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A Canadian National Survey of the Neurosurgical Management of Intracranial Abscesses
- Michelle M. Kameda-Smith, Malavan Ragulojan, Shannon Hart, Taylor R. Duda, Mark A. MacLean, Jonathan Chainey, Minoo Aminnejad, Michael Rizzuto, David Bergeron, Mathew Eagles, Alan Chalil, Anne-Mare Langlois, Charles Gariepy, Amit Persad, Mohammed Hasen, Alick Wang, Lior Elkaim, Sean Christie, Forough Farrokhyar, Kesava Reddy
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 50 / Issue 5 / September 2023
- Published online by Cambridge University Press:
- 03 October 2022, pp. 679-686
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Objective:
Intracerebral abscess is a life-threatening condition for which there are no current, widely accepted neurosurgical management guidelines. The purpose of this study was to investigate Canadian practice patterns for the medical and surgical management of primary, recurrent, and multiple intracerebral abscesses.
Methods:A self-administered, cross-sectional, electronic survey was distributed to active staff and resident members of the Canadian Neurosurgical Society and Canadian Neurosurgery Research Collaborative. Responses between subgroups were analyzed using the Chi-square test.
Results:In total, 101 respondents (57.7%) completed the survey. The majority (60.0%) were staff neurosurgeons working in an academic, adult care setting (80%). We identified a consensus that abscesses >2.5 cm in diameter should be considered for surgical intervention. The majority of respondents were in favor of excising an intracerebral abscess over performing aspiration if located superficially in non-eloquent cortex (60.4%), located in the posterior fossa (65.4%), or causing mass effect leading to herniation (75.3%). The majority of respondents were in favor of reoperation for recurrent abscesses if measuring greater than 2.5 cm, associated with progressive neurological deterioration, the index operation was an aspiration and did not include resection of the abscess capsule, and if the recurrence occurred despite prior surgery combined with maximal antibiotic therapy. There was no consensus on the use of topical intraoperative antibiotics.
Conclusion:This survey demonstrated heterogeneity in the medical and surgical management of primary, recurrent, and multiple brain abscesses among Canadian neurosurgery attending staff and residents.1
A community–university run conference as a catalyst for addressing health disparities in an urban community
- Timothy F. Murphy, Rita Hubbard Robinson, Kelly M. Wofford, Alan J. Lesse, Susan Grinslade, Henry L. Taylor, Jr., Kinzer M. Pointer, George F. Nicholas, Heather Orom
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- Journal:
- Journal of Clinical and Translational Science / Volume 6 / Issue 1 / 2022
- Published online by Cambridge University Press:
- 06 May 2022, e67
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The African American population of Buffalo, New York experiences striking race-based health disparities due to adverse social determinants of health. A team of community leaders and university faculty determined that a community dialogue was needed to focus research and advocacy on the root causes of these disparities. In response, we organized the annual Igniting Hope conference series that has become the premier conference on health disparities in the region. The series, now supported by an R13 conference grant from NCATS, has been held four times (2018–2021) and has attracted community members, community leaders, university faculty, and trainees. The agenda includes talks by national leaders and breakout/working groups that led to a new state law that has reduced disproportionate traffic-ticketing and drivers' license suspensions in Black neighborhoods; mitigation of the disproportionate COVID-19 fatalities in Black communities; and the launching of a university-supported institute. We describe the key elements of success for a conference series designed by a community–university partnership to catalyze initiatives that are having an impact on social determinants of health in Buffalo.
Olfactory impairment in mild cognitive impairment with Lewy bodies and Alzheimer’s disease
- Alan J. Thomas, Calum A. Hamilton, Sally Barker, Rory Durcan, Sarah Lawley, Nicola Barnett, Michael Firbank, Gemma Roberts, Louise M. Allan, John O’Brien, John-Paul Taylor, Paul C. Donaghy
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- Journal:
- International Psychogeriatrics / Volume 34 / Issue 6 / June 2022
- Published online by Cambridge University Press:
- 20 October 2021, pp. 585-592
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Objectives:
Impaired olfaction may be a biomarker for early Lewy body disease, but its value in mild cognitive impairment with Lewy bodies (MCI-LB) is unknown. We compared olfaction in MCI-LB with MCI due to Alzheimer’s disease (MCI-AD) and healthy older adults. We hypothesized that olfactory function would be worse in probable MCI-LB than in both MCI-AD and healthy comparison subjects (HC).
