37 results
Tracking Mississippian Migrations from the Central Mississippi Valley to the Ridge and Valley with a Unified Absolute Chronology
- Lynne P. Sullivan, Kevin E. Smith, Scott C. Meeks, Shawn M. Patch
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- American Antiquity , First View
- Published online by Cambridge University Press:
- 07 March 2024, pp. 1-17
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As regional chronologies become better defined, we are better able to track large-scale population movements and related cultural change. A dataset of 156 radiocarbon dates from the Middle Cumberland Region (MCR), evaluated with 199 more dates from the Ridge and Valley portions of northern Georgia and East Tennessee, enable modeling of population movements from the Central Mississippi Valley into the MCR, as well as subsequent movements and effects in the Ridge and Valley between AD 1200 and 1450. The dissolution of Cahokia is of particular interest, because the MCR falls geographically between the American Bottom and the Ridge and Valley province. This large-scale chronological perspective places key events in this part of the Southeast and Midwest into a unified historical framework that increases our understanding of the timing of cultural events. A related goal is to sort out possible external events and influences that may have affected this large region. This study makes apparent the relationships between cultural events and natural events, such as the drought sequences reported for the Central Mississippi Valley and beyond.
The experience of fathers of children hospitalised with advanced heart disease
- Chase Samsel, Jeffrey R. Reichman, Jessica A. Barreto, David W. Brown, Kevin Hummel, Lynn A. Sleeper, Elizabeth D. Blume
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- Cardiology in the Young , First View
- Published online by Cambridge University Press:
- 10 January 2024, pp. 1-5
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Background:
There are little reported data on the perspectives of fathers caring for children with chronic conditions. Although survival of children with advanced heart disease has improved, long-term morbidity remains high. This study describes the experience and prognostic awareness of fathers of hospitalised children with advanced heart disease.
Methods:Cross-sectional survey study of parents caring for children hospitalised with advanced heart disease admitted for ≥ 7 days over a one-year period. One parent per patient completed surveys, resulting in 27 father surveys. Data were analysed using descriptive methods.
Results:Nearly all (96%) of the fathers reported understanding their child’s prognosis “extremely well” or “well,” and 59% felt they were “very prepared” for their child’s medical problems. However, 58% of fathers wanted to know more about prognosis, and 22% thought their child’s team knew something about prognosis that they did not. Forty-one per cent of fathers did not think that their child would have lifelong limitations, and 32% anticipated normal life expectancies. All 13 fathers who had a clinical discussion of what would happen if their child got sicker found this conversation helpful. Nearly half (43%) of the fathers receiving new prognostic information or changes to treatment course found it “somewhat” or “a little” confusing.
Conclusions:Fathers report excellent understanding of their child’s illness and a positive experience around expressing their hopes and fears. Despite this, there remain many opportunities to improve communication, prognostic awareness, and participation in informed decision-making of fathers of children hospitalised with advanced heart disease.
The family burden of paediatric heart disease during the chronic phase of illness
- Kevin Hummel, Avital Ludomirsky, Lauren Burgunder, Minmin Lu, Sarah Goldberg, Lynn Sleeper, Jeffrey Reichman, Elizabeth D. Blume
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- Cardiology in the Young , First View
- Published online by Cambridge University Press:
- 28 November 2023, pp. 1-7
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Background:
CHD is a lifelong condition with a significant burden of disease to patients and families. With increased survival, attention has shifted to longer-term outcomes, with a focus on social determinants of health. Among children with CHD, socioeconomic status is associated with disparities in outcomes. Household material hardship is a concrete measure of poverty and may serve as an intervenable measure of socioeconomic status.
Methods:A longitudinal survey study was conducted at multiple time points (at acute hospitalisation, then 12–24 months later in the chronic phase) to determine the prevalence of household material hardship among parents of children with advanced heart disease and quality of life during long-term follow-up.
Results:The analytic cohort was 160 children with a median patient age of 1 year (IQR 1,4) with 54% of patients <2 years. During acute hospitalisation, over one-third of families reported household material hardship (37%), with significantly lower household material hardship in the chronic phase at 16% (N = 9 of 52). For parents reporting household material hardship during acute hospitalisation, 50% had resolution of household material hardship by the chronic phase. Household material hardship-exposed children were significantly more likely to be publicly insured (56% versus 20%, p = 0.03) with lower quality of life than those without household material hardship (64% versus 82%, p = 0.013).
