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Changes in antibiotic prescribing by dentists in the United States, 2012–2019
- Swetha Ramanathan, Connie H. Yan, Colin Hubbard, Gregory S. Calip, Lisa K. Sharp, Charlesnika T. Evans, Susan Rowan, Jessina C. McGregor, Alan E. Gross, Ronald C. Hershow, Katie J. Suda
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 44 / Issue 11 / November 2023
- Published online by Cambridge University Press:
- 22 August 2023, pp. 1725-1730
- Print publication:
- November 2023
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Objectives:
Dentists prescribe 10% of all outpatient antibiotics in the United States and are the top specialty prescriber. Data on current antibiotic prescribing trends are scarce. Therefore, we evaluated trends in antibiotic prescribing rates by dentists, and we further assessed whether these trends differed by agent, specialty, and by patient characteristics.
Design:Retrospective study of dental antibiotic prescribing included data from the IQVIA Longitudinal Prescription Data set from January 1, 2012 to December 31, 2019.
Methods:The change in the dentist prescribing rate and mean days’ supply were evaluated using linear regression models.
Results:Dentists wrote >216 million antibiotic prescriptions between 2012 and 2019. The annual dental antibiotic prescribing rate remained steady over time (P = .5915). However, the dental prescribing rate (antibiotic prescriptions per 1,000 dentists) increased in the Northeast (by 1,313 antibiotics per 1,000 dentists per year), among oral and maxillofacial surgeons (n = 13,054), prosthodontists (n = 2,381), endodontists (n = 2,255), periodontists (n = 1,961), and for amoxicillin (n = 2,562; P < .04 for all). The mean days’ supply significantly decreased over the study period by 0.023 days per 1,000 dentists per year (P < .001).
Conclusions:From 2012 to 2019, dental prescribing rates for antibiotics remained unchanged, despite decreases in antibiotic prescribing nationally and changes in guidelines during the study period. However, mean days’ supply decreased over time. Dental specialties, such as oral and maxillofacial surgeons, had the highest prescribing rate with increases over time. Antibiotic stewardship efforts to improve unnecessary prescribing by dentists and targeting dental specialists may decrease overall antibiotic prescribing rates by dentists.
7 - A ‘New Diplomacy’?
- from Part II - Institutions
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- By Alan Sharp
- Edited by Peter Jackson, University of Glasgow, William Mulligan, University College Dublin, Glenda Sluga, European University Institute, Florence
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- Book:
- Peacemaking and International Order after the First World War
- Published online:
- 18 May 2023
- Print publication:
- 01 June 2023, pp 179-201
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Summary
Without falling into the Keynesian trap of implying the entire settlement was created in President Wilson’s ‘hot, dry room’, this chapter acknowledges the central role of the Big Four at the Paris Peace Conference in providing a decision-making forum to which many of the most contentious issues were referred. Their ideas, conflicting ambitions and interactions helped to shape the peace. Wilson and Lloyd George, who largely shared a Gladstonian liberal philosophy, advocated self-determination, disarmament, trade and a new international order based on a League of Nations, though this did not prevent significant clashes between them over reparations and naval construction. Clemenceau pursued a more traditional, though potentially incompatible, policy of alliances and territorial adjustments to counter what he perceived to be a continuing threat from a neighbour with larger resources and a more dynamic demographic. Orlando’s vision was focused more closely on Italy and its European context, though not without imperial aspirations. Keynes dismissed him in a sentence and footnote but Italy had an important part in the negotiations and compromises, which moulded the settlement drafted by the Four and their colleagues. The extent, however, to which a ‘New Diplomacy’ had overtaken the old remained moot.
Devils Hole, Nevada, δ18O record extended to the mid-Holocene
- Isaac J. Winograd, Jurate M. Landwehr, Tyler B. Coplen, Warren D. Sharp, Alan C. Riggs, Kenneth R. Ludwig, Peter T. Kolesar
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- Journal:
- Quaternary Research / Volume 66 / Issue 2 / September 2006
- Published online by Cambridge University Press:
- 20 January 2017, pp. 202-212
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The mid-to-late Pleistocene Devils Hole δ18O record has been extended from 60,000 to 4500 yr ago. The new δ18O time series, in conjunction with the one previously published, is shown to be a proxy of Pacific Ocean sea surface temperature (SST) off the coast of California. During marine oxygen isotope stages (MIS) 2 and 6, the Devil Hole and SST time series exhibit a steady warming that began 5000 to > 10,000 yr prior to the last and penultimate deglaciations. Several possible proximate causes for this early warming are evaluated. The magnitude of the peak δ18O or SST during the last interglacial (LIG) is significantly greater (1 per mill and 2 to 3°C, respectively) than the peak value of these parameters for the Holocene; in contrast, benthic δ18O records of ice volume show only a few tenths per mill difference in the peak value for these interglacials. Statistical analysis provides an estimate of the large shared information (variation) between the Devils Hole and Eastern Pacific SST time series from ∼ 41 to ∼ 2°N and enforces the concept of a common forcing among all of these records. The extended Devils Hole record adds to evidence of the importance of uplands bordering the eastern Pacific as a source of archives for reconstructing Pacific climate variability.
