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According to conventional wisdom, closed-list proportional representation (CLPR) electoral systems create incentives for legislators to favor the party line over their voters’ positions. However, electoral incentives may induce party leaders to tolerate “shirking” by some legislators, even under CLPR. This study argues that in considering whose deviations from the party line should be tolerated, party leaders exploit differences in voters’ relative electoral influence resulting from malapportionment. We expect defections in roll call votes to be more likely among legislators elected from overrepresented districts than among those from other districts. We empirically test this claim using data on Argentine legislators’ voting records and a unique dataset of estimates of voters’ and legislators’ placements in a common ideological space. Our findings suggest that even under electoral rules known for promoting unified parties, we should expect strategic defections to please voters, which can be advantageous for the party’s electoral fortunes.
The aim of the study was to assess the effect of the summer thermal environment on physiological responses, behaviour, milk production and its composition on grazing dairy cows in a temperate climate region, according to the stage of lactation. Twenty-nine Holstein Friesian multiparous cows were randomly selected and divided into two groups, according to the days in milk, as mid-lactation (99 to 170 d in milk, n = 15) and late lactation (225 to 311 d in milk, n = 14). The comprehensive climate index (CCI) was used to classify the hour of each day as thermoneutral or heat stress, considering a threshold value of CCI of 20°C. Data were collected for 16 d (summer 2017) and analysed as a completely randomized 2 × 2 factorial arrangement with repeated measurements over time. Vaginal temperature increased with CCI ≥ 20°C. Respiration rates were dependent on the thermal condition, regardless of days in milk. There was an interaction between the time of day and the CCI category for activity and rumination. Grazing activity decreased by 17.6% but lying down, standing, and shaded animals increased by 1.6, 9.8, and 6.3% respectively when CCI ≥ 20°C. Over 80% of cows presented a panting score ≥1. However, milk production and composition (fat, protein, and lactose concentrations as well as somatic cell count) were not affected by the thermal condition, although there was a numerical (non-significant) decrease in afternoon milk protein concentration on days with CCI ≥ 20°C, while urea in milk increased. In conclusion, thermal condition challenged grazing dairy cows' behaviour and physiology independent of the stage of lactation but had little or no effect on milk production.
By replying to Kurt Weyland’s (2020) comparative study of populism, we revisit optimistic perspectives on the health of American democracy in light of existing evidence. Relying on a set-theoretical approach, Weyland concludes that populists succeed in subverting democracy only when institutional weakness and conjunctural misfortune are observed jointly in a polity, thereby conferring on the United States immunity to democratic reversal. We challenge this conclusion on two grounds. First, we argue that the focus on institutional dynamics neglects the impact of the structural conditions in which institutions are embedded, such as inequality, racial cleavages, and changing political attitudes among the public. Second, we claim that endogeneity, coding errors, and the (mis)use of Boolean algebra raise questions about the accuracy of the analysis and its conclusions. Although we are skeptical of crisp-set Qualitative Comparative Analysis as an adequate modeling choice, we replicate the original analysis and find that the paths toward democratic backsliding and continuity are both potentially compatible with the United States.
The impact of pandemic events such as the coronavirus (COVID-19) pandemic led to an economic crisis worldwide as well as an increase of mental health problems. In the United States, the gaps in the mental health care system struggle to meet the needs of vulnerable populations and have caused a major public health problem. We aim to increase the awareness of health care professionals, psychiatrists, and policy makers regarding failures and gaps in the mental health care system and suggest new ideas to overcome the growing burden of mental disorders.
We utilized data from PubMed, Science Direct, Cochrane, Embase and Clinicaltrials.gov databases to analyze available information on the US mental health system. We included any relevant articles addressing the prevalence of mental diseases, disparities and the gaps for an accessible and affordable mental health system, as well as the psychological impact of COVID-19 pandemic.
‘COVID-19’, ‘Coronavirus’, ‘SARS-CoV-2’, ‘mental health’, ‘Health, Mental’ were used.