Conclusion:The burden of heart disease during the chronic phase of illness is high. Household material hardship may serve as a target to ensure equity in the care and outcomes of CHD patients and their families.
Epidemiology of central-line–associated bloodstream infection mortality in Canadian NICUs before and after 2017
- Maria Spagnuolo, Anada Silva, Jessica Bartoszko, Linda Pelude, Blanda Chow, Jeannette Comeau, Chelsey Ellis, Charles Frenette, Lynn Johnston, Kevin Katz, Joanne Langley, Bonita Lee, Santina Lee, Marie-Astrid Lefebvre, Allison McGeer, Dorothy Moore, Senthuri Paramalingam, Jennifer Parsonage, Donna Penney, Caroline Quach, Michelle Science, Stephanie Smith, Kathryn Suh, Jocelyn Srigley
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- Antimicrobial Stewardship & Healthcare Epidemiology / Volume 3 / Issue S2 / June 2023
- Published online by Cambridge University Press:
- 29 September 2023, p. s48
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Background: The Canadian Nosocomial Infection Surveillance Program (CNISP) observed increased mortality among neonatal intensive care unit (NICU) patients with central-line–associated bloodstream infection (CLABSI) starting in 2017. In this study, we compared NICU patients with CLABSIs before and after 2017, and quantified the impact of epidemiological factors on 30-day survival. Methods: We included 1,276 NICU patients from 8–16 participating CNISP hospitals from the pre-2017 period (2009–2016) and the post-2017 period (2017–2022) using standardized definitions and questionnaires. We used Cox regression modeling to assess the impact of age at date of positive culture, sex, birthweight, CLABSI microorganism, region of the country, and surveillance period (before 2017 vs after 2017) on time to 30-day all-cause mortality from date of positive culture. Gestational age was not available for this analysis. We reported model outputs as hazard ratios with 95% CIs. Results: In total, 769 (60%) NICU CLABSIs were reported in the pre-2017 period and 507 (40%) in the post-2017 period. The 30-day all-cause mortality rate was 8% (n = 100 of 1,276) overall, and significantly higher after 2017 (12%, n = 61 of 507) than before 2017 (5%, n = 39 of 769) (P < .001).
During the post-2017 period, cases were significantly younger: 16 days (IQR, 9–33) versus 21 days (IQR, 11–49) (P = .002). Median days from ICU admission to infection were shorter: 14 (IQR, 8–31) versus 19 (IQR, 10–41) (P < .001). More gram-negative CLABSIs were identified (29% vs 24%; P = .040) and fewer gram-positive CLABSIs were identified (64% vs 72%; P = .006) compared to the pre-2017 period. Mortality was higher in CLABSIs caused by gram-negative bacteria (15%, n = 50 of 328) than gram-positive bacteria (4.4%, n = 39 of 877) (P < .001), and mortality was higher in neonates with birthweight <1,000 g (11%, n = 71 of 673) compared to those weighing ≥1,000 g (5%, n = 28 of 560) (P < .001).
Adjusting for all other factors, survival modeling indicated that NICU CLABSIs identified in the post-2017 period had 2.12 (95% CI, 1.23–3.66) times the hazard ratio of 30-day all-cause mortality compared to those before 2017 (P < .006). Those identified with a gram-positive bacterium had a 0.28 hazard ratio (95% CI, 0.12–0.65) of 30-day mortality compared to those with a gram-negative bacterium or fungus (P = .003). In the fully adjusted model, age, sex, and birthweight were not significantly associated with NICU CLABSI survival. Conclusions: NICU patients with CLABSIs had significantly higher all-cause mortality between 2017–2022 compared to 2009–2016, and those who acquired gram-positive–associated CLABSIs had improved survival compared to other organisms. Further work is needed to identify and understand factors driving the increased mortality among NICU CLABSI patients from 2017–2022.
Disclosures: None
Gender separation and the speech community: Rhoticity in early 20th century Southland New Zealand English
- Dan Villarreal, Lynn Clark, Jennifer Hay, Kevin Watson
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- Language Variation and Change / Volume 33 / Issue 2 / July 2021
- Published online by Cambridge University Press:
- 17 June 2021, pp. 245-266
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- July 2021
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The existence of a shared constraint hierarchy is one of the criteria that defines and delimits speech communities. In particular, women and men are thought to differ only in their rates of variable usage, not in the constraints governing their variation; that is, women and men are typically considered to belong to the same speech community. We find that in early twentieth century Southland, New Zealand, women and men had different constraint hierarchies for rhoticity, with a community grammar of rhoticity only developing later. These results may be a product of a particular set of sociohistorical facts thatare not peculiar to Southland. We suggest that further research in other geographical locations may indeed reveal that men and women have different constraint hierarchies for other variables. Speech communities may thus be delimited along social lines in ways that have not been previously considered.
