Soi-disant: Writing, screening, theorizing the self in French

This paper explores the construction of identity, particularly with reference to texts (literary, philosophic, popular and cinematic) in French, as an introduction to a volume of papers on the topic. We demonstrate that the papers presented in that collection will show the effects on the reading of the self both of inertia and of deliberate modification with respect to convention. In publishing them as a collection, we make no claims to be unveiling a theoretization of the self, c. 2003, which would rise from the ashes of its predecessors. Rather, and despite the recurrence of certain patterns and concerns, we present a corpus that nuances the story of the fragmentation of the coherent self. What emerges from the juxtaposition of these texts is the importance of genre in determining the version of identity presented. That is to say, the instance of the subject, whether the "je" of the text or the focus of narrative identification, is largely determined by generic conventions for writing/producing the self and for formulating identity

Major depressive disorder in a family study of obsessive–compulsive disorder with pediatric probands

Objective: This study examined the comorbidity of obsessive–compulsive disorder (OCD) with major depressive disorder (MDD) in a family study of OCD with pediatric probands. Method: This study assessed the lifetime prevalence of MDD in 141 first‐degree relatives (FDR) and 452 second‐degree relatives (SDR) of pediatric probands with OCD and healthy controls, and identified variables associated with MDD in case FDR. All available FDR were directly interviewed blind to proband status; parents were also interviewed to assess the family psychiatric history of FDR and SDR. Best‐estimate diagnoses were made using all sources of information. Data were analyzed with logistic regression and robust Cox regression models. Results: Lifetime MDD prevalence was significantly higher in case than in control FDR (30.4 versus 15.4%). Lifetime MDD prevalence was significantly higher in FDR of case probands with MDD than in FDR of case probands without MDD or control FDR (46.3 versus 19.7 versus 15.4%, respectively). MDD in case FDR was significantly associated with MDD in case probands and with age and OCD in those relatives. Lifetime MDD prevalence was similar in case and control SDR. However, lifetime MDD prevalence was significantly higher in SDR of case probands with MDD than in SDR of case probands without MDD or control SDR (31.9 versus 16.8 versus 15.4%, respectively). Conclusions: MDD prevalence was significantly higher in both FDR and SDR of case probands with MDD than in relatives of case probands without MDD or control relatives, suggesting that pediatric OCD comorbid with MDD is a complex familial syndrome. Depression and Anxiety, 2011. © 2011 Wiley‐Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/87090/1/20824_ftp.pd

Evaluating the Usability of an Emergency Department After Visit Summary: Staged Heuristic Evaluation

BACKGROUND: Heuristic evaluations, while commonly used, may inadequately capture the severity of identified usability issues. In the domain of health care, usability issues can pose different levels of risk to patients. Incorporating diverse expertise (eg, clinical and patient) in the heuristic evaluation process can help assess and address potential negative impacts on patient safety that may otherwise go unnoticed. One document that should be highly usable for patients-with the potential to prevent adverse outcomes-is the after visit summary (AVS). The AVS is the document given to a patient upon discharge from the emergency department (ED), which contains instructions on how to manage symptoms, medications, and follow-up care. OBJECTIVE: This study aims to assess a multistage method for integrating diverse expertise (ie, clinical, an older adult care partner, and health IT) with human factors engineering (HFE) expertise in the usability evaluation of the patient-facing ED AVS. METHODS: We conducted a three-staged heuristic evaluation of an ED AVS using heuristics developed for use in evaluating patient-facing documentation. In stage 1, HFE experts reviewed the AVS to identify usability issues. In stage 2, 6 experts of varying expertise (ie, emergency medicine physicians, ED nurses, geriatricians, transitional care nurses, and an older adult care partner) rated each previously identified usability issue on its potential impact on patient comprehension and patient safety. Finally, in stage 3, an IT expert reviewed each usability issue to identify the likelihood of successfully addressing the issue. RESULTS: In stage 1, we identified 60 usability issues that violated a total of 108 heuristics. In stage 2, 18 additional usability issues that violated 27 heuristics were identified by the study experts. Impact ratings ranged from all experts rating the issue as no impact to 5 out of 6 experts rating the issue as having a large negative impact. On average, the older adult care partner representative rated usability issues as being more significant more of the time. In stage 3, 31 usability issues were rated by an IT professional as impossible to address, 21 as maybe, and 24 as can be addressed. CONCLUSIONS: Integrating diverse expertise when evaluating usability is important when patient safety is at stake. The non-HFE experts, included in stage 2 of our evaluation, identified 23% (18/78) of all the usability issues and, depending on their expertise, rated those issues as having differing impacts on patient comprehension and safety. Our findings suggest that, to conduct a comprehensive heuristic evaluation, expertise from all the contexts in which the AVS is used must be considered. Combining those findings with ratings from an IT expert, usability issues can be strategically addressed through redesign. Thus, a 3-staged heuristic evaluation method offers a framework for integrating context-specific expertise efficiently, while providing practical insights to guide human-centered design

