26 results on '"Butler, Louise"'
Search Results
2. A man with headache and double vision
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Amin, Muhammad Nauman, Vassallo, Joseph, Butler, Louise, and Catania, James Dominic
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- 2015
3. Building on a Dream of Success.
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Butler, Louise A.
- Abstract
Before a St. Louis (Missouri) school could raise student achievement, its principal had to break through several "false ceilings" to create a new standard of student performance. To achieve this goal, the principal refrained from underestimating her "at-risk" students, provided enrichment instead of remediation programs, initiated science and math competitions, and inspired "average" teachers to improve their students' performance. (MLH)
- Published
- 1997
4. Designer Anatomy
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Butler, Louise A.
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- 1995
5. Autism symptoms in Attention-Deficit/Hyperactivity Disorder: A Familial trait which Correlates with Conduct, Oppositional Defiant, Language and Motor Disorders
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Mulligan, Aisling, Anney, Richard J. L., O’Regan, Myra, Chen, Wai, Butler, Louise, Fitzgerald, Michael, Buitelaar, Jan, Steinhausen, Hans-Christoph, Rothenberger, Aribert, Minderaa, Ruud, Nijmeijer, Judith, Hoekstra, Pieter J., Oades, Robert D., Roeyers, Herbert, Buschgens, Cathelijne, Christiansen, Hanna, Franke, Barbara, Gabriels, Isabel, Hartman, Catharina, Kuntsi, Jonna, Marco, Rafaela, Meidad, Sheera, Mueller, Ueli, Psychogiou, Lamprini, Rommelse, Nanda, Thompson, Margaret, Uebel, Henrik, Banaschewski, Tobias, Ebstein, Richard, Eisenberg, Jacques, Manor, Iris, Miranda, Ana, Mulas, Fernando, Sergeant, Joseph, Sonuga-Barke, Edmund, Asherson, Phil, Faraone, Stephen V., and Gill, Michael
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- 2009
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6. Specialist care of children with complex needs: Insights from comparison of child development and child mental health clinics.
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Butler, Louise, Harris, Alison, Rapaic, Tijana, Heussler, Helen, and Bor, William
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CHILD development , *MENTAL health , *CHILD mental health services , *PEDIATRICIANS , *MENTAL illness , *LIFE change events , *NURSE practitioners , *MENTAL health screening - Abstract
Aim: Paediatricians and child psychiatrists review children with complex comorbidity, noting similarities between tertiary Child Development Service (CDS) and Child and Youth Mental Health Service (CYMHS) cohorts. Mental health comorbidity is common in developmental services. Developmental comorbidity in mental health cohorts is uncharacterised. The study aimed to describe CDS and CYMHS cohorts using measures of child development, mental health, physical health and psychosocial risk. Methods: A questionnaire was completed by parents of CDS and CYMHS new clients aged 4–11. It included measures of mental health symptoms, child development, physical health, stressful life events, family functioning, parent mental health and socio‐economic variables. Sample rates were compared to population norms. CDS and CYMHS cohorts were compared. Results: The study population had elevated rates of psychosocial risk, family dysfunction, physical illness, developmental risk and mental health symptoms. CDS had higher levels of developmental risk and family dysfunction. Most CDS clients (81%) had mental health difficulties. CYMHS clients were older, and had more mental health symptoms, stressful life events and child safety contact; 81% of CYMHS clients demonstrated developmental risk. CDS and CYMHS had similar socio‐demographic profiles and parent mental health difficulties, and similarly high rates of physical health problems. Conclusions: Consideration should be given to mental health screening and support in CDS, and to developmental screening in CYMHS. Both services support at‐risk children with complex developmental, mental health and physical co‐morbidity necessitating shared approaches to clinical and population health, including care integration, and collaborative cross‐disciplinary models of service provision and training, and advocacy. [ABSTRACT FROM AUTHOR]
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- 2022
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7. Performance variability, impulsivity errors and the impact of incentives as gender-independent endophenotypes for ADHD
- Author
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Uebel, Henrik, Albrecht, Björn, Asherson, Philip, Börger, Norbert A., Butler, Louise, Chen, Wai, Christiansen, Hanna, Heise, Alexander, Kuntsi, Jonna, Schäfer, Ulrike, Andreou, Penny, Manor, Iris, Marco, Rafaela, Miranda, Ana, Mulligan, Aisling, Oades, Robert D., van der Meere, Jaap, Faraone, Stephen V., Rothenberger, Aribert, and Banaschewski, Tobias
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- 2010
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8. Delay and Reward Choice in ADHD: An Experimental Test of the Role of Delay Aversion
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Marco, Rafaela, Miranda, Ana, Schlotz, Wolff, Melia, Amanda, Mulligan, Aisling, Müller, Ueli, Andreou, Penny, Butler, Louise, Christiansen, Hanna, Gabriels, Isabel, Medad, Sheera, Albrecht, Bjorn, Uebel, Henrik, Asherson, Phillip, Banaschewski, Tobias, Gill, Michael, Kuntsi, Jonna, Mulas, Fernando, Oades, Robert, Roeyers, Herbert, Steinhausen, Hans-Christoph, Rothenberger, Aribert, Faraone, Stephen V., and Sonuga-Barke, Edmund J. S.
