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Number Needed to Treat and Number Needed to Harm From Two Phase 3 Studies of Sublingual Dexmedetomidine for Treating Acute Agitation in Patients With Schizophrenia and Bipolar Disorder
- Citrome L, Risinger R, Rajachandran L, Patton E, Robison H
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- Journal:
- CNS Spectrums / Volume 28 / Issue 2 / April 2023
- Published online by Cambridge University Press:
- 14 April 2023, p. 226
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Background
Episodes of acute agitation can occur in individuals who suffer from schizophrenia or bipolar disorder and these can be a significant challenge for patients and for those who provide care to them. Sublingual dexmedetomidine is a selective alpha2-adrenergic receptor agonist that was recently approved by the US Food and Drug Administration for the treatment of agitation in adults with schizophrenia or bipolar disorder. The sublingual form of dexmedetomidine does not undergo first-pass hepatic metabolism, thus resulting in greater absorption than when ingested. In two Phase 3 studies of adults with schizophrenia or bipolar disorder, sublingual dexmedetomidine significantly reduced acute agitation at 2 hours, as measured by the five-item Positive and Negative Syndrome Scale-Excited Component (PEC). When initially appraising the potential utility of a new medication, number needed to treat (NNT) and needed to harm (NNH) can be helpful to assess the size of the treatment effect and, hence, clinical relevance.
ObjectiveCalculation of NNT and NNH through post hoc analysis of Phase 3 data.
MethodsPost hoc analysis of data were performed on data from two double-blind, randomized, placebo-controlled studies of sublingual dexmedetomidine in adults with schizophrenia or bipolar disorder experiencing acute agitation. Patients were randomized to a single dose of sublingual dexmedetomidine 180 μg, 120 μg, or placebo. The primary endpoint was mean change from baseline in the PEC total score. A therapeutic response was defined as a ≥40% reduction from baseline in PEC total score at 2 hours. NNT was calculated for PEC response rate for sublingual dexmedetomidine versus placebo. NNH was calculated using the incidence of adverse events for sublingual dexmedetomidine versus placebo. Likelihood to be helped or harmed (LHH) was calculated as the ratio of NNH to NNT.
ResultsNNT (95% CI) was 3 (2, 3) for 180 mcg and 3 (3, 4) for 120 ug in patients with schizophrenia and 3 (2, 3) for 180 mcg and 4 (3, 6) for 120 ug in patients with bipolar disorder. NNH was greater than 10 for all AEs except somnolence, where NNH was 7 (5, 10) for all doses pooled from both studies. LLH values were greater than 1 for efficacy versus applicable tolerability outcomes in all cases.
ConclusionsThis post hoc analysis demonstrated favorable NNT and NNH values for sublingual dexmedetomidine. In all instances therapeutic response was encountered more frequently than any adverse event. These values compare favorably to similar analyses for other approved agents for the treatment of agitation associated with schizophrenia or bipolar disorder, including intramuscular and inhaled formulations.
FundingBioXcel Therapeutics, Inc.
Epidemiology and genomics of a slow outbreak of methicillin-resistant Staphyloccus aureus (MRSA) in a neonatal intensive care unit: Successful chronic decolonization of MRSA-positive healthcare personnel
- Kathleen A. Quan, Mohamad R. A. Sater, Cherry Uy, Robin Clifton-Koeppel, Linda L. Dickey, William Wilson, Pat Patton, Wayne Chang, Pamela Samuelson, Georgia K. Lagoudas, Teri Allen, Lenny Merchant, Rick Gannotta, Cassiana E. Bittencourt, J. C. Soto, Kaye D. Evans, Paul C. Blainey, John Murray, Dawn Shelton, Helen S. Lee, Matthew Zahn, Julia Wolfe, Keith Madey, Jennifer Yim, Shruti K. Gohil, Yonatan H. Grad, Susan S. Huang
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 44 / Issue 4 / April 2023
- Published online by Cambridge University Press:
- 16 June 2022, pp. 589-596
- Print publication:
- April 2023
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Objective:
To describe the genomic analysis and epidemiologic response related to a slow and prolonged methicillin-resistant Staphylococcus aureus (MRSA) outbreak.
Design:Prospective observational study.
Setting:Neonatal intensive care unit (NICU).
Methods:We conducted an epidemiologic investigation of a NICU MRSA outbreak involving serial baby and staff screening to identify opportunities for decolonization. Whole-genome sequencing was performed on MRSA isolates.
Results:A NICU with excellent hand hygiene compliance and longstanding minimal healthcare-associated infections experienced an MRSA outbreak involving 15 babies and 6 healthcare personnel (HCP). In total, 12 cases occurred slowly over a 1-year period (mean, 30.7 days apart) followed by 3 additional cases 7 months later. Multiple progressive infection prevention interventions were implemented, including contact precautions and cohorting of MRSA-positive babies, hand hygiene observers, enhanced environmental cleaning, screening of babies and staff, and decolonization of carriers. Only decolonization of HCP found to be persistent carriers of MRSA was successful in stopping transmission and ending the outbreak. Genomic analyses identified bidirectional transmission between babies and HCP during the outbreak.