Design:Cross-sectional study assessing olfaction using Sniffin’ Sticks 16 (SS-16) in MCI-LB, MCI-AD, and HC with longitudinal follow-up. Differences were adjusted for age, and receiver operating characteristic (ROC) curves were used for discriminating MCI-LB from MCI-AD and HC.
Setting:Participants were recruited from Memory Services in the North East of England.
Participants:Thirty-eight probable MCI-LB, 33 MCI-AD, 19 possible MCI-LB, and 32HC.
Measurements:Olfaction was assessed using SS-16 and a questionnaire.
Results:Participants with probable MCI-LB had worse olfaction than both MCI-AD (age-adjusted mean difference (B) = 2.05, 95% CI: 0.62–3.49, p = 0.005) and HC (B = 3.96, 95% CI: 2.51–5.40, p < 0.001). The previously identified cutoff score for the SS-16 of ≤ 10 had 84% sensitivity for probable MCI-LB (95% CI: 69–94%), but 30% specificity versus MCI-AD. ROC analysis found a lower cutoff of ≤ 7 was better (63% sensitivity for MCI-LB, with 73% specificity vs MCI-AD and 97% vs HC). Asking about olfactory impairments was not useful in identifying them.
Conclusions:MCI-LB had worse olfaction than MCI-AD and normal aging. A lower cutoff score of ≤ 7 is required when using SS-16 in such patients. Olfactory testing may have value in identifying early LB disease in memory services.
Mild cognitive impairment with Lewy bodies: neuropsychiatric supportive symptoms and cognitive profile
- Paul C Donaghy, Joanna Ciafone, Rory Durcan, Calum A Hamilton, Sally Barker, Jim Lloyd, Michael Firbank, Louise M Allan, John T O'Brien, John-Paul Taylor, Alan J Thomas
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- Journal:
- Psychological Medicine / Volume 52 / Issue 6 / April 2022
- Published online by Cambridge University Press:
- 25 August 2020, pp. 1147-1155
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Background
Recently published diagnostic criteria for mild cognitive impairment with Lewy bodies (MCI-LB) include five neuropsychiatric supportive features (non-visual hallucinations, systematised delusions, apathy, anxiety and depression). We have previously demonstrated that the presence of two or more of these symptoms differentiates MCI-LB from MCI due to Alzheimer's disease (MCI-AD) with a likelihood ratio >4. The aim of this study was to replicate the findings in an independent cohort.
MethodsParticipants ⩾60 years old with MCI were recruited. Each participant had a detailed clinical, cognitive and imaging assessment including FP-CIT SPECT and cardiac MIBG. The presence of neuropsychiatric supportive symptoms was determined using the Neuropsychiatric Inventory (NPI). Participants were classified as MCI-AD, possible MCI-LB and probable MCI-LB based on current diagnostic criteria. Participants with possible MCI-LB were excluded from further analysis.
ResultsProbable MCI-LB (n = 28) had higher NPI total and distress scores than MCI-AD (n = 30). In total, 59% of MCI-LB had two or more neuropsychiatric supportive symptoms compared with 9% of MCI-AD (likelihood ratio 6.5, p < 0.001). MCI-LB participants also had a significantly greater delayed recall and a lower Trails A:Trails B ratio than MCI-AD.
ConclusionsMCI-LB is associated with significantly greater neuropsychiatric symptoms than MCI-AD. The presence of two or more neuropsychiatric supportive symptoms as defined by MCI-LB diagnostic criteria is highly specific and moderately sensitive for a diagnosis of MCI-LB. The cognitive profile of MCI-LB differs from MCI-AD, with greater executive and lesser memory impairment, but these differences are not sufficient to differentiate MCI-LB from MCI-AD.
Clinical diagnosis of Lewy body dementia
- Ajenthan Surendranathan, Joseph P. M. Kane, Allison Bentley, Sally A. H. Barker, John-Paul Taylor, Alan J. Thomas, Louise M. Allan, Richard J. McNally, Peter W. James, Ian G. McKeith, David J. Burn, John T. O'Brien
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- Journal:
- BJPsych Open / Volume 6 / Issue 4 / July 2020
- Published online by Cambridge University Press:
- 16 June 2020, e61
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Background
Lewy body dementia, consisting of both dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD), is considerably under-recognised clinically compared with its frequency in autopsy series.
