Mandated Mediation of Civil Cases in State Courts: A Litigant's Perspective on Program Model Choices

Published in cooperation with the American Bar Association Section of Dispute Resolutio

The Effect of Added Weight on Foot Anthropometry in Pregnant Women and Controls

Please refer to the pdf version of the abstract located adjacent to the title

Sports concussion management using Facebook: A feasibility study of an innovative adjunct "iCon

Context: Sports concussion is currently the focus of much international attention. Innovative methods of facilitating management following this injury need to be investigated to assist athletic trainers. Objective: The objective of this study was to investigate the feasibility of using a Facebook concussion management program termed "iCon" ("interactive concussion management") to facilitate the safe return to play (RTP) of young persons following a sports concussion. Design: This qualitative study was designed as a single-group observational feasibility study using programme evaluation methodology, with the focus on gauging the suitability of the Facebook management strategy for a potential larger study. Setting: iCon involved a Facebook group containing interactive elements, with moderation and support from trained healthcare professionals. Patients or Other Participants: Eleven participants completed the study (n=9 males, n=2 females), and ranged from 18 to 28 years old. Data Collection and Analysis: The study was conducted over a three-month period, with participant questionnaires administered pre- and post-intervention. The primary focus was on the qualitative experiences of the participants in the study, and the effect of iCon on their RTP. Usage data was also collected during the study. Results: At the completion of the study, all participants (100%) stated that they would recommend an intervention such as iCon to others, with their supporting quotes all indicating that iCon has the potential to improve the management of concussion amongst this cohort. The majority of participants (n=9 or 82%) stated they were better informed with regards to their RTP because of participating in iCon. Conclusions: This interactive adjunct to traditional concussion management was appreciated amongst this particular participant group and indicated feasibility for a future, larger study of iCon. Athletic trainers should consider the role that multimedia technologies may play in assisting with the management of sports concussion

Childhood maltreatment and attention deficit hyperactivity disorder symptoms in adults: a large twin study

BACKGROUND: Childhood maltreatment (CM) has been associated with increased risk of attention deficit hyperactivity disorder (ADHD) in children and adults. It is, however, unclear whether this association is causal or due to familial confounding. Method Data from 18 168 adult twins, aged 20-46 years, were drawn from the population-based Swedish twin registry. Retrospective self-ratings of CM (emotional and physical neglect, physical and sexual abuse and witnessing family violence), and self-ratings for DSM-IV ADHD symptoms in adulthood were analysed. Possible familial confounding was investigated using a within twin-pair design based on monozygotic (MZ) and dizygotic (DZ) twins. RESULTS: CM was significantly associated with increased levels of ADHD symptom scores in adults [regression coefficient: 0.40 standard deviations, 95% confidence interval (CI) 0.37-0.43]. Within twin-pair analyses showed attenuated but significant estimates within DZ (0.29, 95% CI 0.21-0.36) and MZ (0.18, 95% CI 0.10-0.25) twin pairs. Similar results emerged for hyperactive/impulsive and inattentive ADHD symptom scores separately in association with CM. We conducted sensitivity analyses for early maltreatment, before age 7, and for abuse and neglect separately, and found similarly reduced estimates in DZ and MZ pairs. Re-traumatization after age 7 did not significantly influence results. CONCLUSIONS: CM was significantly associated with increased ADHD symptoms in adults. Associations were partly due to familial confounding, but also consistent with a causal interpretation. Our findings support cognitive neuroscience studies investigating neural pathways through which exposure to CM may influence ADHD. Clinicians treating adults with ADHD should be aware of the association with maltreatment

Opicapone as Adjunct to Levodopa Therapy in Patients With Parkinson Disease and Motor Fluctuations: A Randomized Clinical Trial

Importance: Catechol O-methyltransferase (COMT) inhibitors are an established treatment for end-of-dose motor fluctuations associated with levodopa therapy in patients with Parkinson disease (PD). Current COMT inhibitors carry a high risk for toxic effects to hepatic cells or show moderate improvement. Opicapone was designed to be effective without the adverse effects. Objective: To evaluate the efficacy and safety of 25- and 50-mg/d dosages of opicapone compared with placebo as adjunct to levodopa therapy in patients with PD experiencing end-of-dose motor fluctuations. Design: This phase 3 international, multicenter outpatient study evaluated a 25- and a 50-mg/d dosage of opicapone in a randomized, double-blind, 14- to 15-week, placebo-controlled clinical trial, followed by a 1-year open-label phase during which all patients received active treatment with opicapone. Patients with PD who experienced signs of end-of-dose deterioration and had a mean total awake off-time (state of akinesia or decreased mobility) of at least 1.5 hours, not including morning akinesia, were enrolled. Data were collected from March 18, 2011, through June 25, 2013. Data from the evaluable population were analyzed from July 31, 2013, to July 31, 2014. Main Outcomes and Measures: The primary efficacy outcome of the double-blind phase was the change from baseline in absolute off-time vs placebo based on patient diaries. The open-label phase focused on maintenance of treatment effect in off-time. Results: A total of 427 patients (258 men [60.4%] and 169 women [39.6%]; mean [SD] age, 63.1 [8.8] years) were randomized to a 25-mg/d (n = 129) or a 50-mg/d (n = 154) dosage of opicapone or to placebo (n = 144). Of these, 376 patients completed the double-blind phase and entered the open-label phase, of whom 286 completed 1 year of open-label treatment. At the end of the double-blind phase, the least squares mean change (SE) in off-time was -64.5 (14.4) minutes for the placebo group, -101.7 (14.9) minutes for the 25-mg/d opicapone group, and -118.8 (13.8) minutes for the 50-mg/d opicapone group. The adjusted treatment difference vs placebo was significant for the 50-mg/d opicapone group (treatment effect, -54.3 [95% CI, -96.2 to -12.4] minutes; P = .008), but not for the 25-mg/d opicapone group (treatment effect, -37.2 [95% CI, -80.8 to 6.4] minutes; P = .11). The off-time reduction was sustained throughout the open-label phase (-126.3 minutes at 1-year open-label end point). The most common adverse events in the opicapone vs placebo groups were dyskinesia, constipation, and dry mouth. Fifty-one patients (11.9%) discontinued from the study during the double-blind phase. Conclusions and Relevance: Treatment with a 50-mg once-daily dose of opicapone was associated with a significant reduction in mean daily off-time in levodopa-treated patients with PD and motor fluctuations, and this effect is maintained for at least 1 year. Opicapone was safe and well tolerated. Trial Registration: clinicaltrials.gov Identifier: NCT01227655