Contributors
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- By Mowaffaq Almikhlafi, Osama Al-muslim, Robert Arntfield, Ian M Ball, Sue Berney, Mohit Bhutani, Clay A Block, Ken Blonde, Rudi Brits, Ron Butler, Lois Champion, Chris Clarke, Linda Denehy, Joseph Dreier, A Ebersohn, Shane W English, Ari Ercole, Darren H Freed, John Fuller, Julio P Zavala Georffino, RT Noel Gibney, Jeff Granton, Donald EG Griesdale, Arun K Gupta, Wael Haddara, Ahmed F Hegazy, Umjeet Singh Jolly, Philip M Jones, Ilya Kagan, Kala Kathirgamanathan, Harneet Kaur, John Kellett, Bhupesh Khadka, Biniam Kidane, Carlos Kidel, Anand Kumar, Alejandro Lazo-Langner, David Leasa, W Robert Leeper, Stephen Y Liang, Tania Ligori, Jaimie Manlucu, Janet Martin, Ian McConachie, Alan McGlennan, Lauralyn McIntyre, Tina Mele, MJ Naisbitt, Raj Nichani, Daniel H Ovakim, Neil Parry, Daniel Castro Pereira, Thomas Piraino, Brian Pollard, Valerie Schulz, Michael D Sharpe, Rohit K Singal, Pierre Singer, Mark Soth, Christian P Subbe, Jaffer Syed, Ravi Taneja, Tom Varughese, Jennifer Vergel Del Dios, Jessie R Welbourne, Christopher W White, Rebecca P Winsett, Titus C Yeung, G Bryan Young, Shelley R Zieroth
- Edited by John Fuller, University of Western Ontario, Jeff Granton, University of Western Ontario, Ian McConachie, University of Western Ontario
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- Book:
- Handbook of ICU Therapy
- Published online:
- 05 February 2015
- Print publication:
- 04 December 2014, pp vii-xii
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Amputation of a major propulsor would not be an insuperable obstacle for survivorship of the slender sunfish Ranzania laevis (Molidae: Tetraodontiformes)
- Evgeny V. Romanov, Alan Sharp, Pascal Bach
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- Journal:
- Marine Biodiversity Records / Volume 7 / 2014
- Published online by Cambridge University Press:
- 05 March 2014, e20
- Print publication:
- 2014
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A record of a healthy specimen of slender sunfish Ranzania laevis with an amputated anal fin and healed scars is described from the south-western Indian Ocean. This is the first evidence of nektonic pelagic fish survival in spite of the ablation of a major locomotory organ and the first indication of non-lethal predation on adult slender sunfish.
Contributors
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- By Richard Badenhausen, James J. Berg, John R. Boly, Richard R. Bozorth, Adrian Caesar, David Collard, Patrick Deer, Rainer Emig, Chris Freeman, Susannah Young-ah Gottlieb, Hugh Haughton, Alan Jacobs, Chris Jones, Edward Mendelson, Janet Montefiore, Steve Nicholson, Sean O’Brien, Michael O’Neill, Seamus Perry, Justin Quinn, Gareth Reeves, Stephen Regan, Michael Symmons Roberts, Tony Sharpe, Stan Smith, Andrew Thacker, Aidan Wasley, Keith Williams, Michael Wood, Gregory Woods, Matthew Worley, Tim Youngs
- Edited by Tony Sharpe, Lancaster University
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- Book:
- W. H. Auden in Context
- Published online:
- 05 February 2013
- Print publication:
- 21 January 2013, pp xi-xvi
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. Hackett, Getatchew Haile, Douglas John Hall, Nicholas Hammond, Daphne Hampson, Jehu J. Hanciles, Barry Hankins, Jennifer Haraguchi, Stanley S. Harakas, Anthony John Harding, Conrad L. Harkins, J. William Harmless, Marjory Harper, Amir Harrak, Joel F. Harrington, Mark W. Harris, Susan Ashbrook Harvey, Van A. Harvey, R. Chris Hassel, Jione Havea, Daniel Hawk, Diana L. Hayes, Leslie Hayes, Priscilla Hayner, S. Mark Heim, Simo Heininen, Richard P. Heitzenrater, Eila Helander, David Hempton, Scott H. Hendrix, Jan-Olav Henriksen, Gina Hens-Piazza, Carter Heyward, Nicholas J. Higham, David