AimsThis study investigated the clinical diagnostic pathways of patients with Lewy body dementia to assess if difficulties in diagnosis may be contributing to these differences.
MethodWe reviewed the medical notes of 74 people with DLB and 72 with non-DLB dementia matched for age, gender and cognitive performance, together with 38 people with PDD and 35 with Parkinson's disease, matched for age and gender, from two geographically distinct UK regions.
ResultsThe cases of individuals with DLB took longer to reach a final diagnosis (1.2 v. 0.6 years, P = 0.017), underwent more scans (1.7 v. 1.2, P = 0.002) and had more alternative prior diagnoses (0.8 v. 0.4, P = 0.002), than the cases of those with non-DLB dementia. Individuals diagnosed in one region of the UK had significantly more core features (2.1 v. 1.5, P = 0.007) than those in the other region, and were less likely to have dopamine transporter imaging (P < 0.001). For patients with PDD, more than 1.4 years prior to receiving a dementia diagnosis: 46% (12 of 26) had documented impaired activities of daily living because of cognitive impairment, 57% (16 of 28) had cognitive impairment in multiple domains, with 38% (6 of 16) having both, and 39% (9 of 23) already receiving anti-dementia drugs.
ConclusionsOur results show the pathway to diagnosis of DLB is longer and more complex than for non-DLB dementia. There were also marked differences between regions in the thresholds clinicians adopt for diagnosing DLB and also in the use of dopamine transporter imaging. For PDD, a diagnosis of dementia was delayed well beyond symptom onset and even treatment.
Compositional principal component analysis generates gut microbiota profiles that associate with children's diet and body composition
- Claudia Leong, Jillian J. Haszard, Anne-Louise M. Heath, Gerald W. Tannock, Blair Lawley, Sonya L. Cameron, Ewa A. Szymlek-Gay, Andrew R. Gray, Barry J. Taylor, Barbara C. Galland, Julie A. Lawrence, Anna Otal, Alan Hughes, Rachael W Taylor
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- Journal:
- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E284
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Gut microbiota data obtained by DNA sequencing are not only complex because of the number of taxa that may be detected within human cohorts, but also compositional because characteristics of the microbiota are described in relative terms (e.g., “relative abundance” of particular bacterial taxa expressed as a proportion of the total abundance of taxa). Nutrition researchers often use standard principal component analysis (PCA) to derive dietary patterns from complex food data, enabling each participant's diet to be described in terms of the extent to which it fits their cohort's dietary patterns. However, compositional PCA methods are not commonly used to describe patterns of microbiota in the way that dietary patterns are used to describe diets. This approach would be useful for identifying microbiota patterns that are associated with diet and body composition. The aim of this study is to use compositional PCA to describe gut microbiota profiles in 5 year old children and explore associations between microbiota profiles, diet, body mass index (BMI) z-score, and fat mass index (FMI) z-score. This study uses a cross-sectional data for 319 children who provided a faecal sample at 5 year of age. Their primary caregiver completed a 123-item quantitative food frequency questionnaire validated for foods of relevance to the gut microbiota. Body composition was determined using dual-energy x-ray absorptiometry, and BMI and FMI z-scores calculated. Compositional PCA identified and described gut microbiota profiles at the genus level, and profiles were examined in relation to diet and body size. Three gut microbiota profiles were found. Profile 1 (positive loadings on Blautia and Bifidobacterium; negative loadings on Bacteroides) was not related to diet or body size. Profile 2 (positive loadings on Bacteroides; negative loadings on uncultured Christensenellaceae and Ruminococcaceae) was associated with a lower BMI z-score (r = -0.16, P = 0.003). Profile 3 (positive loadings on Faecalibacterium, Eubacterium and Roseburia) was associated with higher intakes of fibre (r = 0.15, P = 0.007); total (r = 0.15, P = 0.009), and insoluble (r = 0.13, P = 0.021) non-starch polysaccharides; protein (r = 0.12, P = 0.036); meat (r = 0.15, P = 0.010); and nuts, seeds and legumes (r = 0.11, P = 0.047). Further regression analyses found that profile 2 and profile 3 were independently associated with BMI z-score and diet respectively. We encourage fellow researchers to use compositional PCA as a method for identifying further links between the gut, diet and obesity, and for developing the next generation of research in which the impact on body composition of dietary interventions that modify the gut microbiota is determined.
