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Evaluation of MADRS Severity Thresholds in Patients With Bipolar Depression
- Michael E. Thase, Amanda Harrington, Joseph Calabrese, Stuart Montgomery, Xiaomeng Niu, Mehul Patel
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- Journal:
- CNS Spectrums / Volume 26 / Issue 2 / April 2021
- Published online by Cambridge University Press:
- 10 May 2021, pp. 182-183
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Introduction
The Montgomery-Åsberg Depression Rating Scale (MADRS) is commonly used for the assessment of depressive symptom changes in patients with major depressive disorder (MDD) or bipolar depression. Categories of depression severity that correspond to ranges of MADRS total score have been previously reported in patients with MDD, but it appears that MADRS severity ranges have not been reported for patients with bipolar I disorder. The objective of this study was to evaluate MADRS total score ranges that correspond with different grades of depression severity in patients with bipolar I depression.
MethodsData were pooled from 3 randomized, double-blind, placebo-controlled, 6- or 8-week trials of cariprazine in patients with bipolar I depression. MADRS severity ranges were evaluated using an anchor-based approach with the clinician-rated, 7-category Clinical Global Impression-Severity (CGI-S) scale. CGI-S has previously been used to determine severity thresholds in MDD. Correlations between MADRS total score and CGI-S score were assessed in the pooled dataset at week 6; placebo and active treatment arms were pooled together. Youden index from receiver operating characteristic (ROC) curves was used to determine the optimal threshold for MADRS total score corresponding to each CGI-S severity level.
ResultsThe pooled dataset included 1523 patients with bipolar depression. Mean CGI-S scores were highly correlated with mean MADRS total scores at week 6 (r=.87; P<.0001), with MADRS total scores increasing with CGI-S severity. Using the ROC curves, MADRS total score ranges corresponding to each CGI-S severity category were estimated as follows: score of 0-6 for “normal, not at all ill”, 7-12 for “borderline mentally ill”, 13-18 for “mildly ill”, 19-23 for “moderately ill”, 24-36 for “markedly ill”, 37-39 for “severely ill”, and 40 or greater for “extremely ill”. Area under the curve (AUC) values for these cutoffs ranged from 0.930 to 0.997, representing outstanding sensitivity and specificity.
ConclusionsUtilizing data from 3 recent clinical trials of subjects with bipolar depression, we were able to identify MADRS severity thresholds. These empirical findings may help clinicians to understand and contextualize MADRS results from bipolar clinical research and apply to their patients in practice.
FundingAbbVie Inc.
Healthcare Provider Perspectives on Bipolar I Disorder Screening and the Rapid Mood Screener (RMS), a Pragmatic, New Tool
- Michael E. Thase, Stephen M. Stahl, Roger S. McIntyre, Tina Matthews-Hayes, Mehul Patel, Amanda Harrington, Vladimir Maletic, William clay Jackson, Eduard Vieta
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- Journal:
- CNS Spectrums / Volume 26 / Issue 2 / April 2021
- Published online by Cambridge University Press:
- 30 April 2021, p. 181
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Introduction
Although mania is the hallmark symptom of bipolar I disorder (BD-I), most patients initially present for treatment with depressive symptoms. Misdiagnosis of BD-I as major depressive disorder (MDD) is common, potentially resulting in poor outcomes and inappropriate antidepressant monotherapy treatment. Screening patients with depressive symptoms is a practical strategy to help healthcare providers (HCPs) identify when additional assessment for BD-I is warranted. The new 6-item Rapid Mood Screener (RMS) is a pragmatic patient-reported BD-I screening tool that relies on easily understood terminology to screen for manic symptoms and other BD-I features in <2 minutes. The RMS was validated in an observational study in patients with clinically confirmed BD-I (n=67) or MDD (n=72). When 4 or more items were endorsed (“yes”), the sensitivity of the RMS for identifying patients with BP-I was 0.88 and specificity was 0.80; positive and negative predictive values were 0.80 and 0.88, respectively. To more thoroughly understand screening tool use among HCPs, a 10-minute survey was conducted.
MethodsA nationwide sample of HCPs (N=200) was selected using multiple HCP panels; HCPs were asked to describe their opinions/current use of screening tools, assess the RMS, and evaluate the RMS versus the widely recognized Mood Disorder Questionnaire (MDQ). Results were reported by grouped specialties (primary care physicians, general nurse practitioners [NPs]/physician assistants [PAs], psychiatrists, and psychiatric NPs/PAs). Included HCPs were in practice <30 years, spent at least 75% of their time in clinical practice, saw at least 10 patients with depression per month, and diagnosed MDD or BD in at least 1 patient per month. Findings were reported using descriptive statistics; statistical significance was reported at the 95% confidence interval.
ResultsAmong HCPs, 82% used a tool to screen for MDD, while 32% used a tool for BD. Screening tool attributes considered to be of the greatest value included sensitivity (68%), easy to answer questions (66%), specificity (65%), confidence in results (64%), and practicality (62%). Of HCPs familiar with screening tools, 70% thought the RMS was at least somewhat better than other screening tools. Most HCPs were aware of the MDQ (85%), but only 29% reported current use. Most HCPs (81%) preferred the RMS to the MDQ, and the RMS significantly outperformed the MDQ across valued attributes; 76% reported that they were likely to use the RMS to screen new patients with depressive symptoms. A total of 84% said the RMS would have a positive impact on their practice, with 46% saying they would screen more patients for bipolar disorder.
DiscussionThe RMS was viewed positively by HCPs who participated in a brief survey. A large percentage of respondents preferred the RMS over the MDQ and indicated that they would use it in their practice. Collectively, responses indicated that the RMS is likely to have a positive impact on screening behavior.
