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Biomedical subjects

E Silver

Publications and source records attributed to E Silver.

17 recordsLinked to original sources
PubMed2006

The 3C/3D line ratio in Ni XIX: New Ab Initio theory and experimental results.

We report a fully relativistic close-coupling calculation of the electron impact excitation of Ni xix to derive the 3C/3D line intensity ratio, with an uncertainty of 5%. Convergence of the calculation with respect to both channel coupling effects and the many interacting Rydberg series of resonances has been achieved. New measurements in an electron beam ion trap agree with our calculation. We show that the 3C/3D x-ray line ratio depends sensitively on both electron energy and beamwidth in an optically thin plasma. Accounting for this dependence improves the accuracy of the Ni abundance determination in astrophysical sources.

Journal Article↗
PubMed2001

Analysis of broadband x-ray spectra of highly charged krypton from a microcalorimeter detector of an electron-beam ion trap.

Spectra of highly charged Kr ions, produced in an electron-beam ion trap (EBIT), have been recorded in a broad x-ray energy band (0.3 keV to 4 keV) with a microcalorimeter detector. Most of the spectral lines have been identified as transitions of B- to Al-like Kr. The transition energies have been determined with 0.2% uncertainty. A semi-empirical EBIT plasma model has been created to calculate a synthetic spectrum of highly charged Kr and to determine a charge state distribution of Kr ions inside the EBIT.

Journal Article↗
PubMed2000

Reflections upon rehabilitation by members of a community based stroke club.

PURPOSE: To collect qualitative information about personal experiences with stroke rehabilitation from members of a community based stroke club. METHOD: In this focused ethnographic study, four data collectors observed and videotaped two sessions of a community based stroke club. The videotape and written notes were reviewed and analysed according to standard qualitative research procedures. RESULTS: Two themes emerged from analysis of the qualitative data: concerns that individualized needs were not addressed during the rehabilitation process and that services were insufficient to ease the transition to community living. CONCLUSIONS: Rehabilitation professionals can benefit from soliciting reflections and suggestions from individuals who have returned to community living after completing post-stroke rehabilitation programmes. Specific recommendations are provided for tailoring interventions to meet individual goals, for enhancing follow up services provided after inpatient rehabilitation, and for providing early access to available resources in stroke survivors' communities.

Activities of Daily Living↗
PubMed2000

A classification tree approach to the development of actuarial violence risk assessment tools.

Since the 1970s, a wide body of research has suggested that the accuracy of clinical risk assessments of violence might be increased if clinicians used actuarial tools. Despite considerable progress in recent years in the development of such tools for violence risk assessment, they remain primarily research instruments, largely ignored in daily clinical practice. We argue that because most existing actuarial tools are based on a main effects regression approach, they do not adequately reflect the contingent nature of the clinical assessment processes. To enhance the use of actuarial violence risk assessment tools, we propose a classification tree rather than a main effects regression approach. In addition, we suggest that by employing two decision thresholds for identifying high- and low-risk cases--instead of the standard single threshold--the use of actuarial tools to make dichotomous risk classification decisions may be further enhanced. These claims are supported with empirical data from the MacArthur Violence Risk Assessment Study.

Actuarial Analysis↗
PubMed2000

Race, neighborhood disadvantage, and violence among persons with mental disorders: the importance of contextual measurement.

The individualistic fallacy (i.e., the fallacy of assuming that individual-level outcomes can be explained exclusively in terms of individual-level characteristics) is a problem with most research on violence, and is particularly problematic in research on mental disorder and violence. This article illustrates the importance of measuring community context by showing that race is not an important predictor of violence among persons with mental disorders when neighborhood disadvantage is controlled statistically. More generally, these results suggest that researchers run the risk of perpetuating the individualistic fallacy in studies of violence by persons with mental disorders when they use individual-level risk factors as predictors, but do not control for community context.

Adult↗
PubMed2000

Developing a clinically useful actuarial tool for assessing violence risk.

BACKGROUND: A new actuarial method for violence risk assessment--the Iterative Classification Tree (ICT)--has become available. It has a high degree of accuracy but can be time and resource intensive to administer. AIMS: To increase the clinical utility of the ICT method by restricting the risk factors used to generate the actuarial tool to those commonly available in hospital records or capable of being routinely assessed in clinical practice. METHOD: A total of 939 male and female civil psychiatric patients between 18 and 40 years old were assessed on 106 risk factors in the hospital and monitored for violence to others during the first 20 weeks after discharge. RESULTS: The ICT classified 72.6% of the sample as either low risk (less than half of the sample's base rate of violence) or high risk (more than twice the sample's base rate of violence). CONCLUSIONS: A clinically useful actuarial method exists to assist in violence risk assessment.

Actuarial Analysis↗
PubMed1999

Assessing violence risk among discharged psychiatric patients: toward an ecological approach.

