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Understanding the role of antibiotic-associated adverse events in influencing antibiotic decision-making
- Jerald P. Cherian, Taylor N. Helsel, George F. Jones, Zunaira Virk, Alejandra Salinas, Suzanne M. Grieb, Eili Y. Klein, Pranita D. Tamma, Sara E. Cosgrove, for the Centers for Disease Control and Prevention’s Prevention Epicenters Program
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- Journal:
- Antimicrobial Stewardship & Healthcare Epidemiology / Volume 4 / Issue 1 / 2024
- Published online by Cambridge University Press:
- 30 January 2024, e13
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Objective:
To (1) understand the role of antibiotic-associated adverse events (ABX-AEs) on antibiotic decision-making, (2) understand clinician preferences for ABX-AE feedback, and (3) identify ABX-AEs of greatest clinical concern.
Design:Focus groups.
Setting:Academic medical center.
Participants:Medical and surgical house staff, attending physicians, and advanced practice practitioners.
Methods:Focus groups were conducted from May 2022 to December 2022. Participants discussed the role of ABX-AEs in antibiotic decision-making and feedback preferences and evaluated the prespecified categorization of ABX-AEs based on degree of clinical concern. Thematic analysis was conducted using inductive coding.
Results:Four focus groups were conducted (n = 15). Six themes were identified. (1) ABX-AE risks during initial prescribing influence the antibiotic prescribed rather than the decision of whether to prescribe. (2) The occurrence of an ABX-AE leads to reassessment of the clinical indication for antibiotic therapy. (3) The impact of an ABX-AE on other management decisions is as important as the direct harm of the ABX-AE. (4) ABX-AEs may be overlooked because of limited feedback regarding the occurrence of ABX-AEs. (5) Clinicians are receptive to feedback regarding ABX-AEs but are concerned about it being punitive. (6) Feedback must be curated to prevent clinicians from being overwhelmed with data. Clinicians generally agreed with the prespecified categorizations of ABX-AEs by degree of clinical concern.
Conclusions:The themes identified and assessment of ABX-AEs of greatest clinical concern may inform antibiotic stewardship initiatives that incorporate reporting of ABX-AEs as a strategy to reduce unnecessary antibiotic use.
Cumulative lifetime acute stressor exposure interacts with reward responsiveness to predict longitudinal increases in depression severity in adolescence
- Kreshnik Burani, C. J. Brush, Grant S. Shields, Daniel N. Klein, Brady Nelson, George M. Slavich, Greg Hajcak
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- Journal:
- Psychological Medicine / Volume 53 / Issue 10 / July 2023
- Published online by Cambridge University Press:
- 09 June 2022, pp. 4507-4516
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Background
Life stress and blunted reward processing each have been associated with the onset and maintenance of major depressive disorder. However, much of this work has been cross-sectional, conducted in separate lines of inquiry, and focused on recent life stressor exposure, despite the fact that theories of depression posit that stressors can have cumulative effects over the lifespan. To address these limitations, we investigated whether acute and chronic stressors occurring over the lifespan interacted with blunted reward processing to predict increases in depression over time in healthy youth.
MethodParticipants were 245 adolescent girls aged 8–14 years old (Mage = 12.4, s.d. = 1.8) who were evaluated at baseline and two years later. The reward positivity (RewP), an event-related potential measure of reward responsiveness, was assessed at baseline using the doors task. Cumulative lifetime exposure to acute and chronic stressors was assessed two years later using the Stress and Adversity Inventory for Adolescents (Adolescent STRAIN). Finally, depressive symptoms were assessed at both baseline and follow-up using the Children's Depression Inventory.
ResultsAs hypothesized, greater lifetime acute stressor exposure predicted increases in depressive symptoms over two years, but only for youth exhibiting a blunted RewP. This interaction, however, was not found for chronic stressors.
ConclusionsLifetime acute stressor exposure may be particularly depressogenic for youth exhibiting a blunted RewP. Conversely, a robust RewP may be protective in the presence of greater acute lifetime stressor exposure.