Serving Larger Portions of Fruits and Vegetables Together at Dinner Promotes Intake of Both Foods among Young Children

Serving larger portions of energy dense foods has been shown to promote children’s energy intake at meals. Whether larger portions increase children’s intake of both fruits and vegetables (F&V) is less clear. A 2×2 within-subjects design systematically varied portion sizes of fruit (75 vs. 150 g) and vegetable (75 vs. 150 g) side dishes served at dinner. Children’s F&V liking was measured using a validated tasting method. Thirty 4- to 6-year-olds were tested in a laboratory setting at 5:00 PM on weekdays from November 2008 through March 2009. Mixed linear models were used to determine effects of fruit portion size, vegetable portion size, and their interaction on food and energy intakes. Data are presented as model-based means ± standard error unless otherwise indicated. When portions were doubled, children increased their vegetable intake by 37% (12 ± 4 g;

Inhibition of the tyrosine phosphatase SHP-2 suppresses angiogenesis in vitro and in vivo

Endothelial cell survival is indispensable to maintain endothelial integrity and initiate new vessel formation. We investigated the role of SHP-2 in endothelial cell survival and angiogenesis in vitro as well as in vivo. SHP-2 function in cultured human umbilical vein and human dermal microvascular endothelial cells was inhibited by either silencing the protein expression with antisense-oligodesoxynucleotides or treatment with a pharmacological inhibitor (PtpI IV). SHP-2 inhibition impaired capillary-like structure formation (p < 0.01; n = 8) in vitro as well as new vessel growth ex vivo (p < 0.05; n = 10) and in vivo in the chicken chorioallantoic membrane (p < 0.01, n = 4). Additionally, SHP-2 knock-down abrogated fibroblast growth factor 2 (FGF-2)-dependent endothelial proliferation measured by MTT reduction ( p ! 0.01; n = 12). The inhibitory effect of SHP-2 knock-down on vessel growth was mediated by increased endothelial apoptosis ( annexin V staining, p ! 0.05, n = 9), which was associated with reduced FGF-2-induced phosphorylation of phosphatidylinositol 3-kinase (PI3-K), Akt and extracellular regulated kinase 1/2 (ERK1/2) and involved diminished ERK1/2 phosphorylation after PI3-K inhibition (n=3). These results suggest that SHP-2 regulates endothelial cell survival through PI3-K-Akt and mitogen-activated protein kinase pathways thereby strongly affecting new vessel formation. Thus, SHP-2 exhibits a pivotal role in angiogenesis and may represent an interesting target for therapeutic approaches controlling vessel growth. Copyright (C) 2007 S. Karger AG, Basel

