15 results
12 Measuring effort on a continuum provides improved insight into concussion baseline cognitive assessments
- Heather C. Bouchard, Kate L. Higgins, Julia E. Maietta, Julia M. Laing, Douglas H. Schultz
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 889-890
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Objective:
Baseline assessment of cognitive performance is common practice under many concussion management protocols and is required for collegiate athletes by the NCAA. The purpose of baseline cognitive assessment is to understand an athlete’s individual uninjured cognitive performance, as opposed to using population normative data. This baseline can then serve as a reference point for recovery after concussion and can inform return-to-play decisions. However, multiple factors, including lack of effort, can contribute to misrepresentation of baseline results which raises concern for reliability during return-to-play decision-making. Measuring effort across a continuum, rather than as a dichotomous variable (good versus poor effort) may provide informative insight related to cognitive performance at baseline.
Participants and Methods:Collegiate athletes (n = 231) completed the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) as part of their baseline pre-participation concussion evaluation. ImPACT creates composite scores of Verbal Memory, Visual Memory, Visual-Motor Speed, and Reaction Time. Baseline self-reported symptoms and total hours of sleep the night prior to testing are also collected through ImPACT. ImPACT has one embedded indicator within the program to assess effort, and research has identified an additional three embedded indicators. Athletes were also administered one stand-alone performance validity test, either the Medical Symptom Validity Test (n = 130) or the Rey Dot Counting Test (n = 101), to independently measure effort. Effort was estimated across a continuum (zero, one, two, or three or more failed effort indicators) with both stand-alone and embedded effort indicators. We evaluated the relationship between effort, symptoms, self-reported sleep, Reaction Time composite score and Visual-Motor Speed composite score using a linear regression model.
Results:We found that 121 athletes passed all effort indicators, while 39 athletes failed only one effort indicator, 40 athletes failed two effort indicators, and 31 athletes failed three or four (three+) effort indicators. Self-reported symptoms and total hours of sleep were not related to effort, but Reaction Time and VisualMotor Speed composites were. Specifically, performance on the Visual-Motor Speed composite was significantly worse for athletes who failed two or three+ effort indicators compared to athletes who did not fail any, and performance on the Reaction Time composite was significantly worse only for athletes who failed three+ effort indicators. Additionally, athletes who failed one or more effort indicators and reported less sleep performed worse on both the Visual-Motor Speed and Reaction Time composites, compared to those who reported less sleep and did not fail any effort indicators.
Conclusions:Athletes who failed one effort indicator did not perform significantly worse on Reaction Time and Visual-Motor Speed composites compared to those who passed all effort indicators. However, 31% of athletes failed two or more effort indicators and these athletes performed worse on cognitive tests, likely due to factors impacting their ability to put forth good effort. These results suggest that effort is more complex than a previously used dichotomous variable and highlights the importance of using several indicators of effort throughout baseline assessments. In addition, the importance of sleep should be emphasized during baseline assessments, especially when effort is questionable.
Prehospital Modified HEART Score Predictive of 30-Day Adverse Cardiac Events
- Jason P. Stopyra, William S. Harper, Tyson J. Higgins, Julia V. Prokesova, James E. Winslow, Robert D. Nelson, Roy L. Alson, Christopher A. Davis, Gregory B. Russell, Chadwick D. Miller, Simon A. Mahler
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- Journal:
- Prehospital and Disaster Medicine / Volume 33 / Issue 1 / February 2018
- Published online by Cambridge University Press:
- 10 January 2018, pp. 58-62
- Print publication:
- February 2018
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Introduction
The History, Electrocardiogram (ECG), Age, Risk Factors, and Troponin (HEART) score is a decision aid designed to risk stratify emergency department (ED) patients with acute chest pain. It has been validated for ED use, but it has yet to be evaluated in a prehospital setting.
HypothesisA prehospital modified HEART score can predict major adverse cardiac events (MACE) among undifferentiated chest pain patients transported to the ED.