Improving antimicrobial prescribing for upper respiratory infections in the emergency department: Implementation of peer comparison with behavioral feedback
- George F. Jones, Valeria Fabre, Jeremiah Hinson, Scott Levin, Matthew Toerper, Jennifer Townsend, Sara E. Cosgrove, Mustapha Saheed, Eili Y. Klein
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- Journal:
- Antimicrobial Stewardship & Healthcare Epidemiology / Volume 1 / Issue 1 / 2021
- Published online by Cambridge University Press:
- 23 December 2021, e70
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Objective:
To reduce inappropriate antibiotic prescribing for acute respiratory infections (ARIs) by employing peer comparison with behavioral feedback in the emergency department (ED).
Design:A controlled before-and-after study.
Setting:The study was conducted in 5 adult EDs at teaching and community hospitals in a health system.
Patients:Adults presenting to the ED with a respiratory condition diagnosis code. Hospitalized patients and those with a diagnosis code for a non-respiratory condition for which antibiotics are or may be warranted were excluded.
Interventions:After a baseline period from January 2016 to March 2018, 3 EDs implemented a feedback intervention with peer comparison between April 2018 and December 2019 for attending physicians. Also, 2 EDs in the health system served as controls. Using interrupted time series analysis, the inappropriate ARI prescribing rate was calculated as the proportion of antibiotic-inappropriate ARI encounters with a prescription. Prescribing rates were also evaluated for all ARIs. Attending physicians at intervention sites received biannual e-mails with their inappropriate prescribing rate and had access to a dashboard that was updated daily showing their performance relative to their peers.
Results:Among 28,544 ARI encounters, the inappropriate prescribing rate remained stable at the control EDs between the 2 periods (23.0% and 23.8%). At the intervention sites, the inappropriate prescribing rate decreased significantly from 22.0% to 15.2%. Between periods, the overall ARI prescribing rate was 38.1% and 40.6% in the control group and 35.9% and 30.6% in the intervention group.
Conclusions:Behavioral feedback with peer comparison can be implemented effectively in the ED to reduce inappropriate prescribing for ARIs.
The role of procalcitonin results in antibiotic decision-making in coronavirus disease 2019 (COVID-19)
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- Valeria Fabre, Sara Karaba, Joe Amoah, Matthew Robinson, George Jones, Kathryn Dzintars, Morgan Katz, B. Mark Landrum, Sarojini Qasba, Pooja Gupta, Eili Klein, Sara E. Cosgrove
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 43 / Issue 5 / May 2022
- Published online by Cambridge University Press:
- 19 April 2021, pp. 570-575
- Print publication:
- May 2022
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Objective:
To evaluate the role of procalcitonin (PCT) results in antibiotic decisions for COVID-19 patients at hospital presentation.
Design, setting, and participants:Multicenter retrospective observational study of patients ≥18 years hospitalized due to COVID-19 at the Johns Hopkins Health system. Patients who were transferred from another facility with >24 hours stay and patients who died within 48 hours of hospitalization were excluded.
Methods:Elevated PCT values were determined based on each hospital’s definition. Antibiotic therapy and PCT results were evaluated for patients with no evidence of bacterial community-acquired pneumonia (bCAP) and patients with confirmed, probable, or possible bCAP. The added value of PCT testing to clinical criteria in detecting bCAP was evaluated using receiving operating curve characteristics (ROC).
Results:Of 962 patients, 611 (64%) received a PCT test. ROC curves for clinical criteria and clinical criteria plus PCT test were similar (at 0.5 ng/mL and 0.25 ng/mL). By bCAP group, median initial PCT values were 0.58 ng/mL (interquartile range [IQR], 0.24–1.14), 0.23 ng/mL (IQR, 0.1–0.63), and 0.15 ng/mL (IQR, 0.09–0.35) for proven/probable, possible, and no bCAP groups, respectively. Among patients without bCAP, an elevated PCT level was associated with 1.8 additional days of CAP therapy (95% CI, 1.01–2.75; P < .01) compared to patients with a negative PCT result after adjusting for potential confounders. Duration of CAP therapy was similar between patients without a PCT test ordered and a low PCT level for no bCAP and possible bCAP groups.