A review of guidance on fish consumption in pregnancy: is it fit for purpose?
- Caroline M Taylor, Pauline M Emmett, Alan M Emond, Jean Golding
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- Journal:
- Public Health Nutrition / Volume 21 / Issue 11 / August 2018
- Published online by Cambridge University Press:
- 26 March 2018, pp. 2149-2159
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Objective
Public health messages to reduce Hg exposure for pregnant women have focused exclusively on advice on fish consumption to limit Hg exposure, with little account being taken of the positive contribution of fish to nutritional quality. The aim of the present review was to compare and contrast the content and presentation of national guidelines on fish consumption in pregnancy, and comment on their evidence base and impact on consumption.
DesignWe searched for national and international guidelines on fish consumption in pregnancy using Internet search strategies. The detailed content and style of presentation of the guidelines were compared. The evidence base for the guidelines, and evidence for the impact of the guidelines on fish consumption levels, were assessed.
ResultsWe identified nineteen national guidelines and three international guidelines. There was great variation in the content, complexity and presentation style. The guidelines were based largely on the Hg content of fish with far less consideration being given to the positive beneficial effects of nutrients provided by fish. The complexity of the guidelines may lead to pregnant women reducing their fish intake, or not eating fish at all.
ConclusionsGuidelines on fish consumption in pregnancy should take the beneficial effects of fish into account. Guidelines need to be clear and memorable, and appropriately disseminated, to achieve impact. Guidelines could include visual rather than narrative content. Use of technology, for example apps, could enable women to record their fish consumption in real time and log compliance with guidance over a week or other time period.
Exome Sequencing to Detect Rare Variants Associated With General Cognitive Ability: A Pilot Study
- Michelle Luciano, Victoria Svinti, Archie Campbell, Riccardo E. Marioni, Caroline Hayward, Alan F. Wright, Martin S. Taylor, David J. Porteous, Pippa Thomson, James G.D. Prendergast, Nicholas D. Hastie, Susan M. Farrington, Generation Scotland, Malcolm G. Dunlop, Ian J. Deary
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- Journal:
- Twin Research and Human Genetics / Volume 18 / Issue 2 / April 2015
- Published online by Cambridge University Press:
- 06 March 2015, pp. 117-125
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Variation in human cognitive ability is of consequence to a large number of health and social outcomes and is substantially heritable. Genetic linkage, genome-wide association, and copy number variant studies have investigated the contribution of genetic variation to individual differences in normal cognitive ability, but little research has considered the role of rare genetic variants. Exome sequencing studies have already met with success in discovering novel trait-gene associations for other complex traits. Here, we use exome sequencing to investigate the effects of rare variants on general cognitive ability. Unrelated Scottish individuals were selected for high scores on a general component of intelligence (g). The frequency of rare genetic variants (in n = 146) was compared with those from Scottish controls (total n = 486) who scored in the lower to middle range of the g distribution or on a proxy measure of g. Biological pathway analysis highlighted enrichment of the mitochondrial inner membrane component and apical part of cell gene ontology terms. Global burden analysis showed a greater total number of rare variants carried by high g cases versus controls, which is inconsistent with a mutation load hypothesis whereby mutations negatively affect g. The general finding of greater non-synonymous (vs. synonymous) variant effects is in line with evolutionary hypotheses for g. Given that this first sequencing study of high g was small, promising results were found, suggesting that the study of rare variants in larger samples would be worthwhile.