Hilliard, Norman A. Hjelm, Peter C. Hodgson, Arthur Holder, M. Jan Holton, Dwight N. Hopkins, Ronnie Po-chia Hsia, Po-Ho Huang, James Hudnut-Beumler, Jennifer S. Hughes, Leonard M. Hummel, Mary E. Hunt, Laennec Hurbon, Mark Hutchinson, Susan E. Hylen, Mary Beth Ingham, H. Larry Ingle, Dale T. Irvin, Jon Isaak, Paul John Isaak, Ada María Isasi-Díaz, Hans Raun Iversen, Margaret C. Jacob, Arthur James, Maria Jansdotter-Samuelsson, David Jasper, Werner G. Jeanrond, Renée Jeffery, David Lyle Jeffrey, Theodore W. Jennings, David H. Jensen, Robin Margaret Jensen, David Jobling, Dale A. Johnson, Elizabeth A. Johnson, Maxwell E. Johnson, Sarah Johnson, Mark D. Johnston, F. Stanley Jones, James William Jones, John R. Jones, Alissa Jones Nelson, Inge Jonsson, Jan Joosten, Elizabeth Judd, Mulambya Peggy Kabonde, Robert Kaggwa, Sylvester Kahakwa, Isaac Kalimi, Ogbu U. Kalu, Eunice Kamaara, Wayne C. Kannaday, Musimbi Kanyoro, Veli-Matti Kärkkäinen, Frank Kaufmann, Léon Nguapitshi Kayongo, Richard Kearney, Alice A. Keefe, Ralph Keen, Catherine Keller, Anthony J. Kelly, Karen Kennelly, Kathi Lynn Kern, Fergus Kerr, Edward Kessler, George Kilcourse, Heup Young Kim, Kim Sung-Hae, Kim Yong-Bock, Kim Yung Suk, Richard King, Thomas M. King, Robert M. Kingdon, Ross Kinsler, Hans G. Kippenberg, Cheryl A. Kirk-Duggan, Clifton Kirkpatrick, Leonid Kishkovsky, Nadieszda Kizenko, Jeffrey Klaiber, Hans-Josef Klauck, Sidney Knight, Samuel Kobia, Robert Kolb, Karla Ann Koll, Heikki Kotila, Donald Kraybill, Philip D. W. Krey, Yves Krumenacker, Jeffrey Kah-Jin Kuan, Simanga R. Kumalo, Peter Kuzmic, Simon Shui-Man Kwan, Kwok Pui-lan, André LaCocque, Stephen E. Lahey, John Tsz Pang Lai, Emiel Lamberts, Armando Lampe, Craig Lampe, Beverly J. Lanzetta, Eve LaPlante, Lizette Larson-Miller, Ariel Bybee Laughton, Leonard Lawlor, Bentley Layton, Robin A. Leaver, Karen Lebacqz, Archie Chi Chung Lee, Marilyn J. Legge, Hervé LeGrand, D. L. LeMahieu, Raymond Lemieux, Bill J. Leonard, Ellen M. Leonard, Outi Leppä, Jean Lesaulnier, Nantawan Boonprasat Lewis, Henrietta Leyser, Alexei Lidov, Bernard Lightman, Paul Chang-Ha Lim, Carter Lindberg, Mark R. Lindsay, James R. Linville, James C. Livingston, Ann Loades, David Loades, Jean-Claude Loba-Mkole, Lo Lung Kwong, Wati Longchar, Eleazar López, David W. Lotz, Andrew Louth, Robin W. Lovin, William Luis, Frank D. Macchia, Diarmaid N. J. MacCulloch, Kirk R. MacGregor, Marjory A. MacLean, Donald MacLeod, Tomas S. Maddela, Inge Mager, Laurenti Magesa, David G. Maillu, Fortunato Mallimaci, Philip Mamalakis, Kä Mana, Ukachukwu Chris Manus, Herbert Robinson Marbury, Reuel Norman Marigza, Jacqueline Mariña, Antti Marjanen, Luiz C. L. Marques, Madipoane Masenya (ngwan'a Mphahlele), Caleb J. D. Maskell, Steve Mason, Thomas Massaro, Fernando Matamoros Ponce, András Máté-Tóth, Odair Pedroso Mateus, Dinis Matsolo, Fumitaka Matsuoka, John D'Arcy May, Yelena Mazour-Matusevich, Theodore Mbazumutima, John S. McClure, Christian McConnell, Lee Martin McDonald, Gary B. McGee, Thomas McGowan, Alister E. McGrath, Richard J. McGregor, John A. McGuckin, Maud Burnett McInerney, Elsie Anne McKee, Mary B. McKinley, James F. McMillan, Ernan McMullin, Kathleen E. McVey, M. Douglas Meeks, Monica Jyotsna Melanchthon, Ilie Melniciuc-Puica, Everett Mendoza, Raymond A. Mentzer, William W. Menzies, Ina Merdjanova, Franziska Metzger, Constant J. Mews, Marvin Meyer, Carol Meyers, Vasile Mihoc, Gunner Bjerg Mikkelsen, Maria Inêz de Castro Millen, Clyde Lee Miller, Bonnie J. Miller-McLemore, Alexander Mirkovic, Paul Misner, Nozomu Miyahira, R. W. L. Moberly, Gerald Moede, Aloo Osotsi Mojola, Sunanda Mongia, Rebeca Montemayor, James Moore, Roger E. Moore, Craig E. Morrison O.Carm, Jeffry H. Morrison, Keith Morrison, Wilson J. Moses, Tefetso Henry Mothibe, Mokgethi