The effect of a low carbohydrate high fat diet on emerging biochemical markers of cardiometabolic risk
- Deaglan McCullough, Tanja Harrison, Katie Lane, Lynne Boddy, Farzad Amirabdollahian, Michael Schmidt, Kevin Enright, Claire Stewart, Ian Davies
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- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E530
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Worldwide, cardiovascular disease (CVD) is the number 1 cause of mortality and is associated with insulin resistance (IR). Emerging biomarkers such as FGF21 and adiponectin are associated with cardiometabolic risk. Low carbohydrate, high fat (LCHF) diets have been reported to reduce cardiometabolic risk markers; however, few studies have compared a LCHF diet vs. a high carbohydrate (HC), lower fat diet under ad libitum conditions on adiponectin and FGF21. The purpose of this study was to investigate the effects of an ad libitum LCHF vs. HC diet on IR, FGF21 and adiponectin in 16 healthy adults. Ethical approval: Liverpool John Moores University Research Ethics Committee (16/ELS/029); registered with ClinicalTrials.gov (Ref. NCT03257085). Participants were randomly assigned to a HC diet (n = 8, the UK Eatwell guidelines; ≥ 50% of energy from carbohydrates) or a LCHF diet (n = 8, consume < 50 g/day of carbohydrates). All provided plasma samples at 0, 4 and 8 weeks. FGF21 (R&D Systems) was analysed via ELISA and adiponectin, insulin and glucose were analysed via immunoassay technology (Randox Evidence Investigator™ Metabolic Syndrome Arrays I & II). Mann Whitney, Friedmans, Wilcoxon tests and 2×3 ANOVA (IBM SPSS 25®) were undertaken to investigate significant differences between and within groups. The homeostatic model assessment (HOMA) was used to calculate IR. FGF21 significantly (P = 0.04) decreased (Mdn, IQR:148.16, 78.51–282.02 to 99.4, 39.87–132.29 pg/ml) after 4 weeks and significantly (P = 0.02) increased (Mdn, IQR:167.38, 80.82–232.89 pg/ml) by 8 weeks vs. baseline with LCHF. No significant differences (P > 0.05) were observed between groups. Adiponectin was significantly (P = 0.03) different at week 4 only between groups. Adiponectin increased after 4 weeks (Mdn, IQR:13.44, 9.12–25.47 to 16.64, 11.96–21.51 ng/ml) but was only significantly (P = 0.03) different by 8 weeks vs. baseline in the HC group (Mdn, IQR:16, 10.8–27.43 ng/ml). Adiponectin remained unchanged (P = 0.96) in the LCHF group. HOMA significantly decreased with both diets after 8 weeks only (mean ± SD, LCHF: 2.9 ± 1.3 to 1.8 ± 0.8, HC: 2.5 ± 0.6 to 1.9 ± 0.6, P = 0.008) but was not significantly (P = 0.60) different between groups. These preliminary data reveal that while both diets improved insulin sensitivity, they may do so by different mechanisms. Future studies are warranted to investigate further, how a LCHF vs. HC diet affects FGF21 and adiponectin, and the subsequent regulation of IR. Furthermore, studies that extend these findings by determining the impact of LCHF vs. HC on peripheral metabolism to determine potential nutrition-mediated mechanisms of metabolic adaptation are warranted.
