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The Society of Academic Emergency Medicine Disaster Medicine Interest Group, the Office of the Assistant Secretary for Preparedness and Response – Technical Resources, Assistance Center, and Information Exchange (ASPR TRACIE) team, and the National Institutes of Health Library searched disaster medicine peer-reviewed and gray literature to identify, review, and disseminate the most important new research in this field for academics and practitioners.
MEDLINE/PubMed and Scopus databases were searched with key words. Additional gray literature and focused hand search were performed. A Level I review of titles and abstracts with inclusion criteria of disaster medicine, health care system, and disaster type concepts was performed. Eight reviewers performed Level II full-text review and formal scoring for overall quality, impact, clarity, and importance, with scoring ranging from 0 to 20. Reviewers summarized and critiqued articles scoring 16.5 and above.
Articles totaling 1176 were identified, and 347 were screened in a Level II review. Of these, 193 (56%) were Original Research, 117 (34%) Case Report or other, and 37 (11%) were Review/Meta-Analysis. The average final score after a Level II review was 11.34. Eighteen articles scored 16.5 or higher. Of the 18 articles, 9 (50%) were Case Report or other, 7 (39%) were Original Research, and 2 (11%) were Review/Meta-Analysis.
This first review highlighted the breadth of disaster medicine, including emerging infectious disease outbreaks, terror attacks, and natural disasters. We hope this review becomes an annual source of actionable, pertinent literature for the emerging field of disaster medicine.
This article uses a critical theoryllegal mobilization perspective to study the 1987–92 trade union boycott of the British Columbia labour law. The problems encountered establishing a total boycott–one that would eschew all contact with the state–and the subsequent modification of the parameters of the boycott through a selective reliance on the law offer an important case from which to learn more about the role of law and legal rights in highly regulated organizations and how collectives mobilize the law. The author argues that legal rights are important to unions because of their ability to mediate the complexity of labour relations through a decentralization of authority. At the same time, mobilization of the law for this purpose accentuates localized identities and unequal resources that operate in tension with a boycott ethos, necessitating a deliberative politics to legitimize the law. By exploring the tension between these two forms of mobilization around law–one to reduce complexity, another to legitimize broad collective norms–the author analyzes and draws some conclusions about the reproduction of social unionism in British Columbia.
Although the expression special rights emerged most prominently in the twentieth century as a negative response to the civil rights movement, the use of the term has recently acquired a broader, more ubiquitous doctrinal reach. In this paper we elaborate on the meaning of the term special rights as a political device and a way to mobilize power. As a discourse, special rights inverts relations between majority and minority, threatens a cultural contract that distributes universalistic and particular norms, and alters relations of governance. We apply these ideas to an empirical study of special rights politics in three very different issues in Hawai'i-same-sex marriage, the conversion of landholding from leasehold to fee, and indigenous sovereignty. These case studies demonstrate both the pervasiveness and capaciousness of special rights. We show that the use and impact of this discursive strategy varied a great deal from case to case, as did the responses to the accusations of special rights. Our findings suggest that special rights language and its surrogates have become a pervasive part of post-civil rights politics.
While no one would deny that Donne's Devotions Upon Emergent Occasions is a unique work of the imagination, critical comment has generally failed to perceive the commonplaces that lie behind Donne's thought. All too often the work has been labeled the 'curious’ product of an ‘anxious and restless mind' when, in fact, Donne's devotional aims lead him to traditional themes and to a view of the self that tends to deny value to personal idiosyncracies. Devotional literature generally demands from both reader and author a kind of impersonality, or better, universality of self. The author of a devotional work focuses on that area of the self in which he and his reader share similar needs: both identify themselves as fallen men, the crucial fact in their self-understanding.
The discovery of historical genders and sexualities offers the possibility of establishing continuities between the past and present that allow for identification and a more nuanced understanding of contemporary categories. Sexually, femininity was defined by the passive position in heterosexual intercourse, and yet, one of the principal medieval associations with femininity was sexual voracity. The survey of genders and sexualities discussed in this chapter is organized around a few configurations found in medieval literary texts. Beginning in the twelfth century, the literature of romance initiated a new model of heroic masculinity in tandem with the invention of heterosexual courtly love. Same-sex desire in the Middle Ages appears most often in the context of friendship. Virginity provided a kind of gender transitivity for women in a way that it did not for male saints. Finally, the chapter addresses literary representations of gender transgression and sexual acts between members of the same sex.