Motlhabi, Fulata Moyo, Henry Mugabe, Jesse Ndwiga Kanyua Mugambi, Peggy Mulambya-Kabonde, Robert Bruce Mullin, Pamela Mullins Reaves, Saskia Murk Jansen, Heleen L. Murre-Van den Berg, Augustine Musopole, Isaac M. T. Mwase, Philomena Mwaura, Cecilia Nahnfeldt, Anne Nasimiyu Wasike, Carmiña Navia Velasco, Thulani Ndlazi, Alexander Negrov, James B. Nelson, David G. Newcombe, Carol Newsom, Helen J. Nicholson, George W. E. Nickelsburg, Tatyana Nikolskaya, Damayanthi M. A. Niles, Bertil Nilsson, Nyambura Njoroge, Fidelis Nkomazana, Mary Beth Norton, Christian Nottmeier, Sonene Nyawo, Anthère Nzabatsinda, Edward T. Oakes, Gerald O'Collins, Daniel O'Connell, David W. Odell-Scott, Mercy Amba Oduyoye, Kathleen O'Grady, Oyeronke Olajubu, Thomas O'Loughlin, Dennis T. Olson, J. Steven O'Malley, Cephas N. Omenyo, Muriel Orevillo-Montenegro, César Augusto Ornellas Ramos, Agbonkhianmeghe E. Orobator, Kenan B. Osborne, Carolyn Osiek, Javier Otaola Montagne, Douglas F. Ottati, Anna May Say Pa, Irina Paert, Jerry G. Pankhurst, Aristotle Papanikolaou, Samuele F. Pardini, Stefano Parenti, Peter Paris, Sung Bae Park, Cristián G. Parker, Raquel Pastor, Joseph Pathrapankal, Daniel Patte, W. Brown Patterson, Clive Pearson, Keith F. Pecklers, Nancy Cardoso Pereira, David Horace Perkins, Pheme Perkins, Edward N. Peters, Rebecca Todd Peters, Bishop Yeznik Petrossian, Raymond Pfister, Peter C. Phan, Isabel Apawo Phiri, William S. F. Pickering, Derrick G. Pitard, William Elvis Plata, Zlatko Plese, John Plummer, James Newton Poling, Ronald Popivchak, Andrew Porter, Ute Possekel, James M. Powell, Enos Das Pradhan, Devadasan Premnath, Jaime Adrían Prieto Valladares, Anne Primavesi, Randall Prior, María Alicia Puente Lutteroth, Eduardo Guzmão Quadros, Albert Rabil, Laurent William Ramambason, Apolonio M. Ranche, Vololona Randriamanantena Andriamitandrina, Lawrence R. Rast, Paul L. Redditt, Adele Reinhartz, Rolf Rendtorff, Pål Repstad, James N. Rhodes, John K. Riches, Joerg Rieger, Sharon H. Ringe, Sandra Rios, Tyler Roberts, David M. Robinson, James M. Robinson, Joanne Maguire Robinson, Richard A. H. Robinson, Roy R. Robson, Jack B. Rogers, Maria Roginska, Sidney Rooy, Rev. Garnett Roper, Maria José Fontelas Rosado-Nunes, Andrew C. Ross, Stefan Rossbach, François Rossier, John D. Roth, John K. Roth, Phillip Rothwell, Richard E. Rubenstein, Rosemary Radford Ruether, Markku Ruotsila, John E. Rybolt, Risto Saarinen, John Saillant, Juan Sanchez, Wagner Lopes Sanchez, Hugo N. Santos, Gerhard Sauter, Gloria L. Schaab, Sandra M. Schneiders, Quentin J. Schultze, Fernando F. Segovia, Turid Karlsen Seim, Carsten Selch Jensen, Alan P. F. Sell, Frank C. Senn, Kent Davis Sensenig, Damían Setton, Bal Krishna Sharma, Carolyn J. Sharp, Thomas Sheehan, N. Gerald Shenk, Christian Sheppard, Charles Sherlock, Tabona Shoko, Walter B. Shurden, Marguerite Shuster, B. Mark Sietsema, Batara Sihombing, Neil Silberman, Clodomiro Siller, Samuel Silva-Gotay, Heikki Silvet, John K. Simmons, Hagith Sivan, James C. Skedros, Abraham Smith, Ashley A. Smith, Ted A. Smith, Daud Soesilo, Pia Søltoft, Choan-Seng (C. S.) Song, Kathryn Spink, Bryan Spinks, Eric O. Springsted, Nicolas Standaert, Brian Stanley, Glen H. Stassen, Karel Steenbrink, Stephen J. Stein, Andrea Sterk, Gregory E. Sterling, Columba Stewart, Jacques Stewart, Robert B. Stewart, Cynthia Stokes Brown, Ken Stone, Anne Stott, Elizabeth Stuart, Monya Stubbs, Marjorie Hewitt Suchocki, David Kwang-sun Suh, Scott W. Sunquist, Keith Suter, Douglas Sweeney, Charles H. Talbert, Shawqi N. Talia, Elsa Tamez, Joseph B. Tamney, Jonathan Y. Tan, Yak-Hwee Tan, Kathryn Tanner, Feiya Tao, Elizabeth S. Tapia, Aquiline Tarimo, Claire Taylor, Mark Lewis Taylor, Bishop Abba Samuel Wolde Tekestebirhan, Eugene TeSelle, M. Thomas Thangaraj, David R. Thomas, Andrew