bluuebunny/crossref_metadata_2025 huggingface dataset:
Māyā’s Relation to the Temporal Realm
Authors: Gupta Gopal K.
Published: November 2020

This chapter shows how māyā, on behalf of Kṛṣṇa, makes manifest all the ingredients of creation, and, through a sequential series of developments, forms those ingredients into a plurality of universes, bodies, and minds, known as the temporal (phenomenal) realm. It specifically explores māyā’s relation to material creation, concentrating on the Bhāgavata’s Sāṁkhya account of the manner in which māyā transforms into the various elements of the temporal realm. In the course of this examination, we will attempt to compare the Bhāgavata’s Sāṁkhya system to that of classical Sāṁkhya, specifically with regard to such standard Sāṁkhya categories as puruṣa (the individual self), prakṛti (the physical world), ahaṁkāra (false identification), the guṇas (qualitative energies), the twenty-three elements, and so on.
Commerce after Money
Authors: Stewart Dustin D.
Published: November 2020

This chapter addresses the extractive logic of the poet Edward Young. It shows how his late masterpiece Night Thoughts at once extends and complicates the imperialism of his earlier work. At the heart of the analysis is Young’s notion that movement somehow generates depth, so that the mobility of a gold coin produces inner value, immaterial worth ready to be drawn out by its user. The treasure, on Young’s strange view, lies within the gold. Night Thoughts applies this thinking to the spiritual realm. Instead of assuming that it is God who extracts souls from bodies—as workers remove ore from mines—the poem suggests that souls can extract themselves from materiality through religious and poetic inspiration. Then they can delve into the interiorities of other angelic beings and exchange thoughts and feelings with them. Closing the chapter are a comparison to Charles Johnstone’s popular it-narrative Chrysal (1760–5) and a reading of Ignatius Sancho’s gushing praise for Night Thoughts.
Creation after Reproduction
Authors: Stewart Dustin D.
Published: November 2020

This chapter locates Mark Akenside at a point where counter-materialist theology and poetic theory weirdly converge with speculative embryology. The poet and physician held that human beings break into a new category of existence as they advance to an immaterial state, but normal sexual reproduction extends material life as it is. According to Akenside’s MD dissertation, God and the mother do all the work in the latter process and sperm have no functional role to play. His poetry compensates for this picture of men alienated from reproductive futurity, the chapter argues, by assigning certain male poets a power that was often (and notoriously) seen as maternal: they can impress their imaginations on the bodies and minds of other people and so steer humanity toward a different kind of future. The chapter culminates in an extended comparison to Erasmus Darwin, another poet-physician trained in embryology and, as it happens, another rare theorist of the power of paternal impressions.
Interlude
Authors: Stewart Dustin D.
Published: November 2020

The book as a whole emphasizes a productive discontinuity between various eighteenth-century poets and both their Miltonic sources and their Romantic successors. Two interludes, however, qualify this picture by showing how a mortalist poetics, shared by the late Milton and some early Romantic writers, persisted in between the two in certain quarters of Enlightenment England. The second interlude interprets Thomas Gray’s Elegy Written in a Country Churchyard (1751), still perhaps the eighteenth century’s most famous poem, alongside William Cowper’s Sapphic lyric “Hatred and Vengeance, My Eternal Portion” (1774). While Gray’s elegy presents a disembodied heaven as no freer or happier than a common burial site, and worse for being more isolated, Cowper’s bleak poem imagines that hell offers his soul a kind of protection that he lacks during his embodied life on the earth’s surface.
Introduction
Authors: Bowman Alan , Crowther Charles
Published: November 2020

This introduction discusses the character of the different epigraphic traditions in Egypt under the Ptolemies (332–30 bc), Greek and Egyptian, in both Hieroglyphic and Demotic. The book is intended as a complement to the complete collection of editions of these monuments. It summarizes the way in which the following chapters discuss and analyse many aspects of the format, content, and presentation of these Greek and bilingual or trilingual inscriptions. It sketches some of the main themes addressed by the authors and indicates what value the collection adds to our appreciation of the cultural and monumental landscape in which the Greeks absorbed features of the indigenous religion and the Egyptians adapted to the introduction of dynastic royal cult. Rather than offering novel arguments or radical innovations in interpreting the monuments, the chapters in this volume contribute to a deepening understanding of the social and cultural complexities of this bicultural landscape.
Greek Texts on Egyptian Monuments
Authors: Clarysse Willy
Published: November 2020

The subject of this chapter is the combination of Greek inscribed texts with monuments or objects made in the traditional Egyptian style. As a rule, Greek and Egyptian monuments each have their own shape, style, and text and are easily distinguishable. However, Greek texts are inscribed quite frequently on Egyptian-style stelai, and analysis reveals important features of the contact between the different cultural traditions, in onomastic and other social and linguistic practices. The study is limited to texts that are part of the monument, either from the start or in a form of reuse, and covers a range of document types, including honorific decrees, petitions concerning rights of asylum in temples, dedications, building inscriptions, and funerary stelai.
The Palaeography of Ptolemaic Inscriptions from Egypt
Authors: Crowther Charles
Published: November 2020