Conclusions:In comparison to fast outbreaks, outbreaks that are “slow and sustained” may be more common to units with strong existing infection prevention practices such that a series of breaches have to align to result in a case. We identified a slow outbreak that persisted among staff and babies and was only stopped by identifying and decolonizing persistent MRSA carriage among staff. A repeated decolonization regimen was successful in allowing previously persistent carriers to safely continue work duties.
Continuities in maternal substance use from early adolescence to parenthood: findings from the intergenerational cohort consortium
- Kimberly C. Thomson, Christopher J. Greenwood, Primrose Letcher, Elizabeth A. Spry, Jacqui A. Macdonald, Helena M. McAnally, Lindsey A. Hines, George J. Youssef, Jennifer E. McIntosh, Delyse Hutchinson, Robert J. Hancox, George C. Patton, Craig A. Olsson
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- Journal:
- Psychological Medicine / Volume 53 / Issue 5 / April 2023
- Published online by Cambridge University Press:
- 08 October 2021, pp. 2136-2145
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Background
This study assessed the extent to which women's preconception binge drinking, tobacco use and cannabis use, reported prospectively in adolescence and young adulthood, predicted use of these substances during pregnancy and at 1 year postpartum.
MethodsData were pooled from two intergenerational cohort studies: the Australian Temperament Project Generation 3 Study (395 mothers, 691 pregnancies) and the Victorian Intergenerational Health Cohort Study (398 mothers, 609 pregnancies). Alcohol, tobacco and cannabis use were assessed in adolescence (13–18 years), young adulthood (19–29 years) and at ages 29–35 years for those transitioning to parenthood. Exposures were weekly or more frequent preconception binge drinking (5 + drinks in one session), tobacco use and cannabis use. Outcomes were any alcohol, tobacco and cannabis use prior to awareness of the pregnancy, after awareness of pregnancy (up to and including the third trimester pregnancy) and at 1 year postpartum.
ResultsFrequent preconception binge drinking, tobacco use and cannabis use across both adolescence and young adulthood were strong predictors of continued use post-conception, before and after awareness of the pregnancy and at 1 year postpartum. Substance use limited to young adulthood also predicted continued use post-conception.
ConclusionsPersistent alcohol, tobacco use and cannabis use that starts in adolescence has a strong continuity into parenthood. Reducing substance use in the perinatal period requires action well before pregnancy, commencing in adolescence and continuing into the years before conception and throughout the perinatal period.
The time spent in fresh cow pen influences total lactational performance
- F. Hoseyni, D. Zahmatkesh, E. Mahjoubi, M. Hossein Yazdi, R. A. Patton
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- The Journal of Agricultural Science / Volume 158 / Issue 3 / April 2020
- Published online by Cambridge University Press:
- 17 July 2020, pp. 247-253
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This research paper addresses the effect of different grouping strategies of fresh cows on total lactational and reproductive performance. Hundred-sixty multiparous Holstein cows were enrolled in a completely randomized design and assigned to one of following treatments: 21 days in fresh pen with 12.5 kg/day concentrate (C21, n = 60), 10 days in fresh pen with 12.5 kg/day concentrate (C10, n = 50) and 10 days in fresh pen with 10 kg/day concentrate (L10, n = 50). Although there were no differences among treatments within the first 10 days in milk (DIM), C10 and L10 cows tended to produce more milk than C21 from 10 to 21 DIM. In addition, greater milk yield was obtained in C10 and L10 cows during 22–28 DIM and 29–70 DIM. Higher production in early lactation resulted in a tendency for greater milk production for C10 and L10 cows throughout a 305 days lactation. There was no difference in productivity between C10 and L10 groups at any time point. No blood metabolites (Ca, P, non-esterified fatty acids and β-hydroxy butyrate) were affected by treatments. Pregnancy at first, second and third service was 38, 39 and 40%, respectively, which were not influenced by the days in fresh pen or concentrate allowance. Collectively, our results for the first time suggest that fresh cow grouping strategy has a long-term effect on productivity but that adding 2.5 kg/day concentrate has no effect on milk yield in fresh pen.
Threatened efficiency not autonomy: Prescriber perceptions of an established pediatric antimicrobial stewardship program
- Julia E. Szymczak, Eimear Kitt, Molly Hayes, Kathleen Chiotos, Susan E. Coffin, Emily R. Schriver, Ashley M. Patton, Talene A. Metjian, Jeffrey S. Gerber
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 40 / Issue 5 / May 2019
- Published online by Cambridge University Press:
- 28 March 2019, pp. 522-527
- Print publication:
- May 2019
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Background:
Implementing antimicrobial stewardship programs (ASPs) can be challenging due to prescriber resistance. Although barriers to implementing new ASPs have been identified, little is known about how prescribers perceive established programs. This information is critical to promoting the sustainability of ASPs.