FundingAbbVie Inc.
Interactivity between Candidates and Citizens on a Social Networking Site: Effects on Perceptions and Vote Intentions
- Paul R. Brewer, Michael Habegger, Ruby Harrington, Lindsay H. Hoffman, Philip Edward Jones, Jennifer L. Lambe
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- Journal:
- Journal of Experimental Political Science / Volume 3 / Issue 1 / Spring 2016
- Published online by Cambridge University Press:
- 01 July 2015, pp. 84-96
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Voters and political candidates increasingly use social networking sites (SNSs) such as Facebook. This study uses data from an online posttest-only experiment (N = 183) in analyzing how exposure to supportive or challenging user comments on a fictional candidate's Facebook page influenced participants’ perceptions of and willingness to vote for the candidate, as well as whether candidate replies to each type of user comments affected these outcomes. Participants who viewed a page with supportive comments and “likes” reported more favorable perceptions of and greater support for the candidate, relative to participants who viewed a page with challenging comments. Thus, the appearance of interactivity between a candidate and other users on the candidate's Facebook page can shape the responses of those viewing the page. However, exposure to candidate replies to either supportive or challenging comments did not lead to significantly more favorable perceptions or a greater likelihood of voting for the candidate.
Contributors
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- By J. Todd Arnedt, Sharon Aronovich, Alon Y. Avidan, Alp Sinan Baran, Johnathan Barkham, Lizabeth Binns, Tiffany J. Braley, Devin Brown, Paul R. Carney, Philip Cheng, Ronald D. Chervin, Naricha Chirakalwasan, Wattanachai Chotinaiwattarakul, Deirdre A. Conroy, Charles R. Davies, Dawn Dore-Stites, Alan S. Eiser, Todd Favorite, Barbara T. Felt, James D. Geyer, Jennifer R. Goldschmied, Cathy A. Goldstein, John J. Harrington, Fauziya Hassan, Judith L. Heidebrink, Joseph I. Helman, Shelley Hershner, Timothy F. Hoban, Edward D. Huntley, Rahul K. Kakkar, Douglas Kirsch, Raman K. Malhotra, Beth A. Malow, Lauren O’Connell, Shalini Paruthi, Meredith D. Peters, Scott M. Pickett, Satya Krishna Ramachandran, Fouad Reda, Daniel I. Rifkin, Emerson Robinson, Helena M. Schotland, Q. Afifa Shamim-Uzzaman, Anita Valanju Shelgikar, Renée A. Shellhaas, Jeffrey J. Stanley, Leslie M. Swanson, Mihai C. Teodorescu, Mihai C. Teodorescu, Sheila C. Tsai, Katherine Wilson, Michael E. Yurcheshen, Sarah Nath Zallek
- Edited by Ronald D. Chervin
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- Common Pitfalls in Sleep Medicine
- Published online:
- 05 April 2014
- Print publication:
- 10 April 2014, pp x-xiv
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20 - Religious Platonism: philosophy and religion in the Platonic tradition
- from PART II - ANCIENT EUROPE IN THE HISTORICAL PERIOD
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- By Kevin Corrigan, Emory University, Michael Harrington, Duquesne University
- Edited by Lisbeth Bredholt Christensen, University of Freiburg, Germany, Olav Hammer, University of Southern Denmark, David A. Warburton, Aarhus University, Denmark
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- Book:
- The Handbook of Religions in Ancient Europe
- Published by:
- Acumen Publishing
- Published online:
- 05 April 2014
- Print publication:
- 30 November 2013, pp 263-277
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Summary
RETHINKING THE RELATION BETWEEN PHILOSOPHY AND RELIGION
How is one to think of the relation between philosophy and religion in the Platonic tradition? The phrase “religious Platonism” may seem to be an oxymoron, if one defines Platonism, after Nietzsche, as primarily a philosophical or intellectual enterprise, fixated on “reason” and practised by a rationalist elite; or if one defines religion, by contrast, as a set of common beliefs and practices, involving prayers, rituals and accepted procedures, either more or less irrational or possessing their own peculiar traditional roots shared by a specific group of people. Platonism, more broadly conceived, however, resists modern categories, for it is an “in-between” phenomenon that cuts across modern disciplinary and dichotomous notions such as “religion” and “philosophy” as well as across ancient traditionalist representations of divinity (such as the Greek gods), of city-state or nation-hood. Religion is a term derived from Latin with no exact Greek equivalent and for this reason one might claim that there is no notion of religion as such in Greek antiquity. Even for Pseudo-Dionysius, a Christian “Platonist” of the fifth-sixth centuries CE, the approximate terms for our notion of religion, namely threskeia (worship), theologia (theology), hierourgia (holy work), leitourgia (liturgy), theourgia (theurgy), agathourgia, involve a “theology” of lived experience that does not separate philosophy, practice, prayer and community. Equally, neither Plato in the fourth century BCE nor Dionysius in the sixth century CE divides life up into its various domains (social, political, philosophical, etc.)
The association of Aβ amyloid and composite cognitive measures in healthy older adults and MCI
- Karra D. Harrington, Yen Ying Lim, Kathryn A. Ellis, Carly Copolov, David Darby, Michael Weinborn, David Ames, Ralph N. Martins, Greg Savage, Cassandra Szoeke, Christopher Rowe, Victor L. Villemagne, Colin L. Masters, Paul Maruff
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- Journal:
- International Psychogeriatrics / Volume 25 / Issue 10 / October 2013
- Published online by Cambridge University Press:
- 18 July 2013, pp. 1667-1677
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Background:
To date evidence of the relationship between cognition and Aβ amyloid during the early stages of Alzheimer's Disease (AD) has been inconsistent. This study aimed to describe the nature and magnitude of the relationship between Aβ amyloid and cognitive performance of individuals without dementia.