This paper draws upon data from the Pittsburgh site of the MacArthur Foundation's Risk Assessment Study, a large-scale study of violence risk among persons discharged from psychiatric hospitals, to examine the effect of the neighborhood context on risk of violence. This paper has two purposes: (1) to assess the extent to which the inclusion of neighborhood characteristics enhances violence prediction models-models that traditionally only include individual-level characteristics; and (2) to assess the consistency of individual level risk factors across different neighborhood contexts. Results indicate that neighborhood poverty has an impact over and above the effects of individual characteristics in identifying cases with violence. These findings support efforts to include neighborhood context in the assessment and management of violence risk among discharged psychiatric patients.

Adult↗
PubMed1998

Violence by people discharged from acute psychiatric inpatient facilities and by others in the same neighborhoods.

BACKGROUND: The public perception that mental disorder is strongly associated with violence drives both legal policy (eg, civil commitment) and social practice (eg, stigma) toward people with mental disorders. This study describes and characterizes the prevalence of community violence in a sample of people discharged from acute psychiatric facilities at 3 sites. At one site, a comparison group of other residents in the same neighborhoods was also assessed. METHODS: We enrolled 1136 male and female patients with mental disorders between the ages of 18 and 40 years in a study that monitored violence to others every 10 weeks during their first year after discharge from the hospital. Patient self-reports were augmented by reports from collateral informants and by police and hospital records. The comparison group consisted of 519 people living in the neighborhoods in which the patients resided after hospital discharge. They were interviewed once about violence in the past 10 weeks. RESULTS: There was no significant difference between the prevalence of violence by patients without symptoms of substance abuse and the prevalence of violence by others living in the same neighborhoods who were also without symptoms of substance abuse. Substance abuse symptoms significantly raised the rate of violence in both the patient and the comparison groups, and a higher portion of patients than of others in their neighborhoods reported symptoms of substance abuse. Violence in both patient and comparison groups was most frequently targeted at family members and friends, and most often took place at home. CONCLUSIONS: "Discharged mental patients" do not form a homogeneous group in relation to violence in the community. The prevalence of community violence by people discharged from acute psychiatric facilities varies considerably according to diagnosis and, particularly, co-occurring substance abuse diagnosis or symptoms.

Adolescent↗
PubMed1998

Factors associated with the conditional release of persons acquitted by reason of insanity: a decision tree approach.

Most NGRI (not guilty by reason of insanity) acquitties are hospitalized for some period of time following acquittal, which raises the question of when an individual can be safely released into the community. The conditional release (CR) of persons acquitted by reason of insanity, therefore, provokes the question of public safety. This study examines the CR systems in four states--Connecticut, Maryland, New York, and Ohio. A study sample of 529 persons acquitted as NGRI from 1985 to 1987 was followed up for at least five years to determine who is conditionally released. Following a description of the CR systems, findings suggestive of the role of dangerousness and diagnosis as predictors of CR are presented. Personal characteristics are also significant factors in predicting who will be released. The length of hospitalization for this population and other descriptive factors such as history of hospitalization, arrests, substance abuse, family violence, and living arrangements are also addressed.

Decision Trees↗
PubMed1995

Ultrasound and hookwire needle placement for localization of a hydrocele of the canal of Nuck.

BACKGROUND: Hydrocele of the canal of Nuck is a mobile mass entity that can be difficult to locate and excise. We report the use of ultrasound scan and a hookwire needle to localize and stabilize this mass, making its excision easier. CASE: A 24-year-old white female presented with a 6-month history of a painful vulvar mass associated with increased discomfort with prolonged standing. Thorough evaluation revealed a suspected hydrocele that was easily palpable in the standing position but not in the lithotomy position. Translabial ultrasonography and a hookwire needle were used to localize and stabilize the mobile vulvar mass, eliminating the need for extensive surgical exploration. CONCLUSION: Ultrasound scanning and needle localization is a useful technique to identify and stabilize a mobile mass, making its surgical excision possible without extensive exploration and trauma.

Adult↗
PubMed1993

Use of posttraumatic stress disorder to support an insanity defense.

OBJECTIVE: The authors examine the allegation that the diagnosis of posttraumatic stress disorder (PTSD) is frequently abused in the legal system as the basis for a defense of not guilty by reason of insanity. METHOD: Data for the investigation were drawn from a study of insanity pleas gathered from court records in 49 counties in eight states. Data on the 28 insanity plea defendants for whom PTSD was diagnosed before or immediately after trial were compared with data on 8,135 defendants whose insanity pleas were based on other diagnoses. RESULTS: Insanity pleas by defendants with diagnoses of PTSD constituted only 0.3% of the cases. There were few significant differences between the two groups on demographic variables, psychiatric histories, previous involvement in crime, or current charges. The defendants with PTSD were more likely to have been married, less likely to have been arrested as juveniles, and less likely to have been detained after trial. CONCLUSIONS: Contrary to previously expressed concerns, PTSD was infrequently associated with an insanity defense in the cases in this study. In the cases in which pleas based on PTSD were used, they were no more likely to succeed than pleas based on any other diagnosis. Defendants with PTSD-related insanity defenses differed little from other insanity defendants, contradicting the stereotype of the person who is driven by PTSD to commit crimes. The data do not support fears of widespread misuse of the diagnosis of PTSD in connection with the insanity defense.

Humans↗