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Noninstitutional craft production was the foundation of the ancient commercial economy. This chapter discusses the origin of craft production, and how artisans engaged in craft production and overcame the risks and uncertainties associated with it. Differences in the scale and organization of craft production are examined along with how forms of distribution affected the development of full- and part-time craft production.
In this paper, we consider finite mixture models with components having distributions from the location-scale family. We then discuss the usual stochastic order and the reversed hazard rate order of such finite mixture models under some majorization conditions on location, scale and mixing probabilities as model parameters.
An ultraviolet (UV) irradiation-based in situ silver nanoparticle (AgNP) synthesis approach has drawn significant attention for functionalizing a great variety of biomaterials. Here, we designed an AgNP-functionalized 3D-printed polylactic acid (PLA) composite scaffold with a green physical approach by employing the UV irradiation (1, 2, and 3 h) method without using any reducing agent or heat treatments. In situ AgNP synthesis was performed under different UV exposure times. The zeta sizer analysis results demonstrated that AgNPs were highly monodisperse with the particle size of 20 ± 2.2, 30 ± 3.6, and 50 ± 4.8 nm under various UV light exposure times. In situ synthesis of AgNPs on 3D-printed PLA scaffolds significantly changed the surface hydrophilicity of the 3D-printed scaffolds. These results showed that UV irradiation-based in situ AgNP synthesis on 3D-printed PLA scaffolds can be useful in various biomedical applications, such as cell culture scaffolds, biosensors, and wound healing applications.
This chapter discusses the implications of our findings for a new understanding of the drivers of large-scale criminal violence in Mexico, the social scientific study of criminal violence, and the design of security policies in new democracies. The focus on state–criminal collusion in the gray zone of criminality and political-electoral mechanisms as triggers of criminal wars and violence offers a new interpretation of drug wars in Mexico (1990–2012) and provides a tentative interpretation of the exponential growth of violence in the 2012–2018 period. Violence increased because Mexico continued to have intense electoral competition but no rule of law; collusion of state agents with crime expanded; presidents politicized law enforcement for electoral gains; and the administration of President Enrique Peña Nieto retained the same policies that originally caused the escalation of violence. Beyond Mexico, we discuss how our theoretical reformulation and our empirical findings contribute to the development of a political science of organized crime and violence. We conclude by considering how this political approach can shape a new understanding of security policies in new democracies.
This chapter reassesses the role of the novel in producing an economy of scale within which to picture the eighteenth-century body, under colonial conditions. It suggests that the novel of the period is driven by two imperatives, at once to produce an expanded picture of the body at a remove from itself and to produce an opposite image of a bound, organically complete body, which is proof against the alienating effects of colonial distance. The chapter then goes on to explore the first of these two drives, as it is expressed in the novel from from Aphra Behn to Daniel Defoe to Jonathan Swift and Sarah Scott.
Expectant parents who live through perinatal loss experience intense grief, which is not always acknowledged or accepted. A screening tool to detect bereaved parents’ grief reactions can guide professionals, including perinatal palliative care teams, to provide follow-up for those in need. This review's goal is to identify and synthesize the international published literature on existent instruments specifically measuring the grieving process after any perinatal loss and to identify factors that could moderate grief reactions.
Systematic review (PROSPERO # CRD42018092555) with critical synthesis. PUBMED, Cochrane, and PsycINFO databases were searched in English language articles using the keywords “perinatal” AND (“grief” OR “bereavement” OR mourning) AND (“scale” OR “questionnaire” OR “measure” OR “assessment”) up to May 2018. Eligibility criteria included every study using a measure to assess perinatal grief after all kinds of perinatal losses, including validations and translations to other languages and interventions designed to alleviate grief symptoms.
A total of 67 papers met inclusion criteria. Seven instruments measuring perinatal grief published between 1984 and 2002 are described. The Perinatal Grief Scale (PGS) was used in 53 of the selected studies. Of those, 39 analyzed factors associated with grief reactions. Six articles used PGS scores to evaluate pre- and post-bereavement interventions. Studies in English language only might have limited the number of articles.
Significance of results
The PGS is the most used standardized measures to assess grief after perinatal loss. All parents living through any kind of perinatal loss should be screened.
Large-scale investments in farmland can generate adverse effects on food security, minority groups, and the environment. Consequently, this Article analyzes to what extent international investment law has the potential to prevent those effects, considering the current investment treaty reform towards a symmetrical mechanism promoting sustainable development. First this Article presents the current substantive standard on expropriation of large-scale investments in farmland and the regulatory space left for host states. This Article then frames a potential public interest clause that would have the effect of granting due protection to investors and the right to regulate to host states, while not undermining the public interest and also preventing the adverse effects of these investments.
