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SafePsych: Improving patient safety by delivering high-impact simulation training on rare and complex scenarios in psychiatry
- K. Tong, E. McMahon, B. Reid-McDermott, D. Byrne, A. M. Doherty
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S320-S321
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Introduction
Simulation-based training is a practical medical education tool to develop health professionals’ knowledge and experience in a low risk, realistic clinical setting. It trains clinicians to recognise and manage rare and complex clinical scenarios without compromising patient safety. Despite an evidence base demonstrating simulation to be an effective medical education tool, it is not commonly used in postgraduate psychiatry training as it is in other medical specialties.
ObjectivesThis project outlines the development and effectiveness of a hybrid-virtual simulation-based workshop designed to improve patient care by improving clinical skills of non-consultant hospital doctors (NCHDs) in detecting and managing rare and complex psychiatric emergencies.
MethodsThree clinical vignettes based on near-miss clinical scenarios in psychiatry were developed by a multidisciplinary team of doctors and nurses in psychiatry, and experts in simulation-based medical education. The workshop, ‘SafePsych’ was delivered in a simulation laboratory, while being captured on camera and broadcasted via Zoom video-conferencing platform to observers. Debriefing followed each clinical scenario. Participants completed pre- and post-workshop questionnaires to evaluate clinical knowledge of the scenarios in the training programme.
ResultsThe workshop was attended by consultants (n=12), NCHDs in psychiatry and emergency medicine (n=19), and psychiatric nurses (n=5). In the psychiatry NCHD group, test scores significantly improved following the workshop (p<0.001). There were significant improvements in the test scores with a mean difference of 2.56 (SD 1.58, p<0.001). Feedback from participants and observers was positive, with constructive appraisals to improve the virtual element of the workshop.
ConclusionsSimulation-based training is effective in teaching high risk, rare complex psychiatric cases to psychiatry NCHDs. Further exploration of the learning needs of nursing staff is required. Future workshop delivery is feasible in the COVID-19 environment and beyond, using a virtual element to meet social distancing requirements while enhancing the reach of the training.
Disclosure of InterestNone Declared
Gyrokinetic analysis of an argon-seeded EDA H-mode in ASDEX Upgrade
- Karl Stimmel, L. Gil, T. Görler, M. Cavedon, P. David, M. Dunne, R. Dux, R. Fischer, F. Jenko, A. Kallenbach, R.M. McDermott, U. Plank, G. Tardini, D. Told, the ASDEX Upgrade Team
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- Journal:
- Journal of Plasma Physics / Volume 88 / Issue 3 / June 2022
- Published online by Cambridge University Press:
- 23 June 2022, 905880315
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Understanding edge-localised-mode (ELM)-free high-confinement (H-)mode scenarios is vital for developing practical future demonstration reactor scenarios. An argon-seeded EDA H-mode discharge performed in ASDEX Upgrade is computationally studied in detail for the first time with the gyrokinetic GENE code using experimental profiles and magnetic equilibrium as direct code inputs. Linear scans outline dominant instabilities in the regime and reveal distinct ion- and electron-scale wavenumber growth-rate peaks for two local core and two local pedestal top scenarios. Linear ion-scale growth rates are found to be relatively insensitive to the addition of argon, and collisionality scans demonstrate increased sensitivity in the pedestal top. The addition of an argon impurity profile while keeping the input main ion temperature gradient (ITG) largely unchanged is found to reduce ITG-driven turbulence in the outer core. Nonlinear electromagnetic simulations reveal close agreement with experimentally predicted heat fluxes in the core, outline key sensitivities to electron $\beta$ and background $\boldsymbol{E\times B}$ shearing, and reveal gyrokinetic challenges in analysing the quasicoherent mode. Global electrostatic nonlinear simulations reduce local simulated heat transport overpredictions at the pedestal top. A quasilinear analysis finds that there is good core agreement but poor agreement in the pedestal between linear and nonlinear temperature and density fluctuation cross-phases. Local simulation limitations are elucidated and paths forward for future computation are suggested.