The effect of a low carbohydrate high fat diet on apolipoproteins and cardiovascular risk
- Deaglan McCullough, Tanja Harrison, Katie Lane, Lynne Boddy, Farzad Amirabdollahian, Michael Schmidt, Kevin Enright, Claire Stewart, Ian Davies
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- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E677
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Apolipoproteins (apo) regulate lipoprotein characteristics and lipid metabolism. ApoC-III is a regulator of triglyceride-rich lipoprotein (TRL) metabolism and apolipoproteins are important biomarkers for cardiovascular disease (CVD) risk prediction. A low carbohydrate high fat (LCHF) diet improves cardiometabolic risk, especially via reduction of TRL. However, few studies have compared a LCHF vs. a high carbohydrate (HC), lower fat diet under ad libitum conditions on apoC-III levels. The objectives of this investigation were to measure the effect of a LCHF vs. a HC diet on apoC-III, apoA1, apoB and apoB/apoA1 in 16 healthy Caucasian adults aged 19–64. Ethical approval: Liverpool John Moores University Research Ethics Committee (16/ELS/029); registered with ClinicalTrials.gov (Ref. NCT03257085). Participants randomly assigned to a HC diet (UK Eatwell guidelines; ≥ 50% of energy from carbohydrates) (n = 8), or a LCHF diet (consume < 50 g/day of carbohydrates) (n = 8) provided plasma samples at 0, 4 and 8 weeks. ApoA1 and apoB were analysed by an automated chemistry analyser (Daytona, Randox Laboratories Ltd, UK). ApoC-III was analysed via ELISA (Thermo Fisher Ltd, USA). Factorial 2×3 ANOVA and ANCOVA (IBM SPSS 25®) were undertaken to investigate significant differences and to control for variables influenced by baseline measures and visceral adipose tissue (VAT). Results show 0, 4, and 8 weeks respectively: ApoC-III (LCHF: 19.12 ± 9.14, 16.05 ± 7.95, 15.11 ± 3.17 mg/dl; HC: 22.13 ± 8.38, 28.22 ± 13.85, 22.22 ± 7.7 mg/dl) showed no significant (P = 0.319) change. No significant (P = 0.23) change was also observed in ApoB (LCHF: 107.25 ± 20.35, 111.38 ± 24.81, 111.43 ± 19.93 mg/dl; HC: 94.38 ± 20.79, 105.00 ± 20.13, 99.00 ± 29.09 mg/dl). Similarly apoA1 (LCHF: 158.71 ± 14.27, 166.50 ± 23.09, 173.00 ± 29.42 mg/dl; HC: 164.71 ± 30.25, 172.50 ± 29.44, 174.00 ± 32.83 mg/dl) showed no significant change (P = 0.76). This resulted in a relatively unchanged apoB/A1 throughout the study in both diets (P = 0.30). No significant (P > 0.05) differences were found after 4 weeks or between groups also. ANCOVA revealed a trend (P = 0.06) in apoC-III for a difference between groups (LCHF: Δ-6.6 mg/dl vs. HC: Δ1.2 mg/dl) after 8 weeks but no significant (P > 0.05) changes in other apolipoproteins were detected. These preliminary data reveal that a LCHF diet does not improve the apolipoprotein profile; however, when accounting for other metabolic risk factors (i.e. VAT) there was a trend towards lowering apoC-III levels (P = 0.06). Modulation of apoC-III may lead to improved lipid metabolism, but higher-powered studies are warranted before any improvement on CVD risk can be inferred.
2527 Mount Sinai health hackathon: Harnessing the power of collaboration to advance experiential team science education
- Janice Lynn Gabrilove, Peter Backeris, Louise Lammers, Anthony Costa, Layla Fattah, Caroline Eden, Jason Rogers, Kevin Costa
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- Journal of Clinical and Translational Science / Volume 2 / Issue S1 / June 2018
- Published online by Cambridge University Press:
- 21 November 2018, p. 58
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OBJECTIVES/SPECIFIC AIMS: Innovation in healthcare is increasingly dependent on technology and teamwork, requiring effective collaboration between disciplines. Through an intensive team-based competition event, Mount Sinai Health Hackathon 2017, aimed to harness the power of multidisciplinary and transdisciplinary collaboration to foster innovation in the field of cancer. Participants were immersed in an intensive weekend working in teams to develop technology solutions to important problems affecting patients and care providers in the field of cancer. The learning objectives were to enable participants to: Identify cancer-related healthcare problems which lend themselves to technology-based solutions. Delineate key behaviors critical to multidisciplinary team success Identify optimal strategies for communicating in multidisciplinary teams. Engage and inspire participants to apply knowledge of technology to meaningfully impact clinical care and well-being. METHODS/STUDY POPULATION: The Mount Sinai Health Hackathon is an annual 48-hour team-based competition, using a format adapted from guidelines provided by MIT Hacking Medicine. The 2017 event gathered a total of 87 participants (120 registered), representing 17 organizations from as far away as California, with a diverse range of backgrounds in bioinformatics, software and hardware, product design, business, digital health and clinical practice. The overall participation model included: Phase 0: Health Hackathon 101 summer workshops; Phase 1: pre-Hackathon priming activities using online forums Trello and Slack; Phase 2: a 48-hour onsite hackathon to catalyze innovation through problem sharing, solution pitches, team formation and development of prototype solutions; Phase 3: competitive presentations to judges and prize awards; Phase 4: a suite of post-hackathon support to stimulate continued development of innovations. The event sponsored by ConduITS, was also co-sponsored by Persistent Systems, IBM Watson, Tisch Cancer Institute, Sinai AppLab, Sinai Biodesign and other ISMMS Institutes. Mentors circulated throughout the event to support the teams in the technical, clinical, and business development aspects of their solutions. In total, the 14 teams formed during the Hackathon, created innovations ranging from diagnostic devices, networking apps, artificial intelligence tools, and others. The top 3 teams were each awarded $2500 to support their projects’ future development. RESULTS/ANTICIPATED RESULTS: Qualitative and quantitative post-event survey data revealed the Hackathon experience fostered collaborative attitudes and a positive experience for participants, providing insight into