Methods:Composite cognitive measures were developed from the Australian Imaging Biomarkers and Lifestyle study neuropsychological test battery using data from 768 healthy older adults and 133 adults with mild cognitive impairment (MCI). A subgroup of this sample (174 healthy, 53 MCI) underwent neuroimaging for Aβ amyloid.
Results:Within the MCI group individuals with high Aβ amyloid showed selective impairment for memory compared with those with low Aβ amyloid; however, this difference was not evident in the healthy group.
Conclusions:The current findings provide further evidence of the relationship between Aβ amyloid and cognition, with memory impairment being the primary symptom of the underlying disease during the prodromal phases of AD.
Plasma homocysteine and cognitive decline in older hypertensive subjects
- Sunil K. Narayan, Brian K. Saxby, Michael J. Firbank, John T. O'Brien, Frances Harrington, Ian G. McKeith, Monica Hansrani, Gerard Stansby, Gary A. Ford
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- Journal:
- International Psychogeriatrics / Volume 23 / Issue 10 / December 2011
- Published online by Cambridge University Press:
- 06 May 2011, pp. 1607-1615
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Background: Elevated plasma homocysteine concentrations have been associated with both cognitive impairment and dementia. However, it is unclear whether some cognitive domains are more affected than others, or if this relationship is independent of B12 and folate levels, which can also affect cognition. We examined the relationship between plasma homocysteine and cognitive decline in an older hypertensive population.
Methods: 182 older people (mean age 80 years) with hypertension and without dementia, were studied at one center participating in the Study on COgnition and Prognosis in the Elderly (SCOPE). Annual cognitive assessments were performed using a computerized assessment battery and executive function tests, over a 3–5 year period (mean 44 months). Individual rates of decline on five cognitive domains were calculated for each patient. End of study plasma homocysteine, folate and B12 concentrations were measured. The relationship between homocysteine levels and cognitive decline was studied using multivariate regression models, and by comparing high versus low homocysteine quartile groups.
Results: Higher homocysteine showed an independent association with greater cognitive decline in three domains: speed of cognition (β = −27.33, p = 0.001), episodic memory (β = −1.25, p = 0.02) and executive function (β = −0.05, p = 0.04). The association with executive function was no longer significant after inclusion of folate in the regression model (β = −0.032, p = 0.22). Change in working memory and attention were not associated with plasma homocysteine, folate or B12. High homocysteine was associated with greater decline with a Cohen's d effect size of approximately 0.7 compared to low homocysteine.
Conclusions: In a population of older hypertensive patients, higher plasma homocysteine was associated with cognitive decline.
Advance care planning in advanced cancer: Can it be achieved? An exploratory randomized patient preference trial of a care planning discussion
- Louise Jones, Jane Harrington, Cate A Barlow, Adrian Tookman, Robyn Drake, Kelly Barnes, Michael King
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- Journal:
- Palliative & Supportive Care / Volume 9 / Issue 1 / March 2011
- Published online by Cambridge University Press:
- 25 February 2011, pp. 3-13
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Objective:
Little is known about the effectiveness of advance care planning in the United Kingdom, although policy documents recommend that it should be available to all those with life-limiting illness.
Method:An exploratory patient preference randomized controlled trial of advance care planning discussions with an independent mediator (maximum three sessions) was conducted in London outpatient oncology clinics and a nearby hospice. Seventy-seven patients (mean age 62 years, 39 male) with various forms of recurrent progressive cancer participated, and 68 (88%) completed follow-up at 8 weeks. Patients completed visual analogue scales assessing perceived ability to discuss end-of-life planning with healthcare professionals or family and friends (primary outcome), happiness with the level of communication, and satisfaction with care, as well as a standardized measure of anxiety and depression.
Results:Thirty-eight patients (51%) showed preference for the intervention. Discussions with professionals or family and friends about the future increased in the intervention arms, whether randomized or preference, but happiness with communication was unchanged or worse, and satisfaction with services decreased. Trial participation did not cause significant anxiety or depression and attrition was low.
Significance of results:A randomized trial of advance care planning is possible. This study provides new evidence on its acceptability and effectiveness for patients with advanced cancer.
Advance care planning discussions in advanced cancer: Analysis of dialogues between patients and care planning mediators
- Kelly A. Barnes, Cate A. Barlow, Jane Harrington, Karon Ornadel, Adrian Tookman, Michael King, Louise Jones
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- Journal:
- Palliative & Supportive Care / Volume 9 / Issue 1 / March 2011
- Published online by Cambridge University Press:
- 25 February 2011, pp. 73-79
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Objective:
Advance care planning (ACP) provides patients with an opportunity to consider, discuss, and plan their future care with health professionals. Numerous policy documents recommend that ACP should be available to all with life-limiting illness.
Method:Forty patients with recurrent progressive cancer completed one or more ACP discussions with a trained planning mediator using a standardized topic guide. Fifty-two interviews were transcribed verbatim and analyzed for qualitative thematic content.
Results:Most patients had not spoken extensively to health professionals or close persons about the future. Their concerns related to experiencing distressing symptoms or worrying how family members would cope. Some patients wished for more accurate information and were unaware of their options for care. Many felt it was doctors' responsibility to initiate such discussions, but perceived that their doctors were reluctant to do so. However, some patients felt that the time was not yet right for these conversations.
Significance of results:This article reports on the recorded content of ACP discussions. The extent to which patients want to engage in ACP is variable, and support and training are needed for health professionals to initiate such discussions. Our findings do not fully support the current United Kingdom policy of introducing ACP early in life-threatening disease.
