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We read with interest the recent editorial, “The Hennepin Ketamine Study,” by Dr. Samuel Stratton commenting on the research ethics, methodology, and the current public controversy surrounding this study.1 As researchers and investigators of this study, we strongly agree that prospective clinical research in the prehospital environment is necessary to advance the science of Emergency Medical Services (EMS) and emergency medicine. We also agree that accomplishing this is challenging as the prehospital environment often encounters patient populations who cannot provide meaningful informed consent due to their emergent conditions. To ensure that fellow emergency medicine researchers understand the facts of our work so they may plan future studies, and to address some of the questions and concerns in Dr. Stratton’s editorial, the lay press, and in social media,2 we would like to call attention to some inaccuracies in Dr. Stratton’s editorial, and to the lay media stories on which it appears to be based.
Ho JD, Cole JB, Klein LR, Olives TD, Driver BE, Moore JC, Nystrom PC, Arens AM, Simpson NS, Hick JL, Chavez RA, Lynch WL, Miner JR. The Hennepin Ketamine Study investigators’ reply. Prehosp Disaster Med. 2019;34(2):111–113
Herbicide active ingredients, formulation type, ambient temperature, and humidity can influence volatility. A method was developed using volatility chambers to compare relative volatility of different synthetic auxin herbicide formulations in controlled environments. 2,4-D or dicamba acid vapors emanating after application were captured in air-sampling tubes at 24, 48, 72, and 96 h after herbicide application. The 2,4-D or dicamba was extracted from sample tubes and quantified using liquid chromatography and tandem mass spectrometry. Volatility from 2,4-D dimethylamine (DMA) was determined to be greater than that of 2,4-D choline in chambers where temperatures were held at 30 or 40 C and relative humidity (RH) was 20% or 50%. Air concentration of 2,4-D DMA was 0.399 µg m−3 at 40 C and 20% RH compared with 0.005 µg m−3 for 2,4-D choline at the same temperature and humidity at 24 h after application. Volatility from 2,4-D DMA and 2,4-D choline increased as temperature increased from 30 to 40 C. However, volatility from 2,4-D choline was lower than observed from 2,4-D DMA. Volatility from 2,4-D choline at 40 C increased from 0.00458 to 0.0263 µg m−3 and from 0.00341 to 0.025 µg m−3 when humidity increased from 20% to 50% at 72 and 96 h after treatment, respectively, whereas, volatility from 2,4-D DMA tended to be higher at 20% RH compared with 50% RH. Air concentration of dicamba diglycolamine was similar at all time points when measured at 40 C and 20% RH. By 96 h after treatment, there was a trend for lower air concentration of dicamba compared with earlier timings. This method using volatility chambers provided good repeatability with low variability across replications, experiments, and herbicides.
Health anxiety and medically unexplained symptoms cost the National
Health Service (NHS) an estimated £3 billion per year in unnecessary
costs with little evidence of patient benefit. Effective treatment is
rarely taken up due to issues such as stigma or previous negative
experiences with mental health services. An approach to overcome this
might be to offer remotely delivered psychological therapy, which can be
just as effective as face-to-face therapy and may be more accessible and
To investigate the clinical outcomes and cost-effectiveness of remotely
delivered cognitive–behavioural therapy (CBT) to people with high health
anxiety repeatedly accessing unscheduled care (trial registration:
A multicentre randomised controlled trial (RCT) will be undertaken in
primary and secondary care providers of unscheduled care across the East
Midlands. One hundred and forty-four eligible participants will be
equally randomised to receive either remote CBT (6–12 sessions) or
treatment as usual (TAU). Two doctoral research studies will investigate
the barriers and facilitators to delivering the intervention and the
factors contributing to the optimisation of therapeutic outcome.
