bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE EPISTEMIC AND MORAL ROLE OF TESTIMONY1
Authors: TOZZI VERÓNICA 
Published: January 2012

ABSTRACTMy aim in this article is to provide a critical‐productive appreciation of witness testimony that avoids the false and crooked dichotomies that pervade contemporary philosophy of history and historical theory. My specific, pragmatist approach combines the recent accounts of Hayden White about “witness literature” with the “generative‐performative” consideration of testimony by Martin Kusch. The purpose is to appreciate, in a non‐foundationalist way, the epistemic and moral role of testimony in the constitution of the representation of the recent past. To achieve this I examine the assumed epistemic and political privilege of the testimonies of survivors of state terrorism from the recent past, and I draw on insights of three of the most relevant survivor witnesses: Primo Levi, Victor Klemperer, and Pilar Calveiro. The essay tries to avoid both an epistemic and a moral posture based on something like “the privileged victim's perspective,” and instead approaches the specific analysis of production and circulation of witness discourse in terms of its contribution to the constitution of the past. That is, it recommends that one look at witness testimony not as an attempt to return to the past but as an action in the present. The result in so doing is to follow some recent results discussed in the new epistemology of witness testimony, which insist that: first, trust in testimony is an irreducible function of the acceptance of knowledge (this means that testimonies should not be treated as secondary sources of knowledge or as parasitical on experience and reason); and second, the production‐circulation of testimonies does not function only in the context of justification but is also legitimately constitutive of knowledge.
THE DIALECTICS OF JAMESON'S DIALECTICS
Authors: Ankersmit Frank 
Published: January 2012

ABSTRACTThis review essay attempts to understand the book under review against the background of Jameson's previous writings. Failing to do so would invite misunderstanding since there are few contemporary theorists whose writing forms so much of a unity. Jameson's book can be divided into three parts. The first and most important part deals with dialectics, the second with politics, and the third with philosophy of history. In the first part Jameson argues that dialectics best captures our relationship to the sociocultural and historical world we are living in. The second part makes clear that Jameson is not prepared to water down his own Marxist politics in order to spare the liberal sensibilities of his political opponents. In the third part Jameson develops his own philosophy of history, mainly in a dialogue with Ricoeur. Dialectics is his main weapon in his discussion with Ricoeur, and it becomes clear that the Spinozism of dialectics allows for a better understanding of history and of historical writing than does Ricoeur's phenomenological approach. The book is an impressive testimony to the powers of dialectical thought and to its indispensability for a proper grasp of historical writing.
Age Patterns of Incidence of Geriatric Disease in the U.S. Elderly Population: Medicare‐Based Analysis
Authors: Akushevich Igor , Kravchenko Julia , Ukraintseva Svetlana , Arbeev Konstantin , Yashin Anatoliy I. 
Published: January 2012

ObjectivesTo use the Medicare Files of Service Use (MFSU) to evaluate patterns in the incidence of aging‐related diseases in the U.S. elderly population.DesignAge‐specific incidence rates of 19 aging‐related diseases were evaluated using the National Long Term Care Survey (NLTCS) and the Surveillance, Epidemiology, and End Results (SEER) Registry data, both linked to MFSU (NLTCS‐M and SEER‐M, respectively), using an algorithm developed for individual date at onset evaluation.SettingA random sample from the entire U.S. elderly population (Medicare beneficiaries) was used in NLTCS, and the SEER Registry data covers 26% of the U.S. population.ParticipantsThirty‐four thousand seventy‐seven individuals from NLTCS‐M and 2,154,598 from SEER‐M.MeasurementsIndividual medical histories were reconstructed using information on diagnoses coded in MFSU, dates of medical services and procedures, and Medicare enrollment and disenrollment.ResultsThe majority of diseases (e.g., prostate cancer, asthma, and diabetes mellitus) had a monotonic decline (or decline after a short period of increase) in incidence with age. A monotonic increase in incidence with age with a subsequent leveling off and decline was observed for myocardial infarction, stroke, heart failure, ulcer, and Alzheimer's disease. An inverted U‐shaped age pattern was detected for lung and colon carcinomas, Parkinson's disease, and renal failure. The results obtained from the NLTCS‐M and SEER‐M were in agreement (excluding an excess for circulatory diseases in the NLTCS‐M). A sensitivity analysis proved the stability of the incidence rates evaluated.ConclusionThe developed computational approaches applied to the nationally representative Medicare‐based data sets allow reconstruction of age patterns of disease incidence in the U.S. elderly population at the national level with unprecedented statistical accuracy and stability with respect to systematic biases.
Metabolic Complications in Elderly Adults with Chronic Kidney Disease
Authors: Drawz Paul E. , Babineau Denise C. , Rahman Mahboob 
Published: January 2012

