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The maned wolf Chrysocyon brachyurus, the fourth largest canid, is categorized as Near Threatened on the IUCN Red List. The objectives of this study were to update information on the occurrence of this species in Argentina, compare the current distribution to that previously described for 1988–2008, and indicate the areas in which the species is exposed to particular hazards. We created a database that included 1,051 new records of C. brachyurus for 2009-2021, in addition to records for 1988–2008 that had not been reported previously. We calculated the area of occupancy of the species in Argentina to be 500,000 km2. Most of the new records of C. brachyurus are in the Chaco Seco, Espinal and Pampas ecoregions. Our findings indicate a current area of occupancy 61% higher than that calculated from records for 1988–2008. However the location and frequency of reported threats and the intense environmental transformation that characterizes the areas for which we obtained new records suggest counterintuitive implications for the conservation of the species because of increased human–wildlife interactions. Our study reveals the need for systematic research to improve the understanding of the ecological processes that affect the maned wolf in Argentina, and will aid in the development of conservation strategies for the species.
Death anxiety (DA), a condition characterized by fear, angst, or panic related to the awareness of one’s own death, is commonly observed in advanced cancer patients. The aim of this study was to examine the psychometric properties of the Italian version of the Death and Dying Distress Scale (DADDS-IT) in a sample of patients with advanced cancer.
The sample included 200 Italian advanced cancer patients meeting eligibility criteria to access palliative care. Patients’ levels of DA were assessed by using the DADDS-IT, while the levels of depression, anxiety, demoralization, spiritual well-being, and symptom burden were assessed using the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, the Demoralization Scale, the Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being Scale, and the Edmonton Symptom Assessment System, respectively; Karnofsky Performance Status was used to measure functional impairment. Confirmatory factor analyses (CFA) of previous structures and exploratory factor analyses (EFA) were conducted.
CFA revealed that none of the previous structures adequately fitted data from our sample. EFA revealed a 4-factor model comprising Finitude (α = 0.91), Regret (α = 0.86), Dying (α = 0.88), and Relational Burden (α = 0.73), accounting for the 77.1% of the variance. Dying subscore was higher in hospice patients than in those recruited in medical wards.
Significance of results
The present study provides further evidence that DA is a condition that deserves attention and that DADDS-IT shows good psychometric properties to support its use in research and clinical settings.
Effective transboundary corridors play a crucial role in jaguar Panthera onca conservation. Local residents reported jaguar sightings along the Baritú–Tariquía Biological Corridor, which prompted us to carry out this camera-trap survey. We surveyed an area of 1,243 km2 across the corridor to confirm jaguar presence. We used 50 single camera stations, with cameras placed c. 5 km apart. We placed the cameras along trails, streams and mountain ridges. We recorded jaguars at seven sites across the Corridor; at least three different individuals were identified. These records confirm the presence of the jaguar in the Baritú–Tariquía Biological Corridor between Argentina and Bolivia, a trans-frontier area of the Austral Yungas facing multiple threats but hosting one of the southernmost jaguar populations. Conservation efforts in border regions can promote collaboration and synergies between agencies and other conservation stakeholders, with important implications for wide-ranging predators such as jaguars and their habitats.
This Element examines the concept of moral responsibility as it is used in contemporary philosophical debates and explores the justifiability of the moral practices associated with it, including moral praise/blame, retributive punishment, and the reactive attitudes of resentment and indignation. After identifying and discussing several different varieties of responsibility-including causal responsibility, take-charge responsibility, role responsibility, liability responsibility, and the kinds of responsibility associated with attributability, answerability, and accountability-it distinguishes between basic and non-basic desert conceptions of moral responsibility and considers a number of skeptical arguments against each. It then outlines an alternative forward-looking account of moral responsibility grounded in non-desert-invoking desiderata such as protection, reconciliation, and moral formation. It concludes by addressing concerns about the practical implications of skepticism about desert-based moral responsibility and explains how optimistic skeptics can preserve most of what we care about when it comes to our interpersonal relationships, morality, and meaning in life.
To provide an update on the use of health technology assessment (HTA) in Asia and lessons for countries seeking to advance HTA.
Build upon the research by Chootipongchaivat and the World Health Organization identifying eighteen “factors conducive to the development of HTA in Asia.” These factors were used to create a balanced scorecard to assess the progress of HTA, measuring progress against each factor in China, India, Indonesia, Malaysia, Philippines, South Korea, Taiwan, Thailand, and Vietnam. A scoring system was used wherein: 1, No progress; 2, milestone at early stages, ad hoc HTA use; 3, progress on milestone but limited impact; 4, significant progress but limited remit; and 5, significant progress on milestone, routine HTA informs decisions. Total scores indicated progress of HTA while milestone scores provided contextual insights within countries. Literature reviews and expert interviews were used to complete scorecards.