the potential benefits of team science. In the post-event survey (n=24) 92% of participants reported that the experience increased their ability to solve problems and 96% made new professional or personal connections. In addition, 96% of respondents would attend future Hackathon events and 75% reported they were likely to continue working on their project after the Hackathon. Qualitative feedback from 1 participant reported it was: “a wonderful event that really highlighted how much interdisciplinary team science can achieve.” Along with intermediate support interactions, including the winning teams participating in a Shark Tank style event with pitches to external entrepreneurs and investors, all teams will be followed up in 6 months time to determine if participants continue to work on projects, file new patents, create new companies, or leverage the new connections made through the Health Hackathon experience. DISCUSSION/SIGNIFICANCE OF IMPACT: Our experience indicates that a Health Hackathon is a compelling and productive forum to bring together students, trainees, faculty, and other stakeholders to explore tech-based solutions to problems in cancer and other areas of biomedicine. It is a valuable tool to foster collaboration and transdisciplinary team science and education. Follow-up analysis will determine to what extent the Mount Sinai Health Hackathon is contributing to an ecosystem that encourages professionals and trainees in healthcare and in technology development to work together to address unmet needs in healthcare with innovative technology solutions.
2510: QIPR: Creating a Quality Improvement Project Registry
- Amber L. Allen, Christopher Barnes, Kevin S. Hanson, David Nelson, Randy Harmatz, Eric Rosenberg, Linda Allen, Lilliana Bell, Lynne Meyer, Debbie Lynn, Jeanette Green, Peter Iafrate, Matthew McConnell, Patrick White, Samantha Davuluri, Tarun Gupta Akirala
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- Journal of Clinical and Translational Science / Volume 1 / Issue S1 / September 2017
- Published online by Cambridge University Press:
- 10 May 2018, pp. 20-21
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OBJECTIVES/SPECIFIC AIMS: To create a searchable public registry of all Quality Improvement (QI) projects. To incentivize the medical professionals at UF Health to initiate quality improvement projects by reducing startup burden and providing a path to publishing results. To reduce the review effort performed by the internal review board on projects that are quality improvement Versus research. To foster publication of completed quality improvement projects. To assist the UF Health Sebastian Ferrero Office of Clinical Quality & Patient Safety in managing quality improvement across the hospital system. METHODS/STUDY POPULATION: This project used a variant of the spiral software development model and principles from the ADDIE instructional design process for the creation of a registry that is web based. To understand the current registration process and management of quality projects in the UF Health system a needs assessment was performed with the UF Health Sebastian Ferrero Office of Clinical Quality & Patient Safety to gather project requirements. Biweekly meetings were held between the Quality Improvement office and the Clinical and Translational Science – Informatics and Technology teams during the entire project. Our primary goal was to collect just enough information to answer the basic questions of who is doing which QI project, what department are they from, what are the most basic details about the type of project and who is involved. We also wanted to create incentive in the user group to try to find an existing project to join or to commit the details of their proposed new project to a data registry for others to find to reduce the amount of duplicate QI projects. We created a series of design templates for further customization and feature discovery. We then proceed with the development of the registry using a Python web development framework called Django, which is a technology that powers Pinterest and the Washington Post Web sites. The application is broken down into 2 main components (i) data input, where information is collected from clinical staff, Nurses, Pharmacists, Residents, and Doctors on what quality improvement projects they intend to complete and (ii) project registry, where completed or “registered” projects can be viewed and searched publicly. The registry consists of a quality investigator profile that lists contact information, expertise, and areas of interest. A dashboard allows for the creation and review of quality improvement projects. A search function enables certain quality project details to be publicly accessible to encourage collaboration. We developed the Registry Matching Algorithm which is based on the Jaccard similarity coefficient that uses quality project features to find similar quality projects. The algorithm allows for quality investigators to find existing or previous quality improvement projects to encourage collaboration and to reduce repeat projects. We also developed the QIPR Approver Algorithm that guides the investigator through a series of questions that allows an appropriate quality project to get approved to start without the need for human intervention. RESULTS/ANTICIPATED RESULTS: A product of this project is an open source software package that is freely available on GitHub for distribution to other health systems under the Apache 2.0 open source license. Adoption of the Quality Improvement Project Registry and promotion of it to the intended audience are important factors for the success of this registry. Thanks goes to the UW-Madison and their QI/Program Evaluation Self-Certification Tool (https://uwmadison.co1.qualtrics.com/SE/?SID=SV_3lVeNuKe8FhKc73) used as example and inspiration for this project. DISCUSSION/SIGNIFICANCE OF IMPACT: This registry was created to help understand the impact of improved management of quality projects in a hospital system. The ultimate result will be to reduce time to approve quality improvement projects, increase collaboration across the UF Health Hospital system, reduce redundancy of quality improvement projects and translate more projects into publications.
