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Political Polarization, Wage Inequality and Preferences for Redistribution
No full textUsing nationally representative, randomized survey experiments, we investigate how beliefs about wage inequality impact preferences for redistribution. With more than 9,000 respondents in six high-income countries and a novel distribution builder tool, we elicit detailed beliefs about wage inequality and examine the impact of accurate information on support for redistribution. We find most respondents underestimate age inequality and that information treatments have minimal effects, except for respondents on the far-right, who exhibit large increases in support for higher income taxes and social spending. Our findings suggest that far-right voters’ attitudes toward redistribution may be more malleable than is often assumed
The marketing of commercial foods for infants and toddlers in Australian supermarket catalogues
No full textCommercial foods for infants and young children are prominent on supermarket shelves in Australia, with parents commonly believing they are a healthy choice, yet evidence shows many commercial foods are nutrient-poor. The aim of this study was to examine the nature and extent of promotions for commercial infant and toddler foods in Australian supermarket catalogues. Digital catalogues from four leading Australian supermarket chains were collected and content analysed over 12 weeks from August to October 2023 (n = 60 catalogues with 2206 pages). Using a coding guide, one researcher coded all advertised products to identify commercial infant and toddler foods and recorded the labelled age range, product category, packaging type, and associated promotions for each product. A total of 121 commercial infant and toddler food products were identified across 49 catalogue pages (3.5% of all pages examined). The most advertised categories of commercial infant and toddler foods were fruit purees (40%), snacks (27%), and confectionary (12%); 74% of advertised commercial foods were labelled for infants under 12 months; 26% were labelled for toddlers 12-36 months of age; and 50% of products were packaged in pouches. Techniques used to promote commercial infant and toddler foods included price (95%) and health-related messaging (20%). Foods promoted for infants and young children in Australian supermarket catalogues are misaligned with the recommendations within Australia's Infant Feeding Guidelines. There is an urgent need to reduce the promotion of packaged commercial infant and toddler foods in supermarket catalogues to better support and promote healthy diets for young children
Women’s Lived Experiences of Reproductive Coercion and Abuse
No full textAbstract
Purpose
Reproductive coercion and abuse (RCA) refers to the use of physical, psychological or sexual violence or coercive behaviours to control a woman’s reproductive choices. Perpetrators use various forms of RCA such as controlling the outcome of a pregnancy, contraceptive sabotage and pregnancy coercion. Current research has focused primarily on quantitative data and health interventions, yet there is limited qualitative research on the overall experience of RCA. To address this gap, this study aimed to investigate the question: “What are women’s lived experiences of RCA?”.
Methods
Twenty women who had experienced RCA were recruited to participate in qualitative in-depth interviews. Data were analysed using interpretive phenomenological analysis.
Results
Three themes were developed that describe women’s lived experiences of RCA: I didn’t have a way out, where women described how their partners threatened them both with direct violence or indirectly through manipulation; I still feel guilty which centered around women’s overwhelming feelings of guilt and self blame and I don’t feel worthy, that outlined how RCA eroded women’s self-concept, particularly in relation to motherhood.
Conclusions
Our findings foreground the profound impacts of RCA on women’s mental health, identity and wellbeing which can linger for many years after the experience. It is vital that practitioners working with women who have experienced RCA consider these impacts and how to address and respond to them effectively
Clinician perspectives on linked electronic health records for preventing type 2 diabetes after gestational diabetes in primary care—an Australian qualitative study
No full textObjectives The objective of this study was to understand primary care clinician perspectives on a novel linked health data system to facilitate diabetes prevention for individuals with a history of gestational diabetes mellitus (GDM). We used the conceptual example of linking the National Gestational Diabetes Register with primary care electronic health records to understand clinicians’ views on potential implementation. Design A qualitative study of semistructured interviews with primary care clinicians. Setting Australian primary care. Participants Primary care clinicians (n=14). Inclusion criteria were: general practitioners (GPs), practice nurses and/or diabetes educators working in primary care in Australia, and seeing individuals with a history of GDM; aged 18 years and over; and willing to voluntarily contribute to the project. There were no exclusion criteria. Results Clinicians’ views on acceptability, feasibility and utility were characterised by realistic optimism for a linked data system to improve GP workflow and patient outcomes. Clinicians noted existing pressures on primary care and patient concerns regarding confidentiality and privacy, and that these factors should be considered in the development process. Clinicians envisaged three functions for their clinical management systems: (1) automatically updating a patient’s past history; (2) generating actionable alerts and (3) generating recall lists. Discussion Primary care clinicians were unanimously supportive of a linked health data system to facilitate diabetes prevention. Consistent with previous studies, we identified the key clinician-related enabler as the integration into existing GP workflows to facilitate pro-active clinical care. Point-of-care tools and preventative care consultations could increase the uptake of screening and provide opportunities for patient education post partum. Conclusion In combination with effective prevention programmes, and health policy and system supports, linked health data systems could be part of the equation for type 2 diabetes prevention for individuals with a history of GDM. Larger acceptability, feasibility, co-design and implementation studies are recommended
