BackgroundPeople with upper extremity amputations report receiving insufficient information about treatment options. Furthermore, patients commonly report not knowing what questions to ask providers. A question prompt sheet, or list of questions, can support patient-centered care by empowering patients to ask questions important to them, promoting patient-provider communication, and increasing patient knowledge. This study assessed information needs among people with UE amputations about UE vascularized composite allotransplantation and developed a UE VCA-QPS.MethodsThis multi-site, cross-sectional, mixed-methods study involved in-depth and semi-structured interviews with (...) people with UE amputations to assess information needs and develop a UE VCA-QPS. Qualitative data were analyzed by thematic analysis; quantitative data were analyzed by descriptive statistics. The initial UE VCA-QPS included 130 items across 18 topics.ResultsEighty-nine people with UE amputations participated. Most were male, had a mean age of 46 years, and had a unilateral and below-elbow amputation. Participants desired information about UE VCA eligibility, evaluation process, surgery, risks, rehabilitation, and functional outcomes. After refinement, the final UE VCA-QPS included 35 items, across 9 topics. All items were written at a ≤ 6th grade reading level. Most semi-structured interview participants reported being ‘completely’ or ‘very’ likely to use a UE VCA-QPS.ConclusionPeople with UE amputations have extensive information needs about UE VCA. The UE VCA-QPS aims to address patients’ information needs and foster patient-centered care. Future research should assess whether the UE VCA-QPS facilitates patient-provider discussion and informed decision-making for UE VCA. (shrink)

AimWhite matter changes in individuals at ultra-high risk for psychosis (UHR) may be involved in the transition to psychosis. Sleep-wake disturbances commonly precede the first psychotic episode and predict development of psychosis. We examined associations between white matter microstructure and sleep-wake disturbances in UHR individuals compared to healthy controls (HC), as well as explored the confounding effect of medication, substance use, and level of psychopathology.MethodsSixty-four UHR individuals and 35 HC underwent clinical interviews and diffusion weighted imaging. Group differences on global (...) and callosal mean fractional anisotropy (FA) was tested using general linear modeling. Sleep-wake disturbances were evaluated using the subjective measures disturbed sleep index (DSI) and disturbed awakening index (AWI) from the Karolinska Sleep Questionnaire, supported by objective sleep measures from one-night actigraphy. The primary analyses comprised partial correlation analyses between global FA/callosal FA and sleep-wake measures. Secondary analyses investigated multivariate patterns of covariance between measures of sleep-wake disturbances and FA in 48 white matter regions of interest using partial least square correlations.ResultsUltra-high risk for psychosis individuals displayed lower global FA (F = 14.56, p < 0.001) and lower callosal FA (F = 11.34, p = 0.001) compared to HC. Subjective sleep-wake disturbances were significantly higher among the UHR individuals (DSI: F = 27.59, p < 0.001, AWI: F = 36.42, p < 0.001). Lower callosal FA was correlated with increased wake after sleep onset (r = −0.34, p = 0.011) and increased sleep fragmentation index (r = −0.31, p = 0.019) in UHR individuals. Multivariate analyses identified a pattern of covariance in regional FA which were associated with DSI and AWI in UHR individuals (p = 0.028), but not in HC. Substance use, sleep medication and antipsychotic medication did not significantly confound these associations. The association with objective sleep-wake measures was sustained when controlling for level of depressive and UHR symptoms, but symptom level confounded the covariation between FA and subjective sleep-wake measures in the multivariate analyses.ConclusionCompromised callosal microstructure in UHR individuals was related to objectively observed disruptions in sleep-wake functioning. Lower FA in ventrally located regions was associated with subjectively measured sleep-wake disturbances and was partly explained by psychopathology. These findings call for further investigation of sleep disturbances as a potential treatment target. (shrink)

Despite All Critique (2014) -- World Politics and Western Reason (1980) -- The Doubled Outsides of the Modern International (2005) -- The Subject of Security (1995) -- The Protection of Nature and the Nature of Protection (2005) -- Social Movements/World Politics (1994) -- Europe is Not Where It is Supposed to Be (2000) -- They Seek it Here, They Seek it There : Looking for Politics in Clayoquot Sound (2003) -- Violence, Modernity, Silence : From Weber to International Relations (1993) (...) -- Hobbes, Origins, Limits (2011) -- War, Terror, Judgement (2002) -- International, Imperial, Exceptional (2005) -- Which Democracy for Which Demos? (2013) -- The Political Theory of Boundaries and the Boundaries of Political Theory : Interview With Raia Prokhovnik (2012). (shrink)