Thornley, Scott Thumma, Marcelo Timotheo da Costa, George E. “Tink” Tinker, Ola Tjørhom, Karen Jo Torjesen, Iain R. Torrance, Fernando Torres-Londoño, Archbishop Demetrios [Trakatellis], Marit Trelstad, Christine Trevett, Phyllis Trible, Johannes Tromp, Paul Turner, Robert G. Tuttle, Archbishop Desmond Tutu, Peter Tyler, Anders Tyrberg, Justin Ukpong, Javier Ulloa, Camillus Umoh, Kristi Upson-Saia, Martina Urban, Monica Uribe, Elochukwu Eugene Uzukwu, Richard Vaggione, Gabriel Vahanian, Paul Valliere, T. J. Van Bavel, Steven Vanderputten, Peter Van der Veer, Huub Van de Sandt, Louis Van Tongeren, Luke A. Veronis, Noel Villalba, Ramón Vinke, Tim Vivian, David Voas, Elena Volkova, Katharina von Kellenbach, Elina Vuola, Timothy Wadkins, Elaine M. Wainwright, Randi Jones Walker, Dewey D. Wallace, Jerry Walls, Michael J. Walsh, Philip Walters, Janet Walton, Jonathan L. Walton, Wang Xiaochao, Patricia A. Ward, David Harrington Watt, Herold D. Weiss, Laurence L. Welborn, Sharon D. Welch, Timothy Wengert, Traci C. West, Merold Westphal, David Wetherell, Barbara Wheeler, Carolinne White, Jean-Paul Wiest, Frans Wijsen, Terry L. Wilder, Felix Wilfred, Rebecca Wilkin, Daniel H. Williams, D. Newell Williams, Michael A. Williams, Vincent L. Wimbush, Gabriele Winkler, Anders Winroth, Lauri Emílio Wirth, James A. Wiseman, Ebba Witt-Brattström, Teofil Wojciechowski, John Wolffe, Kenman L. Wong, Wong Wai Ching, Linda Woodhead, Wendy M. Wright, Rose Wu, Keith E. Yandell, Gale A. Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- Book:
- The Cambridge Dictionary of Christianity
- Published online:
- 05 August 2012
- Print publication:
- 20 September 2010, pp xi-xliv
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Effects of selection on growth, body composition and food intake in mice I. Responses in selected traits
- Gillian L. Sharp, William G. Hill, Alan Robertson
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- Journal:
- Genetical Research / Volume 43 / Issue 1 / February 1984
- Published online by Cambridge University Press:
- 14 April 2009, pp. 75-92
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Mice were selected for one of three criteria: appetite (A), measured as 4- to 6-week food intake, adjusted by phenotypic regression to minimize change in 4-week body weight, fat percentage (F), using the ratio of gonadal fat pad weight to body weight in 10-week-old males, and total lean mass (protein, P), using the index, body weight in 10-week-old males − (8 × gonadal fat pad weight). For each selection criterion, there were 3 high, 3 low and 3 unselected control lines. At generation 11, the high and low A lines diverged by 17% of the control mean and the realized heritability from within family selection of adjusted food intake was 15%. Selection for this character produced changes in body weight, gross efficiency from 4 to 6 weeks, and percentage of fat, the high lines being heavier, more efficient and less fat than the lows. The high and low F lines diverged by 80% of the control mean and the realized heritability of the ratio of gonadal fat pad weight to body weight was 44%. Selection for this character produced changes in total fat per cent, but little change in percentage protein, body weight, food intake or gross efficiency. The high and low P lines diverged by 40% of the control mean and realized heritability of the lean mass index (10-week weight − [8 × gonadal fat pad weight]) was 51%. Selection for an increase in the index increased body weight at all ages, food intake and 4- to 6-week gross efficiency. There was no change in percentage fat. Responses in the selected traits were not highly correlated, and the different lines provide an opportunity for investigating responses in physiology, metabolism and gene products.