2547: Sinai MedMaker Challenge: A model of experiential team science education
- Peter Backeris, Janice Lynn Gabrilove, Caroline Eden, Crispin Goytia, Kevin Costa
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- Journal of Clinical and Translational Science / Volume 1 / Issue S1 / September 2017
- Published online by Cambridge University Press:
- 10 May 2018, p. 52
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OBJECTIVES/SPECIFIC AIMS: Innovation in healthcare is increasingly dependent on technology and teamwork, requiring effective collaboration among diverse disciplines. However, large knowledge barriers exist between these diverse disciplines which hinders effective communication and the innovation processes. We organized an intensive team-based competition event, Sinai MedMaker Challenge, that engaged individuals with a wide range of backgrounds in medicine, biomedical research, computers science, and engineering to collaborate in solving medical problems with technology-based solutions. The learning objectives were to: enable participants to identify healthcare problems which lend themselves to technology-based solutions; delineate key behaviors critical to multidisciplinary team success; identify optimal strategies for communicating in teams; engage and inspire participants to apply knowledge of technology to meaningfully impact clinical care and well-being. METHODS/STUDY POPULATION: The Sinai MedMaker Challenge was a 48-hour team-based competition, modeled after previously held health “hackathons.” Adapting from guidelines provided by MIT Hacking Medicine, the event gathered participants from diverse backgrounds (clinicians, medical students, graduate students in biomedical science and humanities, software developers, engineers, and others), for the purpose of utilizing technology to address pressing problems in the diagnosis, management and/or treatment of pain and/or fatigue. The event flow can be outlined as follows: Phase 1—pre-event brainstorming via Slack and Sparkboard online platforms; Phase 2—problem review with clinical experts; Phase 3—solution pitches, formation of teams, development of prototype solutions; Phase 4—presentations and prizes awarded. The event was sponsored by ISMMS Institutes and Technology Companies. Mentors roamed throughout the event to support the teams in the technical, clinical, and business development aspects of their solutions. RESULTS/ANTICIPATED RESULTS: In total, 78 participants forming 14 teams, worked on the development of software and hardware prototypes (apps/websites, devices, wearables) to address a variety of pain and fatigue problems, culminating in final pitch presentations to a panel of judges comprised of academic experts; innovators and entrepreneurs in the technology start up space. Award recipients were: (1) PT partners, a wearable device for monitoring physical therapy post knee replacement; (2) SickleMeNot, an interactive, multimodal website/app for children designed to assess, monitor and manage pain; and (3) Biolumen, a functional biofeedback system, to treat chronic back pain. Evaluations revealed a high-degree of satisfaction with the event. Several teams continue to develop their prototypes. DISCUSSION/SIGNIFICANCE OF IMPACT: The Sinai MedMaker Challenge (1) was a compelling and productive forum to bring together students, trainees, faculty and other stakeholders to explore tech-based solutions for management, monitoring, and treatment of pain and fatigue; and (2) can be repeated annually, fostering a “Community of Practice,” and expanded to offer pre and post event opportunities to encourage iterative learning and ongoing creative output.