Use of whole genome sequencing to complement characterisation of a typhoid fever outbreak among a Marshallese community: Oklahoma, 2015
- L. J. Burnsed, L. D. Kovar, K. M. Angelo, E. K. Trees, J. Concepción-Acevedo, M. D. McDermott, D. Wagner, K. K. Bradley
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- Journal:
- Epidemiology & Infection / Volume 147 / 2019
- Published online by Cambridge University Press:
- 21 September 2018, e11
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Typhoid fever is an illness caused by Salmonella enterica serotype Typhi. In developing regions, it affects an estimated 20 million people annually, causing 200 000 deaths. Although uncommon, cases occur in the USA each year, predominantly due to international travel. During February 2015, the Oklahoma State Department of Health (OSDH) detected an outbreak of typhoid fever among residents of northwestern Oklahoma. OSDH conducted case-patient interviews to identify the source and symptomatic contacts. Whole genome sequencing (WGS) was performed to characterise the genetic relatedness of isolates among the four outbreak-associated pulsed-field gel electrophoresis (PFGE) patterns. We identified 38 cases, 25 confirmed and 13 probable, in two states. WGS revealed a 0–10 single-nucleotide polymorphism variation between isolates. Although we were unable to determine the source, almost all case-patients were members of the Marshallese community that attended a common event in Oklahoma, or were contacts to a confirmed case. This is the largest outbreak of typhoid fever in the USA since 1989, and first to apply WGS to complement interpretation of PFGE results during a typhoid fever outbreak investigation. This investigation illustrates the potential risk of outbreaks among communities comprised of international populations from regions where typhoid fever remains endemic.
Aneuploidy in dizygotic twin sheep detected using genome-wide single nucleotide polymorphism data from two commonly used commercial vendors
- D. P. Berry, A. O’Brien, J. O’Donovan, N. McHugh, E. Wall, S. Randles, K. McDermott, R. E. O’Connor, M. A. Patil, J. Ho, A. Kennedy, N. Byrne, D. C. Purfield
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Early detection of karyotype abnormalities, including aneuploidy, could aid producers in identifying animals which, for example, would not be suitable candidate parents. Genome-wide genetic marker data in the form of single nucleotide polymorphisms (SNPs) are now being routinely generated on animals. The objective of the present study was to describe the statistics that could be generated from the allele intensity values from such SNP data to diagnose karyotype abnormalities; of particular interest was whether detection of aneuploidy was possible with both commonly used genotyping platforms in agricultural species, namely the Applied BiosystemsTM AxiomTM and the Illumina platform. The hypothesis was tested using a case study of a set of dizygotic X-chromosome monosomy 53,X sheep twins. Genome-wide SNP data were available from the Illumina platform (11 082 autosomal and 191 X-chromosome SNPs) on 1848 male and 8954 female sheep and available from the AxiomTM platform (11 128 autosomal and 68 X-chromosome SNPs) on 383 female sheep. Genotype allele intensity values, either as their original raw values or transformed to logarithm intensity ratio (LRR), were used to accurately diagnose two dizygotic (i.e. fraternal) twin 53,X sheep, both of which received their single X chromosome from their sire. This is the first reported case of 53,X dizygotic twins in any species. Relative to the X-chromosome SNP genotype mean allele intensity values of normal females, the mean allele intensity value of SNP genotypes on the X chromosome of the two females monosomic for the X chromosome was 7.45 to 12.4 standard deviations less, and were easily detectable using either the AxiomTM or Illumina genotype platform; the next lowest mean allele intensity value of a female was 4.71 or 3.3 standard deviations less than the population mean depending on the platform used. Both 53,X females could also be detected based on the genotype LRR although this was more easily detectable when comparing the mean LRR of the X chromosome of each female to the mean LRR of their respective autosomes. On autopsy, the ovaries of the two sheep were small for their age and evidence of prior ovulation was not appreciated. In both sheep, the density of primordial follicles in the ovarian cortex was lower than normally found in ovine ovaries and primary follicle development was not observed. Mammary gland development was very limited. Results substantiate previous studies in other species that aneuploidy can be readily detected using SNP genotype allele intensity values generally already available, and the approach proposed in the present study was agnostic to genotype platform.