Objective:To identify how prescribers perceive an established pediatric inpatient ASP that primarily utilizes prior authorization.
Methods:We conducted a cross-sectional survey administered from February through June 2017 in a large children’s hospital. The survey contained closed- and open-ended questions. Descriptive statistics and thematic content analysis approaches were used to analyze responses.
Results:Of 394 prescribers invited, 160 (41%) responded. Prescribers had an overall favorable impression of the ASP, believing that it improves the quality of care (92.4% agree) and takes their judgment seriously (73.8%). The most common criticism of the ASP was that it threatened efficiency (26.0% agreed). In addition, 68.7% of respondents reported occasionally engaging in workarounds. Analysis of 133 free-text responses revealed that prescribers perceived that interacting with the ASP involved too many phone calls, caused communication breakdowns with the dispensing pharmacy, and led to gaps between approval and dispensing of antibiotics. Reasons given for workarounds included not wanting to change therapy that appears to be working, consultant disagreement with ASP recommendations, and the desire to do everything possible for patients.
Conclusions:Prescribers had a generally favorable opinion of an established ASP but found aspects to be inefficient. They reported engaging in workarounds occasionally for social and emotional reasons. Established ASPs should elicit feedback from frontline prescribers to optimize program impact.
2421 Development and validation of a translational rat model of neonatal abstinence syndrome
- Lisa Brents, Bryce A. Griffin, Caitlin Caperton, Lauren Russell, Christian Cabanlong, Catheryn Wilson, Kyle Urquhart, Brad Martins, Amy L. Patton, Alexander W. Alund, S. Michael Owens, William E. Fantegrossi, Jeffery H. Moran
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- Journal:
- Journal of Clinical and Translational Science / Volume 2 / Issue S1 / June 2018
- Published online by Cambridge University Press:
- 21 November 2018, p. 9
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OBJECTIVES/SPECIFIC AIMS: Rodent models can be used to study neonatal abstinence syndrome (NAS), but the applicability of findings from the models to NAS in humans is not well understood. The objective of this study was to develop a rat model of norbuprenorphine-induced NAS and validate its translational value by comparing blood concentrations in the norbuprenorphine-treated pregnant rat to those previously reported in pregnant women undergoing buprenorphine treatment. METHODS/STUDY POPULATION: Pregnant Long-Evans rats were implanted with 14-day osmotic minipumps containing vehicle, morphine (positive control), or norbuprenorphine (0.3–3 mg/kg/d) on gestation day 9. Within 12 hours of delivery, pups were tested for spontaneous or precipitated opioid withdrawal by injecting them with saline (10 mL/kg, i.p.) or naltrexone (1 or 10 mg/kg, i.p), respectively, and observing them for well-validated neonatal withdrawal signs. Blood was sampled via indwelling jugular catheters from a subset of norbuprenorphine-treated dams on gestation day 8, 10, 13, 17, and 20. Norbuprenorphine concentrations in whole blood samples were quantified using LC/MS/MS. RESULTS/ANTICIPATED RESULTS: Blood concentrations of norbuprenorphine in rats exposed to 1–3 mg/kg/d of norbuprenorphine were similar to levels previously reported in pregnant women undergoing buprenorphine treatment. Pups born to dams treated with these doses exhibited robust withdrawal signs. Blood concentrations of norbuprenorphine decreased across gestation, which is similar to previous reports in humans. DISCUSSION/SIGNIFICANCE OF IMPACT: These results suggest that dosing dams with 1–3 mg/kg/day norbuprenorphine produces maternal blood concentrations and withdrawal severity similar to those previously reported in humans. This provides evidence that, at these doses, this model is useful for testing hypotheses about norbuprenorphine that are applicable to NAS in humans.