MethodsA retrospective cohort study of patients with chest pain transported by two county-based Emergency Medical Service (EMS) agencies to a tertiary care center was conducted. Adults without ST-elevation myocardial infarction (STEMI) were included. Inter-facility transfers and those without a prehospital 12-lead ECG or an ED troponin measurement were excluded. Modified HEART scores were calculated by study investigators using a standardized data collection tool for each patient. All MACE (death, myocardial infarction [MI], or coronary revascularization) were determined by record review at 30 days. The sensitivity and negative predictive values (NPVs) for MACE at 30 days were calculated.
ResultsOver the study period, 794 patients met inclusion criteria. A MACE at 30 days was present in 10.7% (85/794) of patients with 12 deaths (1.5%), 66 MIs (8.3%), and 12 coronary revascularizations without MI (1.5%). The modified HEART score identified 33.2% (264/794) of patients as low risk. Among low-risk patients, 1.9% (5/264) had MACE (two MIs and three revascularizations without MI). The sensitivity and NPV for 30-day MACE was 94.1% (95% CI, 86.8-98.1) and 98.1% (95% CI, 95.6-99.4), respectively.
ConclusionsPrehospital modified HEART scores have a high NPV for MACE at 30 days. A study in which prehospital providers prospectively apply this decision aid is warranted.
,Stopyra JP ,Harper WS ,Higgins TJ ,Prokesova JV ,Winslow JE ,Nelson RD ,Alson RL ,Davis CA ,Russell GB ,Miller CD .Mahler SA Prehospital Modified HEART Score Predictive of 30-Day Adverse Cardiac Events . Prehosp Disaster Med.2018 ;33 (1 ):58 –62 .
Service users’ experiences of mental health tribunals in Ireland: a qualitative analysis
- R. Murphy, D. McGuinness, E. Bainbridge, L. Brosnan, M. Keys, H. Felzmann, K. Murphy, B. Hallahan, A. Higgins, C. McDonald
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- Journal:
- Irish Journal of Psychological Medicine / Volume 34 / Issue 4 / December 2017
- Published online by Cambridge University Press:
- 15 June 2017, pp. 233-242
- Print publication:
- December 2017
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Objectives
To explore the mental health tribunal experiences of people admitted involuntarily under the Mental Health Act 2001.
MethodsEmploying a qualitative descriptive study design, data were collected from 23 service users who had experienced mental health tribunals during a recent involuntary admission. Face-to-face semi-structured interviews were conducted ~3 months post-revocation of their involuntary admission order. Data were analysed using an inductive thematic process.
ResultsThe majority of participants reported mixed experiences comprising positive and negative aspects in relation to information provision, emotional support and an inclusive atmosphere. Some participants reported receiving accessible information about the tribunal process, felt emotionally supported throughout, and encountered respectful and dignifying practices during the tribunal proceedings. However, many participants described experiencing non-inclusive practices, reported feeling ill-informed regarding the tribunal process, emotionally unsupported during and after the tribunal, and distressed by what they perceived as adversarial tribunal proceedings.
ConclusionsSystemic changes could ensure that the positive experiences encountered by the minority of participants in this study are more consistently experienced. Ongoing education and training of stakeholders in the provision of inclusive tribunal practices, and the provision of accessible information and emotional support to service users through the stages of the involuntary admission process appear likely to be beneficial. Service users should automatically be offered the option of having a support person of their choosing present during tribunals.