Imputation of non-genotyped sheep from the genotypes of their mates and resulting progeny
- D. P. Berry, N. McHugh, S. Randles, E. Wall, K. McDermott, M. Sargolzaei, A. C. O’Brien
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Accurate genomic analyses are predicated on access to a large quantity of accurately genotyped and phenotyped animals. Because the cost of genotyping is often less than the cost of phenotyping, interest is increasing in generating genotypes for phenotyped animals. In some instances this may imply the requirement to genotype older animals with greater phenotypic information content. Biological material for these older informative animals may, however, no longer exist. The objective of the present study was to quantify the ability to impute 11 129 single nucleotide polymorphism (SNP) genotypes of non-genotyped animals (in this instance sires) from the genotypes of their progeny with or without including the genotypes of the progenys’ dams (i.e. mates of the sire to be imputed). The impact on the accuracy of genotype imputation by including more progeny (and their dams’) genotypes in the imputation reference population was also quantified. When genotypes of the dams were not available, genotypes of 41 sires with at least 15 genotyped progeny were used for the imputation; when genotypes of the dams were available, genotypes of 21 sires with at least 10 genotyped progeny were used for the imputation. Imputation was undertaken exploiting family and population level information. The mean and variability in the proportion of genotypes per individual that could not be imputed reduced as the number of progeny genotypes used per individual increased. Little improvement in the proportion of genotypes that could not be imputed was achieved once genotypes of seven progeny and their dams were used or genotypes of 11 progeny without their respective dam’s genotypes were used. Mean imputation accuracy per individual (depicted by both concordance rates and correlation between true and imputed) increased with increasing progeny group size. Moreover, the range in mean imputation accuracy per individual reduced as more progeny genotypes were used in the imputation. If the genotype of the mate of the sire was also used, high accuracy of imputation (mean genotype concordance rate per individual of 0.988), with little additional benefit thereafter, was achieved with seven genotyped progeny. In the absence of genotypes on the dam, similar imputation accuracy could not be achieved even using genotypes on up to 15 progeny. Results therefore suggest, at least for the SNP density used in the present study, that it is possible to accurately impute the genotypes of a non-genotyped parent from the genotypes of its progeny and there is a benefit of also including the genotype of the sire’s mate (i.e. dam of the progeny).
In the Drink: A Review of Morbidity and Mortality Associated with Water-Related Activities in the Top End region, Northern Territory, Australia
- Bevan Jenkins, D. J. Read, K. McDermott, L. M Ward, P. J. Treacy
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- Journal:
- Prehospital and Disaster Medicine / Volume 32 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 29 May 2017, p. e2
- Print publication:
- April 2017
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Study/Objective
A 10-year descriptive analysis of morbidity and mortality associated with water-related activities in the Top End, Northern Territory (NT), Australia.
BackgroundAn outdoor, water-orientated lifestyle characterises the Top End due to its tropical climate, lengthy coastline, many inland-waterways, and common domestic-pool ownership. However, the water holds many dangers: from drowning to the prospect of crocodile attacks.
MethodsData were retrospectively collected from two sources: the Trauma Registry (TR), Royal Darwin Hospital, NT and the National Coronial Information System. Inclusion criteria: all mortality or injury with an Injury Severity Score (ISS) ≥9 from water-related activity in the Top End. Exclusion criteria: envenomation. Data included: demographics, geographical location, time/mechanism of injury, injury narrative/outcome, alcohol consumption, ISS, and Indigenous race.
ResultsNinety-five deaths occurred from 1/1/2005–12/31/2014; 87 prehospital (92%). The leading three mechanisms of injury for the 138 TR admissions were drowning (40%), falling/diving (35%), and watercraft events (14%). Median age 27 (0-90); 78% males. There were 74 children (<16 years) including 20 deaths. Indigenous Australians represent 30% of the NT population, but had 43% of deaths and 12% of admissions. Deaths from crocodile attacks are increasing with 14 deaths from 2005-2014, compared to 10 deaths from 1971-2004 (Caldicutt). Alcohol was recorded in 31% of admissions and 52% of deaths in those age >16. The Top End’s crude rate of drowning averaged over 10 years was 4.36/100,000/annum, compared to 1.31/100,000/annum in Australia.