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- 2009
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9. Trouble in Strange Places.
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Butler, Louise
- Subjects
HEAT waves (Meteorology) ,BABY cribs ,SHOW windows - Abstract
Carrie would pull on his fur and stick her fingers in his open, drooling mouth, but Torgy just took it When I picked up Carrie, the dog was whining and pacing back and forth. With all the excitement of the cleanup after the storm, it took me a week or so to notice that, once again, Torgy was disappearing during the hottest part of the day and coming home remarkably clean for a dog on the move. Mom isn't much of a dog person, but she hugged Torgy to her with one hand while holding Carrie with the other. Embarrassed that our dog hadn't moved an inch, Mom tried to apologize to Mr. Webb again, but he smiled and held up his hand to interrupt her. "Your dog has been coming in since the heat wave started", Mr. Webb explained. [Extracted from the article]
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- 2022
10. A High Density SNP Linkage Scan with 142 Combined Subtype ADHD Sib Pairs
- Author
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Asherson, Philip, Zhou, Kaixin, Anney, Richard J.L., Franke, Barbara, Buitelaar, Jan K, Ebstein, Richard, Gill, Michael, Sham, Pak C., Altink, Marieke, Arnold, Renée, Boer, Frits, Brookes, Keeley Joane, Buschgens, Cathelijne, Butler, Louise, Cambell, Desmond, Chen, Wai, Christiansen, Hanna, Feldman, Liat, Fleischman, Karin, Fliers, Ellen, Howe-Forbes, Raoul, Goldfarb, Abigail, Heise, Alexander, Gabriëls, Isabel, Johansson, Lena, Lubetzki, Isabelle, Marco, Rafaela, Medad, She'era, Minderaa, Ruud, Mulas, Fernando, Müller, Ueli C, Mulligan, Aisling, Rabin, Karina, Rommelse, Nanda, Sethna, Vaheshta, Sorohan, Jean, Uebel, Henrik, Psychogiou, Lamprini, Weeks, Anne, Barrett, Rebecca, Xu, Xiaohui, Banaschewski, Tobias, Sonuga-Barke, Edmund J.S., Eisenberg, Jacques, Manor, Iris, Miranda, Ana, Oades, Robert D., Roeyers, Herbert, Rothenberger, Aribert, Sergeant, Joseph A, Steinhausen, Hans-Christoph, Taylor, Eric A, Thompson, Margaret, and Faraone, Stephen V.
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ddc:610 ,Medizinische Fakultät » Universitätsklinikum Essen » LVR-Klinikum Essen » Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters - Abstract
As part of the International Multi-centre ADHD Gene (IMAGE) project we have completed an affected sibling pair study of 142 narrowly defined DSM-IV combined type ADHD proband-sibling pairs. We found suggestive linkage on chromosomes 9 and 16 with non-parametric multipoint peak LOD scores of 2.13 and 3.1 respectively. There have been several previous ADHD linkage scans. The UCLA study (Fisher et al. 2002; Ogdie et al. 2004; Ogdie et al. 2003), the Dutch study (Bakker et al. 2003), the German study (Hebebrand et al. 2006) and the MGH Study (Faraone et al., submitted) applied the affected sib pair (ASP) strategy; the Columbian study used extended pedigrees ascertained from a population isolate (Arcos-Burgos et al. 2004). No linkage was observed on the most established ADHD linked genomic regions from these studies on 5p and 17p. The highest multipoint nonparametric linkage signal on chromosome 16q23 at 99 cM (LOD=3.1) overlapped with data published from UCLA (LOD>1, ~95cM) and Holland (LOD>1, ~100cM). The second highest peak in this study was on chromosome 9q22 at 90cM (LOD=2.13). Both the UCLA study and the German study also found some evidence of linkage at almost the same location (UCLA LOD=1.45 at 93cM; German LOD=0.68 at 100cM). The overlap of the two main peaks from this study with those from previous studies suggests that true loci linked to ADHD may lie within these regions.