2092 A multicenter study of fecal microbiota transplantation for Clostridium difficile infection in children
- Maribeth R. Nicholson, Erin Alexander, Mark Bartlett, Penny Becker, Zev Davidovics, Elizabeth E. Knackstedt, Michael Docktor, Michael Dole, Grace Felix, Jonathan Gisser, Suchitra Hourigan, Kyle Jensen, Jess Kaplan, Judith Kelsen, Melissa Kennedy, Sahil Khanna, McKenzie Leier, Jeffery Lewis, Ashley Lodarek, Sonia Michail, Paul Mitchell, Maria Oliva‐Hemker, Tiffany Patton, Karen Queliza, Namita Singh, Aliza Solomon, David Suskind, Steven Werlin, Richard Kellermayer, Stacy Kahn
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- Journal:
- Journal of Clinical and Translational Science / Volume 2 / Issue S1 / June 2018
- Published online by Cambridge University Press:
- 21 November 2018, p. 64
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OBJECTIVES/SPECIFIC AIMS: Clostridium difficile infection (CDI) is the most common cause of antibiotic-associated diarrhea and an increasingly common infection in children in both hospital and community settings. Between 20% and 30% of pediatric patients will have a recurrence of symptoms in the days to weeks following an initial infection. Multiple recurrences have been successfully treated with fecal microbiota transplantation (FMT), though the body of evidence in pediatric patients is limited primarily to case reports and case series. The goal of our study was to better understand practices, success, and safety of FMT in children as well as identify risk factors associated with a failed FMT in our pediatric patients. METHODS/STUDY POPULATION: This multicenter retrospective analysis included 373 patients who underwent FMT for CDI between January 1, 2006 and January 1, 2017 from 18 pediatric centers. Demographics, baseline characteristics, FMT practices, C. difficile outcomes, and post-FMT complications were collected through chart abstraction. Successful FMT was defined as no recurrence of CDI within 60 days after FMT. Of the 373 patients in the cohort, 342 had known outcome data at two months post-FMT and were included in the primary analysis evaluating risk factors for recurrence post-FMT. An additional six patients who underwent FMT for refractory CDI were excluded from the primary analysis. Unadjusted analysis was performed using Wilcoxon rank-sum test, Pearson χ2 test, or Fisher exact test where appropriate. Stepwise logistic regression was utilized to determine independent predictors of success. RESULTS/ANTICIPATED RESULTS: The median age of included patients was 10 years (IQR; 3.0, 15.0) and 50% of patients were female. The majority of the cohort was White (89.0%). Comorbidities included 120 patients with inflammatory bowel disease (IBD) and 14 patients who had undergone a solid organ or stem cell transplantation. Of the 336 patients with known outcomes at two months, 272 (81%) had a successful outcome. In the 64 (19%) patients that did have a recurrence, 35 underwent repeat FMT which was successful in 20 of the 35 (57%). The overall success rate of FMT in preventing further episodes of CDI in the cohort with known outcome data was 87%. Unadjusted predictors of a primary FMT response are summarized. Based on stepwise logistic regression modeling, the use of fresh stool, FMT delivery via colonoscopy, the lack of a feeding tube, and a lower number of CDI episodes before undergoing FMT were independently associated with a successful outcome. There were 20 adverse events in the cohort assessed to be related to FMT, 6 of which were felt to be severe. There were no deaths assessed to be related to FMT in the cohort. DISCUSSION/SIGNIFICANCE OF IMPACT: The overall success of FMT in pediatric patients with recurrent or severe CDI is 81% after a single FMT. Children without a feeding tube, who receive an early FMT, FMT with fresh stool, or FMT via colonoscopy are less likely to have a recurrence of CDI in the 2 months following FMT. This is the first large study of FMT for CDI in a pediatric cohort. These findings, if confirmed by additional prospective studies, will support alterations in the practice of FMT in children.
Sulfonylurea Herbicide Safety on Newly Sprigged Bermudagrass and Seashore Paspalum
- Aaron J. Patton, Jon M. Trappe, Ronald E. Strahan, Jeffrey S. Beasley
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- Weed Technology / Volume 24 / Issue 3 / September 2010
- Published online by Cambridge University Press:
- 20 January 2017, pp. 342-348
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Several sulfonylurea herbicides are labeled for use on established bermudagrass or seashore paspalum, but label recommendations for many of these chemicals vary for sprigged turf. The objective of this study was to determine the safety of various sulfonylurea herbicides on newly planted, ‘Tifway’ bermudagrass and ‘Aloha’ seashore paspalum sprigs in Arkansas and Louisiana. Treatments were arranged as a five by two by two factorial with five herbicides (foramsulfuron at 29 and 59 g ai ha−1, halosulfuron at 35 and 70 g ai ha−1, metsulfuron at 21 and 42 g ai ha−1, sulfosulfuron at 66 and 131 g ai ha−1, and trifloxysulfuron at 28 and 56 g ai ha−1), two herbicide rates (low and high), and two application timings at 2 or 4 wk after sprigging (WAS). There was no discernable herbicide injury to, or reduction in, Tifway bermudagrass coverage in Arkansas, regardless of herbicide, application timing, or application rate. Trifloxysulfuron and metsulfuron were more injurious than other herbicides in Louisiana when applied at 2 WAS to Tifway bermudagrass, but injury levels were acceptable (< 15%), and there was no long-term reduction in establishment. Metsulfuron or halosulfuron applied at 2 or 4 WAS and sulfosulfuron applied at 4 WAS allowed > 90% establishment of Aloha seashore paspalum at both locations. Both trifloxysulfuron and foramsulfuron were injurious to seashore paspalum and reduced its establishment. These results suggest that sulfonylurea herbicides can be safely applied shortly after sprigging to Tifway bermudagrass and that metsulfuron, halosulfuron, and sulfosulfuron could be useful herbicides for establishing Aloha seashore paspalum from sprigs.