ConclusionAlcohol plays a major role in the Top End’s water-related harm, associated with all mechanisms and over one-half of adult deaths. Also striking is increasing crocodile fatalities, possibly caused by population recovery from endangered to plentiful, since hunting ceased in 1971. Local authorities/advocates push water-safety and crocodile-awareness programs. However, the lure of tropical waters combined with alcohol remains a risk to life and limb. Further public health campaigns focusing on these issues are called for.
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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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- By Jean Marie Abraham, Catherine Ayoub, Jessica Dym Bartlett, Karen L. Bierman, Paula A. Braveman, Robert H. Bruininks, Frances A. Campbell, Rachel Chazan-Cohen, Peggy Chen, Alyssa Crawford, Katina D’Onise, Celene E. Domitrovich, Greg J. Duncan, Susan Egerter, Michelle M. Englund, Temitope O. Erinosho, Kevin D. Frick, Michael K. Georgieff, Scott D. Gest, Bernard Guyer, Momoko Hayakawa, Ariel Kalil, Pinar Karaca-Mandic, Samuel A. Kleiner, Narayana Kocherlakota, John W. Lynch, Sai Ma, Laurie T. Martin, Robyn A. Mcdermott, Robin E. Mockenhaupt, Robert L. Nix, Helen Raikes, Arthur J. Reynolds, Arthur J. Rolnick, Sharon Rolnick, Lawrence J. Schweinhart, Amy Susman-Stillman, Judy A. Temple, Jim Thorp, Dianne S. Ward, Janet A. Welsh, Barry White, Sung J. Choi Yoo, Kathleen M. Ziol-Guest
- Edited by Arthur J. Reynolds, University of Minnesota, Arthur J. Rolnick, University of Minnesota, Judy A. Temple, University of Minnesota
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- Health and Education in Early Childhood
- Published online:
- 05 February 2015
- Print publication:
- 19 February 2015, pp xiii-xiv
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- By J. Todd Arnedt, Nazem Atassi, Judith Bebchuk, Devin L. Brown, Rickey E. Carter, Rick Chappell, William R. Clarke, Christopher S. Coffey, Peter G. Como, Merit Cudkowicz, Jeffrey Cummings, Gary R. Cutter, Gerald J. Dal Pan, E. Ray Dorsey, Susan S. Ellenberg, Jordan Elm, Changyong Feng, Elizabeth Fisher, Jacqueline A. French, Jean-Michel Germain, Joshua D. Grill, Robert G. Holloway, Karen C. Johnston, S. Claiborne Johnston, Cornelia L. Kamp, Russell Katz, Kathryn M. Kellogg, Karl Kieburtz, Scott Y. H. Kim, Jonathan Kimmelman, Bruce Levin, Michael P. McDermott, Eric A. Mann, John Markman, D. Troy Morgan, Gilmore N. O’Neill, Yuko Y. Palesch, John R. Pollard, R. Michael Poole, Mary E. Putt, Bemard Ravina, Richard A. Rudick, David Schoenfeld, Andrew D. Siderowf, Janet Wittes, Robert F. Woolson, Michael E. Yurcheshen
- Edited by Bernard Ravina, Jeffrey Cummings, Michael McDermott, R. Michael Poole
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- Clinical Trials in Neurology
- Published online:
- 05 May 2012
- Print publication:
- 12 April 2012, pp ix-xii
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Epidemiology of a large restaurant-associated outbreak of Shiga toxin-producing Escherichia coli O111:NM
- K. K. BRADLEY, J. M. WILLIAMS, L. J. BURNSED, M. B. LYTLE, M. D. McDERMOTT, R. K. MODY, A. BHATTARAI, S. MALLONEE, E. W. PIERCEFIELD, C. K. McDONALD-HAMM, L. K. SMITHEE
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- Journal:
- Epidemiology & Infection / Volume 140 / Issue 9 / September 2012
- Published online by Cambridge University Press:
- 25 November 2011, pp. 1644-1654
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In August 2008, a large outbreak of Shiga toxin-producing Escherichia coli (STEC) O111:NM infections associated with a buffet-style restaurant in rural Oklahoma was identified. A case-control study of restaurant patrons and a retrospective cohort study of catered event attendees were conducted coupled with an environmental investigation to determine the outbreak's source and mode of transmission. Of 1823 persons interviewed, 341 (18·7%) met the outbreak case definition; 70 (20·5%) were hospitalized, 25 (7·3%) developed haemolytic uraemic syndrome, and one died. Multiple food items were significantly associated with illness by both bivariate and multivariate analyses, but none stood out as a predominant transmission vehicle. All water, food, and restaurant surface swabs, and stool cultures from nine ill employees were negative for the presence of Shiga toxin and E. coli O111:NM although epidemiological evidence suggested the outbreak resulted from cross-contamination of restaurant food from food preparation equipment or surfaces, or from an unidentified infected food handler.