Conclusions:PCT results may be abnormal in COVID-19 patients without bCAP and may result in receipt of unnecessary antibiotics.
Bulachite, [Al6(AsO4)3(OH)9(H2O)4]⋅2H2O from Cap Garonne, France: Crystal structure and formation from a higher hydrate
- Ian E. Grey, Emre Yoruk, Stéphanie Kodjikian, Holger Klein, Catherine Bougerol, Helen E.A. Brand, Pierre Bordet, William G. Mumme, Georges Favreau, Stuart J. Mills
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- Journal:
- Mineralogical Magazine / Volume 84 / Issue 4 / August 2020
- Published online by Cambridge University Press:
- 30 June 2020, pp. 608-615
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Bulachite specimens from Cap Garonne, France, comprise two intimately mixed hydrated aluminium arsenate minerals with the same Al:As ratio of 2:1 and with different water contents. The crystal structures of both minerals have been solved using data from low-dose electron diffraction tomography combined with synchrotron powder X-ray diffraction. One of the minerals has the same powder X-ray diffraction pattern (PXRD) as for published bulachite. It has orthorhombic symmetry, space group Pnma with unit-cell parameters a = 15.3994(3), b = 17.6598(3), c = 7.8083(1) Å and Z = 4, with the formula [Al6(AsO4)3(OH)9(H2O)4]⋅2H2O. The second mineral is a higher hydrate with composition [Al6(AsO4)3(OH)9(H2O)4]⋅8H2O. It has the same Pnma space group and unit-cell parameters a = 19.855(4), b = 17.6933(11) and c = 7.7799(5) Å i.e. almost the same b and c parameters but a much larger a parameter. The structures are based on polyhedral layers, parallel to (100), of composition [Al6(AsO4)3(OH)9(H2O)4] and with H-bonded H2O between the layers. The layers contain [001] spiral chains of edge-shared octahedra, decorated with corner connected AsO4 tetrahedra that are the same as in the mineral liskeardite. The spiral chains are joined together by octahedral edge-sharing to form layers parallel to (100). Synchrotron PXRD patterns collected at different temperatures during heating of the specimen show that the higher-hydrate mineral starts transforming to bulachite when heated to 50°C, and the transformation is complete between 75 and 100°C.
3068 Effects of exercise and a very low fat diet in metabolically abnormal obese adults
- George Schweitzer, Monica Kearney, Gordon Smith, Samuel Klein
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- Journal:
- Journal of Clinical and Translational Science / Volume 3 / Issue s1 / March 2019
- Published online by Cambridge University Press:
- 26 March 2019, p. 40
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OBJECTIVES/SPECIFIC AIMS: People with metabolically abnormal obesity (MAO), defined as those with insulin resistance and high intrahepatic triglyceride, are at high risk for developing type 2 diabetes and cardiovascular disease. Weight loss through reduced energy intake and increased physical activity has profound impacts on improving cardiometabolic function. However, the specific additional effects of exercise training with diet-induced weight loss on metabolic function are equivocal. METHODS/STUDY POPULATION: A comparative trial is ongoing in MAO adults undergoing 8-10% weight loss induced by a very-low fat plant-based (PB) diet with structured exercise training (n=8) compared to the same weight loss induced by the PB diet alone (n=3). RESULTS/ANTICIPATED RESULTS: Preliminary results indicate that, PB diet with or without exercise training results in significant weight loss concomitant with enhanced insulin sensitivity, reduced intrahepatic triglyceride, reduced 24-hour postprandial glucose response, reduced fat mass, and reduced diastolic blood pressure. Those undergoing PB diet with exercise training had greater improvements in muscular strength and cardiorespiratory fitness than those undergoing PB diet alone. Differences between intervention groups for other cardiometabolic measures are not yet known. DISCUSSION/SIGNIFICANCE OF IMPACT: Each of the interventions resulted in improved cardiometabolic measures; however the extent of the differences between the interventions is not yet clear. It is hypothesized that compared with weight loss induced by a PB diet, the same weight loss induced by a PB diet and structured exercise training will i) cause greater improvement in skeletal muscle insulin sensitivity, ii) will attenuate the usual decline in muscle mass while increasing strength, and iii) result in greater increases in left ventricular diastolic function. The long-term objective of this proposal is to provide a foundation for future studies evaluating mechanisms for the effects of exercise in cardiometabolic disease prevention and therapy.