Following scoping review of several studies we noticed that while prevalence of mental health problems in the US varies between states and socio-demographic groups, it is among the top 10 causes of premature death and disability in adults. We noticed that mental health problems are currently one of the costliest public health issues in the healthcare system. Tracking Poll from one of the studies in our scoping review suggested that financial inequities are magnified by the COVID-19 pandemic and that psychological distress was substantially larger among respondents with lower income (33%), Hispanics (28%) and Blacks (26%). Furthermore, in another poll 62% of US population are shown to be anxious due to COVID-19. We observed that the prevalence of reported symptoms of psychological distress among US adults increased when compared to 2018. Common barriers such as failure of accessibility, insufficient funding, insufficient psychiatric beds, limited insurance access and economic burden, clinician shortages, fragmented care, insufficient mental health care policies and insufficient education and awareness about mental illness become more prominent during the COVID-19 pandemic era.
The impact of COVID-19 on mental health is alarming, which affects public health and has made the health care system more vulnerable. Pandemic events not only cause acute negative impact, they also result in long-lasting health problems, isolation and stigma. The COVID-19 pandemic threatens the mental health of the population and its long-term consequences can lead to a secondary pandemic. The outcomes of the COVID-19 pandemic on mental health emphasize the need for policies and strategies to support and strengthen a concerted effort to address its burden on the US mental health care system. In addition, it magnifies the need for high quality and well-funded research for future pandemics.
ABSTRACT IMPACT: The broad goal of this investigation is to inform the development of culturally sensitive HIV prevention strategies to reduce specific challenges pertaining to PrEP uptake and utilization for Latino men. OBJECTIVES/GOALS: HIV is a significant public health concern affecting Latinos in the U.S. Daily use of pre-exposure prophylaxis (PrEP) effectively prevents HIV infection and has the potential to curb HIV epidemics. The objective of this study is to examine how sociocultural variables impact PrEP-related services among HIV-negative Latinxs. METHODS/STUDY POPULATION: The current study is a mixed-method investigation. Participants will include Latinx adult patients seeking services at an HIV community clinic. Approximately 150 participants will be recruited for the study. Participants who are eligible will complete sociocultural, mental health and PrEP-related measures. For the applied aim, community stakeholders will be recruited who serve the Latinx community. Upon completion of data collection, the data analytic plan is as follows: Aim 1, to establish the relationship between each sociocultural variable and PrEP uptake/utilization, preliminary analyses (i.e., correlations and regression analyses considering co-variates) will be conducted. Aim 2, grounded theory techniques will be conducted to establish community-informed practices to increase the use of PrEP. RESULTS/ANTICIPATED RESULTS: Relatively little is known about cultural factors that may impede PrEP uptake among Latinx MSM. Several researchers have identified specific factors such as language, acculturation, familismo, and similar cultural norms as significant barriers to care (Page et al., 2017). It is expected that each of these variables will contribute significant variance to willingness to use PrEP. Specifically, negative relationships are expected between fatalism and machismo and lower stages on the PrEP Contemplation Ladder. Comparably, a negative relationship is expected between the Hispanic acculturation subscale and lower stages on the PrEP Contemplation Ladder. It is however, hypothesized that there will be a positive relationship between familism and the non-Hispanic acculturation sub-scale. DISCUSSION/SIGNIFICANCE OF FINDINGS: Despite important advances in health to prevent HIV infection, HIV rates among Latinx MSM continue to rise. This investigation will have the potential to inform the development of culturally sensitive prevention strategies. By collecting qualitative data from key community stakeholders, this project will also directly inform a CBPR prevention.
The Mexican Revolution and the new Constitution of 1917 produced transformations in the field of international law both in Mexico and across the Americas. The impact of these transformations, and particularly their implications for continental and regional debates over armed and unilateral interventionism, have tended to be overlooked by scholarship on international relations and the Mexican Revolution.
Ainslie advances our understanding of self-control by theoretically unifying multiple forms of willpower. But one crucial question remains unanswered: How do agents pick the right forms of willpower in each situation? I argue that willpower requires tactical skill, which detects willpower-demanding contexts, selects context-appropriate tactics, and monitors their implementation. Research on tactical skill will significantly advance our understanding of willpower.