- Published
- 2011
11. Performance variability, impulsivity errors and the impact of incentives as gender-independent endophenotypes for ADHD
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Uebel, Henrik, Albrecht, Bjorn, Asherson, Philip, Börger, Norbert A., Butler, Louise, Chen, Wai, Christiansen, Hanna, Heise, Alexander, Kuntsi, Jonna, Schäfer, Ulrike, Andreou, Penny, Manor, Iris, Marco, Rafaela, Meidad, Sheera, Miranda, Ana, Mulligan, Aisling, Oades, Robert D., van der Meere, Jaap, Faraone, Stephen V., Rothenberger, Aribert, Banaschewski, Tobias, and Developmental Psychology
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Male ,Medizin ,CHILDREN ,Neuropsychological Tests ,Developmental psychology ,0302 clinical medicine ,Developmental and Educational Psychology ,false alarms ,Child ,10. No inequality ,state regulation ,AD/HD ,ATTENTION-DEFICIT/HYPERACTIVITY DISORDER ,05 social sciences ,EXECUTIVE FUNCTIONS ,Neuropsychology ,Cognition ,Executive functions ,endophenotype ,Psychiatry and Mental health ,Phenotype ,Female ,medicine.symptom ,Attention-deficit hyperactivity disorder ,Psychology ,RESPONSE-INHIBITION ,050104 developmental & child psychology ,reaction-time variability ,Adolescent ,incentives ,DEFICIT HYPERACTIVITY DISORDER ,QUESTIONNAIRE ,MOTOR CONTROL ,Impulsivity ,Article ,03 medical and health sciences ,Sex Factors ,mental disorders ,Reaction Time ,medicine ,Criterion validity ,Humans ,Attention deficit hyperactivity disorder ,ADHD ,0501 psychology and cognitive sciences ,ddc:610 ,Medizinische Fakultät » Universitätsklinikum Essen » LVR-Klinikum Essen » Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters ,Sibling ,Motivation ,medicine.disease ,Disruptive, Impulse Control, and Conduct Disorders ,executive function ,Attention Deficit Disorder with Hyperactivity ,Endophenotype ,Pediatrics, Perinatology and Child Health ,SUSTAINED ATTENTION ,CRITERION VALIDITY ,Cognition Disorders ,030217 neurology & neurosurgery - Abstract
Background:Attention-deficit hyperactivity disorder (ADHD) is one of the most common and highly heritable child psychiatric disorders. There is strong evidence that children with ADHD show slower and more variable responses in tasks such as Go/Nogo tapping aspects of executive functions like sustained attention and response control which may be modulated by motivational factors and/or state-regulation processes. The aim of this study was (1) to determine if these executive functions may constitute an endophenotype for ADHD; (2) to investigate for the first time whether known modulators of these executive functions may also be familial; and (3) to explore whether gender has an impact on these measures.Methods:Two hundred and five children with ADHD combined type, 173 nonaffected biological siblings and 53 controls with no known family history of ADHD were examined using a Go/Nogo task in the framework of a multi-centre study. Performance-measures and modulating effects of event-rate and incentives were examined. Shared familial effects on these measures were assessed, and the influence of gender was tested.Results:Children with ADHD responded more slowly and variably than nonaffected siblings or controls. Nonaffected siblings showed intermediate scores for reaction-time variability, false alarms and omission errors under fast and slow event-rates. A slower event-rate did not lead to reduced performance specific to ADHD. In the incentive condition, mean reaction-times speeded up and became less variable only in children with ADHD and their nonaffected siblings, while accuracy was improved in all groups. Males responded faster, but also committed more false alarms. There were no interactions of group by gender.Conclusions:Reaction-time variability and accuracy parameters could be useful neuropsychological endophenotypes for ADHD. Performance-modulating effects of incentives suggested a familially driven motivational dysfunction which may play an important role on etiologic pathways and treatment approaches for ADHD. The effects of gender were independent of familial effects or ADHD-status, which in turn suggests that the proposed endophenotypes are independent of gender.