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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- By Agoston T. Agoston, Syed Z. Ali, Mahul B. Amin, Daniel A. Arber, Pedram Argani, Sylvia L. Asa, Rebecca N. Baergen, Zubair W. Baloch, Andrew M. Bellizzi, Kurt Benirschke, Allen Burke, Kenneth B. Calder, Karen L. Chang, Rebecca D. Chernock, Wang Cheung, Thomas V. Colby, Byron P. Croker, Ronald A. DeLellis, Edward F. DiCarlo, Ralph C. Eagle, Hormoz Ehya, Brett M. Elicker, Tarik M. Elsheikh, Robert E. Fechner, Linda D. Ferrell, Melina B. Flanagan, Douglas B. Flieder, Christopher S. Foster, Lillian Gaber, Karuna Garg, Kim R. Geisinger, Ryan M. Gill, Eric F. Glassy, David J. Glembocki, Zachary D. Goodman, Robert O. Greer, David J. Grignon, Gerardo E. Guiter, Kymberly A. Gyure, Ian S. Hagemann, Michael R. Henry, Jason L. Hornick, Ralph H. Hruban, Phyllis C. Huettner, Peter A. Humphrey, Olga B. Ioffe, Edward C. Klatt, Michael J. Klein, Ernest E. Lack, James N. Lampros, Lester J. Layfield, Robin D. LeGallo, Kevin O. Leslie, James S. Lewis, Virginia A. LiVolsi, Alberto M. Marchevsky, Anne Marie McNicol, Mitra Mehrad, Elizabeth Montgomery, Cesar A. Moran, Christopher A. Moskaluk, George J. Netto, G. Petur Nielsen, Robert D. Odze, Arthur S. Patchefsky, James W. Patterson, Elizabeth N. Pavlisko, John D. Pfeifer, Celeste N. Powers, Richard A. Prayson, Anja C. Roden, Victor L. Roggli, Andrew E. Rosenberg, Sherif Said, Margie A. Scott, Raja R. Seethala, Carlie S. Sigel, Jan F. Silverman, Bruce R. Smoller, Edward B. Stelow, Nora C. J. Sun, Mark W. Teague, Satish K. Tickoo, Thomas M. Ulbright, Paul E. Wakely, Jun Wang, Lawrence M. Weiss, Mark R. Wick, Howard H. Wu, Rhonda K. Yantiss, Charles Zaloudek, Yaxia Zhang, Xiaohui Sheila Zhao
- Edited by Mark R. Wick, University of Virginia, Virginia A. LiVolsi, University of Pennsylvania School of Medicine, John D. Pfeifer, Washington University School of Medicine, St Louis, Edward B. Stelow, University of Virginia, Paul E. Wakely, Jr
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- Silverberg's Principles and Practice of Surgical Pathology and Cytopathology
- Published online:
- 13 March 2015
- Print publication:
- 26 March 2015, pp vii-x
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- By Lenard A. Adler, Pinky Agarwal, Rehan Ahmed, Jagga Rao Alluri, Fawaz Al-Mufti, Samuel Alperin, Michael Amoashiy, Michael Andary, David J. Anschel, Padmaja Aradhya, Vandana Aspen, Esther Baldinger, Jee Bang, George D. Baquis, John J. Barry, Jason J. S. Barton, Julius Bazan, Amanda R. Bedford, Marlene Behrmann, Lourdes Bello-Espinosa, Ajay Berdia, Alan R. Berger, Mark Beyer, Don C. Bienfang, Kevin M. Biglan, Thomas M. Boes, Paul W. Brazis, Jonathan L. Brisman, Jeffrey A. Brown, Scott E. Brown, Ryan R. Byrne, Rina Caprarella, Casey A. Chamberlain, Wan-Tsu W. Chang, Grace M. Charles, Jasvinder Chawla, David Clark, Todd J. Cohen, Joe Colombo, Howard Crystal, Vladimir Dadashev, Sarita B. Dave, Jean Robert Desrouleaux, Richard L. Doty, Robert Duarte, Jeffrey S. Durmer, Christyn M. Edmundson, Eric R. Eggenberger, Steven Ender, Noam Epstein, Alberto J. Espay, Alan B. Ettinger, Niloofar (Nelly) Faghani, Amtul Farheen, Edward Firouztale, Rod Foroozan, Anne L. Foundas, David Elliot Friedman, Deborah I. Friedman, Steven J. Frucht, Oded Gerber, Tal Gilboa, Martin Gizzi, Teneille G. Gofton, Louis J. Goodrich, Malcolm H. Gottesman, Varda Gross-Tsur, Deepak Grover, David A. Gudis, John J. Halperin, Maxim D. Hammer, Andrew