This chapter is concerned with the formal characteristics of Greek inscribed writing and their variety and evolution in the multicultural context of Ptolemaic Egypt. The palaeography of Ptolemaic inscriptions is considered in relation both to indigenous written traditions and to the development of documentary scripts in the papyri. The development of lettering styles in decrees and dedications is traced over the course of the Hellenistic period. The particular case of the lengthy multilingual decrees of Egyptian priestly synods is examined separately. Two concluding sections consider, respectively, a small number of inscriptions, for the dating of which palaeographical considerations may provide clarification, and the possibility of identifying individual stonecutters’ hands within the Corpus of Ptolemaic Inscriptions.
The caids and the commune mixte System
Authors: Macmaster Neil
Published: November 2020

In the dualism of colonial space, the peasantry massed in the interior were governed by a system of indirect rule, that of the communes mixtes (CM), in which a European administrator depended on a team of caids, neo-tribal chiefs, to police and manage the inhabitants of the douars. The caids, assisted by the village headmen (kebirs) were responsible for maintaining civil registers, collecting taxes, policing, and providing a flow of information to the intelligence state. A case study of the CM of the Chelif explores the important role of an aristocratic élite, the powerful Saiah family, to show how the caidat politically dominated rural society through patron-client relations and religious, charismatic power. The central government Native Affairs department managed the CM zones through supporting such clan-like, conservative élites, but by the 1930s the basis of patrimonial power was entering a phase of deepening crisis that undermined the system of indirect rule.
Organization of the Early ALN Guerrilla, 1954–7
Authors: Macmaster Neil
Published: November 2020

The chapter examines the processes by which the earliest nationalist guerrilla forces of the ALN (Armée de libération nationale) began to make contact with peasant society in the Chelif and to organize support among the local population. The process was made particularly difficult because of a virtual civil war between the Messalist forces of the MNA, and the newly created FLN, each competing to create a peasant base. The initial small, and poorly equipped forces of the FLN often faced hostility from the inhabitants, but through collective, night-time propaganda meetings they began to create a new autonomous assembly, the nizam. Instead of assassinating or driving away the caids, as has often been claimed, the FLN recruited where possible the existing fraction headmen and field guards. During the propaganda drive led by political commissars the FLN was careful to shape its rhetoric and message to the culture and beliefs of a conservative peasantry.
Creating the FLN Counter-state
Authors: Macmaster Neil
Published: November 2020

This chapter examines how the rural population responded to the presence of FLN forces in their midst. Internal FLN documents captured by the French in September 1957 for kasma 4311, a grouping of four douars in the eastern Chelif, reveal the sophisticated counter-state that was created at the local level. The aim of the ALN in the mountains was, as far as possible, to isolate the population from the colonial administration and to prevent informing, but to do so the guerrillas needed to offer a degree of rebel governance. The detailed kasma reports and accounts reveal how the ALN assumed key state functions, including food supply, civil registration, taxation, education, health care, social welfare, and justice. Through a progressive redistributive taxation policy, funds were transferred from the more wealthy in the towns to the famished peasantry. Peasant support for the FLN was not only moral or ideological, but was also grounded in the significant material rewards of wages, pensions, and family allowances. A key problem facing the ALN was the inability to protect the population from military repression and violence, but to a degree the guerrillas found a solution by reorganizing into small, mobile groups that were less dependent on the rural population.
Psychological Warfare and the Dahra Peasants
Authors: Macmaster Neil
Published: November 2020

Chapter 17 examines how Opération Pilote was implemented through a case study of the military sub-secteur of Ténès. A first problem in implementing Pilote arose from the fact that there were major disagreements within the army about the project. Some commanders resisted the new methods of the psychological warfare 5th bureaux, disliked the creation of a ‘parallel’ hierarchy of political commissars, while major tensions emerged between the civil authorities, the prefect Chevrier, and the generals. A close study of Pilote in the Dahra mountains shows that the aim of ‘pacification’ of each douar by cleansing the ALN and installing harkis autodefense, schools, medical teams, and a proto-municipal government was only successful in two highly mediatized locations, the Breira mine and Bou Maad. Far more typical was the situation in the Djebel Bissa where, following large-scale sweep operations and mass arrests, the army was unable to secure the terrain, and moved on rapidly before consolidating new communal organizations. The army command, frustrated at the slowness of Servier’s ‘hearts and minds’ approach, rapidly reverted to traditional methods of colonial warfare, the creation of zones interdites, bombing of civil populations, starvation, and the forced mass evacuation of peasants into army camps. A generalized ‘Massu model’ of cutting the vital ALN dependency on urban-rural supply networks was also tried in Ténès but failed.
The complexity of grammatical gender and language ecology
Authors: Di Garbo Francesca
Published: November 2020

