A groundbreaking look at how group expectations unify Black Americans in their support of the Democratic party Black Americans are by far the most unified racial group in American electoral politics, ...with 80 to 90 percent identifying as Democrats—a surprising figure given that nearly a third now also identify as ideologically conservative, up from less than 10 percent in the 1970s. Why has ideological change failed to push more Black Americans into the Republican Party? Steadfast Democrats answers this question with a pathbreaking new theory that foregrounds the specificity of the Black American experience and illuminates social pressure as the key element of Black Americans' unwavering support for the Democratic Party.Ismail White and Chryl Laird argue that the roots of Black political unity were established through the adversities of slavery and segregation, when Black Americans forged uniquely strong social bonds for survival and resistance. White and Laird explain how these tight communities have continued to produce and enforce political norms—including Democratic Party identification in the post–Civil Rights era. The social experience of race for Black Americans is thus fundamental to their political choices. Black voters are uniquely influenced by the social expectations of other Black Americans to prioritize the group's ongoing struggle for freedom and equality. When navigating the choice of supporting a political party, this social expectation translates into affiliation with the Democratic Party. Through fresh analysis of survey data and original experiments, White and Laird explore where and how Black political norms are enforced, what this means for the future of Black politics, and how this framework can be used to understand the electoral behavior of other communities.An innovative explanation for why Black Americans continue in political lockstep, Steadfast Democrats sheds light on the motivations consolidating an influential portion of the American electoral population.
In this study, the entropy treatment of a nanomaterial flow in the existence of Lorenz forces within a porous domain is carried out via the non-Darcy model. Fe3O4-water is the ferrofluid flowing ...through the porous enclosure under the magnetic force impact. Simulations for different Darcy, Rayleigh and Hartmann numbers have been reported by applying the novel numerical simulation approach of the control-volume FEM. The outputs of the simulations showed that increasing permeability makes Be to decline, boundary layer thickness enhances with a rise of Lorentz force. In the end, based on the obtained outcomes and employing curve-fitting on the plots, two precise formulas were suggested for the estimation of the Bejan number and average Nusselt number.
► Exhibiting high topographic and climatic diversity, Turkey is mostly covered by three biodiversity hotspots (Caucasus, Irano-Anatolian, and Mediterranean). ► Turkey ranks 140th out of 163 countries ...in biodiversity and habitat conservation, and threats have peaked in the past decade. ► Developmentalist obsession, unchecked urbanization, dam construction, draining of wetlands, poaching, and excessive irrigation are the biggest threats. ► Total forest area increased by 5.9% since 1973, but coasts, wetlands, rivers, grasslands, and endemic-rich Mediterranean chapparal are highly threatened. ► Conserving Turkey’s biodiversity requires immediate action, environmental education, international attention, capacity building, and expanding the Turkish conservation ethic.
Turkey (Türkiye) lies at the nexus of Europe, the Middle East, Central Asia and Africa. Turkey’s location, mountains, and its encirclement by three seas have resulted in high terrestrial, fresh water, and marine biodiversity. Most of Turkey’s land area is covered by one of three biodiversity hotspots (Caucasus, Irano-Anatolian, and Mediterranean). Of over 9000 known native vascular plant species, one third are endemic. Turkey faces a significant challenge with regard to biodiversity and associated conservation challenges due to limited research and lack of translation into other languages of existing material. Addressing this gap is increasingly relevant as Turkey’s biodiversity faces severe and growing threats, especially from government and business interests. Turkey ranks 140th out of 163 countries in biodiversity and habitat conservation. Millennia of human activities have dramatically changed the original land and sea ecosystems of Anatolia, one of the earliest loci of human civilization. Nevertheless, the greatest threats to biodiversity have occurred since 1950, particularly in the past decade. Although Turkey’s total forest area increased by 5.9% since 1973, endemic-rich Mediterranean maquis, grasslands, coastal areas, wetlands, and rivers are disappearing, while overgrazing and rampant erosion degrade steppes and rangelands. The current “developmentalist obsession”, particularly regarding water use, threatens to eliminate much of what remains, while forcing large-scale migration from rural areas to the cities. According to current plans, Turkey’s rivers and streams will be dammed with almost 4000 dams, diversions, and hydroelectric power plants for power, irrigation, and drinking water by 2023. Unchecked urbanization, dam construction, draining of wetlands, poaching, and excessive irrigation are the most widespread threats to biodiversity. This paper aims to survey what is known about Turkey’s biodiversity, to identify the areas where research is needed, and to identify and address the conservation challenges that Turkey faces today. Preserving Turkey’s remaining biodiversity will necessitate immediate action, international attention, greater support for Turkey’s developing conservation capacity, and the expansion of a nascent Turkish conservation ethic.