To controlforceaccurately under a wide range of behavioral conditions, the central nervous system would either require a detailed, continuously updated representation of the state of each muscle (and the load against which each is acting) or else force feedback with sufficient gain to cope with variations in the properties of the muscles and loads. The evidence for force feedback with adequate gain or for an appropriate central representation is not sufficient to conclude that force is the major controlled variable in (...) normal limb movements.Morton's hypothesis, thatlengthis controlled by a follow-up servo, has a number of difficulties related to the delays, gains, variability, and specificity in feedback pathways comprising potential servo loops. However, experimental evidence is consistent with these pathways providing servo assistance for some movements produced by coactivation of α- and static γ-motoneurons. Dynamic γ-motoneurons may provide an additional input for adaptive control of different types of movements.The idea that feedback is used to compensate for changes in musclestiffnesshas received experimental support under static postural conditions. However, reflexes tend to increase rather than decrease the range of variation in muscle stiffness during some cyclic movements. Theoretical problems associated with the regulation of stiffness are also discussed. The possibilities of separate control systems forvelocityorviscosityare considered, but the evidence is either negative or lacking. I conclude that different physical variables can be controlled depending on the type of limb movement required. The concept of stiffness regulation is also useful under some conditions, but should probably be extended to the regulation of the visco-elastic properties (i.e., the mechanical impedance) of a muscle or joint. (shrink)

This article updates the author’s 1982 argument that lutetium and lawrencium, rather than lanthanum and actinium, should be assigned to the d-block as the heavier analogs of scandium and yttrium, whereas lanthanum and actinium should be considered as the first members of the f-block with irregular configurations. This update is embedded within a detailed analysis of Lavelle’s abortive 2008 attempt to discredit this suggestion.

We shall construct a smooth category of mice and embeddings in the core model for measures of order 0. The existence of such a category implies that the global principle □ holds in K. We then prove a much stronger, the so-called condensation-coherent version of global □. The key tool of the whole construction is a new criterion on preserving soundness under condensation.

Axiomatic set theory is the concern of this book. More particularly, the authors prove results about the coding of models M, of Zermelo-Fraenkel set theory together with the Generalized Continuum Hypothesis by using a class 'forcing' construction. By this method they extend M to another model L[a] with the same properties. L[a] is Gödels universe of 'constructible' sets L, together with a set of integers a which code all the cardinality and cofinality structure of M. Some applications are also considered. (...) Graduate students and research workers in set theory and logic will be especially interested by this account. (shrink)

Integration of music in an academic university teaching setting is an example of how artistic practice and competences have potentials to resonate beyond the immediate discipline. The article explo...

This article is in a larger textbook of articles on Medical Ethics. It identifies a number of values that underlie professional commitments to confidentiality that are involved in protecting or promoting the client's (1) privacy, (2)social status, (3) economic advantages, (4) openness of communications, (5) seeking professional help, (6) trust in professionals, (7) autonomous control over personal information. The problem of making exceptions to confidentiality commitments is also examined.

It is a common complaint against moral philosophers that their abstract theorising bears little relation to the practical problems of everyday life. Professor Braithwaite believes that this criticism need not be inevitable. With the help of the Theory of Games he shows how arbitration is possible between two neighbours, a jazz trumpeter and a classical pianist, whose performances are a source of mutual discord. The solution of the problem in the lecture is geometrical, and is based on the formal analogy (...) between the logic of the situation and the geometry of a parabola. But an appendix provides the alternative algebraic treatment of a general two-person collaboration situation. (shrink)

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In this paper a formalized logic of propositions, PA1, is presented. It is proven consistent and its relationships to traditional logic, to PM ([15]), to subjunctive (including contrary-to-fact) implication and to the “paradoxes” of material and strict implication are developed. Apart from any intrinsic merit it possesses, its chief significance lies in demonstrating the feasibility of a general logic containing theprinciple of subjunctive contrariety, i.e., the principle that ‘Ifpwere true thenqwould be true’ and ‘Ifpwere true thenqwould be false’ are incompatible.

This work has been selected by scholars as being culturally important and is part of the knowledge base of civilization as we know it. This work is in the public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and (...) made generally available to the public. To ensure a quality reading experience, this work has been proofread and republished using a format that seamlessly blends the original graphical elements with text in an easy-to-read typeface. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

The question of whether or not children may be used as subjects in non-therapeutic research projects has generated a great deal of debate and received answers varying from 'no, never' to 'yes, if societal interests are served'. It has been claimed that a Kantian, deontological ethics would necessarily rule out such research, since valid consent would be impossible. The present paper gives a deontological argument for allowing children to be subjects in certain types of research.

This book is not a study of Plato's philosophy, but a contribution to the literary interpretation of the dialogues, through analysis of their formal structure, ...

This article is in a larger textbook of articles in Medical Ethics.

In the fourteenth century William of Occam in the course of his attack on the medieval scholastic philosophy enunciated his famous “razor”: Entia non sunt multiplicanda praeter necessitatem. This is the classic claim for the description of nature in terms of the minimum possible number of fundamental concepts. It was presumably so recognized by Newton in the third book of his “Principia” in 1687 when he wrote: “We are to admit no more causes of natural things than such as are (...) both true and sufficient to explain their appearances. To this purpose the philosophers say that Nature does nothing in vain, and more is in vain when less will serve; for Nature is pleased with simplicity and affects not the pomp of superfluous causes.”. (shrink)