ObjectivesTo determine whether elderly adults with a low glomerular filtration rate (GFR) are at risk for anemia, hyperkalemia, acidosis, and hyperphosphatemia.DesignRetrospective study.SettingVeterans Affairs Medical Center.ParticipantsThirteen thousand eight hundred seventy‐four veterans aged 65 and older with chronic kidney disease (CKD) and a GFR between 15 and 60 mL/min per 1.73 m2. Their average age was 79.MeasurementsAnemia was defined as a hemoglobin level of less than 10 g/dL, hyperkalemia as a potassium level greater than 5.5 mEq/L, acidosis as a bicarbonate level of less than 21 mEq/L, and hyperphosphatemia as a phosphorus level greater than 4.6 mg/dL. Multivariable logistic regression was used to evaluate whether age modifies the effect of low GFR on metabolic complications by including an interaction term between age and GFR in each model.ResultsThe average GFR of participants was 46.5 mL/min per 1.73m2, 3.1% had anemia, 2.5% hyperkalemia, 2.3% acidosis, and 4.4% had hyperphosphatemia. Lower GFR was associated with higher rates of metabolic complications across all age groups (odds ratio per 5‐mL/min per 1.73 m2 decrease in GFR in multivariable models was 1.21 for anemia, 1.26 for hyperkalemia, 1.45 for acidosis, and 1.72 for hyperphosphatemia). There was no significant interaction between age and GFR in models including only age and GFR or in multivariable models (P‐values for age by GFR interaction term: 0.66 for anemia, 0.19 for hyperkalemia, 0.54 for acidosis, and 0.22 for hyperphosphatemia).ConclusionElderly adults with CKD are at risk for anemia, hyperkalemia, acidosis, and hyperphosphatemia; age does not modify the relationship between GFR and development of metabolic complications. Elderly adults with low GFR should be monitored for metabolic complications, regardless of age.
Elder Self‐Neglect and Hospitalization: Findings from the Chicago Health and Aging Project
Authors: Dong XinQi , Simon Melissa A. , Evans Denis 
Published: January 2012

ObjectivesTo quantify the relation between reported elder self‐neglect and rate of hospitalization in a community population of older adults.DesignProspective population‐based study.SettingGeographically defined community in Chicago.ParticipantsCommunity dwelling older adults who participated in the Chicago Health and Aging Project. One thousand one hundred sixty‐five of the 6,864 participants in the Chicago Health and Aging Project was reported to social services agency for suspected elder self‐neglect.MeasurementsThe primary predictor was elder self‐neglect reported to social services agency. The outcome of interest was the annual rate of hospitalization, obtained from the Centers for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships.ResultsThe average annual rate of hospitalization was 0.6 ± 1.3 for participants without elder self‐neglect and 1.8 ± 3.2 for those with reported elder self‐neglect. After adjusting for sociodemographic and socioeconomic characteristics, medical commorbidities, and cognitive and physical function, older adults who neglected themselves had significantly higher rate of hospitalization (rate ratio = 1.47, 95% confidence interval = 1.39–1.55). Greater severity of self‐neglect (mild: standardized parameter estimate (PE) = 0.24, standard error (0.05); moderate: PE = 0.45 (0.03); severe: PE = 0.54, (0.11), all P < .001) was associated with higher annual rates of hospitalization after adjusting for the same confounders. Interaction term analyses suggest that medical conditions, cognitive impairment, and physical disability did not mediate the significant relationship between self‐neglect and hospitalization.ConclusionReported elder self‐neglect was associated with higher rates of hospitalization in this community population. Greater severity of self‐neglect was associated with a greater rate of hospitalization.
Efficacy of Cognitive Behavioral Therapy for Anxiety Disorders in Older People: A Meta‐Analysis and Meta‐Regression of Randomized Controlled Trials
Authors: Gould Rebecca L. , Coulson Mark C. , Howard Robert J. 
Published: January 2012