South Korea and Thailand scored highest with seventy-three and seventy-one points, respectively, while Vietnam scored lowest at 28.5. Advanced HTA programs have independent HTA agencies with a broad remit, explicit process and methods, network of researchers, and routine use of HTA. Taiwan and Malaysia fall in a middle tier, with established HTA programs with limited remit. The final tier with China, India, Indonesia, Philippines, and Vietnam, emerging HTA processes.
Universal Health Coverage goals have catalyzed expansion of HTA. Political will, technical expertise, and sustained financing remain challenges for sustainable HTA programs. Legislation supporting HTA is helpful but political will is key. Recommendations for regional collaboration are provided.
Diabetes mellitus (DM) is a dominant chronic disease in the older adult population in the United States as well as in many other countries of the world. The prevalence of DM in the future is only expected to grow with the increase in the population of adults aged 65 and over, the prevalence of obesity, and physical inactivity. Clinicians are faced with many unique challenges when caring for this older diabetic population. The clinician’s major challenges are (1) to avoid symptoms and complications of hyper- and hypoglycemia, (2) to minimize or delay micro- and macrovascular complications, if possible, and (3) to maximize daily functioning. Underlying these challenges is the realization that the geriatric population is a heterogeneous one. Goals of care and treatment decisions may vary, depending more on the patient’s functional abilities and on other comorbidities or coexisting geriatric syndromes, and less on the age of the patient. This chapter will focus on specific aspects of diabetes care in the older adult.
We study the distribution of the roots of a random p-adic polynomial in an algebraic closure of
. We prove that the mean number of roots generating a fixed finite extension K of
depends mostly on the discriminant of K, an extension containing fewer roots when it becomes more ramified. We prove further that for any positive integer r, a random p-adic polynomial of sufficiently large degree has about r roots on average in extensions of degree at most r.
Beyond the mean, we also study higher moments and correlations between the number of roots in two given subsets of
(or, more generally, of a finite extension of
). In this perspective, we notably establish results highlighting that the roots tend to repel each other and quantify this phenomenon.
Anatomically corrected malposition of the great arteries is a rare CHD, involving alignment and position of the great arteries. We report an infant with situs solitus, atrioventricular discordance, and ventriculoarterial concordance with the aorta arising anteriorly and to the right of the pulmonary artery. A mutation of Nodal gene, implicated in the pathogenesis of human left–right patterning defects, was found.
This study aims to identify and codify the facilitators and barriers to help implementing partners institutionalize health technology assessment (HTA) successfully and navigate complex systems for health-related policy making.
We searched for peer-reviewed and gray literature articles examining HTA programs globally using six databases. Keywords used as a guide for capturing articles included “health technology assessment,” “barrier,” and “facilitator” and their synonyms. Search results were scrutinized for duplicates and screened through a review of titles and abstracts. A full-text review was conducted exploring articles’ coverage of twenty-seven evaluation criteria across four primary areas of interest: barriers/facilitators, motivations, guidelines, and institutional frameworks.
A total of 18,599 records were identified for duplication check, title, and abstract review. A total of 1,594 articles underwent full-text review, leading to a final synthesis of 262 studies. We found that ninety-seven articles discussed barriers/facilitators, with fifty-three of those discussing local capacity and unavailable human resources. Out of the sixty-six articles discussing motivations, forty-two cited the interest in supporting the decision-making process for, and promoting, appropriate resource allocation. Of the sixty-one articles that discussed guidelines and institutional framework, twenty-one articles described HTA as an independent national unit, and sixteen described their HTA unit as a unit within the Ministry of Health (MOH).
This systematic review unpacks the dynamic and relevant contexts for understanding the HTA institutionalization process to help policy makers and practitioners achieve tangible progress in confronting the most critical issues facing priority setting and HTA institutionalization.
Enhancing the appearance of physical prototypes with digital elements, also known as mixed prototyping, has demonstrated to be a valuable approach in the product development process. However, the adoption is limited also due to the high time and competence required for authoring the digital contents. This paper presents a content authoring tool that aims to improve the user acceptance by reducing the specific competence required, which is needed for segmentation and UV mapping of the 3D model used to implement a mixed prototype. Part of the tasks related to 3D modelling software, in fact, has been transferred to simpler manual tasks applied onto the physical prototype. Moreover, the proposed tool can recognise these manual inputs thanks to a computer-vision algorithm and automatically manage the segmentation and UV mapping tasks, freeing time for the user in a task that otherwise would require complete engagement. To preliminarily evaluate effectiveness and potential of the tool, it has been used in a case study to build up the mixed prototype of a coffee machine. The result demonstrated that the tool can correctly segment the 3D model of a physical prototype in its relevant parts and generate their corresponding UV maps.
