Kentucky: Decades of Discord, 1865-1900

This period of Kentucky\u27s history began with the unsettled society following the close of the Civil War, included bloody feuds, and closed with the tragic Goebel assassination. This book is the most thorough and most ambitious study yet made of that significant time, and the authors recapture the drama and color of these exciting, violent, partisan, and important years. Hambleton Tapp and James C. Klotter trace the progress—or lack of it—in such fields as agriculture, architecture, commerce, literature and general culture. They present the sporting and social life of both the masses and the elite. The story of the halting progress in education, the efforts of the men and women fighting for reform, the emerging fights for blacks’ and womens’ rights—all are examined. Politics captured and held the people’s attention, and the changing and transitional political history of the era is presented in depth. Over 70 pictures and maps create the atmosphere and temper of the times. Footnotes, appendixes, an index and a bibliographical essay combine to make this a path-breaking study of a long neglected period in Kentucky history. Hambleton Tapp of Versailles received his education at the University of Kentucky (Ph. D. 1950). He wrote and edited numerous books and articles on Kentucky history. James C. Klotter, State Historian and professor of history at Georgetown College, is the author and editor of several books, including A New History of Kentucky, History Mysteries, Our Kentucky, Kentucky: Land of Tomorrow, Kentucky: Portrait in Paradox, William Goebbel, and Faces of Kentucky.https://uknowledge.uky.edu/upk_united_states_history/1028/thumbnail.jp

Automatic Generation and Novel Validation of Patient-Specific, Anatomically Inclusive Scoliosis Models for Biomechanics-Informed Surgical Planning

Scoliosis is an abnormal spinal curvature of greater than 10 degrees. Severe scoliotic deformities are addressed with highly invasive procedures: anterior or posterior spinal fusion approaches. This invasiveness is due, in part, to the constraints of current surgical planning, which utilizes computed tomography (CT) scans unable to discern spinal ligaments that are dissected to make the spine sufficiently compliant for correction. If localization of ligaments and soft tissues were achieved pre-operatively, corrective procedures could become safer and more efficient by using finite element (FE) biomechanical simulations to determine decreased incidences of ligament releases. This research aims to achieve ligament localization within CT scans by deforming computer-aided design (CAD) meshes that encompass vertebrae, intervertebral discs, ligaments, and other soft tissues to emulate patient-specific anatomy. Models are generated through deformable surface algorithms that elastically fit CAD meshes onto segmentations of conspicuous structures. Surrounding soft tissues are locally warped to reconstruct contextually appropriate positions before the CAD mesh is tetrahedralized to support finite element studies. The methods presented use convolutional neural networks (CNNs) that segment vertebrae from CT images to improve initial deformation alignment. In instances of CNN failure, methodological robustness, given an accurate segmentation, is demonstrated through the use of spinal columns which have been molded into a Lenke classification. Dice coefficient and Hausdorff distance metrics demonstrate the accuracy of the deformable model generation. Synthetically generated images are used for additional validation of soft tissue positioning. Quantitative results are highly competitive and qualitative interpretations suggest a strong level of accuracy and appropriate deformation. Soft tissue ground truths, present in synthetic data, provide further confirmation of accurate mesh generation. Following the completion of the methodological pipeline, accurate, patient-specific, anatomically inclusive models are ready for use in FE studies.https://digitalcommons.odu.edu/gradposters2021_engineering/1005/thumbnail.jp

Relationships of rock cleavage fabrics to incremental and accumulated strain in a portion of the Blue Ridge, Virginia.

The deformation history of a small portion of the Virginia Great Valley is described. Pressure solution acted to form two geometrically distinct cleavages in the Conococheague Formation. Limestone layers contain a penetrative cleavage(Sp) formed by the dimensional orientation of calcite microspar and are thickened in the hinge zones of folds and thinned on the limbs of folds. Dolomite layers contain a spaced solution cleavage(Ss) and maintain constant thickness around folds. Cleavage does not transect the fold axes in the fold hinge zones.Cleavage was formed by pervasive pressure solution and some twinning (in crystals larger than 120 microns in diameter) in limestone layers and pressure solution along discrete zones in dolomite layers. Crystal size, strain rate and composition controlled deformation mechanism. The presence of impurities such as phyllosilicates aid in the formation of discrete solution zones.One hundred oriented samples of the Conococheague Formation were collected. Incremental strain and accumulated strain were measured using syntectonic fibrous calcite and deformed ooids respectively. Layering was initially inclined as much as 30(DEGREES) to compression. The deformation was locally non-coaxial as viewed by the deforming material on the fold limbs but was irrotational as viewed from a global reference frame (preserved in fold axis). Penetrative cleavage(Sp) parallels the elongation axis of accumulated strain. The initial and final orientation of Ss are nearly identical with the initial and final orientations of incremental elongation.The volume loss due to pressure solution is estimated by comparing the abundances of metallic elements between matrix and solution zones using electron dot maps prepared on an EDX system. Hinge zones and steeply dipping limbs of folds have closer spacing and greater volume loss than the shallowly dipping limbs of folds. The hinge zones of folds experienced the greatest strain rate and volume loss. Strain rates are greater in limestones than in dolomites

Support for the predictive validity of the multifactor offender readiness model (MORM) : forensic patients' readiness and engagement with therapeutic groups

