Minority Language Rights: What Matters? A Comparison of Belgium and Canada

In federal societies, intergovernmental relations are necessarily a part of political life. But, as a student of intergovernmental relations (IGR), I want to understand, how much do intergovernmental relations really matter to particular policy outcomes? In order to assess this question, I have undertaken a study of minority language rights policies in two federal societies, Belgium and Canada (the Countries). In these circumstances, the above question is refined and can instead be stated as follows: what factors influence the content of minority language policies in the Countries? (author's abstract

The rise and fall of self-esteem: a critical review, reconceptualization, and recommendations

Self-esteem, viewed for decades as psychology’s Holy Grail, has proved to be an elusive and surprisingly barren destination. One of the oldest concepts in psychology, self-esteem likely ranks among the top three covariates occurring in personality and social psychology research. Propelled by the self-esteem movement of the 1970s, it was popularly believed that self-esteem played a significant causal role in determining a wide range of both positive and negative social behaviors. However, the results of a 2003 large-scale literature review showed that it is actually not a major predictor of almost anything, with the exception of positive feelings (happiness) and possibly greater initiative. With over a decade passing since that publication, the current investigation sought to review, synthesize and critically analyze the more recent literature. Results confirmed a similar dearth of meaningful relationships connected to self-esteem, the only exceptions being some modest correlates to happiness, narcissism, and self-perceived attractiveness and intelligence. However, the literature continues to be plagued with myriad conceptual and methodological problems. This study utilizes specific critical thinking principles to advance understanding in this area, to address why the self-esteem obsession still persists, and to propose a new theoretical model, one that accounts for the construct’s heterogeneous and multidimensional nature. Self-esteem is defined as the appraisal of one’s own personal value, including both emotional components (self-worth) and cognitive components (self-efficacy). The multiple forms of self-esteem are a function of how accurately or closely it matches an individual’s measureable reality, composed of the objective outcome of one’s behavior (actual achievements, measurable capabilities) as well as one’s interpersonal interactions (i.e., the level of congruence between how one thinks he or she is perceived and how he or she is actually perceived). Self-esteem also varies in terms of its level of stability, or the degree to which it is influenced by evaluative events or the need to match external standards across time and situation. The permutations of these sorting variables yield eight types of self-esteem: Optimal High, Fragile High, Accurate Low, Fragile Low, Non-compensatory Narcissism, Compensatory Narcissism, Pessimal, and Disorganized. Specific recommendations for clinicians and researchers are provided

Post-Conviction Disclosure in the Canadian Context

It is common knowledge that the criminal justice system is fallible and prone to human error. The most egregious of such errors is the conviction of an innocent person. While wrongful convictions have been acknowledged in Canada in the last few decades, they are mostly regarded as rare and extraordinary events.16 In response to this perception, experts have identified the challenge of determining the number of wrongful convictions and their exact causes.17 A 2019 study estimates that at least 85 people have been exonerated in Canada.18 The recent advent of the Canadian Registry of Wrongful Convictions creates a centralized location for documenting identified wrongful convictions in Canada.19 In the few months it has been operating, the overall number has steadily increased. In the US, wrongful conviction scholars have estimated that wrongful convictions may be as high as 1% of all convictions.20 Even if the number in Canada is half of that estimate, with over 140,000 convictions in Canadian criminal courts in 2019-2020 alone,21 one can estimate that only a tiny fraction of wrongful convictions have been identified in Canada. If the error rate for wrongful convictions was an extremely low (such as, 0.05%), this would still result in approximately 70 miscarriages of justice per year

Plasma Leptin Levels and Incidence of Heart Failure, Cardiovascular Disease, and Total Mortality in Elderly Individuals