This chapter investigates the evolution of grammatical gender agreement, taken as an instance of paradigmatic and syntagmatic morphological complexity, in a sample of thirty-six languages, organized per sets of closely related languages with different sociolinguistic profiles. Both loss and emergence of gender agreement occur in areas of intense language contact between diverse speech communities. However, given similar contact scenarios, asymmetries in the structure of the bilingual population and/or in the prestige dynamics between the languages in contact tend to favour one development over the other. Loss of gender agreement occurs when the demographically dominant and/or more prestigious language lacks grammatical gender. Conversely, borrowing of gender agreement is favoured when the demographically dominant and/or more prestigious language has grammatical gender. Finally, the data suggest that patterns of gender marking may have important ties to the way in which speakers construe their linguistic identity in opposition to that of their neighbours.
Morphological complexity, autonomy, and areality in western Amazonia
Authors: Tallman Adam J. R. , Epps Patience
Published: November 2020

This chapter investigates the relationship between morphological complexity and language contact and change across western Amazonia. We explore morphological proliferation in particular domains (nominal classification, tense, evidentiality, and valence-adjusting), and follow this with a more systematic exploration of morphological complexity in relation to wordhood status across a sample of eleven Amazonian languages. We argue that a large percentage of bound morphemes in these languages display ambiguity between morphotactic versus syntactic analyses, suggesting that morphological autonomy is best characterized as a matter of degree, and that different degrees of autonomy may apply on a regional scale. Since many accounts of word-internal morphological complexity implicitly rely on notions of autonomy, Amazonian languages invite a revision of our current conception of this domain.
How to Assess the Effectiveness of the Pan-European General Principles of Good Administration
Authors: Stelkens Ulrich , Andrijauskaitė Agnė
Published: November 2020

This chapter discusses the approach used in this book to assess the effectiveness of the pan-European general principles of good administration in harmonizing the domestic administrative law of the Member States of the Council of Europe with regard to the ‘limiting function’ of administrative law. It explains the criteria justifying the choice of the twenty-eight Member States included in the research and the exclusion of the others. It gives reasons why the research is not extended to the impact of these principles on the (supranational) legal order of the European Union. Finally, it explains the methods used by the national experts to assess the impact and effectiveness of the pan-European general principles of good administration in their respective legal orders, i.e. the so-called paths of reception, namely through national legislation, through administrative self-commitments, and through national case law referring to and directly applying these principles as standards of review.
The Impact of Pan-European General Principles of Good Administration on United Kingdom Administrative Law
Authors: Nason Sarah
Published: November 2020

This chapter explores the impact of the pan-European principles of good administration on the legal system of the United Kingdom. The chapter reveals that whilst the European Convention on Human Rights, and the judgments of the European Court of Human Rights, have deeply impacted on domestic administrative law, the same cannot be said regarding other sources of the pan-European general principles of good administration. Furthermore, the chapter claims that the UK, as a founder member of the Council of Europe (CoE), sees itself as continuing to provide a degree of critical oversight of the CoE’s system. There is both political and legal resistance to the idea that international norms, such as those developed by the CoE, could provide a template for elements of the domestic legal order. However, the chapter concludes that in a post-Brexit UK the pan-European general principles of good administration may well take on increased significance.
The Council of Europe as a Source of General Principles of Good Administration in Spain
Authors: Utrilla Fernández-Bermejo Dolores
Published: November 2020

This chapter discusses the impact on Spanish administrative law of the pan-European principles of good administration developed by the Council of Europe (CoE). It reveals the prominent role of the CoE in Spain’s transition to democracy after Franco’s death on 20 November 1975. Today, while there is generally no conceptual mismatch between Spanish administrative law and the said principles, their impact is fragmentary and sector-based, rather than comprehensive and systematic. Whereas in areas such as local self-government this impact appears to be high, elsewhere it has been either overshadowed by EU law or the already existing comprehensive domestic legal framework and, hence, very indirect.
Pan-European General Principles of Good Administration in Finland
Authors: Koivisto Ida
Published: November 2020

In this chapter the meaning and effect in the Finnish legal system of the Council of Europe (CoE) conventions and recommendations are discussed. Particular emphasis is placed on the adoption of the European Convention on Human Rights and CoE law pertinent to good administration, administrative law and administrative law principles. The main finding is that, so far, the CoE provisions on good administration have found little room for application due to refined domestic legislation on these matters. Instead of being a follower Finland has been setting the pace in making good administration a central concept and normative requirement in constitutional and administrative law. Thus, although a two-way interconnection between the CoE and Finland can be detected, it could be argued that Finland represents a benchmark case. This development coincides with—and is partially affected by—the general ‘pandemic’ of good governance talk and enthusiasm over the last couple of decades.
The Moderate Impact of the Pan-European General Principles of Good Administration on Slovenian Administrative Law
Authors: Ferčič Aleš
Published: November 2020

This chapter explores the impact of the pan-European general principles of good administration on the Slovenian legal system. It presents the main finding that Slovenian (general) administrative law is more or less in line with these principles. It furthermore discusses several Slovenian legislative acts that have been adopted with explicit reference to these principles as well as other pathways of reception in this legal system. At the same time the chapter makes it clear that the overall impact of the said principles has been moderate and that more could and should be done to spread knowledge about them throughout the whole system of the Slovenian judiciary and public bodies.
The Impact of the Pan-European General Principles of Good Administration on Albanian Law
Authors: Spahiu Irma
Published: November 2020