This paper studies the evolution of the Chilean economy in the late 19th and early 20th century, a period when the country's convergence with developed countries came to an end. We analyse this problem in the context of the modern literature on the middle-income trap. The social, political and economic history of Chile between 1875 and 1939 is examined and the presence of most of the factors associated with the middle-income trap is found. We complement this narrative through a quantitative analysis based on the synthetic control method and argue that the process of state-led industrialisation undertaken in the country leading to the formation of CORFO was a key economic and political event. Our work presents some general lessons for developing countries facing a similar context.
Este trabajo discute las estrategias vinculadas al aprovechamiento de animales durante dos ocupaciones del sitio San Francisco Inca (puna transicional de Chaschuil, Catamarca, Argentina): una incaica (ca. siglos catorce y quince dC) y otra preincaica (ca. siglos diez a trece dC). Los grupos agropastoriles preincaicos que ocuparon estacionalmente el sitio desarrollaron una estrategia de diversificación, intensificación y almacenamiento de los recursos de origen animal para hacer frente a la impredecibilidad puneña y al contexto regional de restricción ambiental. Esta incluyó la caza de vicuñas, la tendencia a evitar el sacrificio de llamas durante dicha ocupación, el procesamiento relativamente intensivo de partes de bajo retorno de los camélidos, el secado de elementos del esqueleto axial y, posiblemente, el consumo diferido de la médula ósea de los metapodios. Durante la ocupación incaica, el Estado organizó festines para legitimar su presencia en la región y sirvió comidas basadas fundamentalmente en los recursos brindados por animales silvestres capturados localmente (vicuñas y, en menor proporción, roedores, aves y guanacos). Además, se plantea la posibilidad de que en dichos eventos festivos se hayan realizado sacrificios de llamas y producido carne seca para su consumo diferido en otros pisos altitudinales o para el intercambio.
To determine the optimal anthropometric cut-off points for predicting the likelihood ratios of hypertension and diabetes in the Peruvian population.
A cross-sectional study was performed to establish cut-off values for body mass index (BMI), waist circumference (WC), waist:height ratio (WHtR) and Conicity index (C-index) associated with increased risk of hypertension and diabetes. Youden’s index (YIndex), area under the curve (AUC), sensitivity and specificity were calculated.
Peruvian population over the age of 18 years.
A total of 31 553 subjects were included, 57 % being women. Among the women, 53·06 % belonged to the 25- to 44-year-old age group [mean age: 41·66 in men and 40·02 in women]. The mean BMI, WHtR and C-index values were higher in women 27·49, 0·61, 1·30, respectively, while the mean WC value was higher in men 92·12 cm (sd ± 11·28). The best predictors of hypertension in men were the WHtR (AUC = 0·64) and the C-index (AUC = 0·64) with an optimal cut-off point of 0·57 (YIndex = 0·284) and 1·301 (YIndex = 0·284), respectively. Women showed an AUC of 0·63 and 0·61 in the WHtR and C-index, respectively, with an optimal cut-off of 0·61 (YIndex = 0·236) and 1·323 (YIndex = 0·225). The best predictor for diabetes was the C-index: with an AUC = 0·67 and an optimal cut-off of 1·337 (YIndex = 0·346) for men and an AUC = 0·66 and optimal cut-off of 1·313 (YIndex = 0·319) for women.
Our findings show that in Peruvian adults, the WHtR and the C-index have the strongest association with hypertension in both sexes. Likewise, the C-index had the strongest association with diabetes.