OBJECTIVE: Obesity predisposes individuals to congestive heart failure (CHF) and cardiovascular disease (CVD). Leptin regulates energy homeostasis, is elevated in obesity, and influences ventricular and vascular remodeling. We tested the hypothesis that leptin levels are associated with greater risk of CHF, CVD, and mortality in elderly individuals. RESEARCH DESIGN AND METHODS: We evaluated 818 elderly (mean age 79 years, 62% women) Framingham Study participants attending a routine examination at which plasma leptin was assayed. RESULTS: Leptin levels were higher in women and strongly correlated with BMI (P < 0.0001). On follow-up (mean 8.0 years), 129 (of 775 free of CHF) participants developed CHF, 187 (of 532 free of CVD) experienced a first CVD event, and 391 individuals died. In multivariable Cox regression models adjusting for established risk factors, log-leptin was positively associated with incidence of CHF and CVD (hazard ratio [HR] per SD increment 1.26 [95% CI 1.03–1.55] and 1.28 [1.09–1.50], respectively). Additional adjustment for BMI nullified the association with CHF (0.97 [0.75–1.24]) but only modestly attenuated the relation to CVD incidence (1.23 [1.00–1.51], P = 0.052). We observed a nonlinear, U-shaped relation between log-leptin and mortality (P = 0.005 for quadratic term) with greater risk of death evident at both low and high leptin levels. CONCLUSIONS: In our moderate-sized community-based elderly sample, higher circulating leptin levels were associated with a greater risk of CHF and CVD, but leptin did not provide incremental prognostic information beyond BMI. Additional investigations are warranted to elucidate the U-shaped relation of leptin to mortality.National Institutes of Health's National Heart, Lung, and Blood Institute (N01-HC25195, N01-HV28178, K24-HL04334, R01-DK080739

HCV Tumor Promoting Effect Is Dependent on Host Genetic Background

BACKGROUND: The hepatitis C virus (HCV) is one of the major risk factors for the development of hepatocellular carcinoma (HCC). Nevertheless, transgenic mice which express the whole HCV polyprotein (HCV-Tg) do not develop HCC. Whereas chronic HCV infection causes inflammation in patients, in HCV-Tg mice, the host immune reaction against viral proteins is lacking. We aimed to test the role of HCV proteins in HCC development on the background of chronic inflammation in vivo. METHODOLOGY/PRINCIPAL FINDINGS: We crossed HCV-Tg mice that do not develop HCC with the Mdr2-knockout (Mdr2-KO) mice which develop inflammation-associated HCC, to generate Mdr2-KO/HCV-Tg mice. We studied the effect of the HCV transgene on tumor incidence, hepatocyte mitosis and apoptosis, and investigated the potential contributing factors for the generated phenotype by gene expression and protein analyses. The Mdr2-KO/HCV-Tg females from the N2 generation of this breeding (having 75% of the FVB/N genome and 25% of the C57BL/6 genome) produced significantly larger tumors in comparison with Mdr2-KO mice. In parallel, the Mdr2-KO/HCV-Tg females had an enhanced inflammatory gene expression signature. However, in the N7 generation (having 99.2% of the FVB/N genome and 0.8% of the C57BL/6 genome) there was no difference in tumor development between Mdr2-KO/HCV-Tg and Mdr2-KO animals of both sexes. The HCV transgene was similarly expressed in the livers of Mdr2-KO/HCV-Tg females of both generations, as revealed by detection of the HCV transcript and the core protein. CONCLUSION: These findings suggest that the HCV transgene accelerated inflammation-associated hepatocarcinogenesis in a host genetic background-dependent manner

VIOLÊNCIA CONJUGAL: continuar porquê?

O presente trabalho busca apresentar por meio de pesquisa qualitativa através de pesquisa bibliográfica alguma resposta para a antiga questão: Porque a mulher continua em um relacionamento violento? Para esta pergunta existe um universo de respostas que vem sendo construído há um longo tempo, portanto, o esforço empregado nesta pesquisa apresenta alguns fatores, pela via da abordagem psicodinâmica, que levam a mulher a permanecer neste relacionamento, partindo da perspectiva da constituição do sujeito de Freud ao conceito da devastação de Lacan. E como resultados obtidos pode-se observar que esses fatores ultrapassam questões financeiras, sociais e culturais, estes fatores psíquicos se iniciam na constituição do sujeito/feminino, mais precisamente na relação mãe e filha que ao se repetir, causa influencia na escolha de seu parceiro. Desta forma, quando a mulher estabelece uma relação amorosa nela emerge a relação primitiva herdada da mãe, e quando nesta relação ocorre violência, a mulher tem neste ato uma expressão de amor, uma outra face do amor, a devastação. Diante destas afirmativas, o trabalho tem como objetivo colaborar para uma melhor compreensão da mulher vítima de violência conjugal, fornecendo subsídios ao profissional em psicologia, buscando auxiliá-lo no atendimento clínico. PALAVRAS-CHAVE: Devastação. Psicanálise. Violência Conjugal. Mulher. Psicologia 