This trial will be the first to test the clinical outcomes and
cost-effectiveness of remotely delivered CBT for the treatment of high
The findings will enable an understanding as to how this intervention
might fit into a wider care pathway to enhance patient experience of
For the Methode of a Poet historical is not such, as of an Historiographer. For an Historiographer discourseth of affayres orderly as they were donne … but a Poet thrusteth into the middest, euen where it most concerneth him, and there recoursing to the thinges forepaste, and diuining of thinges to come, maketh a pleasing Analysis of all.
Spenser, The Faerie Queene
Letter of the Authors.
In his account of twelfth-century ‘cosmologists,’ Winthrop Wetherbee has pointed to an essential problem in the interpretation of Alan of Lille's Anticlaudianus (1182–1183). He argues that the major theme of the poem is ‘the working out of the relation of the Arts to Theology that culminates in Prudentia's vision of God’; given this, Wetherbee argues that there is ‘something gratuitous and anticlimactic about the ensuing psychomachia and the new earthly order to which it leads,’ especially when the ‘virtues associated with the New Man are largely secular.’ The conclusion to which these observations lead is ineluctable: ‘Whatever its significance, the idealism of the “triumph of Nature,” as Alan calls it, is difficult to reconcile with the radical subordination of earthly knowledge in the central books of the poem.’
In the preface to his book, Superior Orders in National and International Law, Professor Green mentions that “… in 1972 the Canadian Department of Justice on behalf of [the Office of] the Judge Advocate General of the Department of National Defence, invited me to undertake a survey of the defence of superior orders in both national and international law … [and] the present book has grown out of the Report that materialized from these studies.” It may be useful, or at least interesting, to readers of the book to preface this review with some of the background to the decision to ask Professor Green to undertake the study.
This paper provides an acoustic phonetic description of Hawai‘i English vowels. The data comprise wordlist tokens produced by twenty-three speakers (twelve males and eleven females) and spontaneous speech tokens produced by ten of those speakers. Analysis of these vowel tokens shows that while there are similarities between Hawai‘i English and other dialects, the particular combination of vowel realizations in Hawai‘i English is unique to this dialect. Additionally, there are characteristics of the Hawai‘i English vowel system that are not found in other English dialects. These findings suggest that Hawai‘i English is a unique regional variety that warrants further description.
Clozapine is used in the management of treatment-resistant schizophrenia and is effective in reducing aggression; however a subgroup of patients is poorly responsive. For violent patients in this group, there is limited literature on the use of strategies to augment clozapine with other agents. Here we present a case series of 6 schizophrenia patients, within a high-security hospital, who have a history of serious violence and who were treated with clozapine augmented with amisulpride.
We reviewed case notes and health records for evidence of violence/aggression and positive factors such as engagement in activities, and Clinical Global Impression (CGI) scores were formulated. We also examined metabolic parameters before and after augmentation.
All 6 of the patients showed clinical improvement in symptoms and a reduction in their risk of violence to others. Five patients had a reduction in number of violent/aggressive incidents, and all patients showed improvement in engagement in occupational, vocational, and/or psychological work. Metabolic parameters were largely unchanged except for 1 patient whose Body Mass Index (BMI) increased. Five patients reported side effects as unchanged or improved.
These schizophrenia patients with a history of violence showed clinical improvement and reduced aggression and violence with amisulpride augmentation of clozapine. To our knowledge, this is the first report of an antiaggressive benefit of this combination in forensic psychiatric patients. Further studies are warranted to establish the efficacy and anti-aggressive effects of amisulpride augmentation of clozapine.