R. Harrison, L. Anne Hayman, Galen V. Henderson, Steven Herskovitz, Caitlin Hoffman, Laryssa A. Huryn, Andres M. Kanner, Gary P. Kaplan, Bashar Katirji, Kenneth R. Kaufman, Annie Killoran, Nina Kirz, Gad E. Klein, Danielle G. Koby, Christopher P. Kogut, W. Curt LaFrance, Patrick J.M. Lavin, Susan W. Law, James L. Levenson, Richard B. Lipton, Glenn Lopate, Daniel J. Luciano, Reema Maindiratta, Robert M. Mallery, Georgios Manousakis, Alan Mazurek, Luis J. Mejico, Dragana Micic, Ali Mokhtarzadeh, Walter J. Molofsky, Heather E. Moss, Mark L. Moster, Manpreet Multani, Siddhartha Nadkarni, George C. Newman, Rolla Nuoman, Paul A. Nyquist, Gaia Donata Oggioni, Odi Oguh, Denis Ostrovskiy, Kristina Y. Pao, Juwen Park, Anastas F. Pass, Victoria S. Pelak, Jeffrey Peterson, John Pile-Spellman, Misha L. Pless, Gregory M. Pontone, Aparna M. Prabhu, Michael T. Pulley, Philip Ragone, Prajwal Rajappa, Venkat Ramani, Sindhu Ramchandren, Ritesh A. Ramdhani, Ramses Ribot, Heidi D. Riney, Diana Rojas-Soto, Michael Ronthal, Daniel M. Rosenbaum, David B. Rosenfield, Durga Roy, Michael J. Ruckenstein, Max C. Rudansky, Eva Sahay, Friedhelm Sandbrink, Jade S. Schiffman, Angela Scicutella, Maroun T. Semaan, Robert C. Sergott, Aashit K. Shah, David M. Shaw, Amit M. Shelat, Claire A. Sheldon, Anant M. Shenoy, Yelizaveta Sher, Jessica A. Shields, Tanya Simuni, Rajpaul Singh, Eric E. Smouha, David Solomon, Mehri Songhorian, Steven A. Sparr, Egilius L. H. Spierings, Eve G. Spratt, Beth Stein, S.H. Subramony, Rosa Ana Tang, Cara Tannenbaum, Hakan Tekeli, Amanda J. Thompson, Michael J. Thorpy, Matthew J. Thurtell, Pedro J. Torrico, Ira M. Turner, Scott Uretsky, Ruth H. Walker, Deborah M. Weisbrot, Michael A. Williams, Jacques Winter, Randall J. Wright, Jay Elliot Yasen, Shicong Ye, G. Bryan Young, Huiying Yu, Ryan J. Zehnder
- Edited by Alan B. Ettinger, Albert Einstein College of Medicine, New York, Deborah M. Weisbrot, State University of New York, Stony Brook
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- Book:
- Neurologic Differential Diagnosis
- Published online:
- 05 June 2014
- Print publication:
- 17 April 2014, pp xi-xx
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Contributors
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- By Benjamin Acloque, Yacine Daddi Addoun, Kofi Anyidoho, Felicitas Becker, Alice Bellagamba, Klara Boyer-Rossol, Alessandra Brivio, Benjamin Claude Brower, Francesca Declich, E. S. D. Fomin, Paolo Gaibazzi, Trevor Getz, Sandra E. Greene, Bruce S. Hall, Bayo Holsey, Hilary Jones, Martin A. Klein, George Michael La Rue, Ghislaine Lydon, Kristin Mann, Elisabeth McMahon, Ismael M. Montana, Bruce L. Mouser, Olatunji Ojo, Richard Roberts, Marie Rodet, Ute Röschenthaler, Benedetta Rossi, Dana Rush, Mohammed Bashir Salau, Ahmadou Sehou, Silke Strickrodt, Hideaki Suzuki, Jeanne Maddox Toungara, Pierluigi Valsecchi
- Edited by Alice Bellagamba, Sandra E. Greene, Cornell University, New York, Martin A. Klein, University of Toronto
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- Book:
- African Voices on Slavery and the Slave Trade
- Published online:
- 05 April 2013
- Print publication:
- 13 May 2013, pp xi-xvi
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Contributors