Bahiagrass (Paspalum notatum) Seedhead Suppression Following Consecutive Yearly Applications of Plant Growth Retardants
- Robert D. Baker, Lambert B. McCarty, Daniel L. Colvin, Jeffery M. Higgins, Jan S. Weinbrecht, Jorge E. Moreno
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- Journal:
- Weed Technology / Volume 13 / Issue 2 / June 1999
- Published online by Cambridge University Press:
- 12 June 2017, pp. 378-384
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Field trials evaluated sequential applications of plant growth retardants (PGRs) to bahiagrass for a 3-yr period at two Florida locations: Newberry (north Florida) and Okeechobee (south Florida). Seven PGRs from various chemical families were used: glyphosate, fluazifop, sethoxydim, maleic hydrazide, trinexapac-ethyl, imazapic, and imazaquin. In 1991 and 1992, PGRs reduced turf color for 2 to 4 wk after treatment (WAT) at the Newberry location but remained above acceptable levels (> 5.0) and recovered by 6 WAT. In 1993, glyphosate, fluazifop, and maleic hydrazide reduced turf color below acceptable levels (< 5.0) 4 WAT, but turf color was acceptable by 6 WAT. Turf color was slightly reduced following single and sequential imazapic applications in Okeechobee; however, turf recovered by 8 WAT. Cumulative seedhead suppression at both locations increased during the 3 yr resulting in at least a 60% reduction in seedhead numbers. Seedhead production each year was 10 to 50% less at 12 WAT in treated plots than in the previous year. Single applications of imazapic and imazapic + imazaquin provided 85 to 100% seedhead suppression for 12 WAT and 100% suppression for up to 16 wk following sequential applications made 8 wk after the initial application (WAI). Single applications of glyphosate, fluazifop, and maleic hydrazide provided ≥ 70% seedhead suppression for 4 to 8 WAT. Sequential applications of fluazifop made 8 WAI provided > 70% control of seedheads through 8 to 16 WAI for 3 yr.
Climate archives from 90 to 250 ka in horizontal and vertical ice cores from the Allan Hills Blue Ice Area, Antarctica
- Nicole E. Spaulding, John A. Higgins, Andrei V. Kurbatov, Michael L. Bender, Steven A. Arcone, Seth Campbell, Nelia W. Dunbar, Laura M. Chimiak, Douglas S. Introne, Paul A. Mayewski
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- Journal:
- Quaternary Research / Volume 80 / Issue 3 / November 2013
- Published online by Cambridge University Press:
- 20 January 2017, pp. 562-574
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Terrestrial meteorite ages indicate that some ice at the Allan Hills blue ice area (AH BIA) may be as old as 2.2 Ma. As such, ice from the AH BIA could potentially be used to extend the ice core record of paleoclimate beyond 800 ka. We collected samples from 5 to 10 cm depth along a 5 km transect through the main icefield and drilled a 225 m ice core (S27) at the midpoint of the transect to develop the climate archive of the AH BIA. Stable water isotope measurements (δD) of the surface chips and of ice core S27 yield comparable signals, indicating that the climate record has not been significantly altered in the surface ice. Measurements of 40Aratm and δ18Oatm taken from ice core S27 and eight additional shallow ice cores constrain the age of the ice to approximately 90–250 ka. Our findings provide a framework around which future investigations of potentially older ice in the AH BIA could be based.
Opinions of key stakeholders concerning involuntary admission of patients under the Mental Health Act 2001
- I. Georgieva, E. Bainbridge, D. McGuinness, M. Keys, L. Brosnan, H. Felzmann, J. Maguire, K. Murphy, A. Higgins, C. McDonald, B. Hallahan
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- Journal:
- Irish Journal of Psychological Medicine / Volume 34 / Issue 4 / December 2017
- Published online by Cambridge University Press:
- 12 February 2016, pp. 223-232
- Print publication:
- December 2017
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Objectives
To evaluate and compare the opinions of key stakeholders involved in the involuntary admission and treatment of patients under the Mental Health Act (MHA) 2001 regarding their views towards the operation of the legislation.
MethodsWe employed a descriptive survey design. A questionnaire was distributed to stakeholders involved in the operation of the MHA 2001 (except service users, whose views were explored in a separate qualitative study) via paper or online versions evaluating their opinions regarding the operation of the MHA 2001 in relation to assessment, care, rights, transfer and information available.
