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High dietary phosphorus (P), particularly soluble salts, may contribute to chronic kidney disease development in cats. The aim of the present study was to assess the safety of P supplied at 1 g/1000 kcal (4184kJ) from a highly soluble P salt in P-rich dry format feline diets. Seventy-five healthy adult cats (n 25/group) were fed either a low P control (1·4 g/1000 kcal [4184kJ]; Ca:P ratio 0·97) or one of two test diets with 4 g/1000 kcal (4184 kJ); Ca:P 1·04 or 5 g/1000 kcal (4184kJ); Ca:P 1·27, both incorporating 1 g/1000 kcal (4184 kJ) sodium tripolyphosphate (STPP) – for a period of 30 weeks in a randomised parallel-group study. Health markers in blood and urine, glomerular filtration rate, renal ultrasound and bone density were assessed at baseline and at regular time points. At the end of the test period, responses following transition to a commercial diet (total P – 2·34 g/1000 kcal [4184kJ], Ca:P 1·3) for a 4-week washout period were also assessed. No adverse effects on general, kidney or bone (skeletal) function and health were observed. P and Ca balance, some serum biochemistry parameters and regulatory hormones were increased in cats fed test diets from week 2 onwards (P ≤ 0·05). Data from the washout period suggest that increased serum creatinine and urea values observed in the two test diet groups were influenced by dietary differences during the test period, and not indicative of changes in renal function. The present data suggest no observed adverse effect level for feline diets containing 1 g P/1000 kcal (4184 kJ) from STPP and total P level of up to 5 g/1000 kcal (4184 kJ) when fed for 30 weeks.
Intrauterine growth restriction (IUGR) due to uteroplacental insufficiency results in a placenta that is unable to provide adequate nutrients and oxygen to the fetus. These growth-restricted babies have an increased risk of hypertension and chronic kidney disease later in life. In rats, both male and female growth-restricted offspring have nephron deficits but only males develop kidney dysfunction and high blood pressure. In addition, there is transgenerational transmission of nephron deficits and hypertension risk. Therefore, epigenetic mechanisms may explain the sex-specific programming and multigenerational transmission of IUGR-related phenotypes. Expression of DNA methyltransferases (Dnmt1and Dnmt3a) and imprinted genes (Peg3, Snrpn, Kcnq1, and Cdkn1c) were investigated in kidney tissues of sham and IUGR rats in F1 (embryonic day 20 (E20) and postnatal day 1 (PN1)) and F2 (6 and 12 months of age, paternal and maternal lines) generations (n = 6–13/group). In comparison to sham offspring, F1 IUGR rats had a 19% decrease in Dnmt3a expression at E20 (P < 0.05), with decreased Cdkn1c (19%, P < 0.05) and increased Kcnq1 (1.6-fold, P < 0.01) at PN1. There was a sex-specific difference in Cdkn1c and Snrpn expression at E20, with 29% and 34% higher expression in IUGR males compared to females, respectively (P < 0.05). Peg3 sex-specific expression was lost in the F2 IUGR offspring, only in the maternal line. These findings suggest that epigenetic mechanisms may be altered in renal embryonic and/or fetal development in growth-restricted offspring, which could alter kidney function, predisposing these offspring to kidney disease later in life.
This collection offers a comprehensive review of the origins, scale and breadth of the privatisation and marketisation revolution across the criminal justice system. Leading academics and researchers assess the consequences of market-driven criminal justice in a wide range of contexts, from prison and probation to policing, migrant detention, rehabilitation and community programmes. Using economic, sociological and criminological perspectives, illuminated by accessible case studies, they consider the shifting roles and interactions of the public, private and voluntary sectors. As privatisation, outsourcing and the impact of market cultures spread further across the system, the authors look ahead to future developments and signpost the way to reform in a 'post-market' criminal justice sphere.
In the Introduction we noted the distinction between privatisation and marketisation, and we argued that this book is necessary because criminal justice has been the site of marketisation to a greater extent than it has privatisation. Yet this concept of marketisation has been underexplored. The chapters in the book demonstrate the sheer scale of marketisation that has occurred in criminal justice in the UK. There is evidence that similar marketisation has occurred in other states around the world (Walby and Lippert, Chapter 8; Swirak, Chapter 6).
As this book demonstrates, there is a whole array of other means by which the market has been used to shape the delivery of experiences of criminal justice. The chapters in this book expose a range of modes of governance and accountability that are at play and demonstrate the ways in which marketisation has impacted on criminal justice at macro-, meso- and micro-levels. Importantly, they have shown what the impact of this has been on the broader field, the individuals working within those fields and the service users that are subjected to systems of power delivered in newly formed markets. In this concluding chapter we attempt to draw together some of the themes that run across the chapters and consider what the future might hold for criminal justice and marketisation.