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- By Brittany L. Anderson-Montoya, Heather R. Bailey, Carryl L. Baldwin, Daphne Bavelier, Jameson D. Beach, Jeffrey S. Bedwell, Kevin B. Bennett, Richard A. Block, Deborah A. Boehm-Davis, Corey J. Bohil, David B. Boles, Avinoam Borowsky, Jessica Bramlett, Allison A. Brennan, J. Christopher Brill, Matthew S. Cain, Meredith Carroll, Roberto Champney, Kait Clark, Nancy J. Cooke, Lori M. Curtindale, Clare Davies, Patricia R. DeLucia, Andrew E. Deptula, Michael B. Dillard, Colin D. Drury, Christopher Edman, James T. Enns, Sara Irina Fabrikant, Victor S. Finomore, Arthur D. Fisk, John M. Flach, Matthew E. Funke, Andre Garcia, Adam Gazzaley, Douglas J. Gillan, Rebecca A. Grier, Simen Hagen, Kelly Hale, Diane F. Halpern, Peter A. Hancock, Deborah L. Harm, Mary Hegarty, Laurie M. Heller, Nicole D. Helton, William S. Helton, Robert R. Hoffman, Jerred Holt, Xiaogang Hu, Richard J. Jagacinski, Keith S. Jones, Astrid M. L. Kappers, Simon Kemp, Robert C. Kennedy, Robert S. Kennedy, Alan Kingstone, Ioana Koglbauer, Norman E. Lane, Robert D. Latzman, Cynthia Laurie-Rose, Patricia Lee, Richard Lowe, Valerie Lugo, Poornima Madhavan, Leonard S. Mark, Gerald Matthews, Jyoti Mishra, Stephen R. Mitroff, Tracy L. Mitzner, Alexander M. Morison, Taylor Murphy, Takamichi Nakamoto, John G. Neuhoff, Karl M. Newell, Tal Oron-Gilad, Raja Parasuraman, Tiffany A. Pempek, Robert W. Proctor, Katie A. Ragsdale, Anil K. Raj, Millard F. Reschke, Evan F. Risko, Matthew Rizzo, Wendy A. Rogers, Jesse Q. Sargent, Mark W. Scerbo, Natasha B. Schwartz, F. Jacob Seagull, Cory-Ann Smarr, L. James Smart, Kay Stanney, James Staszewski, Clayton L. Stephenson, Mary E. Stuart, Breanna E. Studenka, Joel Suss, Leedjia Svec, James L. Szalma, James Tanaka, James Thompson, Wouter M. Bergmann Tiest, Lauren A. Vassiliades, Michael A. Vidulich, Paul Ward, Joel S. Warm, David A. Washburn, Christopher D. Wickens, Scott J. Wood, David D. Woods, Motonori Yamaguchi, Lin Ye, Jeffrey M. Zacks
- Edited by Robert R. Hoffman, Peter A. Hancock, University of Central Florida, Mark W. Scerbo, Old Dominion University, Virginia, Raja Parasuraman, George Mason University, Virginia, James L. Szalma, University of Central Florida
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- The Cambridge Handbook of Applied Perception Research
- Published online:
- 05 July 2015
- Print publication:
- 26 January 2015, pp xi-xiv
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Herpes Simplex Encephalitis
- Sean W. Taylor, Roger M. Smith, Giovanna Pari, Wendy Wobeser, John P. Rossiter, Alan C. Jackson
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- Canadian Journal of Neurological Sciences / Volume 32 / Issue 2 / May 2005
- Published online by Cambridge University Press:
- 02 December 2014, pp. 246-247
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A 28-year-old woman presented with a one day history of high fever and partial seizures with secondary generalization. This was preceded by a three week history of headache, ataxia, and fatigue. An initial computed tomogram head scan showed a low density mass lesion in the right frontal operculum without enhancement. On the next day, a repeat scan showed a new frontopolar, expansile, low density cortical lesion (Figure 1A) suggestive of encephalitis. Cerebrospinal fluid showed a pleocytosis of 311 mononuclear white blood cell count per μL and an elevated protein of 1.57 g/L. She received intravenous acyclovir and antibiotics. She remained febrile and became mute. A magnetic resonance (MR) scan under general anesthesia on her fourth hospital day showed frontal and perisylvian lesions with restricted diffusion (Figure 1B - D and Figure 2). A right frontal brain biopsy showed meningoencephalitis and immunohistochemical staining was positive for herpes simplex virus (HSV) antigen (Figure 3). Subsequently, HSV-1 DNA was demonstrated in both cerebrospinal fluid and brain tissue with polymerase chain amplification. She improved after a course of intravenous therapy with acyclovir with residual frontal lobe signs, including marked executive dysfunction, and her speech became normal.