The objectives of this study were to evaluate, in the Italian cultural context, breast cancer patients’ main meaning themes related to the experience of the disease, on the one side, and to be part of an existentially oriented group intervention, on the other.
A short reorientation-existential (RET) group intervention, structured by using some tools and background from cognitive analytic therapy (CAT) and based on the meaning-centered psychotherapy (MCP) existential framework, was delivered to 29 breast cancer patients. The sessions were audio-recorded and transcribed verbatim, with the narratives from reflective exercises (meaning of the journey cancer, meaning of the journey of intervention) uploaded to computer software NVivo 11. Analysis of the transcripts emerged from reflective exercises on the personal meaning of cancer and the letters of meaning (goodbye letter) written by the patients to express the meaning of their experience in the group was conducted through the interpretative phenomenological analysis (IPA) framework.
Four superordinate themes were identified in the exercise meaning of the experience of cancer, namely “sense of stigma and loneliness (the foreigner),” “guilt (unjust guilt and anticipatory guilt),” “reconsidering one's own life and nostalgia,” and “rebirth (a new life, life after life).” Three superordinate themes were found in the meaning of the group experience in the letters, namely “togetherness and gratitude,” “legacy,” and “acceptance.”
Significance of results
The study confirmed that a short group intervention, based on the existentially oriented framework and delivered in a public clinical healthcare setting, was enriched by focusing on the personal meaning of cancer. Some themes, such as loneliness, nostalgia, and rebirth, emerged during reflection giving, in written letters to participants, the sense of the group therapeutic experience.
The first, which is the focus of this chapter, argues that free will skepticism is the only reasonable position to adopt when it comes to the problem of free will. And since retributive punishment requires the kind of free will associated with basic desert moral responsibility in order to be justified, free will skepticism implies that retributive punishment lacks justification. Hence, in so far as we demand justified legal punishment practices, we should reject retributivism in light of the philosophical arguments against free will and basic desert moral responsibility. We can call this argument the skeptical argument against retributivism since it maintains that free will skepticism undermines the retributivist notion that wrongdoers deserve to be punished in the backward-looking sense required.
In the previous chapter, I argued that the public health–quarantine model can successfully deal with concerns about proportionality, human dignity, victims’ rights, rehabilitation, and preemptive incapacitation. In this chapter, I will argue that it can also successfully deal with concerns about funishment, cost, deterrence, evidentiary standards, and indefinite detention. In the process of defending my account, I will revisit the issue of prison design, explain one important difference between the views of Pereboom and myself, and argue that high evidentiary standards and the importance of actus reus and mens rea can all be preserved.
In this chapter, I will further develop the public health–quarantine model by exploring the relationship between public health and safety. I will focus on how social inequalities and systemic injustices affect health outcomes and crime rates, how poverty affects incarceration rates, how offenders often have preexisting medical conditions including mental health issues, how involvement in the criminal justice system itself can lead to or worsen health and cognitive problems, how treatment and rehabilitation methods can best be employed to reduce recidivism and reintegrate offenders back into society, and how a public health approach could be successfully applied within the criminal justice system. My approach will draw on research from the health sciences, social sciences, public policy, law, psychiatry, medical ethics, epidemiology, neuroscience, and philosophy. I will argue that there are number of important links and similarities between the social determinants of health (SDH) and the social determinants of criminal behavior (SDCB), and that the public health–quarantine model provides the most justified, humane, and effective approach for addressing criminal behavior.
Within the criminal justice system one of the most prominent justifications for legal punishment, both historically and currently, is retributivism. The retributive justification of legal punishment maintains that, absent any excusing conditions, wrongdoers are morally responsible for their actions and deserve to be punished in proportion to their wrongdoing. Unlike theories of punishment that aim at deterrence, rehabilitation, or incapacitation, retributivism grounds punishment in the blameworthiness and desert of offenders. It holds that punishing wrongdoers is intrinsically good. For the retributivist, wrongdoers deserve a punitive response proportional to their wrongdoing, even if their punishment serves no further purpose. This means that the retributivist position is not reducible to consequentialist considerations nor in justifying punishment does it appeal to wider goods such as the safety of society or the moral improvement of those being punished.