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- By Paul S. Appelbaum, Elizabeth K. Dollard, Peter Ash, Madelon V. Baranoski, Alec Buchanan, Philip J. Candilis, J. Richard Ciccone, Eric Elbogen, Graham D. Glancy, Robert P. Granacher, Ezra E. H. Griffith, Jeffrey S. Janofsky, Sally Johnson, Joshua Jones, Alyson Kuroski-Mazzei, Li-Wen Grace Lee, Gregory B. Leong, Barbara McDermott, Richard Martinez, Michael A. Norko, John O’Grady, Debra A. Pinals, Marilyn Price, Patricia Ryan Recupero, Phillip J. Resnick, Robert L. Sadoff, Charles Scott, J. Arturo Silva, Sherif Soliman, Aleksandra Stankovic, Robert Weinstock, Kenneth J. Weiss, Robert M. Wettstein, Cheryl Wills, Howard Zonana
- Edited by Alec Buchanan, Yale University, Connecticut, Michael A. Norko, Yale University, Connecticut
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- The Psychiatric Report
- Published online:
- 07 September 2011
- Print publication:
- 07 July 2011, pp ix-xii
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- By Leonard A. Adler, Henrik Anckarsäter, L. Eugene Arnold, Philip J. Asherson, Russell Barkley, Joseph Biederman, Andrew D. Blackwell, Jessica Bramham, Thomas E. Brown, Richard Bruggeman, Jan K. Buitelaar, C. Keith Conners, Jonathan H. Dowson, Steve V. Faraone, Christopher Gibbins, Christopher Gillberg, I. Carina Gillberg, Ylva Ginsberg, Laurence L. Greenhill, Julia D. Hunter, Cornelis C. Kan, Ronald C. Kessler, Scott H. Kollins, J. J. Sandra Kooij, Johanna Krause, Jonna Kuntsi, Florence Levy, Stephen P. McDermott, Gráinne McLoughlin, Mitul A. Mehta, Asko Niemela, Eleni Paliokosta, Yannis Paloyelis, Vangelis Pappas, Patricia Quinn, Maria Råstam, Doris Ryffel, David Shaw, Seija Sirviö, Thomas Spencer, Lacramioara Spetie, Siegfried Tuinier, Fiona E. van Dijk, Anne M. D. N. van Lammeren, Wim J. C. Verbeeck, Margaret Weiss, Timothy E. Wilens, Kiriakos Xenitidis
- Edited by Jan K. Buitelaar, Cornelis C. Kan, Philip Asherson, Institute of Psychiatry, London
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- Book:
- ADHD in Adults
- Published online:
- 04 April 2011
- Print publication:
- 03 March 2011, pp vii-ix
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Petrology and geochemistry of volcanic rocks of the Cerro Galan caldera, northwest Argentina
- P. W. Francis, R. S. J. Sparks, C. J. Hawkesworth, R. S. Thorpe, D. M. Pyle, S. R. Tait, M. S. Mantovani, F. McDermott
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- Journal:
- Geological Magazine / Volume 126 / Issue 5 / September 1989
- Published online by Cambridge University Press:
- 01 May 2009, pp. 515-547
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At least 2000 km3 of relatively uniform dacitic magma have been erupted from the Cerro Galan caldera complex, northwest Argentina. Between 7 and 4 Ma ago several composite volcanoes predominantly of dacitic lava were constructed, and several large high-K dacitic ignimbrites were erupted. 