Objectives
To assess the effect of timing of folic acid (FA) supplementation during pregnancy on the risk of the neonate being small for gestational age (SGA).
Design
A population database study and ...a systematic review with meta‐analysis including the results of this population study.
Setting and data sources
A UK regional database was used for the population study and an electronic literature search (from inception until August 2013) for the systematic review.
Participants and included studies
Singleton live births with no known congenital anomalies; 111 736 in population study and 188 796 in systematic review.
Outcome measures, data extraction and analysis
The main outcome was SGA based on customised birthweight centile. Associations are presented as odds ratios (OR) and adjusted odds ratios (aOR), adjusted for maternal and pregnancy‐related characteristics.
Results
Of 108 525 pregnancies with information about FA supplementation, 92 133 (84.9%) had taken FA during pregnancy. Time of commencement of supplementation was recorded in 39 416 pregnancies, of which FA was commenced before conception in 10 036, (25.5%) cases. Preconception commencement of FA supplementation was associated with reduced risk of SGA <10th centile (aOR 0.80, 95% CI 0.71–0.90, P < 0.01) and SGA <5th centile (aOR 0.78, 95% CI 0.66–0.91, P < 0.01). This result was reproduced when the data were pooled with other studies in the systematic review, showing a significant reduction in SGA (<5th centile) births with preconception commencement of FA (aOR 0.75, 95% CI 0.61–0.92, P < 0.006). In contrast, postconception folate had no significant effect on SGA rates.
Conclusion
Supplementation with FA significantly reduces the risk of SGA at birth but only if commenced preconceptually independent of other risk factors.
Systematic review registration
This systematic review was prospectively registered with PROSPERO number CRD42013004895.
Building on previous research on the effects of racial priming on the opinions of White Americans, this paper engages the question of how exposure to racial cues in political messages shapes the ...opinions of African Americans. I argue that explanations of racial priming that focus exclusively on White Americans are insufficient to explain how racial cues influence the opinions of Black Americans, as they fail to account for the activation of in-group attitudes and mis-specify the role of explicit racial cues. In two separate laboratory experiments, I test the effects of explicitly racial, implicitly racial, and nonracial verbal cues on both Black and White Americans' assessments of an ostensibly nonracial issue. The results point to important racial differences in the effectiveness of explicit and implicit racial verbal cues in activating racial thinking about an issue. Only frames that provide oblique references to race successfully activated racial out-group resentment for Whites. Among Blacks, explicit references to race most reliably elicited racial thinking by activating racial in-group identification, whereas the effect of implicit cues was moderated by the activation of negative representations of the in group. These findings not only demonstrate that racial attitude activation works differently for African Americans than for Whites but also challenge conventional wisdom that African Americans see all political issues through a racial lens.
BackgroundGenital tract trauma is common with vaginal births and is associated with significant morbidity, particularly with obstetric anal sphincter injuries (OASIS). Debate continues regarding the ...effectiveness of perineal support during childbirth in reducing the risk of trauma.
ObjectivesThis review aimed to assess the effect of routine ‘hands on’/manual perineal support (MPS) during childbirth, versus ad hoc/no perineal support (‘hands off/poised’), on the risk and degree of perineal trauma.
Search strategyThis review is registered on PROSPERO (http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42014007058). We searched the CENTRAL, Embase, Medline, CINAHL, and OVIDs midwifery and infant care databases (from inception to December 2014).
