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The political underrepresentation of women and racial minorities in Canadian politics is well documented. One political arena that has yet to be examined in this respect, however, is school boards. Using data from a candidate survey conducted during the course of the 2018 Ontario school board elections, as well as demographic data collected on the entire population of school board candidates, we explore the unique characteristics of school board elections. The research note begins by describing the gender and racial composition of candidates and trustees in Canada's most populous province. It then considers the ways in which school board elections may serve as a launchpad to higher office for either of these two traditionally underrepresented groups, as we explore the features of progressive political ambition, recruitment into school board campaigns and the relative electoral success of racialized candidates and women in this local office. While women do very well in school board elections, they are significantly less likely than their male counterparts to have the desire to move up to provincial or federal politics. Meanwhile, racialized candidates contest school board election in significant numbers and report similar levels of progressive ambition relative to their white counterparts, but they fare exceptionally poorly in school board elections.
China’s state-directed technology development and deployment programs have led to unprecedented adoption of advanced technologies in its electricity sector. However, signs of inefficient capital allocation are widespread, such as continued coal plant capacity build-out amidst slowing electricity demand growth and underutilization of renewable energy investments. The separation of technology programs from durable local autonomies in electricity systems operation and planning, as well as unsuccessful central reforms to create a market for the fundamental commodity, electricity, contribute to uncaptured economic and public health benefits. China’s programs on high-efficiency coal-fired power plants demonstrate this important lesson for industrial upgrading: technological innovation and adoption do not reap their full benefits without comparable modernization of regulatory and policy frameworks. Ongoing power sector reforms may be insufficient to address these issues.
Previous studies reported an association between advanced paternal age at birth and increased risk for schizophrenia and bipolar disorder. While some hypothesize that this association is caused by de-novo mutations in paternal spermatozoa, others cite factors associated with psycho-social characteristics of fathers who have children at a late age. This study aims to test these hypotheses.
A historical-prospective, population-based cohort study, performed by linking the Israeli Draft Board Registry and the Israeli National Psychiatric Hospitalization Registry (N = 916 439; 4488 with schizophrenia, 883 with bipolar disorder). Odds ratios (OR) and two-sided 95% confidence intervals (CI) were calculated by logistic regression models, using paternal age as predictor and risk for later hospitalizations for schizophrenia or bipolar disorder as outcome measure. Models were first fitted unadjusted, then adjusted for paternal age at birth of the first child.
In the unadjusted model, offspring of fathers aged 45 and above at birth had increased risk of schizophrenia (OR = 1.71, 95% CI 1.49–1.99) and bipolar disorder (OR = 1.63, 95% CI 1.16–2.24). However, taking into account paternal age at birth of first child, advanced paternal age was no longer associated with increased risk of schizophrenia (OR = 0.60, 95% CI 0.48–0.79) or bipolar disorder (OR = 1.03, 95% CI 0.56–1.90).
Controlling for paternal age at birth of the first offspring, advanced paternal age does not predict increased risk for schizophrenia or bipolar disorder. These data indicate that the association between advanced paternal age and having an offspring with schizophrenia and bipolar disorder is likely due to psychos-social factors, or common genetic variation associated with delayed initial fatherhood.
Being a current psychiatric in-patient is one of the strongest statistical risk factors for suicide. It is usually assumed that this strong association is not causal but is a result of the combination of the selection of high-risk patients for admission and the imperfect protection from suicide afforded by psychiatric wards. Logically, a third factor, which is causal, might play a role in the association. It has recently been suggested that adverse experiences in psychiatric units such as trauma, stigma and loss of social role might precipitate some in-patient suicides.
To consider whether there is a causal association between psychiatric hospitalisation and suicide.
We used the framework of Austin Bradford Hill's criteria for assessing causality in epidemiology to consider the possibility that psychiatric hospitalisation might causally contribute to the extent and variation in in-patient suicide rates.
The association between psychiatric hospitalisation and suicide clearly meets five of the nine Hill's criteria (strength of association, consistency, plausibility, coherence and analogy) and partially meets three of the remaining four criteria (gradient of exposure, temporality and experimental evidence).