This chapter is dedicated to exploring the impact on the Albanian legal system of the pan-European general principles of good administration developed by the Council of Europe (CoE). It argues that the CoE has been engaged in almost every area of law reform and been present in monitoring elections and constitutional referendums, delivering programmes and training, offering assistance with law-making (including the Constitution and codes), supporting justice reform and advising government authorities. Especially, the European Convention on Human Rights is held in high esteem in Albania even if its application is often curtailed by language and access barriers. The chapter concludes that in order to reach full compliance with the said principles Albania still has to go through significant reforms, including the justice reform that has been ongoing in the country for the last five years with very slow progress.
Towards Implementation of the Pan-European General Principles of Good Administration through Reforms of the Public Administration System
Authors: Kalashyan Vache , Grigoryan Tigran
Published: November 2020

This chapter discusses the impact of the pan-European general principles of good administration on Armenian administrative law. The chapter claims that successful reform of Armenian public administration is an indispensable prerequisite for successful implementation of these principles but that there is still a long way to go. Besides this, the Armenian legal order is generally open to being shaped and influenced by the said principles and demonstrates numerous successful examples thereof. Nevertheless, the chapter highlights that usually the Armenian legislator is the only one to transfer these principles into Armenian law. It describes the reception of the pan-European general principles of good administration as still being under development in Armenia. The chapter concludes that in order to guarantee the full extent of ‘good administration’ it remains necessary that general reforming of Armenian public administration be successfully implemented.
Mapping, Explaining, and Constructing the Effectiveness of the Pan-European Principles of Good Administration
Authors: Stelkens Ulrich , Andrijauskaitė Agnė , Marique Yseult
Published: November 2020

This chapter is dedicated to transversal analysis of the effectiveness of the pan-European general principles of good administration developed within the framework of the Council of Europe (CoE). First, it gives an overview of the differences and particularities of the national administrative law that come forth when looking at the effectiveness of these principles on the national level. It explains why they have different effects and work in different ways in different legal orders. Second, these different modes of operation of the principles are explained: to be effective on the national level they must be transposed, implemented and enforced. Thirdly, the chapter looks at the normative function of these principles on the level of the CoE. They concretize the ‘founding values’ of the CoE (Article 3 of its Statute) with regard to the administration of its Member States. The chapter finishes with an outlook on further desiderata of research.
Epilogue
Authors: Maguire Laurie
Published: November 2020

The Epilogue looks at the rich metaphoric afterlife that the typographical features explored in Chapters 1 to 3 have linguistically beyond the printed page. In one sense, metaphors from punctuation and typography are simply a subdivision of larger book-related metaphors, and writers in the nascent world of professional publication were understandably alert to printing-house imagery and the conversion of orality to print. But just as writing and type make their way into orality as metaphor, orality makes its way into type: writers and compositors are thinking creatively about how to turn the visual and aural experience of drama into print. The place where we see this most is in play layout. Thus, this epilogue concludes with a survey of compositor creativity in a period when systems and conventions were just coming into being and hence offered scope for flexibility and experimentation.
Introduction
Authors: Scheer Monique
Published: November 2020

The Introduction introduces the term “enthusiasm” and outlines the argument of the book as a whole, as well as the historical and ethnographic methods employed in the study. An understanding of enthusiasm not as a discrete emotion (like “happiness” or “anger”) but as a complex emotional practice is explained with the help of practice theory. This theory rejects the common understanding that emotions are inner states which are displayed or expressed, making a clear distinction between the “inner” subject and the “outer” social forms, often viewed as repressive of “true” emotion. Here, the primacy of interiority becomes the object of historical study, not its premise; it appears as a specific understanding of how emotion works which some actors strive to reproduce in their practice. Adopting an understanding of emotion as practice, because it is counterintuitive, opens up the possibility to question past and current understandings of emotions and how they work, and allows us to analyze the ethical consequences of dominant theories of emotion. This conceptualization is linked to discussions of belief and conviction as material practices in religious studies and compared (and contrasted) to approaches from affect theory.
Awkward Enthusiasts
Authors: Scheer Monique
Published: November 2020

Chapter 5 presents one of the first partial analyses of the Sunday Assembly in Berlin, that is, attempts by secular humanists to create congregations and regular assemblies for singing together and listening to inspiring talks. These “atheist churches” have not been very successful in Germany and this chapter seeks to understand why this is so by examining the practices of enthusiasm invited by the congregations. Comparing the Sunday Assembly to the brand “School of Life,” which had similar beginnings, the analysis suggests that the reticence of Sunday Assembly participants in Germany is due to a lack of practice in the emotional style, which is closer to Charismatic than to mainline Protestant performance.
The Aeneid and the social structures of primitive Italy
Authors: Horsfall Nicholas
Published: November 2020