Effects of selection on growth, body composition and food intake in mice: II. Correlated responses in reproduction
- Forbes D. Brien, Gillian L. Sharp, William G. Hill, Alan Robertson
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- Journal:
- Genetical Research / Volume 44 / Issue 1 / August 1984
- Published online by Cambridge University Press:
- 14 April 2009, pp. 73-85
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Female reproductive performance is reported in mice selected for ten generations for one of three criteria: either appetite (A), fat percentage (F) or total lean mass (P). For each criterion lines were selected for high (H) or low (L) performance, with contemporary unselected controls (C). In the A and P lines, litter size changed in the direction of the selected criterion, the changes being larger and more rapidly established in the A than in the P lines. At generation 10, the differences in litter size between high and low lines were 2·6 live young born in the A lines, and 1·0 live young born in the P lines. The differences in 6-week weight between the high and low lines were 3·5 g in the A lines, 6·5 g in the P lines. Changes in ovulation rate were the primary reason for changes in litter size, the differences between the high and low lines being 3·8 corpora lutea for the A lines, and 3·1 corpora lutea for the P lines. Fitting body weight at mating as a covariate within lines in the analysis of ovulation rate and live foetus number removed the differences between the high and low selected P lines, but not those in the A lines. The high and low selected A and P lines did not differ in prenatal survival. There were no consistent differences in litter size, ovulation rate or pre-natal survival in the F lines.
14 - Neurological disorders
- from Part III - Working with specific units
- Edited by Geoffrey Lloyd, Priory Hospital, London, Elspeth Guthrie, University of Manchester
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- Book:
- Handbook of Liaison Psychiatry
- Published online:
- 10 December 2009
- Print publication:
- 24 May 2007, pp 305-364
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Summary
In practice the psychiatrist working in a clinical neurosciences centre is likely to have to address three main categories of clinical problems on a daily basis: patients with cognitive impairment, patients who present with neurological disease, and patients who present with physical symptoms. This chapter describes specific drug therapies, and concentrates on medical aspects of psychiatry. Careful clinical assessment reveals the diagnosis in the majority of patients. Psychiatrists should be able to perform a competent basic neurological examination as this often provides the crucial clues to a neuropsychiatric diagnosis. The chapter outlines the principles of assessment and management particularly in relation to commonly encountered conditions. However, the same rules of assessment apply whether it is the everyday work of assessing mood in a patient with multiple sclerosis (MS) or the rarely encountered assessment of a teenager with mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS).
Structural Studies of GeTe-AgSbTe2 Alloys
- Alan Thompson, Jeff Sharp, C.J Rawn, B.C. Chackoumakos
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- Journal:
- MRS Online Proceedings Library Archive / Volume 1044 / 2007
- Published online by Cambridge University Press:
- 01 February 2011, 1044-U03-09
- Print publication:
- 2007
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GeTe, a small bandgap semiconductor that has native p-type defects due to Ge vacancies, is an important constituent in the thermoelectric material known as “TAGS” [1]. TAGS is an acronym for alloys of GeTe with AgSbTe2, and compositions are normally designated as TAGS-x, where x is the fraction of GeTe. TAGS-85 is the most important with regard to applications, and there also is commercial interest in TAGS-80. The crystal structure of GeTe1+δ has a composition-dependent phase transformation at a temperature ranging from 430°C (δ = 0) to ∼ 400°C (δ = 0.02) [2]. The high temperature form is cubic. The low temperature form is rhombohedral for δ < 0.01, as is the case for good thermoelectric performance. Addition of AgSbTe2 shifts the phase transformation to lower temperatures, and one of the goals of this work is a systematic study of the dependence of transformation temperature on the parameter x. We present results on phase transformations and associated instabilities in TAGS compositions in the range of 70-85 at.% GeTe.
Anorexia nervosa among female secondary school students in Ghana
- Dinah Bennett, Michael Sharpe, Chris Freeman, Alan Carson
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- Journal:
- The British Journal of Psychiatry / Volume 185 / Issue 4 / October 2004
- Published online by Cambridge University Press:
- 02 January 2018, pp. 312-317
- Print publication:
- October 2004
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Background
We set out to determine whether anorexia nervosa exists in a culture where the pressure to be thin is less pervasive.
AimsTo determine whether there were any cases of anorexia nervosa in female students attending two secondary schools in the north-east region of Ghana.
MethodThe body mass index (BMI) of consenting students was calculated after measuring their height and weight. Those with a BMI ⩽19 kg/m2 underwent a structured clinical assessment including mental state, physical examination and completion of the Eating Attitudes Test and the Bulimic Investigatory Test, Edinburgh. Participants nominated a best friend to serve as a comparison group, and these young women underwent the same assessments.