Aspects of working memory in L2 learning
- Alan Juffs, Michael Harrington
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- Journal:
- Language Teaching / Volume 44 / Issue 2 / April 2011
- Published online by Cambridge University Press:
- 22 February 2011, pp. 137-166
- Print publication:
- April 2011
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This article reviews research on working memory (WM) and its use in second language (L2) acquisition research. Recent developments in the model and issues surrounding the operationalization of the construct itself are presented, followed by a discussion of various methods of measuring WM. These methods include word and digit span tasks, reading, listening and speaking span tasks. We next outline the role proposed for WM in explaining individual differences in L2 learning processes and outcomes, including sentence processing, reading, speaking, lexical development and general proficiency. Key findings are that WM is not a unitary construct and that its role varies depending on the age of the L2 learners, the task and the linguistic domain. Some tests of WM may in fact be tests of differences in ability to attend to aspects of the L2. Future research will focus on matching tests of WM more closely with linguistic tasks and using more standardized, replicable measures of WM in new areas including writing in non-alphabetic scripts, instructional interventions and cognitive neuropsychology.
Processing transfer: Language-specific processing strategies as a source of interlanguage variation
- Michael Harrington
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- Journal:
- Applied Psycholinguistics / Volume 8 / Issue 4 / December 1987
- Published online by Cambridge University Press:
- 03 December 2010, pp. 351-377
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A sentence interpretation experiment based on the functionalist Competition Model of speech processing (Bates & MacWhinney, 1982) was administered to three groups of university-age English L1, Japanese ESL, and Japanese L1 subjects (n = 12 per group) in an attempt to elicit evidence for (1) processing strategies characteristic of the Japanese and English L1 groups and, (2) transfer/influence of Japanese L1 strategies on the English sentence interpretations of the Japanese ESL group. Subjects selected the subject/actor of simple sentences incorporating word order, animacy, and stress cues in random converging and competing orders. The English L1 and ESL groups were tested on English sentences and the Japanese L1 group tested on Japanese sentences. The Japanese L1 interpretations were most heavily influenced by animacy cues, while the English L1 group showed a higher overall sensitivity to word order manipulations. The ESL group resembled the Japanese L1 group in reliance on animacy cues, with the exception of allowing inanimate nouns to act as subjects. While the ESL group showed greater sensitivity to word order effects than the Japanese L1 group, no “second-noun” strategy (i.e., systematically interpreting the NNV and VNN orders as left- and right-dislocated SOV and VOS orders) was evident.
Although the findings were generally consistent with previous research, the presence of contrasting response patterns in the English L1 group suggests caution in attempting to typify languages on the basis of processing strategies drawn from probablistic tendencies evident in grouped data, and leaves open the role of such processing strategy typologies as a potential source of variation in inter-language.
Contributors
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. Hackett, Getatchew Haile, Douglas John Hall, Nicholas Hammond, Daphne Hampson, Jehu J. Hanciles, Barry Hankins, Jennifer Haraguchi, Stanley S. Harakas, Anthony John Harding, Conrad L. Harkins, J. William Harmless, Marjory Harper, Amir Harrak, Joel F. Harrington, Mark W. Harris, Susan Ashbrook Harvey, Van A. Harvey, R. Chris Hassel, Jione Havea, Daniel Hawk, Diana L. Hayes, Leslie Hayes, Priscilla Hayner, S. Mark Heim, Simo Heininen, Richard P. Heitzenrater, Eila Helander, David Hempton, Scott H. Hendrix, Jan-Olav Henriksen, Gina Hens-Piazza, Carter Heyward, Nicholas J. Higham, David Hilliard, Norman A. Hjelm, Peter C. Hodgson, Arthur Holder, M. Jan Holton, Dwight N. Hopkins, Ronnie Po-chia Hsia, Po-Ho Huang, James Hudnut-Beumler, Jennifer S. Hughes, Leonard M. Hummel, Mary E. Hunt, Laennec Hurbon, Mark Hutchinson, Susan E. Hylen, Mary Beth Ingham, H. Larry Ingle, Dale T. Irvin, Jon Isaak, Paul John Isaak, Ada María Isasi-Díaz, Hans Raun Iversen, Margaret C. Jacob, Arthur James, Maria Jansdotter-Samuelsson, David Jasper, Werner G. Jeanrond, Renée Jeffery, David Lyle Jeffrey, Theodore W. Jennings, David H. Jensen, Robin Margaret