Sovereign debt in Latin America, 1820-1913*
- Gerardo della Paolera, Alan M. Taylor
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- Journal:
- Revista de Historia Economica - Journal of Iberian and Latin American Economic History / Volume 31 / Issue 2 / September 2013
- Published online by Cambridge University Press:
- 09 August 2013, pp. 173-217
- Print publication:
- September 2013
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This paper examines sovereign lending to Latin America and the Caribbean from 1820 to 1913. We examine four waves of capital flows where defaults were followed by a return to market access. In spite of extended default, countries kept promising high returns that attracted international investors again and again: financial autarky thus gave way to eras of high integration to global markets as measured by sovereign risk pricing. We discuss imperfections of the sovereign debt institutional context in the region and discuss a menu of options that some countries used to seek funds in the global financial markets after defaults. The parallel with the modern Latin American and Caribbean sovereign bond market experience is striking.
Contributors
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- By Janine B. Adams, Kirsten B. Barnes, Guy C. Bate, Greg A. Botha, Meyrick B. Bowker, Sarah J. Bownes, Nicola K. Carrasco, Clinton P. Chrystal, Robynne A. Chrystal, Xander Combrink, Allan D. Connell, Digby P. Cyrus, Colleen T. Downs, William N. Ellery, Anthony T. Forbes, Nicolette T. Forbes, Caroline Fox, Nuette Gordon, Michael C. Grenfell, Suzanne E. Grenfell, Sylvi Haldorsen, Marc S. Humphries, Hendrik L. Jerling, Bruce E. Kelbe, C. Fiona MacKay, Christopher M. Maine, Andrew Z. Maro, Andrew A. Mather, Nelson A. F. Miranda, David G. Muir, Holly A. Nel, Sibulele Nondoda, Renzo Perissinotto, Deena Pillay, Naomi Porat, Roger N. Porter, Sean N. Porter, Justin J. Pringle, Ursula M. Scharler, Derek D. Stretch, Ricky H. Taylor, Jane Turpie, Jonathan K. Warner, Alan K. Whitfield
- Edited by Renzo Perissinotto, University of KwaZulu-Natal, South Africa, Derek D. Stretch, University of KwaZulu-Natal, South Africa, Ricky H. Taylor
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- Book:
- Ecology and Conservation of Estuarine Ecosystems
- Published online:
- 05 April 2013
- Print publication:
- 16 May 2013, pp xiii-xvi
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Intake of game birds in the UK: assessment of the contribution to the dietary intake of lead by women of childbearing age and children
- Caroline M Taylor, Jean Golding, Alan M Emond
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- Journal:
- Public Health Nutrition / Volume 17 / Issue 5 / May 2014
- Published online by Cambridge University Press:
- 26 March 2013, pp. 1125-1129
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Objective
Concern has recently been expressed about Pb levels in Pb-shot game meat. Our aim was to determine the consumption of game birds in a representative sample population in the UK, and in children and women of childbearing age in particular.
DesignPopulation-based cross-sectional cohort study. Data from 4 d diet diaries from the UK National Diet and Nutrition Survey (NDNS; 2008–2010) were extracted to analyse data on game bird consumption in the sample population, in women of childbearing age (15–45 years old) and in children ≤6 years old.
SettingHome-based study in representative areas of the UK.
SubjectsParticipants in the NDNS (2008–2010; n 2126, age 1·5 to >65 years).
ResultsFifty-eight participants (2·7 %) reported eating game birds. The mean intake was 19·5 (sd 18·1) g/d (median 15·6, range 1·3–92·9 g/d). In women of childbearing age (15–45 years), 11/383 (2·9 %) reported eating game birds, with a mean intake of 22·4 (sd 25·8) g/d (median 15·6, range 2·0–92·9 g/d). In children aged ≤6 years old, 3/342 (0·9 %) were reported as eating game birds, with a mean intake of 6·8 (sd 9·7) g/d (median 2·4, range 1·3–23·2 g/d).
ConclusionsThe prevalence of consumption of game birds by women of childbearing age and children ≤6 years old was relatively low and intakes were small. However, any exposure to Pb in these two groups is undesirable. As are uncertainties about the ability of the diet diary method to capture the consumption of food items that are infrequently consumed, alternative methods of capturing these data should be used in future studies.