ResultsOf the 668 students who were screened for BMI, 10 with a BMI <175 kg/m2 appeared to have self-starvation as the only cause of their low weight. All 10 viewed their food restriction positively and in religious terms. The beliefs of these individuals included ideas of self-control and denial of hunger, without the typical anorexic concerns about weight or shape.
ConclusionsMorbid self-starvation may be the core feature of anorexia nervosa, with the attribution for the self-starvation behaviour varying between cultures.
5 - A Comment
- from PART ONE - PEACE PLANNING AND THE ACTUALITIES OF THE ARMISTICE
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- By Alan Sharp
- Edited by Manfred F. Boemeke, United Nations University Press, Tokyo, Gerald D. Feldman, University of California, Berkeley, Elisabeth Glaser, German Historical Institute
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- Book:
- The Treaty of Versailles
- Published online:
- 05 January 2013
- Print publication:
- 13 September 1998, pp 131-144
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Summary
The chapters of part I each provide interesting and valuable analyses. David Stevenson (chapter 3) offers an appraisal of French war aims and objectives from 1914 through to the end of the conference. Klaus Schwabe (chapter 1) begins his survey slightly later, with the early stirrings of the peace movement within Germany. He, too, follows the process through to what was a bitter end for the socialists and left-wing liberals who had passed the Peace Resolution in the Reichstag and whose belief in Woodrow Wilson's ideals was deep and genuine. David French (chapter 2) analyzes the British military and political desiderata, arguing that part of the objective for the British, as for Wilson, was an ideological one, as can be seen in their effort to bring about a decisive change in Germany's system of government - an aim also pursued by the Germans who opposed the regime and supported the Peace Resolution. Yet it was clear that Britain did not wish to see Germany destroyed if this meant it was merely to be replaced by a new danger to British interests. The possible candidates varied with the changing fortunes of war: first it was Russia, then France, and finally the United States. Like French, Thomas J. Knock (chapter 4) has been more literal in his interpretation, ending his discussion ofWilson's ideas and their domestic political fate more or less as the guns fell silent.
9 - Unnecessary surgery
- Virginia Ashby Sharpe, Alan I. Faden, Georgetown University, Washington DC
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- Book:
- Medical Harm
- Published online:
- 22 September 2009
- Print publication:
- 13 February 1998, pp 194-212
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Summary
In the context of surgery, the term ‘iatrogenic illness’ or ‘iatrogenic complication’ has been reserved for surgical mishaps and adverse surgical outcomes. Although these outcomes may secondarily give rise to an assessment that a procedure was itself unnecessary or inappropriate, unnecessary surgery per se has not traditionally been recognized as an iatrogenic harm. One explanation for this may be that attention to unnecessary surgery has primarily come from private or governmental insurers who have tended to focus on the direct aggregate economic costs of the phenomenon rather than on its indirect or intangible human costs in morbidity, mortality, pain, suffering, or loss of livelihood to individuals. In other words, from the point of view of health policy, unnecessary surgery has been understood principally as a problem of ‘surgical overuse’ rather than iatrogenic harm. Another reason why unnecessary surgery has not itself been regarded as a patient harm may be a general skepticism about even the occurrence of unnecessary surgery. If we understand an unnecessary surgery to be one that offers no anticipated preponderance of benefit to the patient, then many would argue that no doctor would perform such a surgery. This view is of course countered by another common impression that such surgeries do occur and that the only identifiable benefits that accrue from them are remunerative ones to the physician.
In this chapter, we explore both what is meant by the term unnecessary surgery and the evidence that has been offered to explain the scope and nature of the problem.
Part II
- Virginia Ashby Sharpe, Alan I. Faden, Georgetown University, Washington DC
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- Book:
- Medical Harm
- Published online:
- 22 September 2009
- Print publication:
- 13 February 1998, pp 79-80
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7 - From hospitalism to nosocomial infection control
- Virginia Ashby Sharpe, Alan I. Faden, Georgetown University, Washington DC
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- Book:
- Medical Harm
- Published online:
- 22 September 2009
- Print publication:
- 13 February 1998, pp 153-174
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Summary
Historic debates: puerperal fever, antisepsis, and the germ theory of disease
What is now known as nosocomial or hospital-based infection made its indelible mark on history during the childbed fever epidemics of the eighteenth and nineteenth centuries. During this period, puerperal deaths in hospitals and lying-in institutions were estimated to be as high as 150 per 1000 deliveries, whereas the same disease afflicted less than 20 in 1000 women delivering at home. One of the first indications of the physician's role in the etiology of childbed fever was given by Alexander Gordon in 1795 in his account of 28 cases of the disease at the Aberdeen dispensary, Scotland. In this account, he expressed his conviction, based on empirical evidence from his own practice, that he and certain midwives had been the source of transmission.