Jensen, David Jobling, Dale A. Johnson, Elizabeth A. Johnson, Maxwell E. Johnson, Sarah Johnson, Mark D. Johnston, F. Stanley Jones, James William Jones, John R. Jones, Alissa Jones Nelson, Inge Jonsson, Jan Joosten, Elizabeth Judd, Mulambya Peggy Kabonde, Robert Kaggwa, Sylvester Kahakwa, Isaac Kalimi, Ogbu U. Kalu, Eunice Kamaara, Wayne C. Kannaday, Musimbi Kanyoro, Veli-Matti Kärkkäinen, Frank Kaufmann, Léon Nguapitshi Kayongo, Richard Kearney, Alice A. Keefe, Ralph Keen, Catherine Keller, Anthony J. Kelly, Karen Kennelly, Kathi Lynn Kern, Fergus Kerr, Edward Kessler, George Kilcourse, Heup Young Kim, Kim Sung-Hae, Kim Yong-Bock, Kim Yung Suk, Richard King, Thomas M. King, Robert M. Kingdon, Ross Kinsler, Hans G. Kippenberg, Cheryl A. Kirk-Duggan, Clifton Kirkpatrick, Leonid Kishkovsky, Nadieszda Kizenko, Jeffrey Klaiber, Hans-Josef Klauck, Sidney Knight, Samuel Kobia, Robert Kolb, Karla Ann Koll, Heikki Kotila, Donald Kraybill, Philip D. W. Krey, Yves Krumenacker, Jeffrey Kah-Jin Kuan, Simanga R. Kumalo, Peter Kuzmic, Simon Shui-Man Kwan, Kwok Pui-lan, André LaCocque, Stephen E. Lahey, John Tsz Pang Lai, Emiel Lamberts, Armando Lampe, Craig Lampe, Beverly J. Lanzetta, Eve LaPlante, Lizette Larson-Miller, Ariel Bybee Laughton, Leonard Lawlor, Bentley Layton, Robin A. Leaver, Karen Lebacqz, Archie Chi Chung Lee, Marilyn J. Legge, Hervé LeGrand, D. L. LeMahieu, Raymond Lemieux, Bill J. Leonard, Ellen M. Leonard, Outi Leppä, Jean Lesaulnier, Nantawan Boonprasat Lewis, Henrietta Leyser, Alexei Lidov, Bernard Lightman, Paul Chang-Ha Lim, Carter Lindberg, Mark R. Lindsay, James R. Linville, James C. Livingston, Ann Loades, David Loades, Jean-Claude Loba-Mkole, Lo Lung Kwong, Wati Longchar, Eleazar López, David W. Lotz, Andrew Louth, Robin W. Lovin, William Luis, Frank D. Macchia, Diarmaid N. J. MacCulloch, Kirk R. MacGregor, Marjory A. MacLean, Donald MacLeod, Tomas S. Maddela, Inge Mager, Laurenti Magesa, David G. Maillu, Fortunato Mallimaci, Philip Mamalakis, Kä Mana, Ukachukwu Chris Manus, Herbert Robinson Marbury, Reuel Norman Marigza, Jacqueline Mariña, Antti Marjanen, Luiz C. L. Marques, Madipoane Masenya (ngwan'a Mphahlele), Caleb J. D. Maskell, Steve Mason, Thomas Massaro, Fernando Matamoros Ponce, András Máté-Tóth, Odair Pedroso Mateus, Dinis Matsolo, Fumitaka Matsuoka, John D'Arcy May, Yelena Mazour-Matusevich, Theodore Mbazumutima, John S. McClure, Christian McConnell, Lee Martin McDonald, Gary B. McGee, Thomas McGowan, Alister E. McGrath, Richard J. McGregor, John A. McGuckin, Maud Burnett McInerney, Elsie Anne McKee, Mary B. McKinley, James F. McMillan, Ernan McMullin, Kathleen E. McVey, M. Douglas Meeks, Monica Jyotsna Melanchthon, Ilie Melniciuc-Puica, Everett Mendoza, Raymond A. Mentzer, William W. Menzies, Ina Merdjanova, Franziska Metzger, Constant J. Mews, Marvin Meyer, Carol Meyers, Vasile Mihoc, Gunner Bjerg Mikkelsen, Maria Inêz de Castro Millen, Clyde Lee Miller, Bonnie J. Miller-McLemore, Alexander Mirkovic, Paul Misner, Nozomu Miyahira, R. W. L. Moberly, Gerald Moede, Aloo Osotsi Mojola, Sunanda Mongia, Rebeca Montemayor, James Moore, Roger E. Moore, Craig E. Morrison O.Carm, Jeffry H. Morrison, Keith Morrison, Wilson J. Moses, Tefetso Henry Mothibe, Mokgethi Motlhabi, Fulata Moyo, Henry Mugabe, Jesse Ndwiga Kanyua Mugambi, Peggy Mulambya-Kabonde, Robert Bruce Mullin, Pamela Mullins Reaves, Saskia Murk Jansen, Heleen L. Murre-Van den Berg, Augustine Musopole, Isaac M. T. Mwase, Philomena Mwaura, Cecilia Nahnfeldt, Anne Nasimiyu Wasike, Carmiña Navia Velasco, Thulani Ndlazi, Alexander Negrov, James B. Nelson, David G. Newcombe, Carol Newsom, Helen J. Nicholson, George W. E. Nickelsburg, Tatyana Nikolskaya, Damayanthi M. A. Niles, Bertil Nilsson, Nyambura Njoroge, Fidelis Nkomazana, Mary Beth Norton, Christian Nottmeier, Sonene Nyawo, Anthère Nzabatsinda, Edward T. Oakes, Gerald O'Collins, Daniel O'Connell, David W. Odell-Scott, Mercy Amba Oduyoye, Kathleen O'Grady, Oyeronke Olajubu, Thomas O'Loughlin, Dennis T. Olson, J. Steven O'Malley, Cephas N. Omenyo, Muriel Orevillo-Montenegro, César Augusto Ornellas Ramos, Agbonkhianmeghe E. Orobator, Kenan B. Osborne, Carolyn Osiek, Javier Otaola Montagne, Douglas F. Ottati, Anna May Say Pa, Irina Paert, Jerry G. Pankhurst, Aristotle Papanikolaou, Samuele F. Pardini, Stefano Parenti, Peter Paris, Sung Bae Park, Cristián G. Parker, Raquel Pastor, Joseph Pathrapankal, Daniel Patte, W. Brown Patterson, Clive Pearson, Keith F. Pecklers, Nancy Cardoso Pereira, David Horace Perkins, Pheme Perkins, Edward N. Peters, Rebecca Todd Peters, Bishop Yeznik Petrossian, Raymond Pfister, Peter C. Phan, Isabel Apawo Phiri, William S. F. Pickering, Derrick G. Pitard, William Elvis Plata, Zlatko Plese, John Plummer, James Newton Poling, Ronald