Background: Hand hygiene (HH) is the most important measure for preventing healthcare-associated infections. The objective is to gain insight into the evolution of the degree of compliance with recommendations (DCR) on HH and its associated factors in the surgical areas of a tertiary-care hospital. Methods: This observational, cross-sectional study, was repeated over time, with direct observation of the DCR on HH during the daily activity of healthcare workers in surgical areas: general surgery, urology, vascular surgery, traumatology, neurosurgery, thoracic surgery, heart surgery, pediatric surgery, otorhinolaryngology, gynecology and obstetrics, ophthalmology. Over 14 years (from 2005 to 2018), 15,946 HH opportunities were registered, together with different additional variables (age, sex, professional position, surgical area ). The 2 test was used to study the association and the crude, and adjusted odds ratios were used to quantify its magnitude. Results: The DCR on HH in surgical areas was 49.7% (95% CI, 48.9%–50.5%), and in the group of nonsurgical areas it was 53.4% (95% CI, 53.1%–54.1%). The area with the highest degree of compliance was urology (56.7%; 95% CI, 53.9%–59.6%), and the area with the lowest degree of compliance was traumatology (43.3%; 95% CI, 40.4%–46.2%). Some associated factors were the indications after an activity has been performed (58.6%; aOR, 2.7; 95% CI, 2.5–2.9) and the availability of pocket-size alcohol-based disinfectant (63.8%; aOR, 2.4; 95% CI, 2.2–2.5). Conclusions: The DCR on HH in surgical areas is lower than in other hospital areas, and there is still some margin for improvement. We have identified some modifiable factors that have an independent association with HH compliance in surgical areas. Focusing on them will increase compliance with HH with the ultimate goal of reducing healthcare-associated infections.
Background: Annual flu vaccination is the most effective way to prevent the disease and its complications. Vaccine effectiveness (EV) varies from season to season, requiring annual re-evaluation. The objective of this study was to estimate the preliminary effectiveness of the influenza vaccine until epidemiological week 4 of the 2019–2020 season, in patients admitted to a tertiary-level hospital. Method: We conducted a case-control study at University General Hospital, Alicante, Spain, during the 2019–2020 season. We included all patients hospitalized with influenza confirmed by laboratory test (ie, PCR positive for influenza) during the period between epidemiological week 40 of 2019 and epidemiological week 4 of 2020. These were considered cases, and those with clinical suspicion of influenza and negative RT-PCR were considered controls. Vaccination coverage was calculated in cases and in controls, determining the odds ratio. We calculated the vaccine effectiveness (VE) and its 95% confidence interval using the following formula: VE = (1 − odds ratio) ×100. Result: We included 545 patients: 61 cases and 484 controls. The overall EV for influenza cases prevention was 40.7% (95% CI, −17.1 to 70.1), and for those >1 year of age, the overall EV was 56.9% (95% CI, 13.9–78.5). Conclusion: The 2019–2020 Influenza vaccine was effective in preventing influenza cases in patients admitted up to week 4 of the 2019–2020 season. These results are preliminary and may vary; they should be re-evaluated at the end of the season.
Between 7 June 1982 and 1 December 1990, Chad was ruled by the dictator Hissène Habré, who implemented one of the most repressive regimes in Africa in modern history. According to the findings of the Commission of Inquiry into Crimes and Misappropriations Committed by former President Habré and his accomplices, during his tenure in power, there were around 40,000 victims of political assassinations and systematic torture. Exiled to Senegal, Habré was not held accountable for his crimes for a number of years. However, the quest for justice pursued by victims and their lawyers in national and international fora, among other factors, made Senegal finally honour its international obligations to try those responsible for international crimes. This process involved both the Court of Justice of the Economic Community of West African States (hereinafter the ECOWAS Court of Justice), which found that Habré needed to be tried under ‘a special ad-hoc procedure of an international character’, and the International Court of Justice (ICJ), which ordered Senegal to prosecute or extradite Habré without further delay.