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- By Gregory H. Adkisson, Ozan Akça, Nawar Al-Rawas, John T. Anderson, Richard M. Bednarski, Francesca Bernabè, David G. Bjoraker, Lluis Blanch, Stephan H. Böhm, Edwin A. Bowe, Philip G. Boysen, Justin C. Cahill, Ira M. Cheifetz, David C. Cone, Nancy Craig, Daniel P. Davis, John B. Downs, Ronald Dueck, Jay L. Falk, Roger Fletcher, Michael A. Frakes, Andrea Gabrielli, Thomas J. Gallagher, Geoff Gilmartin, J. S. Gravenstein, Antonino Gullo, Donna Hamel, John W. Huang, Amy V. Isenberg, Michael B. Jaffe, Michael C. K. Khoo, Robert R. Kirby, E. F. Klein, A. Joseph Layon, Umberto Lucangelo, Emilio Maldonado, Paul E. Marik, Alicia E. Meuret, Timothy E. Morey, William Muir, Joseph A. Orr, Mehmet S. Ozcan, Lucía Isabel Passoni, David A. Paulus, Yong G. Peng, Carl W. Peters, George A. Ralls, Adriana G. Scandurra, Peter W. Scherer, Gerd Schmalisch, Adam Seiver, Salvatore Silvestri, Bob Smalhout, Fernando Suarez-Sipmann, Daniel E. Supkis, John Thompson, Patrick Troy, Jonathon D. Truwit, Gerardo Tusman, Joseph Varon, Ajeet G. Vinayak, Kevin R. Ward, Marvin A. Wayne, Charles Weissman, Dafna Willner, Kai Zhao, Christian C. Zuver
- Edited by J. S. Gravenstein, University of Florida, Michael B. Jaffe, Nikolaus Gravenstein, University of Florida, David A. Paulus, University of Florida
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- Book:
- Capnography
- Published online:
- 05 August 2011
- Print publication:
- 17 March 2011, pp ix-xii
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Contributors
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- By Robert C. Albright, Joe Arrowsmith, Constantine Athanasuleas, Ashish A Bartakke, Gerald D. Buckberg, Victoria Chilton, Simon Colah, Kevin Collins, David Cook, Kirsty Dempster, Helen Dunningham, Liza Enriquez, Betsy Evans, Steve Gray, Roger Hall, George Hallward, Charles W. Hogue, Brian Keogh, James Keogh, Andrew Klein, G. Burkhard Mackensen, Sukumaran Nair, Barbora Parizkova, Giles J Peek, Susanna Price, Linda Shore-Lesserson, Andrew Snell, Steven Tsui, John Wallwork
- Sunit Ghosh, Papworth Hospital, Cambridge, Florian Falter, Papworth Hospital, Cambridge, David J. Cook
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- Book:
- Cardiopulmonary Bypass
- Published online:
- 15 December 2009
- Print publication:
- 17 September 2009, pp vii-viii
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Sedimentary Structures in the Keuper Marl (Upper Triassic)
- George DeVries Klein
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- Journal:
- Geological Magazine / Volume 99 / Issue 2 / April 1962
- Published online by Cambridge University Press:
- 01 May 2009, pp. 137-144
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Combinations of sedimentary structures in the lacustrine Keuper Marl are segregated bathymetrically. Beds deposited below lacustrine wave base are characterized by even bedding, rhythmic lamination, disturbed stratification, graded bedding, load casts, “pull-apart” structures, and oscillation ripple marks. Lacustrine beds deposited above wave base contain even bedding, rhythmic lamination, oscillation and interference ripple marks, current lineation, rib-and-furrow structure, groove casts, mudcracks, and raindrop imprints.
A marine unit in the Keuper Marl is characterized by even bedding, flat-topped oscillation ripple marks, and air-heave structures.
Comparison with sedimentary structures of other known lacustrine deposits suggests that the combination of structures in the non-marine Keuper Marl is diagnostic of lacustrine deposits. Recognition of such combinations of sedimentary structures should aid in interpreting the origin of continental sequences.