Popivchak, Andrew Porter, Ute Possekel, James M. Powell, Enos Das Pradhan, Devadasan Premnath, Jaime Adrían Prieto Valladares, Anne Primavesi, Randall Prior, María Alicia Puente Lutteroth, Eduardo Guzmão Quadros, Albert Rabil, Laurent William Ramambason, Apolonio M. Ranche, Vololona Randriamanantena Andriamitandrina, Lawrence R. Rast, Paul L. Redditt, Adele Reinhartz, Rolf Rendtorff, Pål Repstad, James N. Rhodes, John K. Riches, Joerg Rieger, Sharon H. Ringe, Sandra Rios, Tyler Roberts, David M. Robinson, James M. Robinson, Joanne Maguire Robinson, Richard A. H. Robinson, Roy R. Robson, Jack B. Rogers, Maria Roginska, Sidney Rooy, Rev. Garnett Roper, Maria José Fontelas Rosado-Nunes, Andrew C. Ross, Stefan Rossbach, François Rossier, John D. Roth, John K. Roth, Phillip Rothwell, Richard E. Rubenstein, Rosemary Radford Ruether, Markku Ruotsila, John E. Rybolt, Risto Saarinen, John Saillant, Juan Sanchez, Wagner Lopes Sanchez, Hugo N. Santos, Gerhard Sauter, Gloria L. Schaab, Sandra M. Schneiders, Quentin J. Schultze, Fernando F. Segovia, Turid Karlsen Seim, Carsten Selch Jensen, Alan P. F. Sell, Frank C. Senn, Kent Davis Sensenig, Damían Setton, Bal Krishna Sharma, Carolyn J. Sharp, Thomas Sheehan, N. Gerald Shenk, Christian Sheppard, Charles Sherlock, Tabona Shoko, Walter B. Shurden, Marguerite Shuster, B. Mark Sietsema, Batara Sihombing, Neil Silberman, Clodomiro Siller, Samuel Silva-Gotay, Heikki Silvet, John K. Simmons, Hagith Sivan, James C. Skedros, Abraham Smith, Ashley A. Smith, Ted A. Smith, Daud Soesilo, Pia Søltoft, Choan-Seng (C. S.) Song, Kathryn Spink, Bryan Spinks, Eric O. Springsted, Nicolas Standaert, Brian Stanley, Glen H. Stassen, Karel Steenbrink, Stephen J. Stein, Andrea Sterk, Gregory E. Sterling, Columba Stewart, Jacques Stewart, Robert B. Stewart, Cynthia Stokes Brown, Ken Stone, Anne Stott, Elizabeth Stuart, Monya Stubbs, Marjorie Hewitt Suchocki, David Kwang-sun Suh, Scott W. Sunquist, Keith Suter, Douglas Sweeney, Charles H. Talbert, Shawqi N. Talia, Elsa Tamez, Joseph B. Tamney, Jonathan Y. Tan, Yak-Hwee Tan, Kathryn Tanner, Feiya Tao, Elizabeth S. Tapia, Aquiline Tarimo, Claire Taylor, Mark Lewis Taylor, Bishop Abba Samuel Wolde Tekestebirhan, Eugene TeSelle, M. Thomas Thangaraj, David R. Thomas, Andrew Thornley, Scott Thumma, Marcelo Timotheo da Costa, George E. “Tink” Tinker, Ola Tjørhom, Karen Jo Torjesen, Iain R. Torrance, Fernando Torres-Londoño, Archbishop Demetrios [Trakatellis], Marit Trelstad, Christine Trevett, Phyllis Trible, Johannes Tromp, Paul Turner, Robert G. Tuttle, Archbishop Desmond Tutu, Peter Tyler, Anders Tyrberg, Justin Ukpong, Javier Ulloa, Camillus Umoh, Kristi Upson-Saia, Martina Urban, Monica Uribe, Elochukwu Eugene Uzukwu, Richard Vaggione, Gabriel Vahanian, Paul Valliere, T. J. Van Bavel, Steven Vanderputten, Peter Van der Veer, Huub Van de Sandt, Louis Van Tongeren, Luke A. Veronis, Noel Villalba, Ramón Vinke, Tim Vivian, David Voas, Elena Volkova, Katharina von Kellenbach, Elina Vuola, Timothy Wadkins, Elaine M. Wainwright, Randi Jones Walker, Dewey D. Wallace, Jerry Walls, Michael J. Walsh, Philip Walters, Janet Walton, Jonathan L. Walton, Wang Xiaochao, Patricia A. Ward, David Harrington Watt, Herold D. Weiss, Laurence L. Welborn, Sharon D. Welch, Timothy Wengert, Traci C. West, Merold Westphal, David Wetherell, Barbara Wheeler, Carolinne White, Jean-Paul Wiest, Frans Wijsen, Terry L. Wilder, Felix Wilfred, Rebecca Wilkin, Daniel H. Williams, D. Newell Williams, Michael A. Williams, Vincent L. Wimbush, Gabriele Winkler, Anders Winroth, Lauri Emílio Wirth, James A. Wiseman, Ebba Witt-Brattström, Teofil Wojciechowski, John Wolffe, Kenman L. Wong, Wong Wai Ching, Linda Woodhead, Wendy M. Wright, Rose Wu, Keith E. Yandell, Gale A. Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- Book:
- The Cambridge Dictionary of Christianity
- Published online:
- 05 August 2012
- Print publication:
- 20 September 2010, pp xi-xliv
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L2 access to UG: Now you see it, now you don't
- Michael Harrington
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- Journal:
- Behavioral and Brain Sciences / Volume 19 / Issue 4 / December 1996
- Published online by Cambridge University Press:
- 04 February 2010, pp. 731-732
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The confirmatory nature of the empirical evidence used to establish UG effects in L2 development is considered. Specific issues are also raised concerning the internal validity of Epstein et al.'s findings. It is concluded that the role of UG in adult L2 development will only be established when researchers better understand the interaction between the development of UG-constrained structural knowledge and the development of overall L2 proficiency.