In-vivo measurement of tri-axial loading at the head during the rugby tackle.

To investigate the anatomical distribution of linear and rotational forces during the tackle scenario, male rugby players performed a total of 48 trials, as ball carrier or tackler. Participants wore headgear accommodating three global positioning system units measuring uniaxial acceleration at the occipital region (OR), left tempero-parietal (LT-PR) and right tempero-parietal region (RT-PR). An additional unit was located at the cervico-thoracic spinal region in a custom vest. There was a significant main effect for tackle condition (P &lt; 0.001), with the tackler exposed to significantly greater load than the ball carrier, supporting epidemiological observations. A repeated measure general linear model also revealed a significant (P &lt; 0.001) main effect for unit location upon 3D load, with significantly higher load at the CSR (1.63 ± 0.54 a.u.) and OR (1.67 ± 0.94 a.u.) units when compared to the LT-PR (1.23 ± 0.39 a.u.) and RT-PR (1.21 ± 0.44 a.u.) units. The anatomical specificity in loading supports epidemiological observations and provides an insight into potential concussion aetiology.</p

Administrative Procedures in Montana: A View after Four Years with the Montana Administrative Procedure Act

Administrative Procedures In Montana: A View After Four Years With The Montana Administrative Procedure Ac

Autobiographical memory: A candidate latent vulnerability mechanism for psychiatric disorder following childhood maltreatment

BACKGROUND: Altered autobiographical memory (ABM) functioning has been implicated in the pathogenesis of depression and post-traumatic stress disorder and may represent one mechanism by which childhood maltreatment elevates psychiatric risk. AIMS: To investigate the impact of childhood maltreatment on ABM functioning. METHOD: Thirty-four children with documented maltreatment and 33 matched controls recalled specific ABMs in response to emotionally-valenced cue words during functional magnetic resonance imaging (fMRI). RESULTS: Children with maltreatment experience showed reduced hippocampal and increased middle temporal and para-hippocampal activation during positive ABM recall compared to peers. During negative ABM recall they exhibited increased amygdala activation, and greater amygdala connectivity with the salience network. CONCLUSIONS: Childhood maltreatment is associated with altered ABM functioning, specifically reduced activation in areas encoding specification of positive memories, and greater activation of the salience network for negative memories. This pattern may confer latent vulnerability to future depression and post-traumatic stress disorder

Gray Wolves (Canis lupus) consume free-ranging horses (Equus ferus caballus) on the Chilcotin plateau, British Columbia

We analyzed 122 Gray Wolf (Canis lupus) scats, collected at all seasons during 2013–2017, to determine what wolves were eating in two adjacent study areas of the Chilcotin region, British Columbia: Brittany Triangle and Nemiah Valley. Free-ranging horses (Equus ferus caballus), Mule Deer (Odocoileus hemionus), Moose (Alces americanus), and small mammals contributed to wolf diet throughout the year. In both study areas, horse appeared more frequently than other species in occurrence-per-faeces (OF) and occurrence-per-item (OI) analyses. Horse occurred in 58 of 97 wolf scats from Brittany (OF 59.8%, OI 52.7%), deer in 26 (OF 26.8%, OI 23.6%), small mammals in 17 (OF 17.5%, OI 17.3%), Moose in four (OF 4.1%, OI 3.6%), and bird and fish minimally (both OF &lt;2.5%, OI &lt;2.5%). The sample size in the more human-developed Nemiah Valley was too small to estimate reliable patterns, but results suggest a similar ranking of dietary items. Domestic Cattle (Bos taurus), available in both study areas, appeared infrequently (combined area OF &lt;3.5%, OI &lt;3.0%). Based on our scat findings, free-ranging horses were a regular dietary item for wolves in the area. Studies elsewhere have found that, where wolves and free-ranging horses are sympatric, a predator–prey relationship exists

Performance of the DNA-citoliq liquid-based cytology system compared with conventional smears

To evaluate the performance of a new, manual, simplified liquid-based system, DNA-Citoliq (Digene Brasil), employed under routine conditions as compared to conventional smears collected from six collaborating private laboratories. Methods: A panel of cytopathologists, who served as the gold standard diagnosis, adjudicated discordant opinions. Results: Of 3206 pairs of slides considered valid for comparison, there were 3008 in full agreement (93.8%), 112 (3.5%) with one diagnostic category discrepancies, and 86 (2.7%) discordant cases. Among the 288 borderline+ by either method, DNA-Citoliq detected abnormalities in 243 (84.4%), and conventional smears (CS) detected abnormalities in 178 (61.8%) (McNemar test, P < 0.000), a 36.5% increased detection of borderline+ cases. Conclusions: For mild dyskaryosis, DNA-Citoliq detected 176 cases and CS 125 cases (McNemar test, P < 0.000); and for moderate+severe dyskaryosis 66 versus 32 cases respectively (McNemar test, P < 0.000)