ObjectivesTo review the magnitude and duration of and factors associated with effects of cognitive behavioral therapy (CBT) for anxiety disorders in older people.DesignElectronic literature databases and the Cochrane Trials Registry were searched for articles. A systematic critical review, random‐effects meta‐analysis, and meta‐regression of randomized controlled trials were conducted.SettingCommunity outpatient clinics.ParticipantsPeople with diagnoses of anxiety disorders.MeasurementsOutcome measures of anxiety and depression.ResultsTwelve studies were included. CBT was significantly more effective than treatment as usual or being on a waiting list at reducing anxiety symptoms at 0‐month follow‐up, with the effect size being moderate, but when CBT was compared with an active control condition, the between‐group difference in favor of CBT was not statistically significant, and the effect size was small. At 6‐ but not 3‐ or 12‐month follow‐up, CBT was significantly more effective at reducing anxiety symptoms than an active control condition, although the effect size was again small. Meta‐regression analyses revealed only one factor (type of control group) to be significantly associated with the magnitude of effect sizes.ConclusionThe review confirms the effectiveness of CBT for anxiety disorders in older people but is suggestive of lower efficacy in older than working‐age people. The small effect sizes in favor of CBT over an active control condition illustrate the need to investigate other treatment approaches that may be used to substitute or augment CBT to increase the effectiveness of treatment of anxiety disorders in older people.
Vitamin D Deficiency in Elderly Women in Nursing Homes: Investigation with Consideration of Decreased Activation Function from the Kidneys
Authors: Terabe Yasuhito , Harada Atsushi , Tokuda Haruhiko , Okuizumi Hiroyasu , Nagaya Masahiro , Shimokata Hiroshi 
Published: January 2012

ObjectivesTo determine the approximate percentage of women in nursing homes who have vitamin D deficiency and to investigate whether, in assessing vitamin D status in elderly women, there are problems with measuring only 25 hydroxy‐vitamin D3 (25(OH)D3) and whether decreased vitamin D activation as a result of poor renal function needs to be considered.DesignCross‐sectional study.SettingForty‐eight nursing homes in Japan.ParticipantsFour hundred three women with a mean age of 86.5 living in nursing homes who had participated in a clinical trial for hip protectors and were not bedridden.MeasurementsAt the start of the trial, in addition to general biochemical data, 25(OH)D3, 1,25‐dihydroxy‐vitamin D3 (1,25(OH)2D3), intact parathyroid hormone (intact PTH), calcium (Ca), phosphorus (P), bone alkaline phosphate (BAP), cross‐linked N‐telopeptide of type I collagen (NTx), and osteocalcin were measured in participants’ blood, and statistical analysis was performed.Results25(OH)D3, which is thought to reflect vitamin D status in the body, was surveyed and found to have a mean value of 16.7 ng/mL. 25(OH)D3 was less than 16 ng/mL in 49.1% of all participants. Creatinine clearance (CCr) was less than 30 mL/min in 20.1% of participants. Participants with serum 25(OH)D3 less than 16 ng/mL and CCr less than 30 mL/min had significantly higher levels of intact PTH and serum NTx. Participants with a CCr less than 30 mL/min had significantly lower levels of 1,25(OH)2D3.ConclusionFrail elderly adults living in nursing homes with poor renal function had lower 1,25(OH)2D3 and higher intact PTH levels and were thus thought to have poorer vitamin D activating capacity. Supplementation with cholecalciferol may be insufficient in people who have poor renal function.
Do Centenarians Have Higher Levels of Depression? Findings from the Georgia Centenarian Study
Authors: Scheetz Laura T. , Martin Peter , Poon Leonard W. 
Published: January 2012

ObjectivesTo examine age differences on specific items and subscales of the Geriatric Depression Scale (GDS).DesignSpecific items, subscales, and total score on the GDS of three age groups were compared.SettingCommunity‐dwelling older adults.ParticipantsOne hundred thirty‐nine centenarians were compared with 93 octogenarians and 91 sexagenarians.MeasurementsGDS scores.ResultsResults indicated age group differences in overall depression score and in withdrawal‐apathy‐vigor (WAV), cognitive impairment, and hopelessness subscale scores. Significant age group differences were also obtained for 12 of the 30 items. Centenarians rated higher on all subscales, but there was no difference in dysphoric mood and worry.ConclusionIt is important to distinguish different dimensions of depression when assessing very old populations because some of the questions on the GDS are associated with fatigue, mild cognitive decline, and decline in physical functioning, which increase with aging. Future research should revisit the concept of depression in very late life.
Depressive Symptoms, Chronic Pain, and Falls in Older Community‐Dwelling Adults: The MOBILIZE Boston Study
Authors: Eggermont Laura H.P. , Penninx Brenda W.J.H. , Jones Rich N. , Leveille Suzanne G. 
Published: January 2012