Site-Sounds: On strategies of sound art in public space
- Georg Klein
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- Journal:
- Organised Sound / Volume 14 / Issue 1 / April 2009
- Published online by Cambridge University Press:
- 26 March 2009, pp. 101-108
- Print publication:
- April 2009
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During the mid twentieth century, space was developed as a composable dimension. Composers used the three spatial dimensions in their own fashion, but space was understood primarily as an abstract concept. It was not until the development of sound installation art that space was discovered in a concrete manner, explored, performed in and could even acquire its own specificity, called site-sound (Ortsklang).
The article shows consequences and strategies of site-sound installations in three sections – from spatial sound to site-sound, public space as performance venue, and public strategies (acoustic interventions, interactive installations and participatory projects) – with three examples of site-sound installations (Site-Sound Marl Mitte, meta.stases and towersounds.2: watch tower).
Acoustic art in public spaces basically involves installing a space in another existing space, both physically and sensorially, and metaphysically and mentally – an interior space in an exterior space, so to speak. The original quality of sound art lies in the oscillation of interior and exterior space. Thus public spaces intensified by sound art cause transitional spaces to come into being, in a political and a psychoanalytic sense.
Index
- Edited by Dwight D. Allman, Associate professor of Political Science at Baylor University.
- Olaf Georg Klein
- Translated by Ann McGlashan, Associate professor of German at Baylor University.
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- Book:
- Suddenly Everything Was Different
- Published by:
- Boydell & Brewer
- Published online:
- 11 May 2017
- Print publication:
- 15 June 2008, pp 201-210
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Suddenly Everything Was Different
- German Lives in Upheaval
- Edited by Dwight D. Allman
- Olaf Georg Klein
- Translated by Ann McGlashan
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- Published by:
- Boydell & Brewer
- Published online:
- 11 May 2017
- Print publication:
- 15 June 2008
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What happens when the world in which people have crafted identities for themselves and lived their lives suddenly disappears? How does a person -- or a nation -- confront such a shock? From 1990 to 1993, at an unparalleled moment in German history, Olaf Georg Klein interviewed almost a hundred fellow former East German citizens, probing their experiences of the sudden collapse of the German Democratic Republic, then crafting that material into twelve first-person narratives. The result is a literary account whose narrators include representatives from the cities and the countryside, from young and old, from the East German power elite and the resistance, as well as from those in position to be critical of both the GDR and united Germany. The book was a sensation in Germany upon its publication in 1994, and the translation will be of interest to students and scholars in history and political science, sociology, psychology, and literary studies. It includes an introduction and extensive annotations to assist the reader in understanding the East German and unified German contexts.