2.2 Ma ago the > 1000km3 Cerro Galan ignimbrite was erupted. The predominant mineral assemblage in the ignimbrites is plagioclase-biotite-quartz-magnetite-ilmenite; the Cerro Galan ignimbrite also contains sanidine. Fe-Ti oxide minerals in the Cerro Galan ignimbrite imply temperatures of 801–816 °C. Plagioclase phenocrysts in the ignimbrites typically have rather homogeneous cores surrounded by complex, often oscillatory zoned, rims. Core compositions show a marked bimodality, with one population consisting of calcic cores surrounded by normally zoned rims, and a second of sodic cores surrounded by reversely zoned rims. The older ignimbrites do not show systematic compositional zonation, but the Cerro Galan ignimbrite exhibits small variations in major elements (66–69% SiO2) and significant variations in Rb, Sr, Ba, Th and other trace elements, consistent with derivation from a weakly zoned magma chamber, in which limited fractional crystallization occurred. The ignimbrites have 87Sr/86Sr = 0.7108–0.7181; 143Nd/144Nd = 0.51215–0.51225, and δ18O = + 10 to + 12.5, consistent with a significant component of relatively non-radiogenic crust with high Rb/Sr and enriched in incompatible elements. Nd model ages for the source region are about 1.24 Ga. 87Sr/86Sr measurements of separated plagioclases indicate that Anrich cores have slightly lower 87Sr/86Sr than less calcic plagioclases, suggesting a small degree of isotopic heterogeniety in different components within the magmas. Pb isotope data for plagioclase show restricted ranges (206Pb/204Pb, 207Pb/204Pb and 208Pb/204Pb = 18.87–18.92, 15.65–15.69 and 39.06–39.16 respectively), and suggest derivation from Proterozoic crustal material(> 1.5 Ga).
Contemporaneous satellite scoria cones and lavas are high-K basalts, basaltic andesites and andesites with SiO2 = 51–57%; K2O = 2–3% and normative plagioclase compositions of An37–48, and may be derived from a mantle source containing both ‘subduction zone’ and ‘within plate’ components. 87Sr/86Sr ranges from 0.7055 to 0.7094 and 143Nd/144Nd from 0.51250 to 0.51290. Variation diagrams such as MgO: SiO2 show two trends, one indicating closed system fractional crystallization and the other crustal contamination. AFC modelling of the open system rocks indicates a parental mantle-derived mafic magma which is itself enriched in K, Rb, Ba, U, Ta/Sm, Ta/Th and Sr, and has 87Sr/86Sr = 0.705–0.706, while the contaminant need not be more radiogenic than the dacitic ignimbrites.
The Cerro Galan dacitic magmas are interpreted in terms of a deep and uniform region of the central Andean continental crust repeatedly melted by emplacement of incompatible-element-enriched, mantle-derived mafic magmas, a proportion of which may also have mixed with the dacite magmas. A component of the crustal material had a Proterozoic age. The magmas derived by crustal melting were also enriched in incompatible elements either by crystal/liquid fractionation processes, or by metasomatism of their source regions just prior to magma generation. Much of the crystallization took place in the source region during the melting process or in mid-crustal magma chambers. The magmas may have re-equilibrated at shallow levels prior to eruption, but only limited compositional zonation developed in high-level magma chambers.