In his reconstruction of daily life in Italy in the era of Aeneas’ arrival, Virgil offers us an inexact poetic image, based on the Homeric heroic world but, at the same time, on antiquarian Roman tradition. This paper offers a rereading of Virgil’s text in the hope of extracting various as yet unidentified remains of the indigenous erudite tradition on Italic constitutional antiquities.
Debt Close to Retirement and its Implications for Retirement Well-being
Authors: Lusardi Annamaria , Mitchell Olivia S. , Oggero Noemi
Published: November 2020

Our chapter aims to analyze debt among pre-retirees and its implications for retirement well-being using data from three waves of the National Financial Capability Study (NFCS). In particular, we will analyze what kinds of debt people carry into older ages and how different types of debt are related to older Americans’ ability to save for retirement. Moreover, we will investigate older Americans’ understanding of debt and its consequences by analyzing their level of financial sophistication. For instance, managing debt can be especially difficult for people who do not know the power of interest compounding or do not have the financial savvy to plan for retirement or execute a retirement saving plan. Our analysis is intended to better guide financial sector practitioners as well as policymakers seeking to help older Americans better prepare for retirement and sustain a reasonable standard of living in retirement.
Extraterritorial Jurisdiction and the Dawn of the Protectorate
Authors: Van Hulle Inge
Published: November 2020

Chapter 3 discusses the indiscriminate extension of extraterritoriality by British imperial agents as a defining feature of British imperial legal techniques. From 1843 onwards, it is possible to discern a boom in the legislation providing for the exercise of extraterritorial jurisdiction and for the creation of consular posts. The term ‘protection’ was an inherent part of the discourse of imperial agents when they referred to the need to extend extraterritorial jurisdiction. In the context of empire, ‘protection’ proved a flexible semiotic tool that often understated the vast extent of intervention that went hand in hand with its use in legal settings. At the same in the meaning of protection as a military alliance implying control over external relations continued to survive and referred to the physical protection of African polities in return for their exclusive relationship with Britain. The growth of extraterritoriality is directly related to the genesis of the ‘colonial’ protectorate as a form of imperial governance.
International Law and the Settlement of Disputes with Regard to West Africa on the Eve of the Scramble (1840–84)
Authors: Van Hulle Inge
Published: November 2020

The haphazard nature in which treaties had been concluded sat awkwardly with the Western rules relating to title to territory. Once imperial competition intensified, rival claims with respect to territory needed to be untangled and brought to stark light the contrast between formal international law and its practical imperial ‘vernacular’. Chapter 5 analyses the varied legal responses resorted to by European states to neutralize conflicts that resulted from the helter-skelter creation of imperial legal techniques, which culminated in the organization of the Berlin Conference. It discusses early occurrences of inter-Western arbitration, the conclusion of sphere of influence treaties, and the outcome of the Berlin West Africa Conference. Finally, it highlights how the legal competition between imperial rivals brought to stark light the lack of theoretical legal consistency with regard to imperial state practices.
The Emergence of White-Collar Unionism in New York’s Culture Industries
Authors: Clark Shannan
Published: November 2020

Chapter 2 explores the development of white-collar unionism in New York’s culture industries during the Great Depression. Culture workers responded to the crisis with new organizing initiatives, many of which eventually gravitated toward the Congress of Industrial Organizations (CIO). Larger groups of workers received charters from the CIO as affiliated international unions, such as the American Newspaper Guild, with the New York locals containing a substantial share of total national membership. Organizing efforts in cultural fields that were more concentrated in the metropolitan area, like the Book and Magazine Guild and the American Advertising Guild, became local unions within the United Office and Professional Workers of America, which was the CIO affiliate with a general jurisdiction covering white-collar workers. This chapter also examines the important role of women activists in white-collar organizing as well as unionists’ participation in the broader Popular Front social movement of the 1930s.
Challenging the Culture of Consumer Capitalism
Authors: Clark Shannan
Published: November 2020

Chapter 3 explores the white-collar insurgents’ efforts to create viable alternatives to the culture of consumer capitalism. These impulses found expression in new media ventures that were launched in New York between 1936 and 1940, including Consumers Union, the advertising-free daily tabloid newspaper PM, the weekly newsletter In Fact, and the weekly photo-journalistic magazine Friday. Through these initiatives, radicalized culture workers propagated the Popular Front’s vision of social consumerism by encouraging Americans to purchase union-made goods, participate in consumer cooperatives, harbor deep skepticism toward advertising claims, use graded or generic goods instead of typical branded goods when possible, and demand an increase in the public provisioning of goods and services. In addition, these endeavors also provided writers, artists, and other members of the creative class with opportunities for greater autonomy in their work.
Cost-Effectiveness and Outcomes of Direct Access to Physical Therapy for Musculoskeletal Disorders Compared to Physician-First Access in the United States: Systematic Review and Meta-Analysis
Authors: Hon Sandra , Ritter Richard , Allen Diane D
Published: November 2020

Objective

Direct access to physical therapy provides an alternative to physician-first systems for patients who need physical therapy for musculoskeletal disorders (MSDs). Direct access across multiple countries and the United States (US) military services has produced improved functional outcomes and/or cost-effectiveness at clinical and health care system levels; however, data remain scarce from civilian health care systems within the United States. The purpose of this study was to compare evidence regarding costs and clinical outcomes between direct access and physician-first systems in US civilian health services.