ObjectivesTo examine whether overall depressive symptoms and symptom clusters are associated with fall risk and to determine whether chronic pain mediates the relationship between depression and fall risk in aging.DesignProspective cohort study.SettingBoston, Massachusetts, and surrounding communities.ParticipantsOlder community‐dwelling adults (N = 722, mean age 78.3).MeasurementsDepressive symptomatology was assessed at baseline using the 20‐item Hopkins Revision of the Center for Epidemiologic Studies Depression Scale (CESDR) as overall depression and two separate domains: cognitive and somatic symptoms. Chronic pain was examined at baseline as number of pain sites (none, single site, or multisite), pain severity, and pain interference with activities of daily living. Participants recorded falls on monthly postcards during a subsequent 18‐month period.ResultsAccording to negative binomial regression, the rate of incident falls was highest in those with the highest burden of depressive symptoms (according to total CESDR and the cognitive and somatic CESDR domains). After adjustment for multiple confounders and fall risk factors, fall rate ratios comparing the highest three CESDR quartiles with the lowest quartile were 1.91, 1.26, and 1.11, respectively. Similarly graded associations were observed according to the CESDR domains. Although pain location and interference were mediators of the relationship between depression and falls, adjustment for pain reduced fall risk estimates only modestly. There was no interaction between depression and pain in relation to fall risk.ConclusionDepressive symptoms are associated with fall risk in older adults and are mediated in part by chronic pain. Research is needed to determine effective strategies for reducing fall risk and related injuries in older people with pain and depressive symptoms.
Diabetes Mellitus in Centenarians
Authors: Davey Adam , Lele Uday , Elias Merrill F. , Dore Gregory A. , Siegler Ilene C. , Johnson Mary A. , Hausman Dorothy B. , Tenover J. Lisa , Poon Leonard W. ,   for the Georgia Centenarian Study
Published: January 2012

ObjectivesTo describe the prevalence of diabetes mellitus (DM) in centenarians.DesignCross‐sectional, population‐based.SettingForty‐four counties in northern Georgia.ParticipantsTwo hundred forty‐four centenarians (aged 98–108, 15.8% male, 20.5% African American, 38.0% community dwelling) from the Georgia Centenarian Study (2001–2009).MeasurementsNonfasting blood samples assessed glycosylated hemoglobin (HbA1c) and relevant clinical parameters. Demographic, diagnosis, and DM complication covariates were assessed.Results12.5% of centenarians were known to have DM. DM was more prevalent in African Americans (27.7%) than whites (8.6%, P < .001). There were no differences between men (16.7%) and women (11.7%, P = .41) or between centenarians living in the community (10.2%) and in facilities (13.9%, P = .54). DM was more prevalent in overweight and obese (23.1%) than nonoverweight (7.1%, P = .002) centenarians. Anemia (78.6% vs 48.3%, P = .004) and hypertension (79.3% vs 58.6%, P = .04) were more prevalent in centenarians with DM than in those without, and centenarians with DM took more nonhypoglycemic medications (8.6 vs 7.0, P = .02). No centenarians with HbA1c of less than 6.5% had random serum glucose levels greater than 200 mg/dL. DM was not associated with 12‐month all‐cause mortality, visual impairment, amputations, cardiovascular disease, or neuropathy. Thirty‐seven percent of centenarians reported onset before age 80 (survivors), 47% between age 80 and 97 (delayers), and 15% aged 98 and older (escapers).ConclusionDiabetes mellitus is a risk factor for cardiovascular disease and mortality but is seen in persons who live into very old age. Aside from higher rates of anemia and use of more medications, few clinical correlates of DM were observed in centenarians.
Coronary Artery Disease Is Associated with Cognitive Decline Independent of Changes on Magnetic Resonance Imaging in Cognitively Normal Elderly Adults
Authors: Zheng Ling , Mack Wendy J. , Chui Helena C. , Heflin Lara , Mungas Dan , Reed Bruce , DeCarli Charles , Weiner Michael W. , Kramer Joel H. 
Published: January 2012