Selection criteriaPublished randomised controlled trials (RCTs) and non‐randomised studies (NRSs) evaluating any ‘hands on’ perineal support technique during childbirth.
Data collection and analysisTwo reviewers independently assessed trials for inclusion, data extraction, and methodological quality. Discrepancies were resolved by discussion with a third reviewer.
Main resultsWe included five RCTs and seven NRSs in the review. Meta‐analysis of RCTs did not demonstrate a statistically significant protective effect of MPS on the risk of OASIS (three studies, 6647 women; relative risk, RR 1.03; 95% confidence interval, 95% CI 0.32–3.36; statistical test for heterogeneity I2 = 71%). Meta‐analysis of NRSs showed a significant reduction in the risk of OASIS with MPS (three studies, 74 744 women; RR 0.45; 95% CI 0.40–0.50; I2 = 32%).
Conclusion
Current evidence is insufficient to drive change in practice. An adequately powered randomised trial with an efficient design to evaluate the complex interventions adopted as part of MPS policies, ensuring controlled childbirth, is urgently needed.
Tweetable
Manual perineal support at birth may be protective against anal sphincter injuries.
Levator ani avulsion: a Systematic evidence review (LASER) Rusavy, Z; Paymova, L; Kozerovsky, M ...
BJOG : an international journal of obstetrics and gynaecology,
March 2022, 2022-03-00, 20220301, Letnik:
129, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Background
There is variation in the reported incidence rates of levator avulsion (LA) and paucity of research into its risk factors.
Objective
To explore the incidence rate of LA by mode of birth, ...imaging modality, timing of diagnosis and laterality of avulsion.
Search strategy
We searched MEDLINE, EMBASE, CINAHL, AMED and MIDIRS with no language restriction from inception to April 2019.
Study eligibility criteria
A study was included if LA was assessed by an imaging modality after the first vaginal birth or caesarean section. Case series and reports were not included.
Data collection and analysis
RevMan v5.3 was used for the meta‐analyses and SW SAS and STATISTICA packages were used for type and timing of imaging analyses.
Results
We included 37 primary non‐randomised studies from 17 countries and involving 5594 women. Incidence rates of LA were 1, 15, 21, 38.5 and 52% following caesarean, spontaneous, vacuum, spatula and forceps births, respectively, with no differences by imaging modality. Odds ratio of LA following spontaneous birth versus caesarean section was 10.69. The odds ratios for LA following vacuum and forceps compared with spontaneous birth were 1.66 and 6.32, respectively. LA was more likely to occur unilaterally than bilaterally following spontaneous (P < 0.0001) and vacuum‐assisted (P = 0.0103) births but not forceps. Incidence was higher if assessment was performed in the first 4 weeks postpartum.
Conclusions
LA incidence rates following caesarean, spontaneous, vacuum and forceps deliveries were 1, 15, 21 and 52%, respectively. Ultrasound and magnetic resonance imaging were comparable tools for LA diagnosis.
Tweetable
Levator avulsion incidence rates after caesarean, spontaneous, vacuum and forceps deliveries were 1, 15, 21 and 52%, respectively.
Tweetable
Levator avulsion incidence rates after caesarean, spontaneous, vacuum and forceps deliveries were 1, 15, 21 and 52%, respectively.
This article includes Author Insights, a video available at: https://vimeo.com/bjog/authorinsights16837
Aims/hypothesis An earlier meta-analysis showed that diabetes is a risk factor for the development and/or recurrence of depression. Yet whether this risk is different for studies using questionnaires ...than for those relying on diagnostic criteria for depression has not been examined. This study examined the association of diabetes and the onset of depression by reviewing the literature and conducting a meta-analysis of longitudinal studies on this topic. Methods EMBASE, MEDLINE and PsycInfo were searched for articles published up to September 2009. All studies that examined the relationship between type 2 diabetes and the onset of depression were included. Pooled relative risks were calculated using fixed and random effects models. Results Eleven studies met our inclusion criteria for this meta-analysis. Based on the pooled data, including 48,808 cases of type 2 diabetes without depression at baseline, the pooled relative risk was 1.24 (95% CI 1.09-1.40) for the random effects model. This risk was significantly higher for studies relying on diagnostic criteria of depression than for studies using questionnaires. However, this difference was no longer significant when controlled for year of publication. Conclusions/interpretation Compared with non-diabetic controls, people with type 2 diabetes have a 24% increased risk of developing depression. The mechanisms underlying this relationship are still unclear and warrant further research.