20 - Pseudo-Dionysius
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- By Kevin Corrigan, Emory University, Michael Harrington, Duquesne University
- Edited by Graham Oppy, Monash University, Austrailia
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- Book:
- The History of Western Philosophy of Religion
- Published by:
- Acumen Publishing
- Published online:
- 05 February 2013
- Print publication:
- 29 October 2009, pp 277-290
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Summary
For many centuries the four major works and ten letters that form the Corpus Dionysiacum were thought to be by St Denys the Areopagite, a member of the Athenian Areopagus converted by St Paul (Acts 17:34), just as their author represents them to be. Doubts about the authorship were raised as early as 532 by a Synod in Constantinople after a pro-monophysite group had claimed support for their views in the corpus, and later still by Peter Abelard (1121), Lorenzo Valla (1457) and John Grocyn (1501), but they were first widely published by Erasmus in 1504. Hardly anyone doubted a generally Platonic background to the corpus, although some, like Luther, thought it “pernicious”: Dionysius “Platonizes more than he Christianizes” (1888: 562). The Neoplatonic character of parts of the corpus was definitively demonstrated in 1895 by Hugo Koch and Josef Stiglmayr (independently): Denys' presentation of evil as a parhypostasis, or by-product of reality without genuine existence on its own account, was dependent on Proclus' De malorum subsistentia. In fact, the corpus employs language and quotations from Hellenic authors stretching back through Proclus, Iamblichus and Plotinus to Aristotle, Plato and Parmenides.
The assessment of lifetime psychopathology: a comparison of two interviewing styles
- Richard Harrington, Jonathan Hill, Michael Rutter, Karen John, Hazel Fudge, Mark Zoccolillo, Myrna Weissman
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- Journal:
- Psychological Medicine / Volume 18 / Issue 2 / May 1988
- Published online by Cambridge University Press:
- 09 July 2009, pp. 487-493
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A structured respondent-based version of the SADS-L interview was compared with a semi-structured investigator-based version of the same interview in terms of efficiency in assessing lifetime psychopathology. There was substantial agreement across most Research Diagnostic Criteria (RDC) categories, but there was less agreement on the rating of symptoms. The implications of these similarities and differences between the techniques are discussed.
Developmental pathways in depression: Multiple meanings, antecedents, and endpoints
- Richard Harrington, Michael Rutter, Eric Fombonne
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- Journal:
- Development and Psychopathology / Volume 8 / Issue 4 / Fall 1996
- Published online by Cambridge University Press:
- 04 March 2009, pp. 601-616
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This article presents an overview of work conducted at the Institute of Psychiatry over the past 30 years on childhood depression. The work began with the basic question of definition and measurement. Epidemiological studies showed that depressive symptoms were quite common in children and were a good, if nonspecific, indicator of psychological disturbance. Further work in both epidemiological and clinical samples provided some evidence for the validity of a depressive syndrome. However, this work also showed that these depressive syndromes represented a heterogeneous group of phenomena. The validity of major depressive disorder in children was therefore tested further in longitudinal and family-genetic studies. These studies supported the validity of the concept but confirmed that there was heterogeneity in respect to both developmental stage at the time of onset and comorbidity with conduct disorder. We concluded that there are probably several different kinds of depressive syndromes in children. Some are strongly linked with depressive disorders in adulthood, but others are probably better conceptualized as part of another psychopathological problem altogether.
Second-Language Acquisition
- Barry McLaughlin, Michael Harrington
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- Journal:
- Annual Review of Applied Linguistics / Volume 10 / March 1989
- Published online by Cambridge University Press:
- 19 November 2008, pp. 122-134
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As H. Douglas Brown pointed out in his review (1980), the field of second language acquisition [SLA] has emerged as its own discipline in the 1980s. A somewhat eclectic discipline, research in SLA involves methodologies drawn from linguistics, sociolinguistics, education, and psychology. Theoretical models are equally diverse (McLaughlin 1987), but in general a distinction is possible between representational and processing approaches (Carroll in press). Representational approaches focus on the nature and organization of second-language knowledge and how this information is represented in the mind of the learner. Processing approaches focus on the integration of perceptual and cognitive Processes with the learner's second-languages knowledge. This distinction is used here for purposes of exposition, although it is recognized that some approaches combine both representational and processing features, as any truly adequate model of second-language learning must.
Attitudes towards and beliefs about nutrition and health among a random sample of adults in the Republic of Ireland and Northern Ireland
- John M Kearney, Michael J Gibney, Barbara E Livingstone, Paula J Robson, Mairead Kiely, Karen Harrington
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- Journal:
- Public Health Nutrition / Volume 4 / Issue 5a / October 2001
- Published online by Cambridge University Press:
- 03 July 2008, pp. 1117-1126
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Objectives
For effective healthy eating promotion, it is necessary to understand the attitudes towards and beliefs about nutrition of the general public. The objective of this study was to provide data on attitudes towards eating a healthy diet and the perceived need to alter eating habits from a random sample of adults in the Republic of Ireland and in Northern Ireland, using a self-administered questionnaire.
