60 percent of large police agencies had adopted CompStat, and a Police Executive Research Forum membership survey in 2011 reported that 85 percent of 166 responding member agencies reported having adopted or plans to adopt CompStat (Bureau of Justice Assistance & Police Executive Research Forum, 2013). Drawing on this survey and the comments of police leaders, researchers, and others attending a conference on CompStat in 2013, a report on the meeting offered a uniformly positive assessment of CompStat’s performance to date, as well as its future potential: “Regardless of how it develops in the future, it is clear that Compstat has become an integral part of policing in the United States by helping agencies become more productive, agile, and effective” (BJA & PERF, 2013: 30).
Conjoint analysis is a common tool for studying political preferences. The method disentangles patterns in respondents’ favorability toward complex, multidimensional objects, such as candidates or policies. Most conjoints rely upon a fully randomized design to generate average marginal component effects (AMCEs). They measure the degree to which a given value of a conjoint profile feature increases, or decreases, respondents’ support for the overall profile relative to a baseline, averaging across all respondents and other features. While the AMCE has a clear causal interpretation (about the effect of features), most published conjoint analyses also use AMCEs to describe levels of favorability. This often means comparing AMCEs among respondent subgroups. We show that using conditional AMCEs to describe the degree of subgroup agreement can be misleading as regression interactions are sensitive to the reference category used in the analysis. This leads to inferences about subgroup differences in preferences that have arbitrary sign, size, and significance. We demonstrate the problem using examples drawn from published articles and provide suggestions for improved reporting and interpretation using marginal means and an omnibus F-test. Given the accelerating use of these designs in political science, we offer advice for best practice in analysis and presentation of results.
Pain and depression are common in the population and co-morbid with each other. Both are predictive of one another and are also associated with cognitive function; people who are in greater pain and more depressed respectively perform less well on tests of cognitive function. It has been argued that pain might cause deterioration in cognitive function, whereas better cognitive function earlier in life might be a protective factor against the emergence of disease. When looking at the dynamic relationship between these in chronic diseases, studying samples that already have advanced disease progression often confounds this relationship.
Using data from waves 1 to 3 of the English Longitudinal Study of Ageing (ELSA) (n = 516), we examined the interplay between pain, cognitive function and depression in a subsample of respondents reporting a diagnosis of arthritis at wave 2 of the ELSA using cross-lagged panel models.
The models showed that pain, cognitive function and depression at wave 1, prior to diagnosis, predict pain at wave 2, and that pain at wave 1 predicts depression at wave 2. Pain and depression at wave 2 predict cognitive function at wave 3.
The results indicate that better cognitive function might be protective against the emergence of pain prior to an arthritis diagnosis, but cognitive function is subsequently impaired by pain and depression. Furthermore, higher depression predicts lower cognitive function, but not vice versa. This is discussed in the context of the emerging importance of inflammation in depression.
Current coverage of mental healthcare in low- and middle-income countries is very limited, not only in terms of access to services but also in terms of financial protection of individuals in need of care and treatment.
To identify the challenges, opportunities and strategies for more equitable and sustainable mental health financing in six sub-Saharan African and South Asian countries, namely Ethiopia, India, Nepal, Nigeria, South Africa and Uganda.
In the context of a mental health systems research project (Emerald), a multi-methods approach was implemented consisting of three steps: a quantitative and narrative assessment of each country's disease burden profile, health system and macro-fiscal situation; in-depth interviews with expert stakeholders; and a policy analysis of sustainable financing options.
Key challenges identified for sustainable mental health financing include the low level of funding accorded to mental health services, widespread inequalities in access and poverty, although opportunities exist in the form of new political interest in mental health and ongoing reforms to national insurance schemes. Inclusion of mental health within planned or nascent national health insurance schemes was identified as a key strategy for moving towards more equitable and sustainable mental health financing in all six countries.
Including mental health in ongoing national health insurance reforms represent the most important strategic opportunity in the six participating countries to secure enhanced service provision and financial protection for individuals and households affected by mental disorders and psychosocial disabilities.
Declaration of interest
D.C. is a staff member of the World Health Organization.
Historic period Plains biographic art provides narratives of the deeds and actions of Indigenous peoples of the region. The Crow (Apsáalooke) are one such people with a rich record of biographic drawings in rock art and portable works. However, chronological and stylistic links between these two media have long been thought out of reach, even though such links are essential if the abundant Historic period rock art is to be fully incorporated into discussions of Apsáalooke history and their connection better ascertained to documented historical and ethnohistorical events and trends. Indeed, the lack of such a framework locks away a vast wealth of history in these hundreds of rock art pictures. In this article we present a statistical framework for comparing better-dated Crow portable artworks with their rock art equivalents. We are able to place rock art imagery from five sites into a relatively fine-grained chronological order, which permits a better understanding of changing patterns in Crow stylistic imagery. This permits a direct association with changing historical circumstances and facilitates a better understanding of the link between social history and the changing patterns seen in these artworks. Moreover, in one case, our analysis provides archaeological confirmation of Crow ethnohistory.