Chapter 6 - The Origins of Liverpool English
- Edited by Raymond Hickey, Universität Duisburg–Essen
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- Listening to the Past
- Published online:
- 21 July 2017
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- 20 April 2017, pp 114-141
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Phonological leveling, diffusion, and divergence: /t/ lenition in Liverpool and its hinterland
- Lynn Clark, Kevin Watson
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- Language Variation and Change / Volume 28 / Issue 1 / March 2016
- Published online by Cambridge University Press:
- 23 February 2016, pp. 31-62
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- March 2016
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This paper examines the phonological leveling and diffusion of variants of /t/ in Liverpool, northwest England, and two localities in its hinterland. We show that lenited realizations of /t/, thought to be historically restricted to Liverpool, are increasing over time and spreading over geographical space. We explore Labov's (2007) claims that linguistic changes that progress via transmission, within a speech community, are reproduced in all their structural complexity, whereas changes that spread across speech communities, via diffusion, are “simplified” en route. We find support for these hypotheses. Using a comparative sociolinguistic methodology, we show that the linguistic constraints operating on the realization of /t/ as [h] in Liverpool have remained stable over time, while those in a nearby town—Skelmersdale—seem to have simplified. However, we show that not all speakers from Skelmersdale share the same constraints on this variable form, and we connect this with speakers' positive or negative attitudes toward Skelmersdale or Liverpool.
Impact of Contact Isolation Precautions on Multi-Drug Resistant Acinetobacter baumannii in the Pediatric Intensive Care Unit
- Adam Tawney, Lynn Semproch, Paul Lephart, Kevin Valentine, Ronald Thomas, Basim I. Asmar, Teena Chopra, Eric J. McGrath
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 36 / Issue 9 / September 2015
- Published online by Cambridge University Press:
- 05 June 2015, pp. 1108-1110
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- September 2015
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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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- Book:
- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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Characterization of materials' elasticity and yield strength through micro-/nano-indentation testing with a cylindrical flat-tip indenter
- Zhong Hu, Kevin Lynne, Fereidoon Delfanian
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- Journal:
- Journal of Materials Research / Volume 30 / Issue 4 / 28 February 2015
- Published online by Cambridge University Press:
- 06 February 2015, pp. 578-591
- Print publication:
- 28 February 2015
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Material property measurements at the micro-/nanoscale are required for within many materials systems, such as thin-films, coatings, nanostructured materials, and interface/interphase. An innovative approach through micro-/nano-indentation testing with a cylindrical flat-tip indenter and coupled with computer modeling was proposed to characterize the material's elastic–plastic properties. A mechanical model proposed for directly extracting the yield strength of the tested materials, based on the hemi-spherical stress–strain distribution assumption, was analytically derived and numerically validated. Specimens being tested are aluminum alloy, low carbon steel, and alloy steel. A micro-/nano-indentation solid model was constructed and computer modeling was conducted. The load point in the indentation load–depth curve and the modifier for extracting the yield strength were identified through computer modeling and validated by indentation tests. The material properties measured by indentation were compared with tensile tests. The indentation testing errors induced by residual stresses in specimens were investigated by a residual stress measurement system.
Introduction: what are mergers and can they be reversed?
- WARREN MAGUIRE, LYNN CLARK, KEVIN WATSON
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- Journal:
- English Language & Linguistics / Volume 17 / Issue 2 / July 2013
- Published online by Cambridge University Press:
- 10 June 2013, pp. 229-239
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In his foundational book on accents of English, Wells (1982: 374–5) describes the apparent merger of the vowels in the nurse and north lexical sets in Tyneside English (‘Geordie’) as follows: ‘In the broadest Geordie the lexical set nurse is merged with north, /ɔː/: work [wɔːk], first [fɔːst], shirt [ʃɔːt] (= short).’
How salient is the nurse~square merger?1
- KEVIN WATSON, LYNN CLARK
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- Journal:
- English Language & Linguistics / Volume 17 / Issue 2 / July 2013
- Published online by Cambridge University Press:
- 10 June 2013, pp. 297-323
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This article reports the results of an experimental investigation into listeners' evaluative reactions towards the nurse~square merger in the north-west of England, in an attempt to shed light on its salience. Although speakers across England's north-west have a nurse~square merger, its realisation differs: in Liverpool, speakers typically merge to a mid front [ɛː], while speakers from St Helens, just 20km further east, merge to a mid central [ɜː]. To test listeners' responses to each variant, we presented two groups of listeners from each of these localities with read sentence data from a single speaker. The speaker was from the north-west of England and had a centralised nurse~square vowel in his native accent (representing the St Helens model). To achieve a matched-guise, the original nurse~square vowels were acoustically manipulated to give the impression of fronting (representing the Liverpool model). Listeners from Liverpool and St Helens were asked to react to guises along the status dimension, and their reaction was measured in real-time using bespoke audience response software administered via the web. The novelty in this approach is that it can be used not only to show that listeners do indeed react to the guises, but also to examine precisely when this reaction takes place. Our results show that (a) overall, speakers with a nurse~square merger are not rated highly on the status dimension, regardless of whether they have a merger to a front or central vowel; (b) listeners' real-time reactions can be correlated with instances of nurse and square; and (c) listeners' responses to nurse can be different from responses to square. We discuss these results in relation to the salience of this merger in particular and to salience in general. We suggest that the salience of nurse and square is related to the local social context and the micro-linguistic context in which they appear.
