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Is American democracy under threat? The question is more prominent in political debate now than at any time in recent memory. However, it is also too blunt; there is widespread recognition that democracy is multifaceted and that backsliding, when it occurs, tends to be piecemeal. To address these concerns, we provide original data from surveys of political science experts and the public measuring the perceived importance and performance of U.S. democracy on a number of dimensions during the first year-and-a-half of the Trump presidency. We draw on a theory of how politicians may transgress limits on their authority and the conditions under which constraints are self-enforcing. We connect this theory to our survey data in an effort to identify potential areas of agreement—bright lines—among experts and the public about the most important democratic principles and whether they have been violated. Public and expert perceptions often differ on the importance of specific democratic principles. In addition, though our experts perceive substantial democratic erosion, particularly in areas related to checks and balances, polarization between Trump supporters and opponents undermines any social consensus recognizing these violations.
In this study, we have examined ceramic matrix composites with silicon carbide fibers in a melt-infiltrated silicon carbide matrix (SiC/SiC). We subjected samples to tensile loads while collecting micro X-ray computed tomography images. The results showed the expected crack slowing mechanisms and lower resistance to crack propagation where the fibers ran parallel and perpendicular to the applied load respectively. Cracking was shown to initiate not only from the surface but also from silicon inclusions. Post heat-treated samples showed longer fiber pull-out than the pristine samples, which was incompatible with previously proposed mechanisms. Evidence for oxidation was identified and new mechanisms based on oxidation or an oxidation assisted boron nitride phase transformation was therefore proposed to explain the long pull-out. The role of oxidation emphasizes the necessity of applying oxidation resistant coatings on SiC/SiC.
Given the frequency of natural hazards in Haiti, disaster risk reduction is crucial. However, evidence suggests that many people exposed to prior disasters do not engage in disaster preparedness, even when they receive training and have adequate resources. This may be partially explained by a link between mental health symptoms and preparedness; however, these components are typically not integrated in intervention.
The current study assesses effectiveness of an integrated mental health and disaster preparedness intervention. This group-based model was tested in three earthquake-exposed and flood-prone communities (N = 480), across three time points, using a randomized controlled trial design. The 3-day community-based intervention was culturally-adapted, facilitated by trained Haitian lay mental health workers, and focused on enhancing disaster preparedness, reducing mental health symptoms, and fostering community cohesion.
Consistent with hypotheses, the intervention increased disaster preparedness, reduced symptoms associated with depression, post-traumatic stress disorder, anxiety, and functional impairment, and increased peer-based help-giving and help-seeking. Mediation models indicated support for the underlying theoretical model, such that the effect of the intervention on preparedness was mediated by mental health, and that effects on mental health were likewise mediated by preparedness.
The community-based mental health-integrated disaster preparedness intervention is effective in improving mental health and preparedness among community members in Haiti vulnerable to natural hazards. This brief intervention has the potential to be scaled up for use with other communities vulnerable to earthquakes, seasonal flooding, and other natural hazards.
Coups d’état, once a common end for democracies in the Americas, have declined sharply in recent years. This article investigates whether overall public support for coups is also in decline. Examining 21 countries in Latin America and the Caribbean from 2004 to 2014 helps to evaluate two alternative theses on democratization: Mainwaring and Pérez-Liñán’s 2013 normative regime preferences theory, which inquires (but does not test) whether public opinion can signal to elites a reluctance or willingness to support a coup; and classic modernization theory (Inglehart 1988; Inglehart and Welzel 2005). We find a substantively meaningful effect of democratic attitudes on coup support and a weak effect for national wealth, from which we infer that evolving elite values and preferences are paralleled at the mass level and that together, those two trends play a stronger role in the consolidation of democratic regimes than does modernization.
The Patient Health Questionnaire (PHQ) is the most commonly used measure to screen for depression in primary care but there is still lack of clarity about its accuracy and optimal scoring method.
To determine via meta-analysis the diagnostic accuracy of the PHQ-9-linear, PHQ-9-algorithm and PHQ-2 questions to detect major depressive disorder (MDD) among adults.
We systematically searched major electronic databases from inception until June 2015. Articles were included that reported the accuracy of PHQ-9 or PHQ-2 questions for diagnosing MDD in primary care defined according to standard classification systems. We carried out a meta-analysis, meta-regression, moderator and sensitivity analysis.
Overall, 26 publications reporting on 40 individual studies were included representing 26 902 people (median 502, s.d.=693.7) including 14 760 unique adults of whom 14.3% had MDD. The methodological quality of the included articles was acceptable. The meta-analytic area under the receiver operating characteristic curve of the PHQ-9-linear and the PHQ-2 was significantly higher than the PHQ-9-algorithm, a difference that was maintained in head-to-head meta-analysis of studies. Our best estimates of sensitivity and specificity were 81.3% (95% CI 71.6–89.3) and 85.3% (95% CI 81.0–89.1), 56.8% (95% CI 41.2–71.8) and 93.3% (95% CI 87.5–97.3) and 89.3% (95% CI 81.5–95.1) and 75.9% (95% CI 70.1–81.3) for the PHQ-9-linear, PHQ-9-algorithm and PHQ-2 respectively. For case finding (ruling in a diagnosis), none of the methods were suitable but for screening (ruling out non-cases), all methods were encouraging with good clinical utility, although the cut-off threshold must be carefully chosen.
The PHQ can be used as an initial first step assessment in primary care and the PHQ-2 is adequate for this purpose with good acceptability. However, neither the PHQ-2 nor the PHQ-9 can be used to confirm a clinical diagnosis (case finding).
The long-term stability of mechanically exfoliated MoS2 flakes was compared for storage in the air and storage under vacuum. Significant changes in MoS2 flakes were observed for samples stored in the air, whereas similar flakes on samples stored in vacuum underwent no change. Small speckles were observed to appear on the surface of flakes stored in the air, followed by thinning and eventual decomposition of MoS2 flakes. The speckles are suspected to be formed by oxidation of MoS2 in the presence of atmospheric oxygen and water molecules, resulting in the formation of hydrated MoO3.
Objectives: Dysbiosis of the gut microbiome is implicated in numerous human health conditions. Animal studies have linked microbiome disruption to changes in cognitive functioning, although no study has examined this possibility in neurologically healthy older adults. Methods: Participants were 43 community-dwelling older adults (50–85 years) that completed a brief cognitive test battery and provided stool samples for gut microbiome sequencing. Participants performing≥1 SD below normative performance on two or more tests were compared to persons with one or fewer impaired scores. Results: Mann Whitney U tests revealed different distributions of Bacteroidetes (p=.01), Firmicutes (p=.02), Proteobacteria (p=.04), and Verrucomicrobia (p=.003) between Intact and Impaired groups. These phyla were significantly correlated with cognitive test performances, particularly Verrucomicrobia and attention/executive function measures. Conclusions: The current findings suggest that composition of the gut microbiome is associated with cognitive test performance in neurologically healthy older adults. Future studies are needed to confirm these findings and explore possible mechanisms. (JINS, 2017, 23, 700–705)