Portfolio Vol. I N 3

Sweitzer, Harry J. Portfolio Goes to Press . Prose. 1. Browne, Phil. William Howard Doane Library . Picture. 2. Overhuls, James. Out of Himself . Prose. 3. MacNeill, Annie Marie. To President and Mrs. Shaw . Poem. 6. Baker, George. Saint in a Silo . Prose 7. Beckham, Adela. In Moods . Poem. 8. Vincent, Charles. Incident of August 7, 1930. Prose. 9. Flory, Doris. Opinions . Poem. 10. Flory, Doris. Thoughts in Spring . Poem. 10. Flory, Doris. Breakfast Scene . Poem. 10. Shaw, Robert B. A Date for the Dances . Prose. 11. Cronberger, Barbara. And the Years Go On . Prose. 13. Hanna, Stanley. Reola, Reola . Poem. 14. Hanna, Stanley. The Dance of the Kobolds . Poem. 14. Nadel, Norman. I died Last Night . Prose. 15. Bethune, Don S. Adolescence . Poem 16. Vodev, Eugene. The Black Day of Bulgaria . Prose. 17. Dick, Pewilla. To a White Violet . Poem. 18. Dick, Pewilla. As With Your Shadow . Poem. 18. Dwelly, Thorndike. Of Mice and Men . Prose. 19. Clements, Helen. Our Town . Prose. 19. Schlle, Alice. Marion is an Old Costume . Picture. 20. Chadeayne, Robert. Factory . Picture. 20. Nadel, Norman. Dmitri Shostakovitch . Prose. 21. Stewart, John. Duke Ellington\u27s Records . Prose. 21. Beck, Virginia. The Dance as an Art . Prose. 22. Dick, Pewilla. Death . Poem. 23. Flory, Doris. On Reforms . Poem. 24. Beckham, Adela. The Lie . Poem. 24. Bethune, Don. Futility . Poem. 24

Assessment instruments in frail older patients:a call for more standardisation

OBJECTIVE: To determine the frequency and background of the use of assessment instruments for the Comprehensive Geriatric Assessment by clinical geriatricians and internists in geriatric medicine; the secondary aim was to make an inventory of the willingness to standardise the assessment instruments used.DESIGN: A descriptive questionnaire study.METHOD: In December 2016, we sent out a digital questionnaire (Survey Monkey) to all the hospitals in the Netherlands. Respondents were asked which instruments they used for specific domains of the Comprehensive Geriatric Assessment, what their choice of instruments was based on, if these instruments had added value, and if they were prepared to change the instruments they used.RESULTS: We received 66 responses (response: 82%). The most frequently-used instruments were: Mini Mental State Examination in combination with the clock drawing test (21%), Geriatric Depression Scale-15 (45%), Katz Index of Independence in Activities of Daily Living-6 (75%), Lawton and Brody (48%), Mini Nutritional Assessment(-short form) (outpatient; 56%) and Short Nutritional Assessment Questionnaire (inpatient: 36%), Experienced Burden Informal Care (46%), Charlson Comorbidity Index (35%), Timed Up and Go (76%), and the Safety Management System (VMS) fall risk question (21%). The most frequently used instruments were used in a large number of hospitals (35-97%).The variation of tests was the greatest in the domains of cognition, malnutrition, and mobility/physical functioning. Many respondents saw the added value of a consensus set of instruments (median: 70%; interquartile range (IQR): 50-86), and most were willing to change the instruments they use (median: 80%; IQR: 65-90).CONCLUSION: This inventory shows that the instruments used in most domains were reasonably uniform. Taking the willingness to change into account, a national set of basis instruments seems to be an achievable aim.</p

Portfolio Vol. II N 1

Browne, Phil. The Approach to Fraternity Row . Picture. 2. Simmons, Fate. The Sand House . Prose. 3. The College Catbird, Groucho. Ode to my Fellow Students . Poem. 6. Varney, Chester. The Tramp . Prose. 7. Browne, Phil. Shell Shock . Prose. 9. West, Bill C. Mr. Freud... . Poem. 10. West, Bill C. Bacchanal . Poem. 10. De Chavannes, Pierre Puvis de. Summer . Poem. 10. Pierce, Ames. A Student Looks at Europe . Prose. 11. Timrud, David. Though you Knew it Not . Poem. 13. Timrud, David. Le Joi De Vivre . Poem. 13. Timrud, David. The Ghostly Loom . Poem. 13. Dohanos, Stephen. West Quoddy Light, Maine . Picture. 13. Millet, Jean Francois. Peasants Going to Work . Picture. 14. Kent, Rockwell. Maine Coast . Picture. 14. Beier, Dean. Review of New Recordings . Prose. 15. Beier, Dean. Advice on Band Booking . Prose. 15. Millay, Edna St. Vincent. From \u27Conversation at Midnight\u27 . Prose. 16. Black, James. Playing Around . Prose. 17. Saunders, Paul. Review of New Books .Prose. 17. Salietti, Alberto. A country Woman . Picture. 18. Eschman, Barbara. Color Scheme . Poem. 18. Whitehead, Richard. A Tribute . Picture. 19. Beckham, Adela. Gethsemane . Poem. 20. Beckham, Adela. Blues Singer . Poem. 20. Flory, Doris. Revelation . Poem. 20. Flory, Doris. Fervor . Poem. 20. Hanna, Stanley. Men of Fortune . Poem. 20. Sweitzer, Harry J. Denison and Education . Prose. 21. Hopkins, Kate. Twillight . Prose. 23. Hopkins, Kate. Afterward . Prose. 23