Potential Damage to Sensitive Landscape Plants from Wood Chips of Aminocyclopyrachlor Damaged Trees
- Aaron J. Patton, Gail E. Ruhl, Tom C. Creswell, Ping Wan, David E. Scott, Joe D. Becovitz, Daniel V. Weisenberger
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- Weed Technology / Volume 27 / Issue 4 / December 2013
- Published online by Cambridge University Press:
- 20 January 2017, pp. 803-809
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Applications of aminocyclopyrachlor in 2011 to turf resulted in brown and twisted shoots, leaves, and needles; shoot dieback; and in some cases, death of trees and ornamental plants adjacent to treated turf areas. Our research objective was to determine if a sensitive plant could be injured from wood chips (mulch) obtained from aminocyclopyrachlor-damaged trees, and to quantify movement of aminocyclopyrachlor from contaminated wood chips into soil and its subsequent uptake by roots into landscape plant tissues. Tomatoes were grown under greenhouse conditions and mulched with chipped tree branches collected from honey locust and Norway spruce damaged 12 mo previously by aminocyclopyrachlor. Analysis of tomato tissue for aminocyclopyrachlor residues 32 d after mulching found aminocyclopyrachlor in all mulched tomato plants, which was consistent with observations of epinasty on tomato leaflets. Aminocyclopyrachlor residues ranged from 0.5 to 8.0 ppb in tomato plants while chipped tree branches contained 1.7 to 14.7 ppb. Aminocyclopyrachlor residues in the potting soil below the mulch ranged from below the quantifiable limit to 0.63 ppb, indicating that aminocyclopyrachlor can leach from wood chips into soil, causing plant injury. These results indicate that trees damaged by aminocyclopyrachlor should not be chipped and used for mulch or as an ingredient in compost.
The population cost-effectiveness of delivering universal and indicated school-based interventions to prevent the onset of major depression among youth in Australia
- Y. Y. Lee, J. J. Barendregt, E. A. Stockings, A. J. Ferrari, H. A. Whiteford, G. A. Patton, C. Mihalopoulos
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- Epidemiology and Psychiatric Sciences / Volume 26 / Issue 5 / October 2017
- Published online by Cambridge University Press:
- 11 August 2016, pp. 545-564
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Aims.
School-based psychological interventions encompass: universal interventions targeting youth in the general population; and indicated interventions targeting youth with subthreshold depression. This study aimed to: (1) examine the population cost-effectiveness of delivering universal and indicated prevention interventions to youth in the population aged 11–17 years via primary and secondary schools in Australia; and (2) compare the comparative cost-effectiveness of delivering these interventions using face-to-face and internet-based delivery mechanisms.
Methods.We reviewed literature on the prevention of depression to identify all interventions targeting youth that would be suitable for implementation in Australia and had evidence of efficacy to support analysis. From this, we found evidence of effectiveness for the following intervention types: universal prevention involving group-based psychological interventions delivered to all participating school students; and indicated prevention involving group-based psychological interventions delivered to students with subthreshold depression. We constructed a Markov model to assess the cost-effectiveness of delivering universal and indicated interventions in the population relative to a ‘no intervention’ comparator over a 10-year time horizon. A disease model was used to simulate epidemiological transitions between three health states (i.e., healthy, diseased and dead). Intervention effect sizes were based on meta-analyses of randomised control trial data identified in the aforementioned review; while health benefits were measured as Disability-adjusted Life Years (DALYs) averted attributable to reductions in depression incidence. Net costs of delivering interventions were calculated using relevant Australian data. Uncertainty and sensitivity analyses were conducted to test model assumptions. Incremental cost-effectiveness ratios (ICERs) were measured in 2013 Australian dollars per DALY averted; with costs and benefits discounted at 3%.
Results.Universal and indicated psychological interventions delivered through face-to-face modalities had ICERs below a threshold of $50 000 per DALY averted. That is, $7350 per DALY averted (95% uncertainty interval (UI): dominates – 23 070) for universal prevention, and $19 550 per DALY averted (95% UI: 3081–56 713) for indicated prevention. Baseline ICERs were generally robust to changes in model assumptions. We conducted a sensitivity analysis which found that internet-delivered prevention interventions were highly cost-effective when assuming intervention effect sizes of 100 and 50% relative to effect sizes observed for face-to-face delivered interventions. These results should, however, be interpreted with caution due to the paucity of data.
Conclusions.School-based psychological interventions appear to be cost-effective. However, realising efficiency gains in the population is ultimately dependent on ensuring successful system-level implementation.
The global coverage of prevalence data for mental disorders in children and adolescents
- H. E. Erskine, A. J. Baxter, G. Patton, T. E. Moffitt, V. Patel, H. A. Whiteford, J. G. Scott
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- Journal:
- Epidemiology and Psychiatric Sciences / Volume 26 / Issue 4 / August 2017
- Published online by Cambridge University Press:
- 20 January 2016, pp. 395-402
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Aims.
