To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
What is critical thinking? To paraphrase the Enlightenment philosopher Immanuel Kant, it is the emergence from one’s self-imposed nonage. Nonage is the inability to use one’s mind without another’s guidance. This inability is self-imposed if its cause lies not in the limits of one’s mind but in the lack of courage to use it independently, without others’ guidance. Yet, in the age of powerful algorithms that play better chess and Go than humans, recommend the music and books we like, predict criminal behavior, and even find us the ideal romantic partner, why would we still need to think critically? Would it not be more economical to cease wasting time on thinking and reflecting, and just click and like? I argue that we need more, not less, critical thinking in the digital age. I discuss several tools for critical thinking, including asking the right questions and detecting misleading statistics, and illustrate these by online dating sites, HIV tests, cancer diagnosis, big data predictive analytics, the Social Credit System, and more. Advances in technology require risk-literate people who can control digital media rather be controlled by it.
According to the conventional theory of the demographic transition, mortality decline has represented the major trigger of fertility decline and sustained economic development. In Sub-Saharan Africa (SSA), the HIV/AIDS epidemic has had a devastating impact on mortality, dramatically reversing the long-term positive trend in life expectancies in high HIV-prevalence countries. Moreover, SSA is experiencing a delayed and slower fertility transition compared to other world regions and there is growing empirical evidence highlighting the potential for a paralysis, or even a reversal, of the fertility transition in countries with severe HIV epidemics. This work builds on a unified growth theory-like general equilibrium model combined with HIV spread, where mortality endogenously feeds back into fertility and education decisions. The model supports the evidence of an HIV-triggered fertility reversal in SSA via the fall in education and human capital investments due to increased adult mortality, which eventually breaks the switch from quantity to quality of children. Fertility reversal is predicted to be more likely to occur in countries experiencing severe HIV epidemics, and its effects may persist even under successful scenarios of HIV control. These results suggest that the alarming possibility of a paralysis in the fertility transition, which so far has aroused little concern among international organizations, e.g., in the last round of UN population projections, should be seriously considered with a view to prioritizing policy interventions.
Anxiety and depression continue to be significant comorbidities for people with human immunodeficiency virus (HIV) infection. The aim of this study was to determine the prevalence of anxiety and depression disorder among HIV patients at Conakry, Guinea. In this cross-sectional study, we described socio-demographic, clinical and psychosocial data related to anxiety and depression in 160 HIV patients of the University Teaching Hospital, Conakry, Guinea. The Hospital Anxiety and Depression Scale (HADS) was used for measuring depression and anxiety in the prior month. The HADS score of ⩾8 was used to identify possible cases of depression and anxiety. Multivariate logistic regression analyses were performed to identify factors associated with symptoms of anxiety and depression. The prevalence of comorbid depression and anxiety among HIV patients was 8.1% and the prevalence of anxiety and depressive symptoms among HIV-infected patients was 13.8% and 16.9%, respectively. Multivariate analysis showed that individuals having BMI ⩽ 18 (AOR = 3.62, 95% confidence interval (CI) 1.37–9.57) and who did not receive antiretroviral treatment (AOR = 18.93, 95% CI 1.88–188.81) were significantly more likely to have depressive symptoms. Similarly, having age <40 years (AOR = 2.81, 95% CI 1.04–7.58) was also significantly associated with anxiety. Prevalence of symptoms of anxiety and depression was high in these HIV patients. This suggests a need for training on the screening and management of anxiety and depression among HIV patients.
Considers how George W. Bush rescued the catastrophe of post-invasion Iraq with his Surge. Analyzes key events of second Bush term, his freedom agenda, and wider counterterrorism efforts. Argues that Bush continued with a foreign policy approach made in the Cold War, in which Russian power remained a central concern. Details how Bush resembled his Cold War predecessors in his Russia policy, especially during the Russo-Georgia War. Examines successes and failures of Bush Jr.’s foreign policy, with a special focus on his approach to China. Argues that Bush’s foreign toward India was a considerable success.
To compare soft-tissue complications following implantation of different bone conduction hearing devices.
Adults who underwent implantation of different bone conduction hearing devices, between January 2008 and December 2016, were included in the study. Five groups were identified depending on the soft-tissue approach: (1) split-thickness skin flap with use of dermatome; (2) Sheffield ‘S’-shaped incision with skin thinning; (3) linear incision without skin thinning (hydroxyapatite-coated abutment); (4) ‘C’-shaped full-thickness incision for passive transcutaneous bone conduction hearing devices; and (5) post-aural incision for active transcutaneous bone conduction hearing devices. The main outcome measures were different soft-tissue complications.