ObjectivesTo examine in cognitively normal elderly adults whether vascular factors predict cognitive decline and whether these associations are mediated by magnetic resonance imaging (MRI) measures of subclinical vascular brain injury.DesignProspective multisite longitudinal study of subcortical ischemic vascular diseases.SettingMemory and aging centers in California.ParticipantsSeventy‐four participants who were cognitively normal at entry and underwent at least two neuropsychological evaluations and two MRI examinations over an average follow‐up of 6.9 years.MeasurementsItem response theory was used to create composite scores of global, verbal memory, and executive functioning. Volumetric MRI measures included white matter hyperintensities (WMHs), silent brain infarcts (SBIs), hippocampus, and cortical gray matter (CGM). Linear mixed‐effects models were used to examine the associations between vascular factors, MRI measures, and cognitive scores.ResultsHistory of coronary artery disease (CAD) was associated with greater declines in global cognition, verbal memory, and executive function. The CAD associations remained after controlling for changes in WMHs, SBIs, and hippocampal and CGM volumes.ConclusionHistory of CAD may be a surrogate marker for clinically significant atherosclerosis, which also affects the brain. Structural MRI measures of WMHs and SBIs do not fully capture the potential adverse effects of atherosclerosis on the brain. Future longitudinal studies of cognition should incorporate direct measures of atherosclerosis in cerebral arteries, as well as more sensitive neuroimaging measures.
Hull Structures as a System: Supporting Lifecycle Analysis
Authors: COLLETTE MATTHEW 
Published: January 2012

AbstractAs modular weapon systems allow cost‐effective upgrades of a vessel's war‐fighting capability, the degradation of the difficult‐to‐upgrade structure of the vessel may soon become one of the key drivers of vessel retirement and lifecycle maintenance costing. Existing structural design approaches are reviewed, along with recent developments in this field. It is argued that recent research has produced a number of ad hoc metrics for structural design, such as producability; however, to truly address the needs of future ship design teams it is necessary to integrate several such metrics in a systems‐engineering view to evaluate how the structural system contributes to the overall capabilities and costs of a proposed vessel. Potential architectures for this approach are discussed, along with key shortcomings. A comparative example is given for structural fatigue of a strength deck under global bending loading, comparing the traditional design approach with a systems‐oriented view.
Using Agents to Model the Kill Chain of the Ballistic Missile Defense System
Authors: HOLLAND O. THOMAS , WALLACE SARA E. 
Published: January 2012

AbstractDeterministic models have long been used to model the individual effectiveness of elements of the Ballistic Missile Defense System (BMDS). Agent‐based models (ABMs) emphasize the specification of the individual components comprising a system and demonstrate higher order system properties through the interactions of those components. ABMs are particularly suited to (1) complex systems where it is easier to understand or observe the individual components rather than the dynamics that govern their interactions and (2) systems where empirical data is insufficient to provide statistical representations. New missions and capabilities desired by national leadership call for increased interaction between the BMDS elements and their subsystems. New capabilities and mission threads include launch on remote and engage on remote capabilities as well as a robust missile defense system capable of defending against threat raids, debris, and decoys. These new capabilities and mission threads may require modifications to kill chains and command and control constructs as well as improved coordination and performance. These capabilities must be realized through modifications to programs of record and integration across elements of the system that have their own independent programmatic momentum. A robust missile defense system must be achieved through a construct of layered defenses. Change in capabilities requires analysis of the complex interdependencies between Standard Missile (SM‐3), SPY, and BMDS elements such as PATRIOT, Terminal High‐Altitude Area Defense, Aegis Ashore Missile Defense System, etc. Synergy among the systems (termed “elements”) is required to meet the new challenges, which can be accomplished through systems of systems engineering. Definition and testing of the interactions between the systems are crucial to provide situational awareness via analysis of data transfer between the elements. ABMs are a tool that allows qualitative evaluation of these interactions of the complex BMDS. This paper presents an investigation of agent‐based modeling as a method to explore the system interrelationships and evaluate the indeterminacy of the BMDS kill chain.