The language of the market
Ironically, or perhaps not, the concepts of free markets, marketisation and privatisation have so well captured the public discourse, we must employ them in highlighting their problems (Corcoran, Chapter 1; Swirak, Chapter 6; Corcoran et al, Chapter 12). We may talk, for example, about costs and benefits, about innovation, responsibility and accountability. Thus, we critique marketisation on its own terms here: in costs and benefits (Corcoran, Chapter 1). Yet despite allowing the market to choose its own grounds on which it might be justified, there are significant problems with the model as currently realised, even on its own terms.
Competition and its discontents
One of the key themes to come out of these chapters is the importance and role of competition. While one would expect competition to be a key feature of marketised services, it is the implications that are of concern.
Criminal justice used to be thought of as a field that ought to be autonomous from politics and the economy, with the management of crime and punishment being seen as essentially the responsibility of the state. Now, however, it is widely agreed that decades of marketisation and privatisation have blurred the institutional boundaries and functions of the public sector with those of for-profit and civil society interests in many parts of the penal/welfare complex. The ‘mixed market’ in criminal justice services, pursued by successive governments since the 1980s, accelerated sharply in the wake of the Austerity Agenda and the reconstruction of the social economy post the banking crisis of 2007 (Corcoran, 2014). The ascendancy of market imaginaries is such that their influence on policing, prisons, probation, legal services and the courts, let alone numerous ancillary services from prisoner transport to interpretation services, is seemingly irreversible.
The dominance of the market in the public sphere was by no means assured nor consensual. In her classic study of the rise of the life insurance business, Morals and Markets (1979/2017), the economic sociologist Viviana Zelizer observed that ‘the introduction of calculative market principles into a sacred sphere provoked a surprisingly strong resistance that took time and effort to overcome’ (Healy, 2017: xi–xii). The essence of Zelizer's thesis was that the great accomplishment of the life insurance industry entailed the structural and cultural transformations which it achieved in establishing ‘monetary equivalents for those aspects of the social order, such as death, life, human organs and other generally ritualised items or behaviour considered sacred, [that had hitherto been considered] beyond the pale of monetary definition’ (Zelizer, 1979/2017: xxii).
Zelizer's finding that there is no ‘sacred sphere’ which cannot eventually be penetrated by commercialism coincided with the ‘experimental phase of neoliberalism’ when governments in Western capitalist countries were – somewhat tentatively – working to ‘roll back the state in various ways’ (Prasad, 2006: 5). More recently, Sandel's (2000) exposition of the ‘moral limits of the markets’ illustrates the ways in which a market economy can distort human behaviour in such a way as to undermine the very aims of the organisation or context which the market was intended to ‘fix’. This book explores the impact of both marketisation and privatisation whilst recognising that there is no global coherence or universal consistency that maps neatly onto services, sectors or national jurisdictions.
To draw lessons from Fiji regarding the challenges and opportunities for policy initiatives to restrict (i) food marketing to children and (ii) marketing of breast milk substitutes, to inform policy for the double burden of malnutrition.
Qualitative political economy analysis of two policy case studies.
Eleven key informants from relevant sectors, representing public health, economic and consumer interests.
This study used two policy initiatives as case studies to examine factors influencing decision-making: Marketing Controls (Foods for Infants and Young Children) Regulations 2010, amended in 2016 to remove guidelines and restrictions on marketing in the form of labelling, and the draft Advertising and Promotion of Unhealthy Foods and Non-Alcoholic Beverages to Children Regulation developed in 2014 but awaiting review by the Solicitor General’s Office. Factors identified included: a policy paradigm in which regulation of business activity contradicts economic policy goals; limited perception by key policy actors of links between nutrition and marketing of breast milk substitutes, foods and beverages; and a power imbalance between industry and public health stakeholders in policymaking. Regulation of marketing for health purposes sits within the health sector’s interest but not its legislative remit, while within the economic sector’s remit but not interest. Opportunities to strengthen restrictions on marketing to improve nutrition and health include reframing the policy issue, strategic advocacy and community engagement.
Restricting marketing should be recognised by public health actors as a public health and an industry policy issue, to support strategic engagement with economic policy actors.