•Cetylpyridinium chloride (CPC)–phenol red (PR) interaction has been studied.•Ethylene glycol affects synergetic effect of PR on surface tension reduction by CPC.•Modified Corrin–Harkins equation is ...derived using the Gibbs–Duhem approach.•Equilibrium constant of dye–micelle binding determined.•A spectrophotometric method for determining dye occupancy of micelle is illustrated.
Knowledge about the fundamental aspects of dye–surfactant interactions is important for developing better formulations required in textile and other coloring industries, and also for improving the efficacy of dye separation processes. In this paper, the interaction between cetylpyridinium chloride (CPC) surfactant and phenol red (PR) dye has been investigated in water and water+ethylene glycol (EG) media using surface tension and spectrophotometric methods. The synergetic effect of PR on the surface tension reducing ability of CPC decreases on adding EG. The modified Corrin–Harkins equation has been derived using the Gibbs–Duhem approach, and by applying this equation CP (cetylpyridinium) micelles are found to be bound predominantly by PR− which is shown to be in accordance with the Collins’ ion-specificity rule. From the absorbance data, using an equation that accounts for the stoichiometry of dye–micelle interaction, the values of binding constant were determined and in water+EG media the electrostatic interactions are found to control the binding of PR− to CP micelles. A spectrophotometric method to determine the counterion binding constant is illustrated. A simple expression that can predict the value of the binding constant of dye–micelle interaction at the cmc is proposed. Dynamic light scattering measurements showed that the amount of dye required to increase the micellar size is dependent on the solvophobicity of the medium. Surface excess values indicate that at the air–solution interface the monolayer consists of both CP+ and PR− when the medium is water, whereas in water+EG the monolayer has CP+ alone and PR− resides in the subsurface.
Aim
To determine the reasons for non‐attendance at structured education sessions among people with a recent diagnosis of Type 2 diabetes.
Methods
This was a qualitative study using semi‐structured ...interviews to elicit the main themes explaining non‐attendance. A thematic framework method was applied to analyse the data. People who had not attended structured education were recruited from a population cohort of newly diagnosed Type 2 diabetes from South London (the South London Diabetes cohort study), UK.
Results
A sample of 30 people was interviewed. Three main themes emerged from the qualitative data explaining non‐attendance at structured education: (1) lack of information/perceived benefit of the programme (e.g. not being informed about the course by their health professional); (2) unmet personal preferences (e.g. parking, timing); and (3) shame and stigma of diabetes (e.g. not wishing to tell others of diabetes diagnosis).
Conclusion
This is the first time that reasons for non‐attendance have been explored in depth among people who have newly diagnosed Type 2 diabetes. Novel reasons identified included non‐attendance because of shame and stigma of diabetes. To improve uptake at structured education we need to: consider how health professionals in primary care communicate with their patients on the subject of structured diabetes education; offer alternatives to the traditional group education format; and understand that diabetes is associated with health‐related stigma, which may affect participation.
What's new?
This is the first time that reasons for non‐attendance at structured education sessions have been explored in depth among people who have newly diagnosed Type 2 diabetes.
Three themes explaining non‐attendance were identified. The results of this study add an additional theme explaining non‐attendance: shame and stigma of diabetes, e.g. not wanting to share diabetes diagnosis with other people.
Improved uptake of structured education may involve: primary care health professionals discussing the benefits of structured diabetes education with their patients; offering alternatives to group education; and considering the impact that diabetes‐related stigma has on participation.
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