- Published
- 2011
12. I'm Not the Person I Thought I Was.
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Butler, Louise
- Published
- 2020
13. Shake, Rattle, and Roll
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Butler, Louise
- Published
- 1998
14. Electricity
- Author
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Butler, Louise
- Published
- 1998
15. Putting people at the centre: facilitating Making Safeguarding Personal approaches in the context of the Care Act 2014.
- Author
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Butler, Louise and Manthorpe, Jill
- Subjects
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PREVENTION of abuse of older people , *CONFIDENCE , *EVALUATION , *INTERVIEWING , *HEALTH policy , *PUBLIC welfare , *SOCIAL services , *SOCIAL workers , *PILOT projects , *HUMAN services programs ,CARE Act 2014 (U.K.) - Abstract
Purpose – The purpose of this paper is to describe and discuss the pilot Making Safeguarding Personal (MSP) project that ran in three London boroughs in England in 2014-2015. The project aimed to help local authority social work practitioners better engage with adults at risk at the beginning, middle and end of safeguarding work and to develop a more outcomes focused approach to safeguarding. Design/methodology/approach – Three adult social care teams volunteered to take part in the MSP pilot for four months, November 2014-February 2015. They were closely supported through telephone conferencing, bespoke training and individual mentoring. Evaluative data were collected from the participating teams about their work and the MSP change processes to assist in further implementation. Findings – The findings suggested that staff felt that the open discussions with adults at risk that were encouraged by the MSP initiative enabled safeguarding to be more effective and provided a better basis of support for adults at risk. The support from the project team was appreciated. Staff reported their own increased confidence as a result of involving adults at risk in decisions about their situations and risks of harm. They also reported their increased awareness of cross-cutting subjects related to adult safeguarding, such as domestic abuse and working with coercive and controlling behaviours. Permission to exercise greater professional discretion to make responses more considered, rather than the need to adhere to time-limited imperatives, was received positively. Staff felt that this enhanced discussions about resolution and recovery with adults at risk although it required greater expertise, more extensive managerial support, and more time. These were available in the pilot. Research limitations/implications – The MSP pilot was confined to three teams and took place over four months. The numerical data reported in this paper are provided for illustrative purposes and are not statistically significant. As with other evaluations of implementation, the data provided need to be set in the local contexts of population profiles, care settings and the reporting source. The pilot also took place during the early implementation of the Care Act 2014 which affected the context of practice and training. The views of adults at risk were not collected. There is a risk of bias in that participants may have wished to convey positive views of MSP to their colleagues. Practical implications – The paper indicates a need for the roll out of MSP philosophy and MSP approaches to be communicated with other agencies supporting adults at risk and for project support of some form to continue. It will be important to see if the overall enthusiasm, support and motivation reported by the pilot teams when taking a MSP approach in practice extend beyond a pilot period during which the staff received substantial support from a dedicated Professional Standards Safeguarding Team. Many of those staff participating in the pilot perceived the MSP approach as a return to core social work principles and welcomed putting these into practice. Originality/value – The paper provides details of one pilot in which the feasibility of the MSP approach was tested by supporting three frontline teams working in different contexts. The pilot suggests that the level and type of support offered to the pilot teams were effective in a variety of practice settings. It draws attention to the need for the MSP concept and approach to be shared with other agencies and for implementation support to continue beyond initial pilot period. [ABSTRACT FROM AUTHOR]
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- 2016
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16. Adapting to change.
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Butler, Louise
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ADAPTABILITY (Personality) ,DENTAL clinics ,ATTITUDE (Psychology) ,CHANGE ,COVID-19 pandemic - Abstract
Dental Nursing talks to Louise Butler about how her practice's team handled the pandemic [ABSTRACT FROM AUTHOR]
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- 2021
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17. Effectiveness of Pretrial Community-Based Diversion in Reducing Reoffending by Adult Intrafamilial Child Sex Offenders.