Methods

A database search of PubMed, CINAHL, Cochrane Reviews, and PEDro was conducted through May 2019. Studies were selected if they specified civilian US, physical therapy for MSDs, direct access or physician-first, and extractable outcomes for cost, function, or number of physical therapy visits. Studies were excluded if interventions utilized early or delayed physical therapy access compared with physician-first. Five retrospective studies met the criteria. Means and standard deviations for functional outcomes, cost, and number of visits were extracted, converted to effect sizes (d) and 95% CI, and combined into grand effect sizes using fixed-effect or random-effects models depending on significance of the Q heterogeneity statistic.

Results

Direct access to physical therapy showed reduced physical therapy costs (d = −0.23; 95% CI = −0.35 to −0.11), total health care costs (d = −0.19; 95% CI = −0.32 to −0.07), and number of physical therapy visits (d = −0.17; 95% CI = −0.29 to −0.05) compared to physician-first systems. Disability decreased in both direct access (d = −1.78; 95% CI = −2.28 to −1.29) and physician-first (d = −0.89; 95% CI = −0.92 to −0.85) groups; functional outcome improved significantly more with direct access (z score = 0.89; 95% CI = 0.40 to 1.39).

Conclusions

Direct access to physical therapy is more cost-effective, resulting in fewer visits than physician-first access in the United States, with greater functional improvement.

Impact

These findings within civilian US health care services support a cost-effective health care access alternative for spine-related MSDs and can inform health care policy makers.
Effects of management system on beef heifer growth and reproductive performance
Authors: Henley Parker A , Ireland Frank A , Canisso Igor F , Edwards J Lannett , Shike Daniel W
Published: November 2020

This study evaluated the effect of heifer development system on body weight (BW), body condition score (BCS), fescue toxicosis symptoms, reproductive performance, and subsequent calf growth of fall-calving beef heifers. Angus × Simmental heifers [n = 399; 240 ± 20.0 kg initial BW; age = 252 ± 20 d] were stratified by BW and BCS and assigned to 1 of 12 groups in each of the two production years. The study utilized a stratified randomized design. Pens were randomly assigned to four treatments: drylot (DL) development (fed ad-libitum diet consisting of 90% hay and 10% DDGS on a dry matter basis), grazing endophyte-infected fescue supplemented daily (2.3 kg as-fed/heifer/d; 50:50 mix of soybean hulls and DDGS; E+/S), grazing endophyte-infected fescue and supplemented from the midpoint of treatment period until breeding (4.5 kg as-fed/heifer/d; 50:50 mix of soybean hulls and DDGS; E+/LS), and grazing novel endophyte-infected fescue with no supplement (NE+/NS). Treatments ceased on d 168 [time of artificial insemination (AI)] and heifers were commingled and managed as a group through second breeding season. Heifers in DL had greatest (P ≤ 0.05) BW and BCS from d 28 until d 254. Furthermore, E+/S heifers had greater (P ≤ 0.05) BW and BCS than both E+/LS and NE+/NS from d 28 until d 168. On d 56 and 84, E+/LS heifers had lower (P ≤ 0.05) BW and BCS compared to NE+/NS, but on d 148 treatments reranked and E+/LS remained at a greater (P ≤ 0.05) BW and BCS compared to NE+/NS through the first breeding season. Drylot heifers had greatest (P ≤ 0.05) percentage cycling and percentage of mature BW at AI (66.6%) and had greater (P ≤ 0.05) AI and overall pregnancy rates compared to E+/LS and NE+/NS. The E+/S (55%) and E+/LS (53.7%) heifers were developed to a greater (P < 0.01) percentage of mature BW than NE+/NS (49.3%). A greater (P ≤ 0.02) percentage of DL and E+/S heifers were pregnant at the end of the first breeding season (89.3 and 85.1%; respectively) compared to NE+/NS (61.5%). In summary, DL heifers had the greatest BW and BCS at AI, percentage cycling, and AI pregnancy rate. However, this strategy did not result in differing overall pregnancy rates between DL, E+/S, and E+/LS and there were no differences in milk production, rebreeding reproductive performance, and calf performance between all treatments. Finally, the poorest AI and overall pregnancy rates of the NE+/NS heifers suggests this is not a viable development strategy for fall-born heifers.
Immunobridging efficacy of a tetravalent dengue vaccine against dengue and against hospitalized dengue from children/adolescents to adults in highly endemic countries
Authors: Huang Ying , Moodie Zoe , Juraska Michal , Fong Youyi , Carpp Lindsay N , Chambonneau Laurent , Coronel Diana L , Dayan Gustavo H , DiazGranados Carlos A , Gilbert Peter B
Published: November 2020

Background

The recombinant tetravalent live-attenuated dengue vaccine based on the YF 17D vaccine virus backbone (CYD-TDV) demonstrated vaccine efficacy (VE) against symptomatic, virologically confirmed dengue of any serotype from month 13 to month 25 (VCD-DENV-AnyM13→M25) in the CYD14 (2–14-y-olds) and CYD15 (9–16-y-olds) phase 3 trials. Fifty percent plaque reduction neutralization test (PRNT50) titers are a potential surrogate for immunobridging VE to adults.