The study comprised 120 patients (group 1 = 20 patients, group 2 = 35, group 3 = 35, group 4 = 20, and group 5 = 10). Soft tissue related problems were encountered in 55 per cent of patients from group 1, 26 per cent in group 2, 3 per cent in group 3, and 0 per cent in groups 4 and 5.
There was a reduction in soft tissue related complications with reduced soft-tissue handling. In addition, there was a shift from an initial skin-penetrating (percutaneous) approach to a non-skin-penetrating (transcutaneous) approach.
Although the HIV/AIDS epidemic in Uganda and Kenya in the 1980s and 1990s elicited dramatically different responses from those two governments, the response from the private sector in the region was remarkably consistent. In short, there were striking similarities in how the business sector responded – or, for the most part, failed to respond in both East African countries. There were relatively few constructive responders over all. Much of the explanation for this has to do with the nature of these political economies and the firms that predominate: mostly small to medium-sized and many operating in agriculture and the services sub-sectors, areas of the economy in which it may be difficult for business to organize collectively. Finally, a very large number of Kenyans and Ugandans either work fort themselves or are employed in the informal sectors and hence the relationship between labour and big business is very different from what presents in Southern Africa.
The HIV/AIDS epidemic in Southern Africa is perhaps the world’s deadliest. Again, despite highly contrasting responses by the national governments of South African and Botswana respectively, there were significant similarities in how the private sector actors in these two countries responded to that epidemic. While many (if not most) firms provided little by way of a constructive response to the epidemic, a number of high-profile firms, notably within the mining and financial subsectors, rolled out a variety of remarkably constructive responses to the epidemic, programmes that at their most comprehensive included the provision of free antiretroviral drugs to their staff, and support for broader societal initiatives to combat the epidemic.
The reasons for peer education's ascendance as a core pedagogy in sex education are as much historical as they are reasonable or ethical. This article traces the history of peer-led sex education from the 1970s to the 1990s against the backdrop of New York City's financial ruin, social unrest, and a public health crisis. Starting with an analysis of the Student Coalition for Relevant Sex Education's Peer Information Project, founded in 1974, it investigates the application of new pedagogical techniques, the interplay between pedagogy and bureaucracy, and the transformation of school culture. Peer education thrived when educators and activists agreed that young people were more likely to accept advice from other young people, a reasonable contention that was nonetheless underassessed. Yet peer education's least intriguing attribute proved to be its most important characteristic: it could be quickly and inexpensively enacted. When HIV/AIDS began to decimate New York City's adolescent population, and the Board of Education proved slow and contradictory in its actions, the city turned to peer education, henceforth coupling the concepts of sex education and peer education.
Because of advances in treatment over the past 30 years, the number of older people living with HIV is growing. This is important for Indigenous Peoples in Canada, given their continuing over-representation in HIV diagnoses. However, little is known about the experiences of older, HIV-positive Indigenous Peoples. Taking a strength-based approach, this research explored how older Indigenous men with HIV conceptualize successful aging. Research was conducted in partnership with the Canadian Aboriginal AIDS Network. First Nations, Inuit, and Métis men, ranging in age from 43 to 63 years who had been HIV positive for 10–29 years participated in sharing circles and interviews. An open analytic approach was used to explore the content of transcripts, and codes were collaboratively developed through an inductive and iterative process. From our analysis of commonalities across Indigenous groups, we offer our insights on the application of the successful aging model to Indigenous men aging with HIV.
This chapter examines the debate over the right and ability of countries to grant compulsory licenses on patented pharmaceutical products, including biologic drugs produced in living organisms, as a means of ensuring access to medicines. Opponents of such measures sometimes label them as “theft.” This chapter contemplates the validity of such theft rhetoric from an unconventional perspective: that of biblical teachings on what it means to steal. After an introduction to the issue, Part II describes the use of theft rhetoric in relation to intellectual property infringement broadly and drug patent compulsory licenses in particular. Part III challenges the contention, suggested by theft rhetoric, that compulsory licenses are morally wrong as a form of stealing, by considering the meaning of theft in the context of its Judeo-Christian origins. Part IV considers the cogency of the accusation that the issuance of compulsory licenses in developing countries destroys pharmaceutical company innovation incentives. Part V concludes that expanding the definition of theft to include, as the Bible does, the possibility that a property owner may be stealing from the poor, can help us to properly evaluate the morality of drug patent compulsory licenses.