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- By Chris Beyers, Amy Branam, Alan Brown, Mark Canada, Patricia A. Cunningham, Satwik Dasgupta, David Dowling, John Evelev, Michael J. Everton, Benjamin F. Fisher, Paul Fisher, Meghan A. Freeman, Christopher Gair, Andrea Goulet, Jonathan Hartmann, Kevin J. Hayes, Gregory Hays, Alvin Holm, Lindsey Hursh, James M. Hutchisson, Paul Christian Jones, Katherine Kim, Nathaniel Lewis, Bruce Mills, Travis Montgomery, Tara Moore, Bran Nicol, Philip Edward Phillips, Anne Boyd Rioux, Therese M. Rizzo, Kathryn K. Shinn, Heidi Silcox, Peter Swirski, Jonathan Taylor, John Tresch, Lois Davis Vines, Jeffrey Andrew Weinstock, Brett Zimmerman
- Edited by Kevin J. Hayes, University of Central Oklahoma
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- Book:
- Edgar Allan Poe in Context
- Published online:
- 05 November 2013
- Print publication:
- 29 October 2012, pp ix-xiv
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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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- The Cambridge Dictionary of Christianity
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- 05 August 2012
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- 20 September 2010, pp xi-xliv
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Contributors
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- By Mona Aboulghar, Mostafa Abuzeid, Valentine Akande, Carolyn J. Alexander, Gautam N. Allahbadia, Vicki Arguello, Nabil Aziz, Osama M. Azmy, Shawky Z. A. Badawy, Susan L. Baker, Tony Bazi, Nicole Brooks, Robin Brown, William W. Brown, Maria Cerrillo, Rebecca Chilvers, Angela Clough, Willie Cotten, Alan H. DeCherney, Aygul Demirol, Richard Palmer Dickey, Essam S. Dimitry, Maria Dimitry, Tiffany Driver, Alaa El-Ebrashy, Kareem El-Nahhas, Amr Etman, Aimee Eyvazzadeh, Juan A. Garcia-Velasco, Tarek A. Gelbaya, Seth Granberg, Timur Gurgan, Gurkan Levent, Suleyman Guven, Lars Hamberger, Andrew C. Harbin, Wayne J. G. Hellstrom, Micah J. Hill, James Hole, Yakoub Khalaf, John C. LaFleur, Deborah Levine, Iwan Lewis-Jones, Edward A. Lyons, Diana M. Marcus, Samuel F. Marcus, Mohamed F. M. Mitwally, Hany F. Moustafa, Manubai Nagamani, Luciano G. Nardo, Mary G. Nawar, Moshood Olatinwo, Lia Ornat, Sheri Owens, Kathy B. Porter, Jose M. Puente, Puscheck Elizabeth, Rizk Botros, Christine B. Rizk, Christopher B. Rizk, Hassan N. Sallam, Dimitrios Siassakos, Youssef Simaika, Stuart J. Singer, Brad Steffler, Annika Strandell, Sherri K. Taylor, Antoine Watrelot, Matts Wikland, Tony G. Zreik
- Edited by Botros R. M. B. Rizk, University of South Alabama
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- Ultrasonography in Reproductive Medicine and Infertility
- Published online:
- 07 September 2011
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- 25 March 2010, pp ix-xii
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Stand dynamics in Mpanga Research Forest Reserve, Uganda, 1968–1993
- David M. Taylor, Alan C. Hamilton, J. Duncan Whyatt, Patrick Mucunguzi, R. Bukenya-Ziraba
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- Journal:
- Journal of Tropical Ecology / Volume 12 / Issue 4 / July 1996
- Published online by Cambridge University Press:
- 10 July 2009, pp. 583-597
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Changes in the composition and structure of mid-altitude, semi-deciduous tropical forest in Mpanga Research Forest Reserve, Uganda are described for a 25-year period between 1968 and 1993. Three surveys of a 0.64 ha (80 m × 80 m) permanent plot were carried out in 1968, 1982 and 1993, during which a total of 397 trees with a dbh≥9.5 cm were identified. Forty-nine species were identified in total, representing 19 families. Eight individuals remain unidentified. Dbh measurements were recorded for 359 non-buttressed trees, whilst the equivalent measurement for 38 buttressed trees was the diameter of the trunk immediately above the buttress. Basal area, diversity and density of trees increased within the plot during the survey period by, respectively, 8% (from 39.2 to 42.2 m2 ha−1). 7% (from 44 to 47 species) and 11% (459 to 508 trees ha−1). The main compositional changes were increases in understorey trees and a decline in serai taxa. Growth rates (productivity) and turnover were lower during the period 1982 to 1993 than the period 1968 to 1982. Rates of growth and mortality were generally highest in serai species and lowest in main canopy taxa. Mortality rates were also highest amongst the smallest trees enumerated (dbh <30 cm). Changes in composition and structure over the survey period are believed to reflect forest recovery after low intensity pit-sawing was curtailed from 1951. Forest recovery also may have caused the reduced growth rates and turnover recorded for the most recent survey period, by restricting the opportunities for light-demanding, faster-growing and relatively productive serai taxa, and to have outweighed any effects of externally-driven processes, such as changes in atmospheric conditions.