Methods

Using PRNT50 calibration datasets, we applied immunobridging approaches using baseline and/or M13 PRNT50 titers to estimate VE against VCD-DENV-AnyM0→M25 and against hospitalized VCD (HVCD)-DENV-AnyM0→M72 in hypothetical 18–45-y-old and 46–50-y-old CYD14 and CYD15 cohorts.

Results

Baseline and M13 geometric mean PRNT50 titers were greater in 18–45-y-olds and in 46–50-y-olds vs 9–16-y-olds for most comparisons. Estimated VE (95% CIs against VCD-DENV-AnyM0→M25 ranged from 75.3% to 90.9% (52.5% to 100%) for 18–45-y-olds and 74.8% to 92.0% (53.4% to 100%) for 46–50-y-olds. Estimated VE (95% CIs) against HVCD-DENV-AnyM0→M72 ranged from 58.8% to 78.1% (40.9 to 98.9%) for 18–45-y-olds and 57.2% to 78.4% (40.5 to 97.6%) for 46–50-y-olds. Corresponding predictions among baseline-seropositive individuals yielded comparable or higher VE estimates.

Conclusions

VE M0→M25 against DENV-Any and VE against HVCD-DENV-AnyM0→M72 are both expected to be higher in 18–45 and 46–50-y-olds vs CYD14 and CYD15 9–16-y-olds.
Epidemiology and challenges of dengue surveillance in the WHO South-East Asia Region
Authors: Tsheten Tsheten , Gray Darren J , Clements Archie C A , Wangdi Kinley
Published: November 2020

Dengue poses a significant health and economic burden in the WHO South-East Asia Region. Approaches for control need to be aligned with current knowledge on the epidemiology of dengue in the region. Such knowledge will ensure improved targeting of interventions to reduce dengue incidence and its socioeconomic impact. This review was undertaken to describe the contemporary epidemiology of dengue and critically analyse the existing surveillance strategies in the region. Over recent decades, dengue incidence has continued to increase with geographical expansion. The region has now become hyper-endemic for multiple dengue virus serotypes/genotypes. Every epidemic cycle was associated with a change of predominant serotype/genotype and this was often associated with severe disease with intense transmission. Classical larval indices are widely used in vector surveillance and adult mosquito samplings are not implemented as a part of routine surveillance. Further, there is a lack of integration of entomological and disease surveillance systems, often leading to inaction or delays in dengue prevention and control. Disease surveillance does not capture all cases, resulting in under-reporting, and has thus failed to adequately represent the true burden of disease in the region. Possible solutions include incorporating adult mosquito sampling into routine vector surveillance, the establishment of laboratory-based sentinel surveillance, integrated vector and dengue disease surveillance and climate-based early warning systems using available technologies like mobile apps.
J-curve relationship between admission SBP and 2-year cardiovascular mortality in older patients admitted for acute coronary syndrome
Authors: Jiang Chunyan , Wu Shanshan , Wang Man , Zhao Xueqiao , Li Hongwei
Published: November 2020

Objective:

To investigate the relationship between admission SBP and subsequent cardiovascular and all-cause mortality in older patients hospitalized for acute coronary syndrome (ACS).

Methods:

This is a retrospective observational study. Data from the CBD Bank (Cardiovascular Center Beijing Friendship Hospital Database Bank) were used to analyze the cardiovascular and all-cause mortality during hospitalization and over the follow-up period in relation to admission SBP among patients aged at least 65 years admitted for ACS from December 2012 through July 2019. Results were presented according to SBP quartiles: Q1, less than 120 mmHg; Q2, from 120 to 129 mmHg; Q3, from 130 to 143 mmHg; and Q4, at or above 144 mmHg.

Results:

A total of 6785 patients were included in this cohort study. Mean (SD) patient age was 74.0 (6.5) years, and 47.6% were women. Mean (SD) follow-up time was 2.54 (1.82) years. A nonlinear relation was observed between SBP at admission and cardiovascular and all-cause mortality during hospitalization and over the follow-up period using restricted cubic splines. After adjustment for potential confounders, patients in Q1 had higher risk for 2-year cardiovascular death by Cox proportional hazard model compared with patients in Q2 [hazard ratio, 1.58; 95% confidence interval (CI), 1.12–2.21, P = 0.009], whereas patients in Q3 or Q4 exhibited a trend towards increased risk for 2-year cardiovascular death (hazard ratio, 1.33, 95% CI, 0.95–1.86, P = 0.094, for Q3 vs. Q2; and hazard ratio, 1.28, 95% CI, 0.91–1.82, P = 0.160, for Q4 vs. Q2). Meanwhile, when compared with patients in Q1, patients in Q2 had lower risk for 2-year cardiovascular death (hazard ratio, 0.64; 95% CI, 0.45–0.89, P = 0.009) whereas patients in Q3 or Q4 had similar risk for cardiovascular death (hazard ratio, 0.85, 95% CI, 0.63–1.14, P = 0.272, for Q3 vs. Q1; and hazard ratio, 0.82, 95% CI, 0.59–1.13, P = 0.221, for Q4 vs. Q1). However, low-admission SBP was not an independent predictor of 2-year all-cause mortality in this population.