This paper presents impressionistic, electroglottographic and acoustic data exploring the distribution of glottalic and pulmonic airstream in word-final Scottish English obstruents. We explore the relationship between these airstream mechanisms and aspirated or glottalised phonatory settings of individual speakers near this obstruent locus. We address the hypothesis that the tendency for pre-stop glottalisation found in some British English varieties can explain the occurrence of glottalically-released stops. This hypothesis suggests that ejectives would appear as an occasional artefact of mistimed glottalisation. We also investigate whether a glottalic airstream acts as a potential contrast enhancement mechanism, through association with /−voice/ as opposed to /+voice/ stops. We show that glottalisation and aspiration can readily co-occur in the same speaker, and that local phonatory setting (with glottalised or aspirated articulation) can be consistently used as a secondary correlate of obstruent /−voice/, in the context of stops and fricatives respectively. The results show that although glottalisation as a secondary correlate of /−voice/ stops often co-occurs with an ejective release, they are not necessarily bound together. These results argue against a simple epiphenomenal explanation for the appearance of ejective stops in English, while also showing that they are not (yet) a systematic phonological enhancement in this variety.
Community archaeology is a rapidly expanding approach to archaeological research. Whilst the archaeology itself is central to individual projects, issues of community' may be heavily implicated within the agendas of many project partners. In this paper, I will argue that community archaeology projects are complex arenas in which a variety of agendas are interwoven within both the planned activities and the unplanned outcomes that occur during the life of a project. Drawing on ethnographic evidence of community archaeology from my recently completed doctoral research as well as from recent experience of the proactive delivery of community archaeology I will focus on the role of memory in relation to both the initial design of community archaeology projects and also the ways in which projects come to be understood and valued by those who have supported and/or participated in them. I will identify projects as being arenas in which aspects of social memory can be central to much that is both planned for and experienced by participants. The rediscovery of lost memories, the preserving of fragile memories and the making of new memories will be shown to be especially significant within the narratives aggregating around individual community projects. I identify ‘living memory'sites as being especially meaningful and effective for community archaeology and argue that the event of a community archaeology project can serve as an arena for the construction of community in the present.
Heritage, memory, community archaeology and the politics of the past form the main strands running through the papers in this volume. The authors tackle these subjects from a range of different philosophical perspectives, with many drawing on the experience of recent community, commercial and other projects. Throughout, there is a strong emphasis on both the philosophy of engagement and with its enactment in specific contexts; the essays deal with an interest in the meaning, value and contested nature of the recent past and in the theory and practice of archaeological engagements with that past.
Chris Dalglish is a lecturer in archaeology at the University of Glasgow. Contributors: Julia Beaumont, David Bowsher, Terry Brown, Jo Buckberry, Chris Dalglish, James Dixon, Audrey Horning, Robert Isherwood, Robert C Janaway, Melanie Johnson, Siân Jones, Catriona Mackie, Janet Montgomery, Harold Mytum, Michael Nevell, Natasha Powers, Biddy Simpson, Matt Town, Andrew Wilson
This volume publishes a selection of the papers first presented during the Society for Post-Medieval Archaeology's conference Engaging the Recent Past in 2010. This introductory paper seeks to situate the other contributions, placing them in the context of wider processes including the rise of Community Archaeology and the development of an explicit political consciousness in archaeology. Concepts of multivocality and memory are discussed, as are the practices of public participation. The paper argues that a more critical stance needs to be taken towards public engagement in archaeology, and this is discussed in relation to concepts of power and social learning. The paper advocates a move beyond limited participation (confined to particular activities, such as participatory site identification and recording, and to the context of particular projects) and it advocates a move towards participatory governance. Here, the archaeological professional is repositioned as a collaborator engaging with others, including relevant public constituencies and the relevant authorities, in the social process of creating knowledge about the past and defining how historic environments and relationships will be protected, managed or transformed in the future.
This volume arises from the Society for Post-Medieval Archaeology conference Engaging the Recent Past: Public, Political Post-Medieval Archaeology (Glasgow, September 2010). The focus of the conference was the contemporary context of post-medieval archaeology: the values, politics and ethics associated with the recent past, and the practices through which we engage with and construct that past. Contributors to the conference considered these issues in relation to the post-medieval and contemporary archaeologies of the U.K., Ireland and a number of other countries, and they promoted positions founded in a variety of philosophical, political and practice traditions.