9 - Achieving effective ECT
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- By M. D. Michael Alan Taylor, University of Michigan School of Medicine, M. D. Max Fink, State University of New York at Stony Brook
- Michael Alan Taylor, University of Michigan, Ann Arbor, Max Fink, State University of New York, Stony Brook
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- Melancholia
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- 14 August 2009
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- 01 June 2006, pp 181-195
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Summary
Practice makes perfect.
Remission of melancholia is achieved in 80–95% of patients treated with electroconvulsive therapy (ECT). Lesser remission rates, however, are commonly reported. What accounts for the differences in clinical outcome?
The technical practice of ECT is complex and not all treatment courses are optimized to assure the maximum therapeutic benefit. Inappropriate frequency and inadequate numbers of treatments, energies too low to assure an effective seizure, elevated seizure thresholds, inefficient electrode placements, and missed or incomplete seizures result in courses of treatment with limited benefit.
Patient selection
Convulsive therapy relieves depressive mood disorders, yet the benefits are best established in those with melancholia. The relief of severe disorders in mood was discovered early in ECT history. In patients with both the depressed and manic phases of “manic-depressive insanity” and “involutional depression,” the introduction of ECT was quickly identified as a life-saving treatment. To assure proper selection of patients, an intensive search for predictors of good response examined identifiable symptoms and syndromes, demographic features, severity of illness, and duration of illness. An excellent and rapid clinical response found in melancholia of recent onset with severe vegetative signs, suicide intent, and delusional thinking occurred in older rather than younger patients. A poor outcome was associated with chronic illness, limited impairment that allowed sustained employment, comorbid personality disorder, “neurotic symptoms” (pervasive anxiety, dysthymia, hypochondriasis), and substance abuse. Specific behavior-rating scales designed as predictors were developed.
10 - The validity of the pharmacotherapy literature in melancholia
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- By M. D. Michael Alan Taylor, University of Michigan School of Medicine, M. D. Max Fink, State University of New York at Stony Brook
- Michael Alan Taylor, University of Michigan, Ann Arbor, Max Fink, State University of New York, Stony Brook
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- Melancholia
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- 14 August 2009
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- 01 June 2006, pp 196-210
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Summary
… my few hours of sleep were usually terminated at three or four in the morning, when I stared up into yawning darkness, wondering and writhing at the devastation taking place in my mind and awaiting the dawn, which usually permitted me a feverish, dreamless nap
Melancholia is a severely debilitating illness with a high death rate and high potential for suicide. Its consequences were so dire that the introduction of even so intrusive a treatment as induced seizures was hailed as a remarkable advance. Over the past half-century, medications effective in ameliorating melancholia were developed and the fears that melancholia engendered in earlier centuries lessened.
Our present therapeutic ideal is to select treatments based on scientific study, defined as evidence-based medicine. Randomized controlled clinical trials form the foundation of evidence-based medicine, and the literature assessing the benefits of antidepressant and mood-stabilizing drugs is widely accepted. Reviews of this evidence conclude that all antidepressant medications have equal efficacy for major depression, differing only in side-effects. These conclusions influence clinical guidelines.
Present teaching, as expressed by an expert National Institutes of Mental Health (NIMH) panel states that: “The SSRIs [selective serotonin reuptake inhibitors] are clearly the drug treatment of choice for all forms of depression in the United States … These drugs are approximately equivalent to each other and to TCAs [tricyclic antidepressants] in efficacy … The SSRIs have a much more benign side effect profile than TCAs and, largely for this reason, have replaced TCAs as first line therapy.”
List of patient vignettes
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- By M. D. Michael Alan Taylor, University of Michigan School of Medicine, M. D. Max Fink, State University of New York at Stony Brook
- Michael Alan Taylor, University of Michigan, Ann Arbor, Max Fink, State University of New York, Stony Brook
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- Book:
- Melancholia
- Published online:
- 14 August 2009
- Print publication:
- 01 June 2006, pp ix-x
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