Admission to hospital itself might play a causal role in a proportion of in-patient suicides. The safety of being in hospital with respect to suicide could be examined with a large-scale randomised controlled trial (RCT). In the absence of an RCT, the possibility of a causal role provides further impetus to calls to make care in the community more available and psychiatric hospitals more acceptable to patients.
There is limited knowledge on vitamin D status of children residing in the Andes and its association with undernutrition. We evaluated the vitamin D status of children residing in a low socio-economic status (SES) setting in the Ecuadorian Andes and assessed the association between vitamin D status, stunting and underweight. We hypothesized that children who were underweight would have lower serum 25-hydroxyvitamin D (25(OH)D) levels and lower 25(OH)D levels would be associated with a higher risk of stunting.
We conducted a cross-sectional secondary analysis of a randomized controlled trial, the Vitamin A, Zinc and Pneumonia study. Children had serum 25(OH)D concentrations measured. A sensitivity analysis was undertaken to determine a vitamin D cut-off specific for our endpoints. Associations between serum 25(OH)D and underweight (defined as weight-for-age Z-score≤−1) and stunting (defined as height-for-age Z-score≤−2) were assessed using multivariate logistic regression.
Children residing in five low-SES peri-urban neighbourhoods near Quito, Ecuador.
Children (n 516) aged 6–36 months.
Mean serum 25(OH)D concentration was 58·0 (sd 17·7) nmol/l. Sensitivity analysis revealed an undernutrition-specific 25(OH)D cut-off of <42·5 nmol/l; 18·6 % of children had serum 25(OH)D<42·5 nmol/l. Children who were underweight were more likely to have serum 25(OH)D<42·5 nmol/l (adjusted OR (aOR)=2·0; 95 % CI 1·2, 3·3). Children with low serum 25(OH)D levels were more likely to be stunted (aOR=2·8; 95 % CI 1·6, 4·7).
Low serum 25(OH)D levels were more common in underweight and stunted Ecuadorian children.
Although we tend to think of literary modernism as a revolution of the material word, it is less often noted that it is underwritten by the material body. The fragmentations and dislocations that we associate with modernist experimentation often accompany representations of psychological and physical trauma. It is hard to think of any major modernist work that does not, in some way, feature disease or disability as a figure for social upheavals and cultural malaise – from Charlotte Perkins Gilman's “The Yellow Wall-Paper” (1892) and Edith Wharton's Ethan Frome (1911) to Henry James's The Wings of the Dove (1902), from Ford Madox Ford's The Good Soldier (1915) to Joseph Conrad's The Secret Agent (1907), from Dostoevsky's The Idiot (1868) and Ibsen's Ghosts (1881) to Andre Gide's L'Immoralist (1902), from Thomas Mann's Death in Venice (1912) and The Magic Mountain (1924) to Gunter Grass's The Tin Drum (1959), Katherine Ann Porter's “Pale Horse Pale Ryder” (1939), and most of the plays and prose by Samuel Beckett. If we were to include in this list the psychological toll of physical impairments caused by World War I, we would have to add figures such as Jake Barnes in The Sun Also Rises (1926), Sir Clifford Chatterley in Lady Chatterley's Lover (1928), and Septimus Smith in Mrs. Dalloway (1925). If to be ill is to produce narrative, as Athena Vrettos says in my epigraph, nothing could embody this fact more vividly than those cosmopolitan novels whose grand tours include stops at health spas, sanitaria, or the therapeutic air of the Alps.
At another level, the rhetoric of disease permeates modernist cultural poetics. Matthew Arnold in “The Scholar Gypsy” (1853), speaks of “this strange disease of modern life, / With its sick hurry, its divided aims,” and Søren Kierkegaard describes the unredeemed time of modernity as a “sickness unto death.” Dostoevsky's Underground Man in Notes from the Underground (1864) regards “excessive consciousness [as] a … genuine absolute disease,” and Walter Benjamin refers to Baudelaire's description of the “shock” of the metropolitan crowd as a type of nervous disorder.