ResultsStakeholders agreed that in their opinion that patients generally benefit from the care they receive (79%) and that the MHA 2001 ensures an independent and fair review of the person’s detention (65%). However, only 23% of stakeholders were satisfied with the process of transferring patients to hospital and with the clinical assessment procedures therein (37%), with the greatest levels of dissatisfaction amongst Gardai (Police), general practitioners (GPs) and family members.
ConclusionsWhile the introduction of the MHA 2001 has assisted delivery of care to patients with improved adherence to international human rights frameworks applicable at the time of its enactment, substantial dissatisfaction with the implementation of the MHA 2001 in practice is experienced by stakeholders particularly at the distressing phase of clinical assessment and transfer to hospital.
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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Single Dose versus Fractionated Stereotactic Radiotherapy for Meningiomas
- Simon S. Lo, Kwan H. Cho, Walter A. Hall, Ronald J. Kossow, Wilson L. Hernandez, Kim K. McCollow, Bruce J. Gerbi, Patrick D. Higgins, Chung K. Lee, Kathryn E. Dusenbery
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 29 / Issue 3 / August 2002
- Published online by Cambridge University Press:
- 02 December 2014, pp. 240-248
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Objective:
To evaluate the safety and efficacy of stereotactic radiosurgery (SRS) compared to fractionated stereotactic radiation therapy (FSRT) for meningiomas treated over a seven year period.
Methods and materials:Of the 53 patients (15 male and 38 female) with 63 meningiomas, 35 were treated with SRS and the 18 patients with tumors adjacent to critical structures or with large tumors were treated with FSRT. The median doses for the SRS and the FSRT groups were 1400 cGy (500- 4500 cGy) and 5400 cGy (4000-6000 cGy) respectively. Median target volumes for SRS and FSRT were 6.8 ml and 8.8 ml respectively. The median follow-up for the SRS and FSRT groups were 38 months (4.1-97 months) and 30.5 months (6.0-63 months) respectively.
Results:The five-year tumor control probability (TC) for benign versus atypical meningiomas were 92.7% vs. 31% (P=.006). The three-year TC were 92.7% vs. 93.3% for SRS vs. FSRT groups respectively (P=.62). For benign meningiomas, the three-year TC were 92.9% vs. 92.3% for the SRS group (29 patients) vs. FSRT group (14 patients) respectively (P=.77). Two patients in the SRS group and one in the FSRT group developed late complications.
Conclusion:Preliminary data suggest that SRS is a safe and effective treatment for patients with benign meningiomas. Fractionated stereotactic radiation therapy with conventional fractionation appeared to be an effective and safe treatment alternative for patients not appropriate for SRS. A longer follow-up is required to determine the long-term efficacy and the toxicity of these treatment modalities.
MANAGEMENT OF REDUCED FETAL MOVEMENTS
- L E HIGGINS, E D JOHNSTONE, A E P HEAZELL
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- Journal:
- Fetal and Maternal Medicine Review / Volume 24 / Issue 4 / November 2013
- Published online by Cambridge University Press:
- 29 November 2013, pp. 201-231
- Print publication:
- November 2013
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Reduced fetal movement (RFM) is commonly defined as any reduction in maternal perception of fetal activity. Perceived fetal activity may be movement of limbs, trunk or head movement, but excludes fetal hiccoughs (as this is involuntary movement). The perception of fetal movement by an expectant mother is the first, and ongoing, non-sonographic indicator of fetal viability. The “normal” pattern of fetal movements varies from pregnancy to pregnancy, and often does not become established until 28 weeks’ gestation. Many babies have particularly active periods of the day, usually corresponding to periods of maternal rest and inactivity (which may in itself reflect increased maternal awareness of fetal movement). A variable percentage of sonographically observed fetal movements are perceived by prospective mothers (commonly 30–40%, although some studies report rates as high as 80%).