The most significant epidemiological work on the physician's role in the transmission of puerperal fever was done in the mid-nineteenth century by Ignaz Semmelweis at the Allgemeines Krankenhaus in Vienna. During this period, pathological anatomy was becoming an integral part of the medical curriculum, and medical students and physicians moved freely between the autopsy and delivery rooms. Based on astute clinical observation of the two obstetric wards at the hospital, Semmelweis identified physicians going from cadavers to parturient women as the main vector of the disease. In Ward 1, where deliveries were performed by physicians and students, 600 to 800 women or 20% died each year from childbed fever.
Medical Harm
- Historical, Conceptual and Ethical Dimensions of Iatrogenic Illness
- Virginia Ashby Sharpe, Alan I. Faden
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- Published online:
- 22 September 2009
- Print publication:
- 13 February 1998
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It is estimated that up to thirteen percent of hospital admissions result from the adverse effects of diagnosis or treatment, and that almost seventy percent of iatrogenic complications are preventable. The obligation to 'do no harm' has been central to medical conduct since ancient times, yet iatrogenic illness has now come to be recognized as a significant risk factor in health care delivery. This book integrates history, philosophy, medical ethics and empirical data to examine the concept and phenomenon of medical harm. Issues covered include appropriateness of care, acceptable risk and practitioner accountability, and the book concludes with recommendations for limiting iatrogenic harm. Essential reading for medical ethicists, physicians and those involved in health care policy and administration, this stimulating and highly readable book will be of interest to all providers of health care, and many of their patients.
Index
- Virginia Ashby Sharpe, Alan I. Faden, Georgetown University, Washington DC
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- Book:
- Medical Harm
- Published online:
- 22 September 2009
- Print publication:
- 13 February 1998, pp 271-280
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10 - The concept of appropriateness in patient care
- Virginia Ashby Sharpe, Alan I. Faden, Georgetown University, Washington DC
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- Book:
- Medical Harm
- Published online:
- 22 September 2009
- Print publication:
- 13 February 1998, pp 213-229
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Summary
Appropriateness, values and risk
The shift to appropriateness in health services research underscores that judgments about surgical overuse and the provision of unnecessary services depend on prior judgments about the criteria for appropriate use. This shift is, in other words, an acknowledgment that clinically sound utilization decisions depend on a sound evidentiary basis regarding what works in clinical practice. Because only a small minority (15 to 20%) of treatments have been evaluated in rigorous scientific trials, however, this is a daunting task. It is also one that raises important and controversial questions about what counts as an authoritative form of evidence in determinations regarding efficacy, effectiveness, and safety – or in other words, regarding clinical benefit and harm. The shift to appropriateness also raises important questions regarding the values that do and should guide medical decision making. To say that something is ‘appropriate’ is to say that it is ‘suitable or fitting for a particular purpose, occasion, or person’. The term ‘appropriate’ is, thus, fundamentally evaluative; it implies the endorsement of some goal. ‘Appropriate for what and whom?’ and ‘appropriate to what and whose ends?’ are questions that must be answered, therefore, if the term is to be made meaningful.
Traditionally, the authority for clinical decision-making has rested with the physician; the physician was believed to know what was best or appropriate for a patient and due deference was paid to medical judgment.
1 - Divided loyalties: harm to the profession vs. harm to the patient
- Virginia Ashby Sharpe, Alan I. Faden, Georgetown University, Washington DC
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- Book:
- Medical Harm
- Published online:
- 22 September 2009
- Print publication:
- 13 February 1998, pp 21-35
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Summary
Recent scholarship in the history and sociology of American medicine provides a compelling account of how the professional authority of physicians was consolidated in the mid-nineteenth and early twentieth centuries. This consolidation occurred both by chance and by design. The introduction of surgical antisepsis (and later asepsis) and of diagnostic technologies such as the stethoscope, and X-ray as well as diagnostic tests, enhanced the credibility of the ‘regular’ physician and distinguished his abilities from the less demonstrative ones of homeopaths and botanics. This was also the most dramatic period of hospital growth in the United States. In 1873, there were 178 hospitals and by 1910 there were more than 4000. The role of physicians – and especially surgeons – was essential to this growth, for it was surgeons who provided the patients to fill the ever increasing number of hospital beds. By the late 1920s, surgical admissions outnumbered medical admissions by almost two to one. Further, as the public began to respond to the promise of surgical cures, the availability of surgical resources provided the all important argument for the advantage of hospital over home care. During this period, the hospital as a social institution was changing dramatically. In the early 1800s, hospitals were essentially charitable institutions, indeed, almshouses for the ‘deserving poor’. A patient's admission to the hospital was based on an assessment by hospital trustees of the moral character of the potential ‘inmate’.