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Our food systems have performed well in the past, but they are failing us in the face of climate change and other challenges. This book tells the story of why food system transformation is needed, how it can be achieved and how research can be a catalyst for change. Written by a global interdisciplinary team of researchers, it brings together perspectives from multiple areas including climate, environment, agriculture, and the social sciences to describe how different tools and approaches can be used to tackle food system transformation. It provides practical, actionable insights for policymakers and advisors, demonstrating how science together with strong partnerships can enable real transformation on the ground. It also contributes to the academic debate on the transformation of food systems, and so will be an invaluable reference for researchers and students alike. This title is also available as Open Access on Cambridge Core.
Presenteeism, or working while ill, by healthcare personnel (HCP) experiencing influenza-like illness (ILI) puts patients and coworkers at risk. However, hospital policies and practices may not consistently facilitate HCP staying home when ill.
Objective and methods:
We conducted a mixed-methods survey in March 2018 of Emerging Infections Network infectious diseases physicians, describing institutional experiences with and policies for HCP working with ILI.
Of 715 physicians, 367 (51%) responded. Of 367, 135 (37%) were unaware of institutional policies. Of the remaining 232 respondents, 206 (89%) reported institutional policies regarding work restrictions for HCP with influenza or ILI, but only 145 (63%) said these were communicated at least annually. More than half of respondents (124, 53%) reported that adherence to work restrictions was not monitored or enforced. Work restrictions were most often not perceived to be enforced for physicians-in-training and attending physicians. Nearly all (223, 96%) reported that their facility tracked laboratory-confirmed influenza (LCI) in patients; 85 (37%) reported tracking ILI. For employees, 109 (47%) reported tracking of LCI and 53 (23%) reported tracking ILI. For independent physicians, not employed by the facility, 30 (13%) reported tracking LCI and 11 (5%) ILI.
More than one-third of respondents were unaware of whether their institutions had policies to prevent HCP with ILI from working; among those with knowledge of institutional policies, dissemination, monitoring, and enforcement of these policies was highly variable. Improving communication about work-restriction policies, as well as monitoring and enforcement, may help prevent the spread of infections from HCP to patients.
Fusion legislation is the latest in a long line of reforms in mental health law that have sought to increase patient autonomy. It has not been without controversy, having been proposed and rejected in various jurisdictions throughout the UK and internationally, while causing considerable debate in the academic literature. This article considers some of the history and debate, along with the criminal justice provisions of the first piece of fusion legislation internationally, the Mental Capacity Act (Northern Ireland) 2016, and their potential implications.
• Understand the history of fusion legislation in the UK and internationally
• Understand the advantages and disadvantages of fusion legislation
Mental health legislation in Northern Ireland has always been separate from legislation in the rest of the UK; the Mental Health (Northern Ireland) Order (MHO) had been in place since 1986. In common with other jurisdictions, this legislation utilises the presence of mental disorder and risk as criteria for detention and involuntary treatment. The MHO has been replaced by the Mental Capacity Act (Northern Ireland) 2016 (MCA), an example of ‘fusion’ legislation in which impairment of decision-making capacity and best interests are the only criteria to be used when making decisions across health and social care. In this paper, we outline the development of the MCA to date, and discuss its potential to improve mental healthcare by placing the treatment of mental illness within the same legislative framework as physical illnesses.
Existing research suggests that voters tend to respond positively to legislator independence due to two types of mechanism. First, dissent has an indirect effect, increasing a legislator’s media coverage and personal recognition among constituents (profile effects). Secondly, constituents react positively to dissent when this signals that the legislator has matching political or representational preferences (conditional evaluation). This article presents a third effect: dissent acts as a valence signal of integrity and trustworthiness. Consistent with the valence signalling mechanism, it uses new observational and experimental evidence to show that British voters have a strong and largely unconditional preference for legislators who dissent. The findings pose a dilemma for political systems that rely on strong and cohesive parties.
To determine the effect of interhospital patient sharing via transfers on the rate of Clostridium difficile infections in a hospital.