This chapter rejoins the methodology of normative approaches to voice-ranges and functions sketched in Chapter 5. Renaissance polyphony is considered in terms of the related compositional determinants of scoring, texture, and scale. The principal topics are: fifteenth-century pieces that lie outside the normative parameters seen in Chapter 5; the rise of imitation, viewed as a sub-category of texture, through to its paradigmatic status in the sixteenth century; the polyphony of the English Renaissance, much of whose earlier history develops along very different lines to continental music; and finally, the changes of approach to scale in Renaissance polyphony, from the ‘out-sized’ cyclic Masses at the turn of the sixteenth century to the growing emphasis on the number of voices, culminating in the ‘sonic blockbusters’ fashionable in European courts at the end of the century, whose most enduring manifestation is Tallis’ forty-part motet ‘Spem in alium’.
Triage - the sorting of patients according to urgency of need for clinical care - is an essential part of delivering effective and efficient emergency care. But when frequent over- or under-triaging occurs, finite time and resources are diverted away from those in greatest need of care and the entire Emergency Medical Services (EMS) system is strained. In resource-constrained settings, such as South Africa, poor triage in EMS only serves to compound other contextual challenges. This study examined the accuracy of dispatcher triage over a one-year period in the Western Cape Government (WCG) EMS system in South Africa.
A retrospective analysis of existing dispatch and EMS data to assess the accuracy of dispatch-assigned priorities was conducted. The mismatch between dispatcher-assigned call priority and triage levels determined by EMS personnel was analyzed via over- and under-triage rates, sensitivity and specificity, and positive and negative predictive values (PPVs and NPVs, respectively).
A total of 185,166 records from December 2016 through November 2017 were analyzed. Across all dispatch complaints, the over-triage rate was 67.6% (95% CI, 66.34-68.76) and the under-triage rate was 16.2% (95% CI, 15.44-16.90). Dispatch triage sensitivity for all included records was 49.2% (95% CI, 48.10-50.38), specificity 71.9% (95% CI, 71.00-72.92), PPV 32.5% (95% CI, 30.02-34.88), and NPV 83.8% (95% CI, 81.93-85.73).
This study provides the first evaluation of dispatch triage accuracy in the WCG EMS system, identifying that the system is suffering from both under- and over-triage. Despite variance across dispatch complaints, both under- and over-triage remained higher than widely accepted norms, and all rates were significantly above acceptable target metrics described in similar studies. Results of this study will be used to motivate the development of more rigorous training programs and resources for WCG EMS dispatchers, including improved dispatch protocols for conditions suffering from high over- and under-triage.
This study sought to compare the Hospital Anxiety and Depression Subscale (HADS-D) and Brief Edinburgh Depression Scale (BEDS) as case-finding tools of major depressive disorder in patients with advanced cancer in a palliative care service.
An observational study was performed which included patients with advanced cancer who attended the palliative care service at the National Institute of Cancer in Mexico. Patients were asked to fill out the Hospital Anxiety and Depression Scale (HADS) and BEDS and were then assessed by a psychiatrist to evaluate major depressive disorder (MDD) as per the DSM-5 criteria. The case-finding capability of each scale was determined using receiver operating characteristic curves, assessing the area under the curve (AUC) in comparison to the clinical diagnosis.
Eighty-nine patients were included; median age was 57 years, and 71% were female. Among these, 19 patients were diagnosed with MDD during the interview. When comparing the self-reported scales, BEDS had a better performance compared with HADS-D (AUC 0.8541 vs. 0.7665). Limitations include a heterogeneous population and a limited sample size.
Significance of results
The BEDS outperformed the HADS-D tool in discriminating patients with and without depression. A BEDS cutoff value of ≥5 is suggested as a case-finding score for depression in this population.
This chapter discusses the challenges in the scale-up of perfusion bioreactors from the few litres laboratory scale to the thousands of litres clinical and commercial scale. We consider comparative studies between laboratory- and large-scale reactor systems, including multiphase reactor models, computational fluidynamic tools as well as omics studies to support solid and reliable scale-up procedures. Specific scale-up issues – such as the scalability of the cell retention device, long-term operation, and batch definition in the case of process failure – are discussed. Finally, we evaluate the potential of single-use technologies and close the chapter with economic, financial, and environmental considerations in the context of future developments in biomanufacturing.