Collaboration between Civilian and Military Healthcare Professionals: A Better Way for Planning, Preparing, and Responding to All Hazard Domestic Events
- LeRoy A. Marklund, Adrienne M. Graham, Patricia G. Morton, Charles G. Hurst, Ivette Motola, Donald W. Robinson, Vivian A. Kelley, Kimberly J. Elenberg, Michael F. Russler, Daniel E. Boehm, Jr, Dawn M. Higgins, Patrick E. McAndrew, Hope M. Williamson, Rodney D. Atwood, Kermit D. Huebner, Angel A. Brotons, Geoffrey T. Miller, Laukton Y. Rimpel, Larry L. Harris, Manuel Santiago, LeRoy Cantrell
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- Journal:
- Prehospital and Disaster Medicine / Volume 25 / Issue 5 / October 2010
- Published online by Cambridge University Press:
- 28 June 2012, pp. 399-412
- Print publication:
- October 2010
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Collaboration is used by the US National Security Council as a means to integrate inter-federal government agencies during planning and execution of common goals towards unified, national security. The concept of collaboration has benefits in the healthcare system by building trust, sharing resources, and reducing costs. The current terrorist threats have made collaborative medical training between military and civilian agencies crucial.
This review summarizes the long and rich history of collaboration between civilians and the military in various countries and provides support for the continuation and improvement of collaborative efforts. Through collaboration, advances in the treatment of injuries have been realized, deaths have been reduced, and significant strides in the betterment of the Emergency Medical System have been achieved. This review promotes collaborative medical training between military and civilian medical professionals and provides recommendations for the future based on medical collaboration.
Childbearing after age 35: its effect on early perinatal outcomes
- Judith A. Fortney, J. E. Higgins, A. Diaz-Infante, F. Hefnawi, L. G. Lampe, I. Batar
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- Journal:
- Journal of Biosocial Science / Volume 14 / Issue 1 / January 1982
- Published online by Cambridge University Press:
- 31 July 2008, pp. 69-80
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Births to women aged 35 years and older are compared with births to women aged 20–34 in three hospitals, one each in Mexico, Egypt and Hungary. In the two developing countries, babies born to the older women had lower rates of survival until hospital discharge, and were more likely to have depressed 5-minute Apgar scores. They were not, however, more likely to be of low birth weight. The differences were statistically significant, and remained when several other variables were controlled. The variables controlled were known to be age-related and to influence pregnancy outcome.
Hungary, the only developed country in the analysis, was quite different. Age had a significant influence on the weight of the infant, but not on survival or Apgar score. It seems therefore that when older women are in general good health and there are no concurrent social risk factors, advanced maternal age does not necessarily increase the risk of an adverse pregnancy outcome.
A long-term observational study of the impact of badger removal on herd restrictions due to bovine TB in the Irish midlands during 1989–2004
- G. E. KELLY, J. CONDON, S. J. MORE, L. DOLAN, I. HIGGINS, J. EVES
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- Journal:
- Epidemiology & Infection / Volume 136 / Issue 10 / October 2008
- Published online by Cambridge University Press:
- 17 December 2007, pp. 1362-1373
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An observational study was carried out, using data collected from four areas in the Irish midlands, between 1989 and 2004, to critically evaluate the long-term effects of proactive badger culling and to provide insights into reactive badger culling tuberculosis (TB) prevalence in cattle. Confirmed cattle herd TB incidence is the outcome measure used throughout. Relative to reactive culling, proactive badger culling was associated with a decrease in incidence in each of the 16 years of observation, which encompassed periods of both intensive and less-intensive badger removal. By 2004, we observed a decrease of 22% [95% confidence interval (CI) 15–29, P<0·001] in the entire proactive and 37% (95% CI 25–47, P<0·001), in the inner proactive removal areas. The size of the decrease increased with time (P=0·055). There was a decrease (constant over time) of at least 14% (95% CI 76–97, P=0·013) in incidence in the inner compared to the outer control area (herds ⩽2 km, >2 km, from proactive removal area boundaries, respectively). Incidence in the outer proactive removal area (herds <1·6 km from the proactive removal boundary) was similar to the inner control area (P=0·890). Incidence in the outer control area and total control area, compared to a neighbouring area some distance away, increased over the course of the study. Differences with the total control area were not statistically significant but the outer control area was 11% higher than the neighbouring area by 2004 (borderline significance P=0·057).