Contributors
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- By Jennifer L. Allen, Inés Baños, Isabel Boege, Susan M. Bögels, Sam Cartwright-Hatton, Sarah Clark, Judith A. Cohen, Cathy Creswell, Esther I. de Bruin, Jessica Deighton, Helen F. Dodd, Caroline L. Donovan, Nicola Dummett, Sandra Dunsmuir, Melinda Edwards, Lara J. Farrell, Iyabo A. Fatimilehin, Andrew Fugard, Peter Fuggle, Philip Graham, Alice M. Gregory, Amira Hassan, Kevin Hilbert, Jennifer L. Hudson, Georgina C. Krebs, Jennifer Y. F. Lau, Anthony P. Mannarino, Sonja March, Ella L. Milliner, Laura K. Murray, Lynne Murray, Carol Newall, Thomas H. Ollendick, Dennis Ougrin, Ronald M. Rapee, Shirley Reynolds, Natalie Rodriguez, Benjamin C. Schwartzman, Stephen Scott, Susan H. Spence, Paul Stallard, Ellen Trautmann, David Trickey, Cynthia M. Turner, Saskia van der Oord, Beth Watkins, Miranda Wolpert, Jeffrey J. Wood
- Edited by Philip Graham, Shirley Reynolds, University of Reading
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- Book:
- Cognitive Behaviour Therapy for Children and Families
- Published online:
- 05 March 2013
- Print publication:
- 14 March 2013, pp viii-x
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Contributors
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- By Virginie Attina, Pierre Badin, Gérard Bailly, Denis Beautemps, Atef Ben Youssef, Lynne Bernstein, Jonas Beskow, Christoph Bregler, N. Michael Brooke, Vicki Bruce, Denis Burnham, Ruth Campbell, Marie-Agnès Cathiard, Rashid Clark, Michael M. Cohen, Tony Ezzat, Gadi Geiger, Rafaël Laboissière, Karen Lander, Hélène Loevenbrück, Juergen Luettin, MairÉad MacSweeney, Dominic W. Massaro, Iain Matthews, Kevin Munhall, Chalapathy Neti, Pascal Perrier, Tomaso A. Poggio, Gerasimos Potamianos, Robert E. Remez, Lionel Revéret, Christophe Savariaux, Jean-Luc Schwartz, Simon D. Scott, Kaoru Sekiyama, Malcom Slaney, Marija Tabain, Eric Vatikiotis-Bateson, Anne Vilain
- Edited by Gérard Bailly, Université de Grenoble, Pascal Perrier, Université de Grenoble, Eric Vatikiotis-Bateson, University of British Columbia, Vancouver
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- Book:
- Audiovisual Speech Processing
- Published online:
- 05 May 2012
- Print publication:
- 26 April 2012, pp xviii-xxxii
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Contributors
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- By William C. Banks, Daphne Barak-Erez, Kevin E. Davis, Laura K. Donohue, Mark Fenwick, Helen Fenwick, Colin Harvey, Fu Hualing, Hikmahanto Juwana, Michael Hor, Andrew Lynch, Nicola McGarrity, Gavin Phillipson, C. H. Powell, Victor V. Ramraj, Javaid Rehman, Kent Roach, H. Harry L. Roque, Edward Santow, Ujjwal Kumar Singh, Clive Walker, George Williams, Chris Oxtoby, Lynn Welchman, Simon N. M. Young
- Edited by Victor V. Ramraj, National University of Singapore, Michael Hor, National University of Singapore, Kent Roach, University of Toronto, George Williams, University of New South Wales, Sydney
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- Book:
- Global Anti-Terrorism Law and Policy
- Published online:
- 05 February 2012
- Print publication:
- 12 January 2012, pp viii-ix
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