The position people occupy in their social and professional networks is related to their social status and has strong effects on their access to social resources. While attainment of particular positions is driven by behavioral traits, many biological factors predispose individuals to certain behaviors and motivations. Prior work on exposure to fetal androgens (measured by second-to-fourth digit ratio, 2D:4D) shows that it correlates with behaviors and traits related to social status, which might make people more socially integrated. However, it also predicts certain anti-social behaviors and disorders associated with lower socialization. We explore whether 2D:4D correlates with network position later in life and find that individuals with low 2D:4D become more central in their social environment. Interestingly, low 2D:4D males are more likely to exhibit high betweenness centrality (they connect separated parts of the social structure), while low 2D:4D females are more likely to exhibit high in-degree centrality (more people name them as friends). These gender-specific differences are reinforced by transitivity (the likelihood that one's friends are also friends with one another): neighbors of low 2D:4D men tend not to know each other; the contrary is observed for low 2D:4D women. Our results suggest that biological predispositions influence the organization of human societies and that exposure to prenatal androgens influences different status seeking behaviors in men and women.
Objectives: To summarize the clinical characteristics and outcomes of pediatric sports-related concussion (SRC) patients who were evaluated and managed at a multidisciplinary pediatric concussion program and examine the healthcare resources and personnel required to meet the needs of this patient population. Methods: We conducted a retrospective review of all pediatric SRC patients referred to the Pan Am Concussion Program from September 1st, 2013 to May 25th, 2015. Initial assessments and diagnoses were carried out by a single neurosurgeon. Return-to-Play decision-making was carried out by the multidisciplinary team. Results: 604 patients, including 423 pediatric SRC patients were evaluated at the Pan Am Concussion Program during the study period. The mean age of study patients was 14.30 years (SD: 2.32, range 7-19 years); 252 (59.57%) were males. Hockey (182; 43.03%) and soccer (60; 14.18%) were the most commonly played sports at the time of injury. Overall, 294 (69.50%) of SRC patients met the clinical criteria for concussion recovery, while 75 (17.73%) were lost to follow-up, and 53 (12.53%) remained in active treatment at the end of the study period. The median duration of symptoms among the 261 acute SRC patients with complete follow-up was 23 days (IQR: 15, 36). Overall, 25.30% of pediatric SRC patients underwent at least one diagnostic imaging test and 32.62% received referral to another member of our multidisciplinary clinical team. Conclusion: Comprehensive care of pediatric SRC patients requires access to appropriate diagnostic resources and the multidisciplinary collaboration of experts with national and provincially-recognized training in TBI.
Evidence exists that analgesics are underutilized, delayed, and insufficiently dosed for emergency department (ED) patients with acute abdominal pain. For physicians practicing in a Canadian paediatric ED setting, we (1) explored theoretical practice variation in the provision of analgesia to children with acute abdominal pain; (2) identified reasons for withholding analgesia; and (3) evaluated the relationship between providing analgesia and surgical consultation.
Physician members of Paediatric Emergency Research Canada (PERC) were prospectively surveyed and presented with three scenarios of undifferentiated acute abdominal pain to assess management. A modified Dillman’s Tailored Design method was used to distribute the survey from June to July 2014.
Overall response rate was 74.5% (149/200); 51.7% of respondents were female and mean age was 44 (SD 8.4) years. The reported rates of providing analgesia for case scenarios representative of renal colic, appendicitis, and intussusception, were 100%, 92.1%, and 83.4%, respectively, while rates of providing intravenous opioids were 85.2%, 58.6%, and 12.4%, respectively. In all 60 responses where the respondent indicated they would obtain a surgical consultation, analgesia would be provided. In the 35 responses where analgesia would be withheld, 21 (60%) believed pain was not severe enough, while 5 (14.3%) indicated it would obscure a surgical condition.
Pediatric emergency physicians self-reported rates of providing analgesia for acute abdominal pain scenarios were higher than previously reported, and appeared unrelated to request for surgical consultation. However, an unwillingness to provide opioid analgesia, belief that analgesia can obscure a surgical condition, and failure to take self-reported pain at face value remain, suggesting that the need exists for further knowledge translation efforts.