Visual Analytics Dashboard Promises to Improve Hypertension Guideline Implementation

BACKGROUND: Primary care management of hypertension under new guidelines incorporates assessment of cardiovascular disease risk and commonly requires review of electronic health record (EHR) data. Visual analytics can streamline the review of complex data and may lessen the burden clinicians face using the EHR. This study sought to assess the utility of a visual analytics dashboard in addition to EHR in managing hypertension in a primary care setting. METHODS: Primary care physicians within an urban, academic internal medicine clinic were tasked with performing two simulated patient encounters for HTN management: the first using standard EHR, and the second using EHR paired with a visual dashboard. The dashboard included graphical blood pressure trends with guideline-directed targets, calculated ASCVD risk score, and relevant medications. Guideline-appropriate antihypertensive prescribing, correct target blood pressure goal, and total encounter time were assessed. RESULTS: We evaluated 70 case simulations. Use of the dashboard with the EHR compared to use of the EHR alone was associated with greater adherence to prescribing guidelines (95% vs. 62%, p\u3c0.001) and more correct identification of BP target (95% vs. 57%, p\u3c0.01). Total encounter time fell an average of 121 seconds (95% CI 69 - 157 seconds, p\u3c0.001) in encounters that used the dashboard combined with the EHR. CONCLUSIONS: The integration of a hypertension-specific visual analytics dashboard with EHR demonstrates the potential to reduce time and improve hypertension guideline implementation. Further widespread testing in clinical practice is warranted

Effects of Allergen Sensitization on Response to Therapy in Children with Eosinophilic Esophagitis

Background: In children with eosinophilic esophagitis (EoE) foods are the most common disease triggers, but environmental allergens are also suspected culprits. Objective: To determine the effects of environmental allergen sensitization on response to treatment in children with EoE in the southeastern United States. Methods: Patients 2 to 18 years old who were referred to the Arkansas Children’s Hospital Eosinophilic Gastrointestinal Disorders Clinic from January 2012 to January 2016 were enrolled in a prospective, longitudinal cohort study with collection of demographics, clinical symptoms, medical history, allergy sensitization profiles, and response to treatment over time. Comparisons were made between complete responders (peak esophageal eosinophil count \u3c 15 per high-power field [HPF]) and nonresponders (\u3e 25 eosinophils per HPF) after treatment with diet elimination alone, swallowed corticosteroids alone, or diet elimination and swallowed corticosteroids. Sensitization patterns to environmental allergens found in the southeastern United States were analyzed for the effect on treatment response. Results: A total of 223 individuals were enrolled. Of these, 182 had environmental allergy profiling and at least one endoscopy while receiving proton pump inhibitor (PPI) therapy. Twenty-nine individuals had PPI-responsive EoE and were excluded from further analysis, leaving 123 individuals with none-PPI-responsive EoE who were further analyzed; 72 (58.5%) were complete responders and 33 (26.8%) were nonresponders. Seventeen individuals (13.8%) were partial responders (≥ 1 but ≤ 25 eosinophils per HPF) and excluded from further analysis. Nonresponders were more likely to be sensitized to perennial allergens (P = .02). There was no significant difference in response based on seasonal allergen sensitization. Individuals with mold or cockroach sensitization were more likely to fail combination diet and swallowed corticosteroid treatment (P = .02 and P = .002). Conclusion: Perennial allergen and mold sensitization may lead to nonresponse to EoE treatment in some patients. Additional studies are needed to further understand the effect of environmental allergens on EoE