Trotabresib (CC-90010) in combination with adjuvant temozolomide or concomitant temozolomide plus radiotherapy in patients with newly diagnosed glioblastoma

Standard-of-care treatment for newly diagnosed glioblastoma (ndGBM), consisting of surgery followed by radiotherapy (RT) and temozolomide (TMZ), has improved outcomes compared with RT alone; however, prognosis remains poor. Trotabresib, a novel bromodomain and extraterminal inhibitor, has demonstrated antitumor activity in patients with high-grade gliomas. In this phase Ib, dose-escalation study (NCT04324840), we investigated trotabresib 15, 30, and 45 mg combined with TMZ in the adjuvant setting and trotabresib 15 and 30 mg combined with TMZ+RT in the concomitant setting in patients with ndGBM. Primary endpoints were to determine safety, tolerability, maximum tolerated dose, and/or recommended phase II dose (RP2D) of trotabresib. Secondary endpoints were assessment of preliminary efficacy and pharmacokinetics. Pharmacodynamics were investigated as an exploratory endpoint. The adjuvant and concomitant cohorts enrolled 18 and 14 patients, respectively. Trotabresib in combination with TMZ or TMZ+RT was well tolerated; most treatment-related adverse events were mild or moderate. Trotabresib pharmacokinetics and pharmacodynamics in both settings were consistent with previous data for trotabresib monotherapy. The RP2D of trotabresib was selected as 30 mg 4 days on/24 days off in both settings. At last follow-up, 5 (28%) and 6 (43%) patients remain on treatment in the adjuvant and concomitant settings, respectively, with 1 patient in the adjuvant cohort achieving complete response. Trotabresib combined with TMZ in the adjuvant setting and with TMZ+RT in the concomitant setting was safe and well tolerated in patients with ndGBM, with encouraging treatment durations. Trotabresib 30 mg was established as the RP2D in both setting

Delirium in older COVID-19 patients:Evaluating risk factors and outcomes

Objectives: A high incidence of delirium has been reported in older patients with Coronavirus disease 2019 (COVID-19). We aimed to identify determinants of delirium, including the Clinical Frailty Scale, in hospitalized older patients with COVID-19. Furthermore, we aimed to study the association of delirium independent of frailty with in-hospital outcomes in older COVID-19 patients. Methods: This study was performed within the framework of the multi-center COVID-OLD cohort study and included patients aged ≥60 years who were admitted to the general ward because of COVID-19 in the Netherlands between February and May 2020. Data were collected on demographics, co-morbidity, disease severity, and geriatric parameters. Prevalence of delirium during hospital admission was recorded based on delirium screening using the Delirium Observation Screening Scale (DOSS) which was scored three times daily. A DOSS score ≥3 was followed by a delirium assessment by the ward physician In-hospital outcomes included length of stay, discharge destination, and mortality. Results: A total of 412 patients were included (median age 76, 58% male). Delirium was present in 82 patients. In multivariable analysis, previous episode of delirium (Odds ratio [OR] 8.9 [95% CI 2.3–33.6] p = 0.001), and pre-existent memory problems (OR 7.6 [95% CI 3.1–22.5] p < 0.001) were associated with increased delirium risk. Clinical Frailty Scale was associated with increased delirium risk (OR 1.63 [95%CI 1.40–1.90] p < 0.001) in univariable analysis, but not in multivariable analysis. Patients who developed delirium had a shorter symptom duration and lower levels of C-reactive protein upon presentation, whereas vital parameters did not differ. Patients who developed a delirium had a longer hospital stay and were more often discharged to a nursing home. Delirium was associated with mortality (OR 2.84 [95% CI1.71–4.72] p < 0.001), but not in multivariable analyses. Conclusions: A previous delirium and pre-existent memory problems were associated with delirium risk in COVID-19. Delirium was not an independent predictor of mortality after adjustment for frailty