Social media are frequently implicated in the racist and right-wing populist mobilisations that found voice in support for Brexit. However, research tends to focus on platform affordances and fails ...to provide a sociological account of individuals’ actual experiences with these media, and how they interact with broader social and political experiences to impact attitudes. Based on interviews with newly passionately engaged pro-Brexit Facebook users, this article examines the trajectories by which individuals came to be so engaged. The findings demonstrate that the technological opportunities provided by social media were only significant in the context of offline experiences and socio-political factors. These include racist discourses that predate social media, a loss of trust in traditional media and government, and the opportunity provided by Brexit to articulate and activate pre-held attitudes.
More than two decades ago, a well‐known study on heart attack treatments provided evidence suggesting that, when appropriately adjusted for quality, medical care prices were actually declining ...(Cutler, McClellan, Newhouse, and Remler (1998)). Our paper revisits this subject by leveraging estimates from more than 8000 cost‐effectiveness studies across a broad range of conditions and treatments. We find large quality‐adjusted price declines associated with treatment innovations. To incorporate these quality‐adjusted indexes into an aggregate measure of inflation, we combine an unadjusted medical‐care price index, quality‐adjusted price indexes from treatment innovations, and proxies for the diffusion rate of new technologies. In contrast to official statistics that suggest medical care prices increased by 0.53 percent per year relative to economy‐wide inflation from 2000 to 2017, we find that quality‐adjusted medical care prices declined by 1.33 percent per year over the same period.
Facebook has frequently been implicated in the 2016 ‘Brexit’ referendum result, and support for Leave has been linked to wider nativist and populist mobilisations online. However, close-up, ...qualitative sociological research has not been conducted into the relationship between Brexit and social media use. This is, in part, due to the computational turn in online research, which has led to a disproportionate focus on quantitative big data analysis. This article argues for the value of close-up, qualitative enquiry to facilitate situated understandings of the reality of social media use and what it means to individuals. It outlines one such methodology developed to investigate pro-Leave Facebook users, to demonstrate how challenges posed by such research can be overcome, and the opportunities such enquiry affords for studying the role of social media in contentious politics. Invaluable insights gained include the way Facebook provides an empowering tool for making claims to political knowledge in the context of growing transnational nativist and populist grievances.
Most research into online misinformation has investigated its direct effects—the impact it may have on citizens’ beliefs and behavior. Much less attention has been paid to how citizens themselves ...make sense of misinformation as a broader social problem. We integrate theories of narrative, identity, cultural capital, and social distinction to examine how people construct the problem of misinformation and their orientation to it. We show how people engage in everyday ontological narratives of social distinction. These involve making a variety of discursive moves to position one’s “taste” in information consumption as superior to others constructed as lower in a social hierarchy. This serves to enhance social status by separating oneself from misinformation, which is presented as “other people’s problem.” We argue that these narratives have significant implications not only for citizens’ vigilance toward misinformation but also their receptiveness to interventions by policymakers, fact-checkers, news organizations, and media educators.
Adequate nutrition during the pre- and early-postnatal periods plays a critical role in programming early neurodevelopment. Disruption of neurodevelopment by nutritional deficiencies can result not ...only in lasting functional deficits, but increased risk of neuropsychiatric disease in adulthood. Historical periods of famine such as the Dutch Hunger Winter and the Chinese Famine have provided foundational evidence for the long-term effects of developmental malnutrition on neuropsychiatric outcomes. Because neurodevelopment is a complex process that consists of many nutrient- and brain-region-specific critical periods, subsequent clinical and pre-clinical studies have aimed to elucidate the specific roles of individual macro- and micronutrient deficiencies in neurodevelopment and neuropsychiatric pathologies. This review will discuss developmental iron deficiency (ID), the most common micronutrient deficiency worldwide, as a paradigm for understanding the role of early-life nutrition in neurodevelopment and risk of neuropsychiatric disease. We will review the epidemiologic data linking ID to neuropsychiatric dysfunction, as well as the underlying structural, cellular, and molecular mechanisms that are thought to underlie these lasting effects. Understanding the mechanisms driving lasting dysfunction and disease risk is critical for development and implementation of nutritional policies aimed at preventing nutritional deficiencies and their long-term sequelae.
is a globally emerging multidrug resistant fungal pathogen causing nosocomial transmission. We report an ongoing outbreak of
in a London cardio-thoracic center between April 2015 and July 2016. This ...is the first report of
in Europe and the largest outbreak so far. We describe the identification, investigation and implementation of control measures.
Data on
case demographics, environmental screening, implementation of infection prevention/control measures, and antifungal susceptibility of patient isolates were prospectively recorded then analysed retrospectively. Speciation of
is was performed by MALDI-TOF and typing of outbreak isolates performed by amplified fragment length polymorphism (AFLP).
This report describes an ongoing outbreak of 50
cases over the first 16 month (April 2015 to July 2016) within a single Hospital Trust in London. A total of 44 % (
= 22/50) patients developed possible or proven
infection with a candidaemia rate of 18 % (
= 9/50). Environmental sampling showed persistent presence of the yeast around bed space areas. Implementation of strict infection and prevention control measures included: isolation of cases and their contacts, wearing of personal protective clothing by health care workers, screening of patients on affected wards, skin decontamination with chlorhexidine, environmental cleaning with chorine based reagents and hydrogen peroxide vapour. Genotyping with AFLP demonstrated that
isolates from the same geographic region clustered.
This ongoing outbreak with genotypically closely related
highlights the importance of appropriate species identification and rapid detection of cases in order to contain hospital acquired transmission.