The study analysed the HIV/AIDS situation in Zambia six years after the onset of mass campaigns of Voluntary Medical Male Circumcision (VMMC). The analysis was based on data from Demographic and Health Surveys (DHS) conducted in 2001, 2007 and 2013. Results show that HIV prevalence among men aged 15–29 (the target group for VMMC) did not decrease over the period, despite a decline in HIV prevalence among women of the same age group (most of their partners). Correlations between male circumcision and HIV prevalence were positive for a variety of socioeconomic groups (urban residence, province of residence, level of education, ethnicity). In a multivariate analysis, based on the 2013 DHS survey, circumcised men were found to have the same level of infection as uncircumcised men, after controlling for age, sexual behaviour and socioeconomic status. Lastly, circumcised men tended to have somewhat riskier sexual behaviour than uncircumcised men. This study, based on large representative samples of the Zambian population, questions the current strategy of mass circumcision campaigns in southern and eastern Africa.
We estimated the impact of the Indian tariff on the demand for imported fresh apples from theUnited States. A 1% decrease in the tariff would increase the quantities demanded by 3.83%. If India eliminates the tariff on all imported fresh apples, total consumer welfare in terms of the imported fresh apple market will increase by $120 million yearly, 57% of the value of all fresh apples imported by India in 2015. This study adds evidence on the effects of tariff reduction on trade volume and welfare of consumers in the importing country.
There is evidence of increased morbidity, decreased quality of life, and premature mortality in people living with HIV (PLHIV) who smoke tobacco compared to PLHIV who do not smoke tobacco. Evidence-based screening for tobacco dependence, pharmacological treatment, and treatment monitoring and education into relapse prevention are not readily available in low- and middle-income countries (LMIC). We evaluated the effects of a brief tobacco dependence intervention in improving knowledge on the health effects of smoking and intention to quit smoking in PLHIV in Nepal, a low-income country in south Asia.
Using a quasi-experimental design, we assigned 59 smokers to participate in the intervention and 67 in the control group. The 1.5 h smoking cessation intervention emphasized harms of smoking, reasons for smoking and quitting, causes of relapse in previous quit attempts, and quitting strategies. We collected data at baseline and immediately post-intervention.
Findings indicate that a brief smoking cessation intervention produced a significant increase in smoking-related knowledge and intention to quit among PLHIV. The positive effects of our intervention remained significant after adjusting for potential confounders.
Our brief tobacco dependence intervention was effective in improving knowledge on the health effects of smoking and intention to quit among PLHIV. Further studies are required to evaluate the effectiveness of our intervention in increasing smoking cessation among PLHIV in LMIC.
Background. Disinformation, now best known generically as “fake news,” is an old and protean weapon. Prominent in the 1980s was AIDS disinformation, including the HIV-from-Fort-Detrick myth, for whose propagation some figures ultimately admitted blame while others shamelessly claimed credit. In 2013 we reported a comprehensive analysis of this myth, finding leading roles for the Soviet Union’s state security service, the KGB, and for biologist and independent conspiracy theorist Jakob Segal but not for East Germany’s state security service, the Stasi. We found Stasi involvement had been much less extensive and much less successful than two former Stasi officers had begun claiming following German reunification. In 2014 two historians crediting the two former Stasi officers coauthored a monograph challenging our analysis and portraying the Stasi as having directed Segal, or at least as having used him as a “conscious or unconscious multiplier,” and as having successfully assisted a Soviet bloc AIDS-disinformation conspiracy that they soon inherited and thenceforth led. In 2017 a German appellate court found our 2013 analysis persuasive in a defamation suit brought by a filmmaker whose work the 2014 monograph had depicted as co-funded by the Stasi.
Question and methods. Were our critics right about the Stasi? We asked and answered ten subsidiary questions bearing upon our critics’ arguments, reassessing our own prior work and probing additional sources including archives of East Germany’s Partei- und Staatsführung [party-and-state leadership] and the recollections of living witnesses.
Findings. Jakob Segal transformed and transmitted the myth without direction from the KGB or the Stasi or any element of East Germany’s party-and-state leadership. The Stasi had trouble even tracking Segal’s activities, which some officers feared would disadvantage East Germany scientifically, economically, and politically. Three officers in one Stasi section did show interest in myth propagation, but their efforts were late, limited, inept, and inconsequential.