DesignCross-sectional survey using a self-administered attitudinal questionnaire on beliefs and attitudes to healthy eating.
SettingThe survey was carried out between October 1997 and October 1999 in the Republic of Ireland and in Northern Ireland.
SubjectsA randomly selected sample of 1256 adults from the Republic of Ireland and Northern Ireland completed the attitudinal questionnaire.
ResultsA majority of subjects (62%) perceived that they make conscious efforts to eat a healthy diet either most of the time or quite often, while just over half (52%) agreed that they do not need to make changes to their diet as it is healthy enough. Subjects most likely to make conscious efforts to try to eat a healthy diet were females, older subjects (51-64 years) and those with the highest intakes of fruit and vegetables and lowest quartile of fat (% food energy). When self-assessed adequacy of fruit and vegetables was examined, two-thirds of the total sample felt they ate too little fruit while just one-third felt they ate too little vegetables.
ConclusionResults of the present study, in general, revealed good agreement between attitude and behaviour with respect to healthy eating. This suggests that people appear to be reasonably accurate at evaluating their own diet in terms of how healthy it is. In terms of the two food groups examined in this study, some optimistic bias was evident for vegetables but not for fruit. It may be useful therefore to assess attitudes and beliefs about healthy eating by way of examining attitudes to such food groups individually.
12 - Pseudo-Dionysius: the mediation of sacred traditions
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- By Kevin Corrigan, Professor of the Liberal Arts Graduate Institute of the Liberal Arts Emory University Atlanta Georgia, Michael Harrington, Assistant Professor of Philosophy University of Dallas
- Edited by James R. Lewis, University of Wisconsin, Milwaukee, Olav Hammer, University of Southern Denmark
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- Book:
- The Invention of Sacred Tradition
- Published online:
- 22 September 2009
- Print publication:
- 29 November 2007, pp 241-257
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Summary
INTRODUCTION: FORGERY AND ORIGINALITY
Dionysius, or Pseudo-Dionysius, as he has come to be called, was an unknown person who wrote in the late fifth or early sixth century ce and who transposed in a thoroughly original way the whole of Pagan Neoplatonism from Plotinus to Proclus into a distinctively new Christian context. Since he represented himself as St. Dionysius the Areopagite, an Athenian member of the judicial council, the Areopagus, who was converted instantly by St. Paul, his work, strictly speaking, might be regarded as a successful “forgery,” providing him with impeccable Christian credentials that conveniently antedated Plotinus by over 200 years. Dionysius' fictitious identity was first seriously called into question by Lorenzo Valla in 1457 and John Grocyn in 1501, a critical viewpoint later accepted and publicized by Erasmus from 1504 onward. But only in modern times has it become generally accepted that instead of being the disciple of St. Paul, Dionysius must have lived in the time of Proclus, and was perhaps of Syrian origin, someone who knew enough of Platonism and the Christian tradition to transform them both. So he has come to be known as Pseudo-Dionysius, that is, a kind of counterfeit representation or forgery of a supposed original.
“Forgery,” however, is a modern notion, from the Anglo-French verb forger, “to falsify or counterfeit” (and more distant still from the Latin fabricari), whose usage is first attested in 1574.
Improving safety for children with cardiac disease
- Ravi R. Thiagarajan, Geoffrey L. Bird, Karen Harrington, John R. Charpie, Richard C. Ohye, James M. Steven, Michael Epstein, Peter C. Laussen
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- Journal:
- Cardiology in the Young / Volume 17 / Issue S4 / September 2007
- Published online by Cambridge University Press:
- 26 November 2007, pp. 127-132
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The complexity of the modern systems providing health care presents a unique challenge in delivering care of the required quality in a safe environment. Issues of safety have been thrust into the limelight because of adverse events highly publicized in the general media.
In the United States of America, improving the safety and quality in health care has been set forth as a priority for improvements in the 21st century in the report from the Institute of Medicine. Many measures have now been initiated for improving the safety of patients at hospital, regional, and national level, and through initiatives sponsored by governments and private organizations. In this review, we summarize known concepts and current issues on the safety of patients, and their applicability to children with congenital cardiac disease. Prior to examining the issues of medical error and safety, it is important to define the terminology.
An error is defined as the failure of a planned action to be completed as intended, also known as an execution error, or the use of a wrong plan to achieve an aim, this representing a planning error. An active error is an error that occurs at the level of the frontline operator, and the effects of which are felt immediately. A latent error is an error in the design, organization, training and maintenance, that leads to operator errors, and the effects of which are typically dormant in the system for lengthy periods of time. Latent errors may cause harm given the right circumstances and environment.
An adverse event is defined as an injury resulting from medical intervention. A preventable adverse event is an adverse event that occurs due to medical error. Negligent adverse events are a subset of preventable adverse events where the care provided did not meet the standard of care expected of that practitioner.
The study of improving the delivery of safe care for our patients is a rapidly growing field. Important components for development of programmes to improve the safety of patients include the leadership for the programme, the implementation of process design based on human limitations, the promotion of teamwork and function, the anticipation of unexpected events, and the creation of a learning environment.
Much is yet to be learned about the risk and incidence of adverse events during hospitalization of children with congenital cardiac disease. Errors due to human factors, such as poor communication, poor coordination, and suboptimal team work, have shown to be important causes of adverse outcomes in children undergoing cardiac surgery, and should be a focus for improvement. Future research on evaluating causes and prevention of medical errors and adverse events in this population at high risk, and consuming high resources, is essential.
Issues of inadequate safeguards for patients have been prominent in the media, and have been highlighted in reports from the Institute of Medicine. Our review discusses research on the causes of medical error, and proposes concepts to design successful programmes to improve safety for the patients on a local level.