Children and adolescents make up almost a quarter of the world's population with 85% living in low- and middle-income countries (LMICs). Globally, mental (and substance use) disorders are the leading cause of disability in young people; however, the representativeness or ‘coverage’ of the prevalence data is unknown. Coverage refers to the proportion of the target population (ages 5–17 years) represented by the available data.
Methods.Prevalence data for conduct disorder (CD), attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorders (ASDs), eating disorders (EDs), depression, and anxiety disorders were sourced from systematic reviews conducted for the Global Burden of Disease Study 2010 (GBD 2010) and 2013 (GBD 2013). For each study, the location proportion was multiplied by the age proportion to give study coverage. Location proportion was calculated by dividing the total study location population by the total country population. Age proportion was calculated by dividing the population of the country aged within the age range of the study sample by the country population aged 5–17 years. If a study only sampled one sex, study coverage was halved. Coverage across studies was then summed for each country to give coverage by country. This method was repeated at the region and global level, and separately for GBD 2013 and GBD 2010.
Results.Mean global coverage of prevalence data for mental disorders in ages 5–17 years was 6.7% (CD: 5.0%, ADHD: 5.5%, ASDs: 16.1%, EDs: 4.4%, depression: 6.2%, anxiety: 3.2%). Of 187 countries, 124 had no data for any disorder. Many LMICs were poorly represented in the available prevalence data, for example, no region in sub-Saharan Africa had more than 2% coverage for any disorder. While coverage increased between GBD 2010 and GBD 2013, this differed greatly between disorders and few new countries provided data.
Conclusions.The global coverage of prevalence data for mental disorders in children and adolescents is limited. Practical methodology must be developed and epidemiological surveys funded to provide representative prevalence estimates so as to inform appropriate resource allocation and support policies that address mental health needs of children and adolescents.
Preventing depression and anxiety in young people: a review of the joint efficacy of universal, selective and indicated prevention
- E. A. Stockings, L. Degenhardt, T. Dobbins, Y. Y. Lee, H. E. Erskine, H. A. Whiteford, G. Patton
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- Journal:
- Psychological Medicine / Volume 46 / Issue 1 / January 2016
- Published online by Cambridge University Press:
- 28 August 2015, pp. 11-26
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Depression and anxiety (internalizing disorders) are the largest contributors to the non-fatal health burden among young people. This is the first meta-analysis to examine the joint efficacy of universal, selective, and indicated preventive interventions upon both depression and anxiety among children and adolescents (5–18 years) while accounting for their co-morbidity. We conducted a systematic review of reviews in Medline, PsycINFO and the Cochrane Library of Systematic Reviews, from 1980 to August 2014. Multivariate meta-analysis examined the efficacy of preventive interventions on depression and anxiety outcomes separately, and the joint efficacy on both disorders combined. Meta-regressions examined heterogeneity of effect according to a range of study variables. Outcomes were relative risks (RR) for disorder, and standardized mean differences (Cohen's d) for symptoms. One hundred and forty-six randomized controlled trials (46 072 participants) evaluated universal (children with no identified risk, n = 54) selective (population subgroups of children who have an increased risk of developing internalizing disorders due to shared risk factors, n = 45) and indicated prevention (children with minimal but detectable symptoms of an internalizing disorder, n = 47), mostly using psychological-only strategies (n = 105). Reductions in internalizing disorder onset occurred up to 9 months post-intervention, whether universal [RR 0.47, 95% confidence interval (CI) 0.37–0.60], selective (RR 0.61, 95% CI 0.43–0.85) or indicated (RR 0.48, 95% CI 0.29–0.78). Reductions in internalizing symptoms occurred up to 12 months post-intervention for universal prevention; however, reductions only occurred in the shorter term for selective and indicated prevention. Universal, selective and indicated prevention interventions are efficacious in reducing internalizing disorders and symptoms in the short term. They might be considered as repeated exposures in school settings across childhood and adolescence. (PROSPERO registration: CRD42014013990.)
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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A heavy burden on young minds: the global burden of mental and substance use disorders in children and youth
- H. E. Erskine, T. E. Moffitt, W. E. Copeland, E. J. Costello, A. J. Ferrari, G. Patton, L. Degenhardt, T. Vos, H. A. Whiteford, J. G. Scott
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- Psychological Medicine / Volume 45 / Issue 7 / May 2015
- Published online by Cambridge University Press:
- 23 December 2014, pp. 1551-1563
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Background
Mental and substance use disorders are common and often persistent, with many emerging in early life. Compared to adult mental and substance use disorders, the global burden attributable to these disorders in children and youth has received relatively little attention.
MethodData from the Global Burden of Disease Study 2010 was used to investigate the burden of mental and substance disorders in children and youth aged 0–24 years. Burden was estimated in terms of disability-adjusted life years (DALYs), derived from the sum of years lived with disability (YLDs) and years of life lost (YLLs).