Conclusion. The HIV-from-Fort-Detrick myth, most effectively promoted by Jakob Segal acting independently of any state’s security service, was not, contrary to claims, a Stasi success.
What are the conditions under which participatory institutions increase the voice of marginalized groups in policymaking? Existing studies of local participatory institutions highlight the role of leftist politicians and a strong civil society in determining outcomes, yet they fail to explain significant variation among participatory institutions at the national level. Examining the case of Brazil’s AIDS policy sector, this article argues that to fully understand the dynamics of national participatory governance, we must consider the role of bureaucrats. As studies of state-society synergy have shown, bureaucrats may seek outside political support from civil society when other actors inside the state prevent them from advancing their policy preferences. National bureaucrats may create new participatory institutions, and even help civil society delegates coordinate their engagement in such institutions, as strategies to strengthen their policy alliances with civil society.
Globally, human immune deficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) continues to be a major public health issue. With improved survival, the number of people living with HIV/AIDS is increasing, with over 2 million among pregnant women. Investigating adverse pregnant outcomes of HIV-infected population and associated factors are of great importance to maternal and infant health. A cross-sectional data collected from hospital delivery records of 4397 mother–infant pairs in southwestern China were analysed. Adverse pregnant outcomes (including low birthweight/preterm delivery/low Apgar score) and maternal HIV status and other characteristics were measured. Two hundred thirteen (4.9%) mothers were HIV positive; maternal HIV infection, rural residence and pregnancy history were associated with all three indicators of adverse pregnancy outcomes. This research suggested that maternal population have high prevalence in HIV infection in this region. HIV-infected women had higher risks of experiencing adverse pregnancy outcomes. Rural residence predisposes adverse pregnancy outcomes. Findings of this study suggest social and medical support for maternal-infant care needed in this region, selectively towards rural areas and HIV-positive mothers.
This study aims to investigate the prevalence and genotype distribution of anal human papillomavirus (HPV) infection among men with different sexual orientations with or without human immunodeficiency virus (HIV) in China. A cross-sectional study was conducted during 2016–2017 in Taizhou City, Zhejiang Province. Convenient sampling was used to recruit male participants from HIV voluntary counselling and testing clinics and Center for Disease Control and Prevention. A face-to-face questionnaire interview was administered and an anal-canal swab was collected for HPV genotyping. A total of 160 HIV-positive and 113 HIV-negative men participated in the study. The prevalence of any type HPV was 30.6% for heterosexual men, 74.1% for homosexual and 63.6% for bisexual men among HIV-positive participants, while the prevalence was 8.3%, 29.2% and 23.8% respectively among HIV-negatives. The most prevalent genotypes were HPV-58 (16.9%), HPV-6 (15.6%) and HPV-11 (15.0%) among HIV-positive men, and were HPV-16 (4.4%), HPV-52 (4.4%) and HPV-6 (3.5%) among HIV-negative men. Having ever had haemorrhoids and having ever seen blood on tissue after defaecation was associated with HPV infection. One-fourth of the HPV infections in this study population can be covered by the quadrivalent vaccine in market. The highly prevalent anal HPV infection among men especially HIV-infected men calls for close observation and further investigation for anal cancer prevention.
Recent infection testing algorithms (RITA) for HIV combine serological assays with epidemiological data to determine likely recent infections, indicators of ongoing transmission. In 2016, we integrated RITA into national HIV surveillance in Ireland to better inform HIV prevention interventions. We determined the avidity index (AI) of new HIV diagnoses and linked the results with data captured in the national infectious disease reporting system. RITA classified a diagnosis as recent based on an AI < 1.5, unless epidemiological criteria (CD4 count <200 cells/mm3; viral load <400 copies/ml; the presence of AIDS-defining illness; prior antiretroviral therapy use) indicated a potential false-recent result. Of 508 diagnoses in 2016, we linked 448 (88.1%) to an avidity test result. RITA classified 12.5% of diagnoses as recent, with the highest proportion (26.3%) amongst people who inject drugs. On multivariable logistic regression recent infection was more likely with a concurrent sexually transmitted infection (aOR 2.59; 95% CI 1.04–6.45). Data were incomplete for at least one RITA criterion in 48% of cases. The study demonstrated the feasibility of integrating RITA into routine surveillance and showed some ongoing HIV transmission. To improve the interpretation of RITA, further efforts are required to improve completeness of the required epidemiological data.