Cardiovascular Outcomes of Perioperative Sodium-Glucose Transporter 2 Inhibition in Cardiac Surgery Patients: An Open-Label Randomized Pilot Study
No full textBACKGROUND: Previous studies have shown cardiovascular benefits of SGLT2 inhibitors. The aim of this study was to evaluate the cardiovascular effects of perioperative SGLT2 inhibition in patients undergoing cardiac surgery. METHODS: In this open-label pilot study, adult patients undergoing cardiac surgery were randomized to receive a daily dose of empagliflozin (10 mg; oral) 3 days before surgery until 2 days after surgery, or standard of care. Blood pressure, heart rate, postoperative diuresis, intravenous fluid administration, fluid balance, and vasoactive support were compared between groups during the first 24 postoperative hours. RESULTS: About 55 patients (sex: 73% male, age: 66 ± 10 years, BMI: 28 ± 4 kg/m2, empagliflozin n = 25, control n = 30) were included in this study and analyzed according to the intention-to-treat principle. Empagliflozin was associated with increased diuresis, mean difference 549 mL (95% CI 258-839, p < 0.001), and less positive fluid balance postoperatively, mean difference -1217 mL (95% CI -2373- -61, p = 0.039). Empagliflozin did not increase the amount of intravenous fluid administered. In the empagliflozin group, norepinephrine was infused for 11.8 ± 11.5 h compared to 19.3 ± 19.3 h in the control group (p = 0.080). No significant between-group differences were observed in postoperative blood pressure and heart rate. CONCLUSIONS: Perioperative SGLT2 inhibition was associated with increased diuresis and lesser fluid accumulation without an increase in vasopressor requirement. These data warrant validation and further evaluation in a larger-scale, double-blind, placebo-controlled trial. EDITORIAL COMMENT: In this sub-study of the randomized MERCURI-2 trial of perioperative empagliflozin for nondiabetics in cardiac surgery, the authors describe the hemodynamic outcomes and fluid status of the patients. The authors noted a higher urine output and a more negative fluid balance in the intervention group compared to the placebo group. An interesting observation is the trend towards lower noradrenaline usage, although this cannot be concluded with confidence based on this data. The findings support considering and further studying the use of these medications for patients with cardiovascular disease undergoing surgery. TRIAL REGISTRATION: https://onderzoekmetmensen.nl/en/trial/26563 Identifier: NL9561
Computational Design of Alternative Binders for Sintering of Tungsten Carbide (WC) Hard Metals
No full textAbstract
There has been a long-standing effort to find alternative binders for tungsten carbide (WC) hardmetals that mitigate the safety and ethical issues related to the use of cobalt. The process of identifying new binders is often performed using conventional, experimentally based prototype-and-test approaches, which are time-consuming and expensive. Further, these efforts are mostly focused on mechanical properties with limited concern for processability, particularly through powder metallurgy routes. However, the properties of a material, including hardmetals, are path dependent and are thus determined by processing as well as composition. Here, we introduce a new computational method for finding alternative binders for the sintering of WC hardmetals that considers processing and properties simultaneously. The methodology incorporates a multi-objective optimization algorithm coupled with reduced order material design models for sintering and binder hardness. The former is based on spreading of the binder in the solid state and the sintering shrinkage rate; the latter is calculated using a generalized model for solid solution strengthening. Thermodynamic and kinetic parameters for the models are calculated using the CalPhaD (Calculation of Phase Diagram) method. Reduced order models facilitate the efficient search of compositional space enabling multiple design objectives to be optimized simultaneously. The methodology is scalable in that additional properties can be incorporated as required. The models are validated using data from the literature. Nominal design exercises using the suggested approach indicate how they can be used to guide the search for alternative binder alloys, reducing the cost and time required for the development of new materials
Charles Bonnet Syndrome associated with unilateral vision loss: A new diagnostic perspective