ResultsGlobally, mental and substance use disorders are the leading cause of disability in children and youth, accounting for a quarter of all YLDs (54.2 million). In terms of DALYs, they ranked 6th with 55.5 million DALYs (5.7%) and rose to 5th when mortality burden of suicide was reattributed. While mental and substance use disorders were the leading cause of DALYs in high-income countries (HICs), they ranked 7th in low- and middle-income countries (LMICs) due to mortality attributable to infectious diseases.
ConclusionsMental and substance use disorders are significant contributors to disease burden in children and youth across the globe. As reproductive health and the management of infectious diseases improves in LMICs, the proportion of disease burden in children and youth attributable to mental and substance use disorders will increase, necessitating a realignment of health services in these countries.
15 - Space magnetometry
- from Part II - Applications
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- By B. Patton, University of California, A. W. Brown, Polatomic Inc., R. E. Slocum, Polatomic Inc., E. J. Smith, California Institute of Technology
- Edited by Dmitry Budker, University of California, Berkeley, Derek F. Jackson Kimball, California State University, East Bay
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- Optical Magnetometry
- Published online:
- 05 May 2013
- Print publication:
- 07 March 2013, pp 285-302
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Summary
Introduction
Magnetometry has been an invaluable tool in all stages of space exploration, from the first ionospheric sounding rockets to the most modern interplanetary probes. Our solar system is fundamentally a magnetically active environment – indeed, one might define the extent of the solar system by its heliopause, as it is the magnetic influence of the Sun which separates us from the interstellar medium. The interactions between the solar wind and the bodies of the solar system are varied and complex, and they have strong implications for the past and future of these bodies. Most importantly, a planet's magnetic field is one of the few characteristics which can be measured from space to yield information about the nature and dynamics of its interior. Recognizing these scientific imperatives, mission designers have included precise magnetometers on nearly all the spacecraft used to explore our solar system; this in turn has driven advances in magnetometer technology over the past fifty years.
Achievements of space magnetometry
Discoveries made by space magnetometers have been among the most profound achievements of space exploration. Rocket-borne magnetometers gave the first definitive evidence of electrical currents in the Earth's ionosphere and their effect on diurnal variations of the geomagnetic field [1]. These data not only shed light on the interaction between the solar wind and the Earth; they also complemented radiation studies which mapped out the Van Allen belts and thus paved the way for manned space flight. Later spacecraft magnetometers advanced dynamo theory by confirming the lack of a planet-scale dipolar field on Venus [2,3] and discovering, to much surprise, a still-active dynamo within Mercury [4].
Contributors
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- By Audrey N. Beck, John Berry, Edmond P. Bowers, Xenia Chryssochoou, Miles Corak, Radosveta Dimitrova, Andrew J. Fuligni, Eugene E. García, Cynthia Garcia Coll, Jonathan Israel Gershuny, Taveeshi Gupta, Donald J. Hernandez, Gabriel Horenczyk, Inga Jasinskaja-Lahti, Ciğdem Kağitçibaşi, Yoav Lavee, Jacqueline V. Lerner, Richard M. Lerner, Selva Lewin-Bizan, Karmela Liebkind, Tuuli Anna Mähönen, Amy Kerivan Marks, Ann S. Masten, Andrea Michel, Frosso Motti-Stefanidi, Brian Nolan, Andrea Patrico, Flannery Patton, Jean Phinney, Karen Robson, Abraham Sagi-Schwartz, David Lackland Sam, Rainer K. Silbereisen, Selcuk R. Sirin, Timothy M. Smeeding, Christiane Spiel, Dagmar Strohmeier, Gloria A. Suarez, Moshe Tatar, Eva H. Telzer, Marta Tienda, Peter F. Titzmann, Maykel Verkuyten, Coady Wing, Rui Yang
- Edited by Ann S. Masten, Karmela Liebkind, Donald J. Hernandez, Hunter College, City University of New York
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- Book:
- Realizing the Potential of Immigrant Youth
- Published online:
- 05 November 2012
- Print publication:
- 21 May 2012, pp xiii-xviii
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Is Transparent Belief “Intolerably Odd” ?
- Thomas E. Patton
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- Dialogue: Canadian Philosophical Review / Revue canadienne de philosophie / Volume 13 / Issue 4 / December 1974
- Published online by Cambridge University Press:
- 09 June 2010, pp. 647-655
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The ascription of beliefs and other propositional attitudes, as Russell called them, raises more than one philosophical puzzle as to how language is being used. A certain complexity is implied for these puzzles by W. V. Quine's relatively recent observation that propositional attitude (PA) ascriptions can be construed in two distinct ways. In particular, Quine distinguishes between what he calls transparent and opaque belief, and treatments of belief that ignore this distinction do so at their own considerable risk. However, while Quine's observation per se may help towards more circumspect solutions, what he goes on to say about transparent belief, as I will urge, adds a bogus puzzle to the real ones that confront us. For Quine holds that transparent belief is so very odd that to countenance its ascription, though he thinks that we must, brings us to the edge of nonsense. Parenthetically, I might say that I am myself mystified by his proposal to prevent our slipping over. This proposal can be ignored, however, if it can be shown that transparent PA ascription is far from nonsense. Elsewhere, I will try to show as much, but all that this paper aspires to is a negative preliminary: the refutation of Quine's main argument for his opposite stand.