The Bureau of Economic Analysis recently created new price indexes for health care in its health care satellite account and now faces the problem of how to adjust them for quality. I review the ...literature on this topic and divide the articles that created quality-adjusted price indexes for individual medical conditions into those that use primarily outcomes-based adjustments and those that use only process-based adjustments. Outcomes-based adjustments adjust the indexes based on observed aggregate health outcomes, usually mortality. Process-based adjustments adjust the indexes based on the treatments provided and medical knowledge of their effectiveness. Outcomes-based adjustments are easier to implement, while process-based adjustments are more demanding in terms of data and medical knowledge. In general, the research literature shows adjusting for quality in the measurement of output in the medical sector to be quantitatively important.
Much remains unknown about how the intestinal microbiome interfaces with the protective intestinal mucus layer.
species colonize the intestinal mucus layer and can modulate mucus production by goblet ...cells. However, select
strains can also degrade protective glycans on mucin proteins. We hypothesized that the human-derived species
would increase intestinal mucus synthesis and expulsion, without extensive degradation of mucin glycans.
data revealed that
lacked the enzymes necessary to extensively degrade mucin glycans. This finding was confirmed by demonstrating that
could not use naive mucin glycans as primary carbon sources
To examine
mucus modulation
, Swiss Webster germfree mice were monoassociated with live or heat-killed
Live
-monoassociated mice exhibited increased colonic expression of goblet cell markers
(
),
(
),
-β,
, and several glycosyltransferases compared to both heat-killed
and germfree counterparts. Likewise, live
-monoassociated colon had increased acidic mucin-filled goblet cells, as denoted by Periodic Acid-Schiff-Alcian Blue (PAS-AB) staining and MUC2 immunostaining.
,
-secreted products, including acetate, were able to increase MUC2 levels in T84 cells. We also identified that
-secreted products, such as γ-aminobutyric acid (GABA), stimulated autophagy-mediated calcium signaling and MUC2 release. This work illustrates that
is capable of enhancing the intestinal mucus layer and goblet cell function via upregulation of gene expression and autophagy signaling pathways, with a net increase in mucin production.
Microbe-host interactions in the intestine occur along the mucus-covered epithelium. In the gastrointestinal tract, mucus is composed of glycan-covered proteins, or mucins, which are secreted by goblet cells to form a protective gel-like structure above the epithelium. Low levels of mucin or alterations in mucin glycans are associated with inflammation and colitis in mice and humans. Although current literature links microbes to the modulation of goblet cells and mucins, the molecular pathways involved are not yet fully understood. Using a combination of gnotobiotic mice and mucus-secreting cell lines, we have identified a human-derived microbe,
, which adheres to intestinal mucus and secretes metabolites that upregulate the major mucin MUC2 and modulate goblet cell function. Unlike other
species,
does not extensively degrade mucin glycans and cannot grow on mucin alone. This work points to the potential of using
and similar mucin-friendly microbes as therapeutic agents for intestinal disorders with disruptions in the mucus barrier.
It is widely accepted that maternal healthcare is vital for improving maternal and neonatal mortality rates. Furthermore, the continuum of care-the integrated delivery of antenatal, delivery and ...postnatal care-has been shown to be particularly important. Sub-Saharan Africa has the highest neonatal and maternal mortality rates in the world; significant improvements in the provision and utilisation of the continuum are urgently needed, therefore the barriers preventing access need to be better understood. This study aimed to identify key factors associated with the utilisation of maternal healthcare, in the Mchinji District of Malawi.
4,244 pregnant women from the Mchinji District of Malawi were interviewed between March and December 2013. The overall utilisation of maternal healthcare was calculated by combining the use of antenatal, delivery and postnatal care into one variable-continuum of care. Univariate and multivariate logistic regressions were performed to determine the factors associated with utilisation of maternal healthcare.
Utilisation of maternal healthcare in the Mchinji District was inadequate; only 24% of women received the recommended package. Being further from a healthcare facility (OR = 0.2, 95%CI = 0.04-0.96), having at least one live child (OR = 0.87, 95%CI = 0.84-0.99), previous experience of miscarriage (OR = 0.64, 95%CI = 0.50-0.82) or abuse (OR = 0.81, 95%CI = 0.69-0.95) reduced utilisation, whereas being in the richest 20% (OR = 1.33 95%CI = 1.08-1.65), having a planned pregnancy (OR = 1.3, 95%CI = 1.11-1.51) or more control over decisions (OR = 1.09, 95%CI = 0.80-1.49) increased utilisation.
Seven groups of women were identified as having an increased risk of low utilisation of maternal healthcare; women living >5km from a healthcare facility, within the poorest socio-economic group, experiencing an unplanned pregnancy, with at least one live child, experience of a previous miscarriage, no control over their healthcare decisions or experience of abuse. Policy makers should pay extra attention to these high-risk groups when designing and delivering strategies to improve maternal healthcare utilisation.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The fitness effect of a mutation can depend on both its genetic background, known as epistasis, and the prevailing external environment. Many examples of these dependencies are known, but few studies ...consider both aspects in combination, especially as they affect mutations that have been selected together. We examine interactions between five coevolved mutations in eight diverse environments. We find that mutations are, on average, beneficial across environments, but that there is high variation in their fitness effects, including many examples of mutations conferring a cost in some, but not other, genetic background-environment combinations. Indeed, even when global interaction trends are accounted for, specific local mutation interactions are common and differed across environments. One consequence of this dependence is that the range of trade-offs in genotype fitness across selected and alternative environments are contingent on the particular evolutionary path followed over the mutation landscape. Finally, although specific interactions were common, there was a consistent pattern of diminishing returns epistasis whereby mutation effects were less beneficial when added to genotypes of higher fitness. Our results underline that specific mutation effects are highly dependent on the combination of genetic and external environments, and support a general relationship between a genotype’s current fitness and its potential to increase in fitness.
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