In successfully implementing and completing these judicial steps, the African Union (AU) played a pivotal role. The Extraordinary African Chambers in the Senegalese courts (EAC) were set up following an agreement between the AU and Senegal on 8 February 2013, which contains the EAC Statute as an annex. The EAC was given the mandate to prosecute those most responsible for international crimes, under customary international law and conventions ratified by Chad and Senegal, for crimes perpetrated in Chad from 7 June 1982 to 1 December 1990, namely during the years that Habré was in power in Chad. On 30 May 2016, the EAC Trial Chamber convicted Habré of: (i) crimes against humanity, in particular rape, sexual slavery, murder, summary execution, enforced disappearance, torture and inhumane acts; (ii) torture as an autonomous crime; and (iii) war crimes, in particular murder, torture, cruel, inhumane treatment and unlawful confinement of prisoners of war. This conviction was largely ratified by the EAC Appeals Chamber on 27 April 2017. As confirmed on appeal, Habré's conviction marked the closure of the EAC, except for the ongoing process of implementing the reparation award ordered by the EAC.
The COVID-19 pandemic has had a major impact on clinical practice. Safe standards of practice are essential to protect health care workers while still allowing them to provide good care. The Canadian Society of Clinical Neurophysiologists, the Canadian Association of Electroneurophysiology Technologists, the Association of Electromyography Technologists of Canada, the Board of Registration of Electromyography Technologists of Canada, and the Canadian Board of Registration of Electroencephalograph Technologists have combined to review current published literature about safe practices for neurophysiology laboratories. Herein, we present the results of our review and provide our expert opinion regarding the safe practice of neurophysiology during the COVID-19 pandemic in Canada.
Social and environmental factors such as poverty or violence modulate the risk and course of schizophrenia. However, how they affect the brain in patients with psychosis remains unclear.
We studied how environmental factors are related to brain structure in patients with schizophrenia and controls in Latin America, where these factors are large and unequally distributed.
This is a multicentre study of magnetic resonance imaging in patients with schizophrenia and controls from six Latin American cities. Total and voxel-level grey matter volumes, and their relationship with neighbourhood characteristics such as average income and homicide rates, were analysed with a general linear model.
A total of 334 patients with schizophrenia and 262 controls were included. Income was differentially related to total grey matter volume in both groups (P = 0.006). Controls showed a positive correlation between total grey matter volume and income (R = 0.14, P = 0.02). Surprisingly, this relationship was not present in patients with schizophrenia (R = −0.076, P = 0.17). Voxel-level analysis confirmed that this interaction was widespread across the cortex. After adjusting for global brain changes, income was positively related to prefrontal cortex volumes only in controls. Conversely, the hippocampus in patients with schizophrenia, but not in controls, was relatively larger in affluent environments. There was no significant correlation between environmental violence and brain structure.
Our results highlight the interplay between environment, particularly poverty, and individual characteristics in psychosis. This is particularly important for harsh environments such as low- and middle-income countries, where potentially less brain vulnerability (less grey matter loss) is sufficient to become unwell in adverse (poor) environments.
The formation of magmatic plumbing systems in the crust involves mass and heat transfer from deep to shallow levels. This process modifies the local geotherm and increases the thermal maturation of the crust, affecting the rheological state of the host rock and the composition of magma. Here, we report a petrological, geochemical, isotopic and geochronological integrated study of the Huaco (354 Ma) and Sanagasta (353 Ma, from a new U–Pb zircon age) units from the Carboniferous (Lower Mississippian) Huaco Intrusive Complex, NW Argentina. Similar values of ϵNdt and δ18O, of −3.2 ± 0.7 and +11.2‰ ± 0.3‰ (V-SMOW), respectively, for both units indicate that they shared the same source, as a result of mixing and later homogenization of a crustal component at the Late Devonian (378 to 366 Ma), with metasomatized mantle-derived melts. Slightly higher contents of TiO2, FeO, MgO, CaO and rare earth elements for the Sanagasta unit in comparison with the Huaco unit suggest an increase in the degree of partial melting, which may have been caused by a higher temperature at the lower crust. In addition, the previous structural model of the Huaco Intrusive Complex points to an increase in thermal maturation in the upper crust, which drives a change in the emplacement style from tabular subhorizontal (Huaco) to vertically elongated (Sanagasta) bodies. Therefore, the evolution of the intrusive complex may reflect a generalized thermal maturation of the complete magmatic column, at both upper and lower crustal levels.