List of Contributors
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- By Ralph Adolphs, Bernard J. Baars, John A. Bargh, Jesse M. Bering, David F. Bjorklund, Joseph E. Bogen, Rebekah Bradley, Wallace Chafe, Michael C. Corballis, Diego Cosmelli, Jean-Marie Danion, Richard J. Davidson, Steven W. Day, Georges Dreyfus, John D. Dunne, Stan Franklin, Helena Hong Gao, Lisa Geraci, Deborah E. Hannula, J. Allan Hobson, Caroline Huron, John F. Kihlstrom, Asher Koriat, Uriah Kriegel, Jean-Philippe Lachaux, Charles D. Laughlin, Antoine Lutz, Drew McDermott, Katharine McGovern, Keith Oately, Suparna Rajaram, Henry L. Roediger III, Edmund T. Rolls, Daniel L. Schachter, William Seager, Daniel J. Simons, Scott D. Slotnick, Henry Stapp, Petra Stoerig, Ron Sun, Evan Thompson, C. Jason Throop, Rebecca Todd, Carlo Umiltà, David E. Warren, Joel Weinberger, Drew Westen, Dan Zahavi, Philip David Zelazo
- Edited by Philip David Zelazo, University of Toronto, Morris Moscovitch, University of Toronto, Evan Thompson, University of York
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- Book:
- The Cambridge Handbook of Consciousness
- Published online:
- 05 June 2012
- Print publication:
- 14 May 2007, pp -
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Differences in the epidemiology of theileriosis on smallholder dairy farms in contrasting agro-ecological and grazing strata of highland Kenya
- G. K. GITAU, J. J. McDERMOTT, J. M. KATENDE, C. J. O'CALLAGHAN, R. N. BROWN, B. D. PERRY
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- Journal:
- Epidemiology & Infection / Volume 124 / Issue 2 / April 2000
- Published online by Cambridge University Press:
- 01 April 2000, pp. 325-335
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A prospective cohort study was conducted in five purposively-sampled agro-ecological zone (AEZ)-grazing system strata in Murang’a District, Kenya, between March 1995 and June 1996. The study strata were selected based on a preliminary characterization study to represent the widest range of risks to East Coast fever (ECF) in the District and included zero-grazing and open-grazing farms. In total, 225 calves from 188 smallholder farms were examined from birth to 6 months of age and visited within the first 2 weeks of life and thereafter at bi-weekly intervals for up to 14 visits.
The purpose of the study was to characterize the differences in epidemiology (risks of infection, morbidity and mortality) and potential control of ECF between the selected strata. Evidence of Theileria parva infection was assessed by increased antibody levels as measured in an indirect ELISA assay by the percent positivity (PP) of serum samples relative to a strong positive reference serum.
Sero-conversion risks of T. parva were highest in the open-grazing strata. Antibody prevalence in adult cattle and ECF morbidity and mortality risks were also highest in open-grazing strata. While different, all five AEZ-grazing strata were considered to be endemically unstable for ECF. East Coast fever challenge was low in all zero-grazing strata and this challenge is likely to remain low due to continuing intensification of smallholder farming in the central highlands. In the open-grazing strata, there was higher challenge and a greater impact of ECF.
The ABA-1 allergen of Ascaris lumbricoides: sequence polymorphism, stage and tissue-specific expression, lipid binding function, and protein biophysical properties
- Y. XIA, H. J. SPENCE, J. MOORE, N. HEANEY, L. McDERMOTT, A. COOPER, D. G. WATSON, B. MEI, R. KOMUNIECKI, M. W. KENNEDY
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- Journal:
- Parasitology / Volume 120 / Issue 2 / February 2000
- Published online by Cambridge University Press:
- 01 February 2000, pp. 211-224
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The ABA-1 protein of Ascaris lumbricoides (of humans) and Ascaris suum (of pigs) is abundant in the pseudocoelomic fluid of the parasites and also appears to be released by the tissue-parasitic larvae and the adult stages. The genes encoding the polyprotein precursor of ABA-1 (aba-1) were found to be arranged similarly in the two taxa, comprising tandemly repeating units encoding a large polyprotein which is cleaved to yield polypeptides of approximately 15 kDa which fall into 2 distinct classes, types A and B. The polyprotein possibly comprises only 10 units. The aba-1 gene of A. lumbricoides is polymorphic, and the majority of substitutions observed occur in or near predicted loop regions in the encoded proteins. mRNA for ABA-1 is present in infective larvae within the egg, and in all parasitic stages, but was not detectable in unembryonated eggs. ABA-1 mRNA was confined to the gut of adult parasites, and not in body wall or reproductive tissues. Recombinant protein representing a single A-type unit for the A. lumbricoides aba-1 gene was produced and found to bind retinol (Vitamin A) and a range of fatty acids, including the pharmacologically active lipids lysophosphatidic acid, lysoplatelet activating factor, and there was also evidence of binding to leukotrienes. It failed to bind to any of the anthelmintics screened. Differential Scanning Calorimetry showed that the recombinant protein was highly stable, and unfolded in a single transition at 90·4 °C. Analysis of the transition indicated that the protein occurs as a dimer and that the dimer dissociates simultaneously with the unfolding of the monomer units.