Using data from the Healthcare Cost and Utilization Project California State Inpatient Database, 2005–2011, we identified 2,752,639 transfers. We then constructed a series of networks detailing the connections formed by hospitals. We computed 2 measures of connectivity, indegree and weighted indegree, measuring the number of hospitals from which transfers into a hospital arrive, and the total number of incoming transfers, respectively. Next, we estimated a multivariate model of C. difficile infection cases using the log-transformed network measures as well as covariates for hospital fixed effects, log median length of stay, log fraction of patients aged 65 or older, and quarter and year indicators as predictors.
We found an increase of 1 in the log indegree was associated with a 4.8% increase in incidence of C. difficile infection (95% CI, 2.3%–7.4%) and an increase of 1 in log weighted indegree was associated with a 3.3% increase in C. difficile infection incidence (1.5%–5.2%). Moreover, including measures of connectivity in our models greatly improved their fit.
Our results suggest infection control is not under the exclusive control of a given hospital but is also influenced by the connections and number of connections that hospitals have with other hospitals.
Infect. Control Hosp. Epidemiol. 2015;36(9):1031–1037
Research has explored the impact of politicians holding second jobs, or moonlighting, on their performance and recruitment, but less is known about how citizens respond to such behavior. Citizens may react negatively to Members of Parliament (MPs) moonlighting, viewing outside earnings as a conflict of interest or a distraction, or instead they might view MPs with second incomes positively, seeing them as a connection with the “real world” beyond politics. Utilizing a series of survey experiments, we assess how British citizens respond to MPs moonlighting. We demonstrate preferences more complex than those revealed by traditional survey instruments. Citizens respond to both size and source of income. They do not respond negatively to all second incomes; they are more sympathetic to the entrepreneur who continues to draw an income than medical doctors or lawyers who continue to practice. They are most hostile to politicians who take on part-time company directorships.
To systematically review studies reporting the effectiveness of various models of follow-up in primary care on a range of outcomes (physical, psychological, social functioning, or quality of life) for survivors of stroke and their caregivers.
Stroke is a major cause of disability globally. Current UK policy calls for a primary care-based review of healthcare and social-care needs at six weeks and six months after hospital discharge and then annually.
Trials meeting the pre-defined inclusion criteria were identified by the systematic searching of electronic databases. Data were extracted by two independent researchers. Studies were rated using the McMaster University Quality Assessment Tool.
Nine randomised controlled trials that met the inclusion criteria were identified. These studies included interventions using stroke support workers, care coordinators or case managers. The methodological quality of the studies was variable, and models of care demonstrated inconsistent working relationships with general practitioners. Patients and caregivers receiving formal primary care-based follow-up did not show any gains in physical function, mood, or quality of life when compared with those who did not. Patients and caregivers receiving follow-up were generally more satisfied with some aspects of communication, and had a greater knowledge of stroke.
The limited quality of these studies and the lack of a sound theoretical basis for the development of interventions together highlight the urgent need for high-quality research studies in this area.
The present study is the first behavioral genetic investigation of relationships between the Dark Triad of personality — Machiavellianism, narcissism, and subclinical psychopathy — and moral development. Participants were 154 monozygotic twin pairs and 82 same-sex dizygotic twin pairs. Higher scores on Machiavellianism and psychopathy were positively correlated with low levels of moral development; high psychopathy scores also correlated negatively with high levels of moral development. Individual differences in lower levels of moral development were attributable to genetic and nonshared environmental factors but, very interestingly, individual differences in the highest levels of moral development showed no genetic basis but were entirely attributable to shared and nonshared environmental factors. Finally, correlations between the Dark Triad and moral development variables showed no genetic basis while correlations among the moral development variables were variously attributable to correlated genetic and correlated environmental factors.
The 6dF Galaxy Survey provides a very large sample of galaxies with reliable measurements of Lick line indices and velocity dispersions. This sample can be used to explore the correlations between mass and stellar population parameters such as age, metallicity and [α/Fe]. Preliminary results from such an analysis are presented here, and show that age and metallicity are significantly anti-correlated for both passive and star-forming galaxies. Passive galaxies have strong correlations between mass and metallicity and between age and α-element over-abundance, which combine to produce a downsizing relation between age and mass. For old passive galaxies, the different trends of M/L with mass and luminosity in different passbands result from the differential effect of the mass–metallicity relation on the luminosities in each passband. Future work with this sample will examine the Fundamental Plane of bulge-dominated galaxies and the influence of environment on relations between stellar population parameters and mass.
