Identification of Violence in Psychiatric Case Presentations

Previous research on medical discourse suggests that physicians minimize patients\u27 social problems through conversational and linguistic interactions. There has been little assessment, however, of the neglect of violence by psychiatric staff. In an attempt to address this important area, the case presentations of 77 recently violent psychiatric patients were examined. A contextual analysis of the violence mentioned during the case presentations revealed four categories of identification violence as part of the primary problem, as a psychiatric disorder, as an unrelated incident, or not mentioned at all In nearly two-thirds of the case presentations, the violence was not identified as part of the primary problem The findings and case examples substantiate the assertion that social problems are neglected, minimized, or medicalized in medical discourse They also suggest that clinical protocol should be established to ensure more extensive consideration of the dangerousness implied by reported violenc

Metabolic Routing of Dietary Nutrients in Birds: Effects of Diet Quality and Macronutrient Composition Revealed Using Stable Isotopes

During fall migration many songbirds switch from consuming primarily insects to consuming mostly fruit. Fruits with more carbohydrates and less protein may be sufficient to rebuild expended fat stores, but such fruits may be inadequate to replace catabolized protein. We manipulated the concentrations and isotopic signatures of macronutrients in diets fed to birds to study the effects of diet quality on metabolic routing of dietary nutrients. We estimated that approximately 45% and 75%, respectively, of the carbon in proteinaceous tissue of birds switched to high‐ or low‐protein diets came from nonprotein dietary sources. In contrast, we estimated that approximately 100% and 20%–80%, respectively, of the nitrogen in proteinaceous tissues of birds switched to high‐ or low‐protein diets was attributable to dietary protein. Thus, the routing and assimilation of dietary carbon and nitrogen differed depending on diet composition. As a result, δ15N of tissues collected from wild animals that consume high‐quality diets may reliably indicate the dietary protein source, whereas δ13C of these same tissues is likely the product of metabolic routing of carbon from several macronutrients. These results have implications for how isotopic discrimination is best estimated and how we can study macronutrient routing in wild animals

A systematic correlation between two-dimensional flow topology and the abstract statistics of turbulence

Velocity differences in the direct enstrophy cascade of two-dimensional turbulence are correlated with the underlying flow topology. The statistics of the transverse and longitudinal velocity differences are found to be governed by different structures. The wings of the transverse distribution are dominated by strong vortex centers, whereas, the tails of the longitudinal differences are dominated by saddles. Viewed in the framework of earlier theoretical work this result suggests that the transfer of enstrophy to smaller scales is accomplished in regions of the flow dominated by saddles.Comment: 4 pages, 4 figure

The Legal Foundation–Defining the Legislative Format

Current and pending mediation legislative programs in the United States, Canada, and other countries were examined by speakers and panelists who are living under these new systems or were authors of their design. Topics included court annexed programs, mandatory programs, voluntary programs, private institutional programs, the Uniform Mediation Act, state and federal initiatives, and the impact each has, or will have, on the mediation practice

Archeological Investigations and National Register Testing at 41CV1636, Coryell County, Texas

Prewitt and Associates, Inc. (PAI), conducted archeological testing of 41CV1636 for the Texas Department of Transportation (TxDOT), Environmental Affairs Division, under Contract No. 575XXSA006 (Work Authorization No. 57530SA006) and Texas Antiquities Permit No. 3980 from the Texas Historical Commission. Site 41CV1636 is situated in northwestern Coryell County, approximately 13 km east of Evant, Texas. The site was located during an archeological survey for a proposed roadway widening project along U.S. Highway 84. Proposed design plans required an additional 5 m of new right of way that would directly impact 41CV1636. Site 41CV1636 is a prehistoric site buried in Holocene alluvium of a relict channel of Cowhouse Creek. At this location, Cowhouse Creek has a ca. 1.5-km-wide stretch of Holocene alluvium. Archeological testing consisted of the excavation of two backhoe trenches and four 1x1-m hand-dug units. All sediments were water-screened. Excavations recovered a rather large lithic assemblage and two burned rock features: a partially dismantled slab-lined, basin-shaped hearth and a possible burned rock discard pile or stockpile. The recovery of Pedernales and Provisional Type 1 projectile point forms argues for a multicomponent occupation during portions of the early Late Archaic Period; however, only one analysis unit could be defined. The alluvial deposits at 41CV1636 appear correlative to the Fort Hood and West Range alluvium identified by other researchers along downstream portions of Cowhouse Creek on the Fort Hood military reservation. Soil stratigraphy at the site indicates that cultural occupations occurred as floodplain aggradation slowed and soil development began. Sedimentation via overbank flooding and colluvial deposition continued at a pace quick enough to impose some vertical separation between multiple occupations that occurred during a short time span. Poor preservation of organic remains has been a hindrance to providing good temporal control at the site. The lack of radiocarbon ages and poor preservation mean that few substantial statements can be made regarding chronology or subsistence. 41CV1636 is considered ineligible for the National Register of Historic Places or as a designated State Archeological Landmark, and no further work is warranted for this site