Quine's Truth: The Unending Pursuit*
- Thomas E. Patton
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- Journal:
- Dialogue: Canadian Philosophical Review / Revue canadienne de philosophie / Volume 31 / Issue 1 / Winter 1992
- Published online by Cambridge University Press:
- 13 April 2010, pp. 107-114
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This book is both shorter and more comprehensive than any of Quine's other six since Word and Object. But let this description raise no fears that it must stretch itself too thin, at least for veteran students of his major philosophical project, “to examine the evidential support of science” (p. 2). For with less detail in focus, the structural elements of that project stand revealed as never before. Improvements in presentation, as Quine sees them, help here. And veterans can learn of certain changes, notable if not huge, in various Quinean views. For besides summing up and explaining, Pursuit of Truth moves on.
Staphylococcus aureus community-onset pneumonia in patients admitted to children's hospitals during autumn and winter of 2006–2007
- A. J. KALLEN, C. REED, M. PATTON, K. E. ARNOLD, L. FINELLI, J. HAGEMAN
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- Journal:
- Epidemiology & Infection / Volume 138 / Issue 5 / May 2010
- Published online by Cambridge University Press:
- 07 December 2009, pp. 666-672
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Staphylococcus aureus is a relatively uncommon cause of community-onset pneumonia (COP) that may complicate influenza infection. We reviewed admissions to children's hospitals to describe more systematically this entity. Records of patients hospitalized at three children's hospitals between 1 October 2006 and 30 April 2007 who had a positive S. aureus culture from a sterile site or respiratory specimen were reviewed and data were abstracted for episodes of primary S. aureus COP. Overall, 30 episodes met criteria for primary S. aureus COP; 12 (41%) involved methicillin-resistant S. aureus. Patients in 11 (37%) episodes were seen by a healthcare provider for their symptoms prior to hospital admission; three received an antimicrobial, none of which had activity against the S. aureus isolated. Mechanical ventilation was required in 21 (70%) episodes; five (17%) patients died. When evaluating patients with severe COP, providers should be aware of the potential for S. aureus, including methicillin-resistant strains.
Contributors
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- By Sonia Ancoli-Israel, Ragnar Asplund, Michel Billiard, Theresa M. Buckley, Rohit Budhiraja, Robert N. Butler, Daniel J. Buysse, Scott S. Campbell, Daniel P. Cardinali, Julie Carrier, Cynthia L. Comella, Jana R. Cooke, Pietro Cortelli, Agnès Demazieres, Glenna A. Dowling, Luigi Ferini-Strambi, Philip R. Gehrman, Nalaka Sudheera Gooneratne, David S. Hallegua, Patrick J. Hanly, David G. Harper, Orla P. Hornung, Magdolna Hornyak, Michal Karasek, Milton Kramer, Andrew D. Krystal, Malcolm H. Lader, Rachel Leproult, Kenneth L. Lichstein, Andrea H.S. Loewen, Rémy Luthringer, Laurin J. Mack, Evelyn Mai, Atul Malhotra, Jennifer L. Martin, Judy Mastick, Monique A.J. Mets, Andrew A. Monjan, Timothy H. Monk, Daniel Monti, Jaime M. Monti, Patricia J. Murphy, C. Ineke Neutel, Eric A. Nofzinger, Seithikurippu R. Pandi-Perumal, Scott B. Patton, Donald B. Penzien, Max H. Pittler, Giora Pillar, Marc J. Poulin, Louis J. Ptácek, Stuart F. Quan, Jeanetta C. Rains, Megan E. Ruiter, Bruce D. Rybarczyk, Colin M. Shapiro, Vijay Kumar Sharma, D. Warren Spence, Kai Spiegelhalder, Luc Staner, Stephanie A. Studenski, Nikola N. Trajanovic, Eve Van Cauter, Gregory S. Vander Wal, Joris C. Verster, Aleksandar Videnovic, Matthew P. Walker, Daniel J. Wallace, David K. Welsh, David P. White, Barbara Wider, Theresa B. Young, Stefano Zanigni
- Edited by S. R. Pandi-Perumal, Jaime M. Monti, Universidad de la República, Uruguay, Andrew A. Monjan, National Institute on Aging, Bethesda, Maryland
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- Principles and Practice of Geriatric Sleep Medicine
- Published online:
- 04 August 2010
- Print publication:
- 26 November 2009, pp ix-xii
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