There are few Australian data on the incidence of catheter-associated bloodstream infection (BSI) among patients in hematology-oncology units. We found an increase in catheter-associated BSI rates coincident with the introduction of a mechanical valve connector (2.6 infections vs 5.8 infections per 1,000 catheter-days; incidence rate ratio, 2.2; P = .031).
MOS capacitors were fabricated from MOCVD HfO2 and HfxSiyO gate dielectrics with ALD TaN / PVD Ta metal electrodes. Dielectrics with 1.8 to 2.6 nm capacitance equivalent thickness (CET) were investigated with gate leakage (Jg) of 1×10−7 to 1×10−3 A/cm2 at Vg = Vfb−1V in accumulation. In addition to the C-V and I-V characterization of the MOSCAPs, XPS physical characterization was performed on monitor wafers to determine composition and physical thickness. From the combined results of the electrical and physical characterization, the relative dielectric constants of the Hf-Si-O films and the metal electrode work functions are determined, and simple models for the compositional dependence of the dielectric constant are formulated. Capacitors with the same dielectric composition and thickness exhibited 100 mV Vfb change when the thickness of the ALD TaN electrode layer was changed from 40-80Å. This change is attributed to a change in the work function of the aggregate TaN / Ta metal electrode. Workfunctions were found to be located near middle of the Si band gap, with workfunctions of 4.6 eV to 4.7 eV.
In Experience Hendrix LLC v. PPX Enterprises Inc., Edward Chalpin, the Court of Appeal gives further impetus to the radical recasting of the law of damages for breach of contract along restitutionary lines made possible by A.-G. v. Blake (Jonathan Cape Ltd. Third Party). Whilst Blake made it more difficult to argue that hypothetical release damages were compensatory rather than restitutionary in nature, it left a residue of serious uncertainty because it did not make it impossible to do so. Hendrix goes a long way towards eradicating this particular uncertainty by awarding hypothetical release damages on an unambiguously restitutionary basis and saying that an account of profits, though not justified in the circumstances of the case, might also have been awarded on this basis.
Endovascular stents can be altered to improve radioopacity by applying a gold coating. We examined the vascular response in porcine coronary arteries to implantation of 9 mm NIR® stents that were either left intact, gold-coated, or heat-treated following gold coating. Our results show that while gold coating exacerbates neointimal hyperplasia and the inflammatory response, heat treatment removes this negative effect. Heat treatment was shown to increase the diffusion at the gold-steel interface and reduce the surface roughness.
John F. Kennedy's narrow popular vote margin in 1960 has already insured this presidential election a classic position in the roll call of close American elections. Whatever more substantial judgments historical perspective may bring, we can be sure that the 1960 election will do heavy duty in demonstrations to a reluctant public that after all is said and done, every vote does count. And the margin translated into “votes per precinct” will become standard fare in exhortations to party workers that no stone be left unturned.
The 1960 election is a classic as well in the license it allows for “explanations” of the final outcome. Any event or campaign strategem that might plausibly have changed the thinnest sprinkling of votes across the nation may, more persuasively than is usual, be called “critical.” Viewed in this manner, the 1960 presidential election hung on such a manifold of factors that reasonable men might despair of cataloguing them.
Nevertheless, it is possible to put together an account of the election in terms of the broadest currents influencing the American electorate in 1960. We speak of the gross lines of motivation which gave the election its unique shape, motivations involving millions rather than thousands of votes. Analysis of these broad currents is not intended to explain the hairline differences in popular vote, state by state, which edged the balance in favor of Kennedy rather than Nixon. But it can indicate quite clearly the broad forces which reduced the popular vote to a virtual stalemate, rather than any of the other reasonable outcomes between a 60-40 or a 40–60 vote division.
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