BACKGROUND: Treatment non-engagement in forensic health settings has ethical and economic implications. The multifactor offender readiness model (MORM) provides a framework for assessing treatment readiness across person, programme and contexts. AIMS: To answer the following question: Are the internal factors of the MORM associated with likelihood of engagement in groups by patients in forensic mental health services? METHOD: In a retrospective design, associations were investigated between internal factors of the MORM, measured as part of assessment for group participation, and the outcomes of treatment refusal, treatment dropout and treatment completion. RESULTS: One hundred and eighteen male patients in a high security hospital consecutively referred for group treatment agreed to participate. Internal factors of the MORM associated with treatment refusals included: psychopathic cognition, negative self-evaluation/affect and effective goal-seeking strategies. Those associated with dropouts included emotional dysregulation, low competencies to engage and low levels of general distress. MORM factors associated with completion included: low motivation, ineffective goal-seeking strategies, absence of psychopathic cognition, high levels of general distress and competency to engage. CONCLUSIONS: Internal factors of the MORM could be useful contributors to decisions about treatment readiness for hospitalised male offender-patients. Up to one in three programmes offered were refused, so clinical use of the MORM to aid referral decisions could optimise the most constructive use of resources for every individual

Substance misuse in personality disorder and schizophrenia : findings and clinical implications from a high secure hospital

Purpose Substance misuse (SMU) is widely prevalent in mentally disordered offenders and is linked with violence and offending behaviour. There is however, a scarcity of literature dedicated to investigating SMU and its clinical correlates in relation to patients detained within high secure hospital settings. The purpose of this paper is to investigate the extent and severity of SMU and corresponding treatment needs in patients with a primary diagnosis of personality disorder (PD) in comparison with mental illness (MI) in a high secure hospital. Design/methodology/approach The responsible clinicians of all patients (n=240) detained in a high secure hospital were asked to record information using a SMU screening questionnaire over a ten-month period. Details requested included substance type, history of past use and assessment and treatment needs. Data were recorded and then analysed: descriptive statistics were conducted to report historical use of substances, cross tabulations and χ2 analysis explored the relationship between SMU and treatment status and diagnosis and offending behaviour and a means comparison analysis was employed to explore length of stay and treatment of SMU. Findings A total of 230 questionnaires were returned (95 per cent of the patient population). A history of SMU was reported in 88.6 per cent of the sample, with alcohol and cannabis misuse being the most prevalent. At least one substance had been abused by 74.3 per cent of the sample. In two-thirds of the sample, SMU was linked with the onset of mental health problems and symptom exacerbation, including violence. Interestingly, patients with a diagnosis of MI as compared with PD were more likely to have used substances (93.3 per cent compared to 81.9 per cent) and were more likely to need treatment for SMU (64.3 per cent compared to 36.8 per cent). In those with an MI diagnosis, SMU was more likely to be linked with violence and index offence (74.3 per cent compared to 59.0 per cent). Practical implications SMU is significantly prevalent in high risk mentally disordered offenders and linked to onset of mental health problems and offending. Patients with schizophrenia have a higher prevalence of SMU than PD and are likely to be more in need of treatment. Violence and offending are more likely to be related to SMU in schizophrenia than in PD. Originality/value This study substantiates existing evidence that SMU contributes to mental health problems and criminogenic behaviour. Furthermore, the study reports new findings that characterize differences of the relationship of SMU to offending in schizophrenia and PD in forensic psychiatric patients presenting to a high secure hospital. </jats:sec

A psychometric evaluation of the Defence Style Questionnaire-40 in a UK forensic patient population

Psychological defence mechanisms have been considered important personality processes in the onset, maintenance and recovery of mental disorders. More recently, their application to understanding presenting problems and as potential outcome indicators for forensic patients has been recommended. However, to date there have been no investigations into the reliability and factor structure of defence mechanism assessments for this population. The current study investigated the factor structure, internal consistency and test-retest reliability of the Defence Style Questionnaire-40 (DSQ) for 160 adult male UK forensic patients. The three-factor model of defences proposed by the DSQ-40 developers was not confirmed in the study sample. Reliability indices of the three factors indicated that the Immature factor was the most ‘acceptable’ in terms of internal consistency. Test-retest reliability coefficients ranged from .70 to .91. A revised three-factor structure that closely corresponds to the original validation study is recommended following an exploratory factor analysis. The findings are compared with previous reliability and factor analytic evaluations of the DSQ-40, and recommendations for its use with forensic patients are discussed

Schizophrenia, narcolepsy, and HLA-DR15, DQ6

A strong association between HLA-DR2, DQ1 and narcolepsy-cataplexy has been known since 1986. In 1990 a subdivision (HLA-DR15, DQ6) was shown to be equally associated. Narcolepsy symptoms include rapid eye movement (REM)-sleep intrusion hallucinations during the day. Some narcoleptics may be so hallucinated that they become delusional and receive a diagnosis of schizophrenia. Fifty-six inpatient schizophrenics and 56 normal controls were compared to see if there was an excess of the narcolepsy-associated antigens (NAA) among schizophrenics. Patients had frequency of the NAA 3.89 times higher than controls. After a subset was studied by night (n = 9) and day (n = 7) polysomnography, two patients were found to be true narcoleptics. Their psychosis improved with treatment for narcolepsy. When NAA(+) and NAA(-) schizophrenics were compared, the NAA(+) subgroup had significantly higher Brief Psychiatric Rating Scale (BPRS) scores and more hospitalizations. There were no effects attributable only to gender or race. We conclude that narcolepsy can simulate schizophrenia in some cases, and that even in nonnarcoleptic patients, the HLA-DR15, DQ6 antigens mark a group of severe schizophrenics that merits further study.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30431/1/0000052.pd