Conclusion:

Among patients aged at least 65 years admitted for ACS, there is a J-curve relationship between supine admission SBP and risk for 2-year cardiovascular death, with a nadir at 120–129 mmHg.
A Within-Subjects Comparison of Clinical Outcomes for Patients' First and Second Concussions
Authors: French Jonathan , Jennings Sabrina , Eagle Shawn R. , Collins Michael W. , Kontos Anthony P.
Published: November 2020

Objectives:

To examine the difference between an individual's first and second concussion using a comprehensive, multidomain assessment including symptoms, neurocognitive, vestibular, ocular, and individual demographic and medical history risk factors associated with protracted recovery.

Setting:

Concussion Specialty Clinic.

Participants:

Seventy-three patients (aged 13-21 years; 57% female) diagnosed with 2 separate concussions (380.5 ± 278.7 days between injuries) from August 2016 to August 2018.

Design:

Retrospective within-subjects cohort study.

Main Measures:

ImPACT, PCSS, and Vestibular-Ocular Motor Screen (VOMS) at each visit. Patients were divided into “normal” (≤30 days) and “protracted” recovery (>30 days) for χ2 analyses.

Results:

There were no differences between the first and second injuries in recovery time, VOMS, visual and verbal memory, or reaction time. Visual motor speed scores were higher at the second injury time point and reported sleep symptoms were higher at the first injury time point. In addition, participants reported to the clinic on average 3 days earlier for an evaluation for their second injury. Results from χ2 analyses indicated that female sex predicted protracted recovery (>30 days) from concussion at the first injury time point (OR = 4.1; 95% CI, 1.5-11.6; P = .006).

Conclusions:

The findings provide preliminary evidence that there is no clinical difference between patients' first and second concussions when both injuries were treated through a concussion specialty clinic.
Predictors of Concussion Outcomes in Individuals With ADHD
Authors: Lambert Maude , Marshall Cameron , Holahan Matthew R.
Published: November 2020

Objectives:

To describe and delineate the epidemiological profile of concussion injuries in individuals with attention-deficit/hyperactivity disorder (ADHD) by identifying characteristics associated with poorer outcomes.

Setting:

One hundred forty-four multidisciplinary concussion-specialized clinics across Canada.

Participants:

Two hundred twenty-two individuals with a diagnosis of ADHD aged 7 to 53 years who sustained a concussion within the last year.

Design:

Multicenter cohort study.

Main Measures:

Candidate predictor variables (ie, age, sex, concussion history, loss of consciousness, and internalized and learning disorder comorbidities) were collected through oral interviews. Concussion outcomes (ie, symptom severity and total number of symptoms experienced) were assessed with the Sport Concussion Assessment Tool.

Results:

Older age, female sex, and the presence of an internalized disorder predicted poorer concussion outcomes in individuals with ADHD. Males with ADHD reported significantly worse concussion outcomes with increasing age, while outcomes remained fairly stable across age in females.

Conclusion:

The current findings represent a promising step toward the optimization of concussion management in individuals with ADHD. With a more thorough understanding of the demographic and comorbidity variables, clinical care decisions and intervention strategies can be developed to help individuals with ADHD who might be at a higher risk of poorer outcomes following a concussion.
Healthcare Utilization Following Traumatic Brain Injury in a Large National Sample
Authors: Albrecht Jennifer S. , Wickwire Emerson M.
Published: November 2020

Objective:

To evaluate the impact of traumatic brain injury (TBI) on healthcare utilization (HCU) over a 1-year period in a large national sample of individuals diagnosed with TBI across multiple care settings.

Setting:

Commercial insurance enrollees.

Participants:

Individuals with and without TBI, 2008-2014.

Design:

Retrospective cohort.

Main Measures:

We compared the change in the 12-month sum of inpatient, outpatient, emergency department (ED), and prescription HCU from pre-TBI to post-TBI to the same change among a non-TBI control group. Most rehabilitation visits were not included. We stratified models by age ≥65 and included the month of TBI in subanalysis.

Results:

There were 207 354 individuals in the TBI cohort and 414 708 individuals in the non-TBI cohort. Excluding the month of TBI diagnosis, TBI resulted in a slight increase in outpatient visits (rate ratio [RtR] = 1.05; 95% confidence interval [CI], 1.04-1.06) but decrease in inpatient HCU (RtR = 0.86; 95% CI, 0.84-0.88). Including the month of TBI in the models resulted in increased inpatient (RtR = 1.55; 95% CI, 1.52-1.58) and ED HCU (RtR = 1.37; 95% CI, 1.34-1.40).

Conclusion:

In this population of individuals who maintained insurance coverage following TBI, results suggest that TBI may have a limited impact on nonrehabilitation HCU at the population level.