The study of the significance of Cather's sexuality for her writing was decisively launched by Sharon O'Brien in a 1984 essay; subsequent work in this area takes O'Brien's 1987 biography of Cather as a benchmark, a necessary point of departure. In “'The Thing Not Named': Willa Cather as a Lesbian Writer,” O'Brien linked the topics I address here - the question of Cather's artistic practices; the question of her sexuality - in the phrase she highlights from Cather's programmatic 1922 essay, “The Novel Démeublé.” “The thing not named” names the love that dare not speak its name, the crime not to be named among Christians. For O'Brien, Cather's self-recognition as a lesbian was inscribed under this prohibition (O'Brien found evidence for this self-understanding in an 1892 letter of Cather's to Louise Pound). “Cather did not fully or uncritically internalize the emotionally crippling definition of lesbianism as 'sick' or 'perverse' and challenged the social construction of female friendship as unnatural. And yet simultaneously she could not help accepting it” (p. 81). Out of this ambivalence, O'Brien argued, Cather fashioned gender-ambivalent characters (as she had early named herself William Cather, MD; she signed the letter to Pound “William”), displaced same-sex desire into luscious descriptions of feminized landscapes, and eventually molded strong women characters who, however, never were coupled with other women.
The purpose of this paper is to identify the important gaps in research coverage, particularly in areas key to the National Service Framework for Mental Health (NSF-MH) (Department of Health, 1999) and the NHS Plan (Department of Health, 2000), and to translate these gaps into researchable questions, with a view to developing a potential research agenda for consideration by research funders.
Policy makers find much mental health research irrelevant to their concerns. What types of research would directly assist those who formulate policy? The two purposes of this paper are (i) to identify important gaps in completed research, particularly in relation to the National Service Framework (NSF) for Mental Health (Department of Health, 1999a) and the NHS Plan (NHS Confederation, 2001); and (ii) to translate these gaps into researchable questions that can contribute to a debate about the future research agenda for general adult mental health in England.
The York resource allocation formula includes a calculation of the amount needed to purchase mental health services equitably in each health authority in England. However, the amount which is actually spent on services is at the discretion of the authority.
To compare expenditure on mental health services with allocation, and test the hypothesis that differences between them are to the disadvantage of services in deprived areas.
A comparison of routine expenditure and allocation data, and linear regression modelling of the ratio of expenditure to allocation.
The ratio of expenditure to allocation varies widely. Relative underspending occurs more frequently in deprived areas, although not in the four inner-London health authorities.
The intentions of the York formula are not achieved in practice. The implications of the formula for mental health should be made explicit to health authorities, and shortfalls in mental health expenditure relative to allocation should be justified at a local level.
There have been long questions about the relationship of schizophrenia to other mental disorders. Lifetime DSM-III-R diagnoses of mood and anxiety disorders in twins with clinically diagnosed schizophrenia (n = 24) and their non-affected co-twins (n = 24) were compared with twins from pairs without schizophrenia (n = 3327) using a sample from the Vietnam Era Twin Registry. Schizophrenic probands had significantly elevated rates of all included disorders (bipolar disorder, major depression, dysthymia, generalized anxiety disorder, panic disorder, and PTSD) compared with controls (P < 0.01). The odd ratios comparing co-twins of schizophrenic probands with controls was greater than three for every disorder, but did not attain statistical significance. A similar pattern was observed when analyses were restricted to only monozygotic twins (n = 12). Consistent with other studies, schizophrenics appeared to have higher rates of a range of mental disorders. Our results suggest that schizophrenia per se represents a risk factor for other psychiatric disorders, but the absence of significantly elevated risk among non-schizophrenic co-twins suggested that family environmental and/or genetic factors that contribute to risk of schizophrenia do not increase the risk of mood and anxiety disorders to the same extent that the risk of these other disorders is increased by the presence of schizophrenia. Twin Research (2000) 3, 28–32.
WR 2721 (ethiofos) protects against the toxic effects of the heavy metal compound cisplatin. which is used in the treatment of solid tumours. In a Phase I protocol designed to determine the maximum dose of WR 2721 which could be tolerated when administered in combination with cisplatin and radiation therapy to patients with cervical carcinoma. 11 patients were evaluated by audiologic testing before and after cisplatin WR 2721 administration in an attempt to identify the degree of ototoxicity. Forty-five per cent were noted to have significant hearing threshold changes. predominantly in the high frequencies. There were no significant changes in the speech frequencies in this series. This contrasts with the greater degrees of ototoxicity observed in controls treated in the same way who received cisplatin without WR 2721 protection.
Although the efficacy of chlorpromazine and other phenothiazine derivatives in the treatment of schizophrenic psychotic reactions has been established for almost a decade, there remain differences of opinion regarding which symptoms and behaviours are affected favourably by psychopharmacologic treatment. By and large, the phenothiazines have been characterized as “ataractics” or “tranquillizers”, the implication being that their predominant action is to calm excited patients by relieving the patient's anxiety or other forms of psychic distress. However, clinical experience increasingly asserts that the phenothiazines influence many manifestations of schizophrenic patients other than anxiety and excitement, including symptoms such as incoherent thought and apathy.
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