The design and development of perfusion cultures require extensive experiental campaigns in order to identify the most convenient conditions in terms of a very large number of operating parameters. There is a need for high-throughput technologies that allow for the simultaneous operation and monitoring of several cultures at different process conditions. This requires suitable scale-down models, which allow the reliable prediction of the behaviour at larger scale. Within this chapter, we describe systems allowing the operation at the µL and mL scale and enabling early process development, such as clone and media screening, as well as the design of suitable process operating conditions at the larger scale. Managing such a high number of experiments is not possible without a proper level of automation, including suitable sensors for process monitoring.
The paper is devoted to the existence and rigorous homogenisation of the generalised Poisson–Nernst–Planck problem describing the transport of charged species in a two-phase domain. By this, inhomogeneous conditions are supposed at the interface between the pore and solid phases. The solution of the doubly non-linear cross-diffusion model is discontinuous and allows a jump across the phase interface. To prove an averaged problem, the two-scale convergence method over periodic cells is applied and formulated simultaneously in the two phases and at the interface. In the limit, we obtain a non-linear system of equations with averaged matrices of the coefficients, which are based on cell problems due to diffusivity, permittivity and interface electric flux. The first-order corrector due to the inhomogeneous interface condition is derived as the solution to a non-local problem.
The evidence base for stigma in mental health largely originates from high-income countries.
This study from Pakistan aimed to address the gap in literature on stigma from low- and middle-income countries.
This cross-sectional study surveyed 1470 adults from Karachi, Pakistan. Participants from three groups (healthcare professionals, healthcare students and the general public) completed the adapted Bogardus Social Distance Scale (SDS) as a measure of stigma.
All three groups reported higher scores of stigma toward mental disorders compared with physical disorders. SDS scores for mental illness in the general public were significantly higher than in healthcare students (mean difference (MD) 6.93, 95% CI 5.45–8.45, P < 0.001) and healthcare professionals (MD 6.93, 95% CI 5.48–8.38, P < 0.001). However, SDS scores between healthcare students and healthcare professionals were not significantly different (MD 0.003, 95% CI −1.14–1.14, P > 0.99). Being female was associated with lower stigma scores and being over the age of 30 years was associated with higher stigma scores.
Stigma campaigns in Pakistan need to target the general population. However, evidence of negative attitudes toward mental illness in healthcare students and healthcare professionals supports the need for stronger emphasis on psychiatric education within undergraduate and postgraduate training in Pakistan.
Poor post-prandial glucose control is a risk factor for multiple health conditions. The second-meal effect refers to the progressively improved glycaemic control with repeated feedings, an effect which is achievable with protein ingestion at the initial eating occasion. The most pronounced glycaemic response each day therefore typically occurs following breakfast, so the present study investigated whether ingesting protein during the night could improve glucose control at the first meal of the day. In a randomised crossover design, fifteen adults (seven males, eight females; age, 22 (sd 3) years; BMI, 24·0 (sd 2·8) kg/m2; fasting blood glucose, 4·9 (sd 0·5) mmol/l) woke at 04.00 (sd 1) hours to ingest 300 ml water with or without 63 g whey protein. Participants then completed a mixed-macronutrient meal tolerance test (1 g carbohydrate/kg body mass, 2356 (sd 435) kJ), 5 h 39 min following the nocturnal feeding. Nocturnal protein ingestion increased the glycaemic response (incremental AUC) to breakfast by 43·5 (sd 55·5) mmol × 120 min/l (P = 0·009, d = 0·94). Consistent with this effect, individual peak blood glucose concentrations were 0·6 (sd 1·0) mmol/l higher following breakfast when protein had been ingested (P = 0·049, d = 0·50). Immediately prior to breakfast, rates of lipid oxidation were 0·02 (sd 0·03) g/min higher (P = 0·045) in the protein condition, followed by an elevated post-prandial energy expenditure (0·38 (sd 0·50) kJ/min, P = 0·018). Post-prandial appetite and energy intake were similar between conditions. The present study reveals a paradoxical second-meal phenomenon whereby nocturnal whey protein feeding impaired subsequent glucose tolerance, whilst increasing post-prandial energy expenditure.
This chapter evaluates the applicability of the natural monopoly framework in digital platform markets. It starts by discussing the role of technological change in fostering concentrated market structures in digital industries and by evalauting the policy implications that should be derived from the economic literature on multisided platforms. On that basis, it then identifies the general conditions that may give rise to a natural monopoly platform.