6 - The Poor in the Mid-Nineteenth-Century Northeastern United States: Evidence from the Monroe County Almshouse, Rochester, New York
- Edited by Richard H. Steckel, Ohio State University, Jerome C. Rose, University of Arkansas
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- The Backbone of History
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- 01 March 2010
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- 26 August 2002, pp 162-184
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Summary
ABSTRACT
Data were collected from254 skeletons at the Monroe County Almshouse in Rochester, NewYork, dating from1826–1863.Additional evidence was used to calculate mortality rates for paupers (Brighton Town Clerk's Records) and the general population of the City of Rochester (Mount Hope records and census data). Because death rates were so high at the almshouse, the signs of biological stress observed in the skeletons, with the possible exception of infants, were probably not the result of institutionalization but, rather, the result of nutritional inadequacies or diseases experienced outside the almshouse. Documentary evidence indicates that mortality in the City of Rochester around the middle of the nineteenth century was highly variable and characterized by considerable infectious and parasitic diseases. Infant and early childhood mortality was severe. At the Monroe County Almshouse almost one-half of the subadults (as evidenced in both the skeletal collection and the BTC Record) died within the first year of life.
The health index for the sample is 72.3% of the possible maximum score, which is higher than that for the St. Thomas' Anglican Church sample. Documentary evidence, when available, should be included in the overall assessment of health among skeletal samples. It is evident from the Brighton Town Clerk's record that acute infectious disease played a major role in the mortality experience of almshouse residents, a situation that was not incorporated into the Mark I version of the index. In some respects, inmates of the almshouse do not appear much different from the population in general, for example, with respect to the stature of adult males.
Calving outcome following transfer of in vivo or in vitro produced bovine embryos
- K. L. Goodhand, D. F. Dolman, R. G. Watt, L. C. Higgins, M. E. Staines, P. J. Broadbent
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- Proceedings of the British Society of Animal Science / Volume 1997 / 1997
- Published online by Cambridge University Press:
- 05 November 2021, p. 34
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- 1997
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Embryo culture or manipulation can severely influence fetal development resulting in increased gestation length and unusually large offspring (Walker et al, 1996). The aim of this study was to compare the effect of transferring in vivo or in vitro produced bovine embryos on gestation length, calf sex, birth weight and calving ease.
The Physicochemical Properties Of Vpi-7: A Microporous Zincosilicate With Three-Membered Rings
- Michael J. Annen, Mark E. Davis, John B. Higgins, John L. Schlenker
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- Journal:
- MRS Online Proceedings Library Archive / Volume 233 / 1991
- Published online by Cambridge University Press:
- 15 February 2011, 245
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- 1991
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The synthesis of materials with void volumes in excess of 50% is an ongoing challenge in molecular sieve science. It has been shown that a correlation exists between the minimum framework density (FD) and the smallest ring in which all tetrahedral atoms reside (MINR). Based on this evidence it appears that materials containing 3-membered rings (3MR) will be necessary in order to obtain FDs lower than those currently attainable. Several framework beryllosilicate minerals including the natural zeolite, lovdarite, contain 3MRs. Unfortunately, beryllium can form highly toxic compounds that limit its suitability for many applications. Thus, in this study we have searched for a replacement for Be and have found that zinc is a suitable substitute with respect to the formation of three-membered rings.
We report here VPI-7, a novel zincosilicate molecular sieve which contains three-membered rings. The VPI-7 framework contains rings composed of 3–, 4– and 5 T-atoms which form unidimensional 8– and intersecting 9MR channels.