No full textPURPOSE: To increase recognition of Charles Bonnet Syndrome (CBS) beyond its conventional association with 'significant vision loss', which is indicated in the current literature as a diagnostic criterion. METHODS: Clinical observation of CBS associated with unilateral visual loss following enucleation due to choroidal melanoma. Comprehensive visual assessments were performed. The cognitive function was assessed with the Montreal Cognitive Assessment (MoCA)-BLIND. The phenomenology, occurrence and impact of visual hallucinations were evaluated using the University of Miami Parkinson's Disease Hallucinations Questionnaire (UM-PDHQ). A critical literature review of CBS cases associated with vision loss in one eye only was conducted. RESULTS: In this case and in an additional nine reported cases in the literature, CBS hallucinations occurred following unilateral vision loss despite preserved visual function in the fellow eye. These hallucinations are phenomenologically consistent with those observed after severe bilateral vision loss, indicating that both conditions can lead to the development of CBS. CONCLUSIONS: CBS should be screened in all patients who have experienced any degree of vision loss
Will I Have to Be Reborn? Collective Sensemaking of Stigma among White-Collar Inmates
No full textWe have a limited understanding of how individuals anticipate the experience of stigma, make sense of it as a group, and how such sensemaking trickles down to the individual level, especially for white-collar inmates who have experienced a drastic fall from grace. To address these issues, we draw on three waves of semi-structured interviews and focus group data with 70 inmates in a federal prison in the United States over a period of 16 months. Our findings reveal that following collective sensemaking, inmates use varying tactics to either select, borrow, contribute, reinforce, disguise or maintain the status quo, which variably impact on their perceptions of their ability to both reassure others of their soundness of character and adapt their professional identity. Our work contributes to the sociology of stigma and white-collar crime by showing how high-status professionals collectively prepare for stigmatization and implications for their individual responses to stigma
Sudden cardiac death in young First Nations Australians in the Northern Territory, Australia: Potential implications for pre-participation screening
No full textObjective To present data from coronial records on sudden cardiac death (SCD) cases seen in young, First Nations Australians in the Northern Territory of Australia, estimate its incidence, and propose potential pre-participation screening strategies. Design Retrospective observational study. Methods Coronial records of sudden cardiac death cases in First Nations Australians in the Northern Territory under 40 years of age occurring between 2019 and 2023 were reviewed to study the incidence, demographics, medical history, circumstances of death and causes of death with autopsy and toxicology analysis. Results A total of 59 SCD cases in First Nations Australians under 40 years of age were recorded in the Northern Territory with an annual incidence of 19.8 cases per 100,000 persons. The mean ± SD of age was 32.8 ± 6.14 years. There were 61 % male and 2/3 of SCD cases occurred in remote location. Coronary heart disease (n = 36; 61 %) was the most common cause of death. In 3 cases, SCD was related to sports or exercise activity. Most common medical co-morbidities were cardiac (38.9 %), Diabetes mellitus (35.6 %), and rheumatic heart disease (20.3 %). Smoking (37.3 %) and alcohol abuse (32.2 %) were the most common risk factors. Conclusions SCD is more common and coronary heart disease and rheumatic heart disease are the most common causes in First Nations Australians in the Northern Territory under the age of 40 years. Medical co-morbidities and risk factors are prevalent in this population. There is a need for First Nation Australians specific local guidelines for a comprehensive pre-participation Heart-Health assessment
Data Assimilation of Transitional and Separated Turbomachinery Flows With Physics-Informed Neural Networks
No full textAbstract
Despite the demonstrated utility of Reynolds-averaged Navier–Stokes (RANS) calculations for many industrially relevant problems, the method yields unsatisfactory representations of many flows of engineering interest, such as nonequilibrium turbulence, massive flow separation, coherent unsteadiness, and secondary flow features. Due to the Reynolds-averaging process, a turbulence model is required to close the RANS equations, and the simple physical arguments and approximations used in many turbulence models can cause erroneous results when applied to the flows that feature strong pressure gradients, sudden changes in mean-strain-rate, surface curvature, and turbulence anisotropy. Physics-informed neural networks (PINNs) offer a way to model aerodynamic problems without explicitly requiring turbulence closure. The network can use sparse training data and unclosed RANS equations to reconstruct the flow without a turbulence model. In this work, PINNs are applied to two problems of relevance in the turbomachinery community. First, we consider a variable area channel known as the periodic hills, which features a shear layer, a separation bubble, as well as favorable and adverse pressure gradients. Second, a PINN is applied to the T106C low-pressure turbine blade with two different levels of inlet turbulence intensity, featuring the additional challenges of transition and laminar separation. We demonstrate that PINNs are capable of modeling wall-bounded quantities such as Cf and Cp in such complex flows, capturing sensitive features such as the change in separation length when the turbulent inlet conditions are altered. This article undertakes a considered and pragmatic assessment of the state of PINNs when applied to complex high Reynolds number flows, highlighting where the method is comparable to the quality of high-fidelity simulations, and conversely where the method degrades with a lack of training data around regions of interest