Olaf Georg Klein's novel Aftermath was published in translation by Northwestern University Press in 1999. Ann McGlashan is Associate Professor of German and Dwight D. Allman is Associate Professor of Political Science, both at Baylor University.
Frontmatter
- Edited by Dwight D. Allman, Associate professor of Political Science at Baylor University.
- Olaf Georg Klein
- Translated by Ann McGlashan, Associate professor of German at Baylor University.
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- Book:
- Suddenly Everything Was Different
- Published by:
- Boydell & Brewer
- Published online:
- 11 May 2017
- Print publication:
- 15 June 2008, pp i-iv
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Works Consulted & Cited
- Edited by Dwight D. Allman, Associate professor of Political Science at Baylor University.
- Olaf Georg Klein
- Translated by Ann McGlashan, Associate professor of German at Baylor University.
-
- Book:
- Suddenly Everything Was Different
- Published by:
- Boydell & Brewer
- Published online:
- 11 May 2017
- Print publication:
- 15 June 2008, pp 199-200
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Contents
- Edited by Dwight D. Allman, Associate professor of Political Science at Baylor University.
- Olaf Georg Klein
- Translated by Ann McGlashan, Associate professor of German at Baylor University.
-
- Book:
- Suddenly Everything Was Different
- Published by:
- Boydell & Brewer
- Published online:
- 11 May 2017
- Print publication:
- 15 June 2008, pp v-vi
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3 - “You should know I won't be blackmailed …”
- from Suddenly Everything was Different: German Lives in Upheaval
- Edited by Dwight D. Allman, Associate professor of Political Science at Baylor University.
- Olaf Georg Klein
- Translated by Ann McGlashan, Associate professor of German at Baylor University.
-
- Book:
- Suddenly Everything Was Different
- Published by:
- Boydell & Brewer
- Published online:
- 11 May 2017
- Print publication:
- 15 June 2008, pp 31-45
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Summary
— Protestant country pastor, born 1925
There are days you never forget. For instance, March 9, 1960; that was a Wednesday. I remember it to this day. Because it's unusual to have funerals on a Sunday, but on Sunday March 6, in K., I buried an old farmer. Back then funeral services were still held in the home, with an open coffin. Only after everything was over was the coffin closed and carried out. Afterwards, there was the usual coffee drinking, and the atmosphere was very subdued. Normally, you see, gatherings after funerals were quite lighthearted affairs. But the undercurrent was: “Today we buried the last free farmer.” Because these “recruitment teams” would come from Rostock and on Wednesday they were ensconced here in our town. They consisted of three or four men who went from farm to farm and, first in a friendly fashion then later by force, made people sign. Some signed immediately. Those who held out were taken to the offices of the local authority. The council chairman at the time turned up as well and gave the recalcitrants a good talking to. They said to Farmer Linkshofen, who stood firm until the end: “If you don't sign — and you don't have to — then we'll fence in your land, we'll brick up your chimney, and then you can see how you get on.” That's the kind of tactics they used. In the end, they all signed.
There was a church service again the next Sunday. What an uproar! What had I said? That we had had a very emotional week, something like that, and I also talked about injustice.
“As far as I'm concerned, large-scale agriculture might make sense. But not the way it's happening here.”
But it only became really bad when, a little later, all the animals were driven out of their stalls. The horses, the cows, the animals the farmer depends on, you know. And how the animals were treated on the collective farms! The food they got! The horses disappeared right away, the good milk cows were ruined in a very short time. And the farmers had to watch all this happen.