Stimulation of gastrointestinal taste receptors affects eating behaviour. Intraduodenal infusion of tastants leads to increased satiation and reduced food intake, whereas intraileal infusion of tastants does not affect eating behaviour. Currently, it is unknown whether oral- or intragastric administration of tastants induces a larger effect on eating behaviour. This study investigated the effects of oral- and/or intragastric administration of quinine on food intake, appetite sensations and heart rate variability (HRV). In a blinded randomised crossover trial, thirty-two healthy volunteers participated in four interventions with a 1-week washout: oral placebo and intragastric placebo (OPGP), oral quinine and intragastric placebo (OQGP), oral placebo and intragastric quinine (OPGQ) and oral quinine and intragastric quinine (OQGQ). On test days, 150 min after a standardised breakfast, subjects ingested a capsule containing quinine or placebo and were sham-fed a mixture of quinine or placebo orally. At 50 min after intervention, subjects received an ad libitum meal to measure food intake. Visual analogue scales for appetite sensations were collected, and HRV measurements were performed at regular intervals. Oral and/or intragastric delivery of the bitter tastant quinine did not affect food intake (OPGP: 3273·6 (sem 131·8) kJ, OQGP: 3072·7 (sem 132·2) kJ, OPGQ: 3289·0 (sem 132·6) kJ and OQGQ: 3204·1 (sem 133·1) kJ, P = 0·069). Desire to eat and hunger decreased after OQGP and OPGQ compared with OPGP (P < 0·001 and P < 0·05, respectively), whereas satiation, fullness and HRV did not differ between interventions. In conclusion, sole oral sham feeding with and sole intragastric delivery of quinine decreased desire to eat and hunger, without affecting food intake, satiation, fullness or HRV.
Executive function (EF) difficulties are commonly found in youth with intellectual disability (ID). Given mixed results from studies using performance-based EF measures, the EF profile has not been well characterized for this population. No published work has examined the clinical utility of the Behavior Rating Inventory of Executive Function, Second Edition (BRIEF2) in distinguishing EF in ID. We hypothesized that the BRIEF2 would show greater elevations in youth with ID compared to the Average IQ comparison group.
Participants included a large sample of 504 youth (157 in ID group; aged 8–18 years) referred for (neuro)psychological evaluation (2015–2019) and identified as meeting criteria for either ID or Average IQ comparison group.
Significant elevations were found across BRIEF2 indices and scales. Only mild elevations were noted in selective cognitive regulation scales within the Average IQ group. Groups differed significantly across all EF dimensions, with greater differences observed in behavioral regulation (Self-Monitoring, Inhibition), Shift, and Working Memory. An elevated but less variable pattern of index scores was noted in ID, while the overall pattern of scaled scores appeared similar between groups.
The less variable and consistently elevated profile may suggest fewer EF dimensions in individuals with ID than the model proposed in the test manual. Similar profiles between groups may reflect differences in severity, rather than differences in constructs measured by the EF factors, per se. Additional examination is needed to confirm potential structural differences in EF for youth with ID as measured by BRIEF2, with a clinical implication for greater efficiency of EF assessment in this population.
The satiating efficiency of food has been increasingly quantified using the Satiety Quotient (SQ). The SQ integrates both the energy content of food ingested during a meal and the associated change in appetite sensations. This systematic review examines the available evidence regarding its methodological use and clinical utility. A literature search was conducted in six databases considering studies from 1900 to April 2020 that used SQ in adults, adolescents and children. All study designs were included. From the initial 495 references found, fifty-two were included. Of the studies included, thirty-three were acute studies (twenty-nine in adults and four in adolescents) and nineteen were longitudinal studies in adults. A high methodological heterogeneity in the application of the SQ was observed between studies. Five main utilisations of the SQ were identified: its association with (i) energy intake; (ii) anthropometric variables; (iii) energy expenditure/physical activity; (iv) sleep quality and quantity and (v) to classify individuals by their satiety responsiveness (i.e. low and high satiety phenotypes). Altogether, the studies suggest the SQ as an interesting clinical tool regarding the satiety responsiveness to a meal and its changes in responses to weight loss in adults. The SQ might be a reliable clinical indicator in adults when it comes to both obesity prevention and treatment. There is a need for more standardised use of the SQ in addition to further studies to investigate its validity in different contexts and populations, especially among children and adolescents.