On Gravitational Waves in Spacetimes with a Nonvanishing Cosmological Constant

We study the effect of a cosmological constant $\Lambda$ on the propagation and detection of gravitational waves. To this purpose we investigate the linearised Einstein's equations with terms up to linear order in $\Lambda$ in a de Sitter and an anti-de Sitter background spacetime. In this framework the cosmological term does not induce changes in the polarization states of the waves, whereas the amplitude gets modified with terms depending on $\Lambda$. Moreover, if a source emits a periodic waveform, its periodicity as measured by a distant observer gets modified. These effects are, however, extremely tiny and thus well below the detectability by some twenty orders of magnitude within present gravitational wave detectors such as LIGO or future planned ones such as LISA.Comment: 8 pages, 4 figures, accepted for publication in Physical Review

Disease activity flares and pain flares in an early rheumatoid arthritis inception cohort; characteristics, antecedents and sequelae

© 2019 The Author(s). This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background: RA flares are common and disabling. They are described in terms of worsening inflammation but pain and inflammation are often discordant. To inform treatment decisions, we investigated whether inflammatory and pain flares are discrete entities. Methods: People from the Early RA Network (ERAN) cohort were assessed annually up to 11 years after presentation (n = 719, 3703 person-years of follow up). Flare events were defined in 2 different ways that were analysed in parallel; DAS28 or Pain Flares. DAS28 Flares satisfied OMERACT flare criteria of increases in DAS28 since the previous assessment (≥1.2 points if active RA or ≥ 0.6 points if inactive RA). A ≥ 4.8-point worsening of SF36-Bodily Pain score defined Pain Flares. The first documented episode of each of DAS28 and Pain Flare in each person was analysed. Subgroups within DAS28 and Pain Flares were determined using Latent Class Analysis. Clinical course was compared between flare subgroups. Results: DAS28 (45%) and Pain Flares (52%) were each common but usually discordant, with 60% of participants in DAS28 Flare not concurrently in Pain Flare, and 64% of those in Pain Flare not concurrently in DAS28 Flare. Three discrete DAS28 Flare subgroups were identified. One was characterised by increases in tender/swollen joint counts (14.4%), a second by increases in symptoms (13.1%), and a third displayed lower flare severity (72.5%). Two discrete Pain Flare subgroups were identified. One occurred following low disease activity and symptoms (88.6%), and the other occurred on the background of ongoing active disease and pain (11.4%). Despite the observed differences between DAS28 and Pain Flares, each was associated with increased disability which persisted beyond the flare episode. Conclusion: Flares are both common and heterogeneous in people with RA. Furthermore our findings indicate that for some patients there is a discordance between inflammation and pain in flare events. This discrete flare subgroups might reflect different underlying inflammation and pain mechanisms. Treatments addressing different mechanisms might be required to reduce persistent disability after DAS28 and Pain Flares.Peer reviewedFinal Published versio

Archeological Investigations and National Register Testing at 41CV163, Coryell County, Texas

Prewitt and Associates, Inc. (PAI), conducted archeological testing of 41CV1636 for the Texas Department of Transportation (TxDOT), Environmental Affairs Division, under Contract No. 575XXSA006 (Work Authorization No. 57530SA006) and Texas Antiquities Permit No. 3980 from the Texas Historical Commission. Site 41CV1636 is situated in northwestern Coryell County, approximately 13 km east of Evant, Texas. The site was located during an archeological survey for a proposed roadway widening project along U.S. Highway 84. Proposed design plans required an additional 5 m of new right of way that would directly impact 41CV1636. Site 41CV1636 is a prehistoric site buried in Holocene alluvium of a relict channel of Cowhouse Creek. At this location, Cowhouse Creek has a ca. 1.5-km-wide stretch of Holocene alluvium. Archeological testing consisted of the excavation of two backhoe trenches and four 1x1-m hand-dug units. All sediments were water-screened. Excavations recovered a rather large lithic assemblage and two burned rock features: a partially dismantled slab-lined, basin-shaped hearth and a possible burned rock discard pile or stockpile. The recovery of Pedernales and Provisional Type 1 projectile point forms argues for a multicomponent occupation during portions of the early Late Archaic Period; however, only one analysis unit could be defined. The alluvial deposits at 41CV1636 appear correlative to the Fort Hood and West Range alluvium identified by other researchers along downstream portions of Cowhouse Creek on the Fort Hood military reservation. Soil stratigraphy at the site indicates that cultural occupations occurred as floodplain aggradation slowed and soil development began. Sedimentation via overbank flooding and colluvial deposition continued at a pace quick enough to impose some vertical separation between multiple occupations that occurred during a short time span. Poor preservation of organic remains has been a hindrance to providing good temporal control at the site. The lack of radiocarbon ages and poor preservation mean that few substantial statements can be made regarding chronology or subsistence. 41CV1636 is considered ineligible for the National Register of Historic Places or as a designated State Archeological Landmark, and no further work is warranted for this site