Prior research has shown that sipping of alcohol begins to emerge during childhood and is potentially etiologically significant for later substance use problems. Using a large, community sample of 9- and 10-year-olds (N = 11,872; 53% female), we examined individual differences in precocious alcohol use in the form of alcohol sipping. We focused explicitly on features that are robust and well-demonstrated correlates of, and antecedents to, alcohol excess and related problems later in the lifespan, including youth- and parent-reported externalizing traits (i.e., impulsivity, behavioral inhibition and activation) and psychopathology. Seventeen percent of the sample reported sipping alcohol outside of a religiously sanctioned activity by age 9 or 10. Several aspects of psychopathology and personality emerged as small but reliable correlates of sipping. Nonreligious sipping was related to youth-reported impulsigenic traits, aspects of behavioral activation, prodromal psychotic-like symptoms, and mood disorder diagnoses, as well as parent-reported externalizing disorder diagnoses. Religious sipping was unexpectedly associated with certain aspects of impulsivity. Together, our findings point to the potential importance of impulsivity and other transdiagnostic indicators of psychopathology (e.g., emotion dysregulation, novelty seeking) in the earliest forms of drinking behavior.
Firefighting service is known to involve high rates of exposure to potentially traumatic situations, and research on mental health in firefighting populations is of critical importance in understanding the impact of occupational exposure. To date, the literature concerning prevalence of trauma-related mental disorders such as posttraumatic stress disorder (PTSD) has not distinguished between symptomology associated routine duty-related exposure and exposure to large-scale disaster. The present systematic review synthesizes a heterogeneous cross-national literature on large-scale disaster exposure in firefighters and provides support for the hypothesis that the prevalence of PTSD, major depressive disorder, and anxiety disorders are elevated in firefighters compared with rates observed in the general population. In addition, we conducted narrative synthesis concerning several commonly assessed predictive factors for disorder and found that sociodemographic factors appear to bear a weak relationship to mental disorder, while incident-related factors, such as severity and duration of disaster exposure, bear a stronger and more consistent relationship to the development of PTSD and depression in cross-national samples. Future work should expand on these preliminary findings to better understand the impact of disaster exposure in firefighting personnel.
The combination of clozapine and other potentially leukopenic drugs may pose a greater risk for neutropenia. However, neutropenia may not always be due to clozapine. When adding potentially leukopenic drugs, clinicians should look for possible alternatives especially as clozapine is often a drug used as the last resort in treatment refractory schizophrenia.
Depressive episodes experienced in unipolar (UD) and bipolar (BD) disorders are characterized by anhedonia and have been associated with abnormalities in reward processes related to reward valuation and error prediction. It remains however unclear whether these deficits are associated with familial vulnerability to mood disorders.
In a functional magnetic resonance imaging study, we evaluated differences in the expected value (EV) and reward prediction error (RPE) signals in ventral striatum (VS) and prefrontal cortex between three groups of monozygotic twins: affected twins in remission for either UD or BD (n = 53), their high-risk unaffected co-twins (n = 34), and low-risk twins with no family history of mood disorders (n = 25).
Compared to low-risk twins, affected twins showed lower EV signal bilaterally in the frontal poles and lower RPE signal bilaterally in the VS, left frontal pole and superior frontal gyrus. The high-risk group did not show a significant change in the EV or RPE signals in frontostriatal regions, yet both reward signals were consistently lower compared with low-risk twins in all regions where the affected twins showed significant reductions.
Our findings strengthen the notion that reduced valuation of expected rewards and reduced error-dependent reward learning may underpin core symptom of depression such as loss of interest in rewarding activities. The trend reduction in reward-related signals in unaffected co-twins warrants further investigation of this effect in larger samples and prospective follow-up to confirm possible association with increased familial vulnerability to mood disorders.
Lithium (Li) is the gold standard treatment for bipolar disorder (BD). However, its mechanisms of action remain unknown but include neurotrophic effects. We here investigated the influence of Li on cortical and local grey matter (GM) volumes in a large international sample of patients with BD and healthy controls (HC).
We analyzed high-resolution T1-weighted structural magnetic resonance imaging scans of 271 patients with BD type I (120 undergoing Li) and 316 HC. Cortical and local GM volumes were compared using voxel-wise approaches with voxel-based morphometry and SIENAX using FSL. We used multiple linear regression models to test the influence of Li on cortical and local GM volumes, taking into account potential confounding factors such as a history of alcohol misuse.
Patients taking Li had greater cortical GM volume than patients without. Patients undergoing Li had greater regional GM volumes in the right middle frontal gyrus, the right anterior cingulate gyrus, and the left fusiform gyrus in comparison with patients not taking Li.
Our results in a large multicentric sample support the hypothesis that Li could exert neurotrophic and neuroprotective effects limiting pathological GM atrophy in key brain regions associated with BD.