- Author
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Butler, Louise, Goodman-Delahunty, Jane, and Lulham, Rohan
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CHILD molesters ,SEX crimes ,DIVERSION programs ,RECIDIVISM ,COMPARATIVE studies ,REGRESSION analysis ,PUNISHMENT ,ESTIMATION theory - Abstract
To investigate whether diversion to a pretrial community-based diversion program reduced sexual recidivism in adult intrafamilial child sex offenders, 208 offenders assessed for treatment between 1989 and 2003 were monitored for periods ranging from 2.8 to 18 years. Participants accepted for treatment (n = 88) were compared to those who declined (n = 120). After applying propensity score analysis to control for selection bias, Probit regression analysis and Cox proportional hazards regression were used to estimate rates of desistance between the groups. Although differences were not statistically significant, estimated rates of sexual reoffending were lower and time taken to sexually reoffend was longer in the diverted than the undiverted group. An overall effect size for treatment was large (OR = 0.52, 95% CI = 0.18, 1.5), and examination of the recidivists in the treatment group supported inferences of positive treatment effects. Limitations of this study are examined, and future directions for intrafamilial sex offender treatment are discussed. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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18. Acute Aspergillus pneumonia associated with mouldy tree bark-chippings, complicated by anti-glomerular basement membrane disease causing permanent renal failure.
- Author
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Butler, Louise, Brockley, Tomos, Denning, David, Richardson, Malcolm, Chisholm, Roger, Sinha, Smeeta, and O’Driscoll, Ronan
- Abstract
Abstract: A non-immunocompromised man developed acute Aspergillus pneumonia after spreading mouldy tree bark mulch. Despite normal renal function at presentation, he developed rapidly progressive glomerulonephritis with acute kidney injury due to anti-glomerular basement membrane antibodies (anti-GBM) 4 weeks later. He remained dialysis dependent and died of sepsis 10 months later. We hypothesise that he contracted invasive pulmonary Aspergillosis from heavy exposure to fungal spores, leading to epitope exposure in the alveoli with subsequent development of GBM auto-antibodies. [Copyright &y& Elsevier]
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- 2013
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19. Improving the Quality of Care in Care Homes Using the Quality Improvement Collaborative Approach: Lessons Learnt from Six Projects Conducted in the UK and The Netherlands.
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Devi, Reena, Martin, Graham, Banerjee, Jay, Butler, Louise, Pattison, Tim, Cruickshank, Lesley, Maries-Tillott, Caroline, Wilson, Tracie, Damery, Sarah, Meyer, Julienne, Poot, Antonius, Chamberlain, Peter, Harvey, Debbie, Giebel, Clarissa, Hinsliff-Smith, Kathryn, Chadborn, Neil, and Lee Gordon, Adam
- Published
- 2020
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20. A red-letter day for colour trademarks.
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Butler, Louise
- Subjects
TRADEMARK infringement ,ACTIONS & defenses (Law) - Abstract
The article discusses the litigation "Christian Louboutin v Yves Saint Laurent America Holdings," at U.S. Court of Appeals for the Second Circuit, September 5, 2012. The U.S. trademark infringement action brought by Christian Louboutin, a well-known designer of luxury products for women, against Yves Saint Laurent (YSL).
- Published
- 2012
21. LETTERS.
- Author
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Sterrett, Joan, Bolgos, Sally, Lowery, Keith, Nelson, Richard, Pavlovits, Sharon, Carter, Michael, Lucas, Al, and Butler, Louise
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LETTERS to the editor ,GARDEN design ,ORGANIC gardening ,CHICKENS ,RACCOON - Abstract
Several letters to the editor are presented in response to articles in the June/July 2010 issue including "Design Like a Pro," "Organic Manifesto," by Maria Rodale and "Raccoons."
- Published
- 2010
22. Understand your administrative enforcement options.
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Chatterton, Edward, Dequiré-Portier, Raphaëlle, Pozzo di Borgo, Marie-Ange, Mitchell, Ewen, Kretschmar, Paul, Baines, Rebecca, Reed, Nishani, and Butler, Louise
- Subjects
INTELLECTUAL property ,PATENT infringement ,TRADEMARK infringement ,COPYRIGHT infringement ,UNFAIR competition - Abstract
The article offers tips on how intellectual property (IP) owners could draw the support of administrative enforcement officials in resolving IP violations in four jurisdictions. The jurisdictions are the global practice, China, France, and Germany. Among the violations of IP rights are trade mark infringement, copyright infringement, and unfair competition.
- Published
- 2014
23. Resources reviews.
- Author
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Butler, Louise
- Subjects
- SCIENCE Projects (Book)
- Abstract
Reviews the book `Science Projects: Electricity,' by Simon De Pinna.
- Published
- 1998
24. A man with headache and double vision.
- Author
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Amin MN, Vassallo J, Butler L, and Catania JD
- Subjects
- Aged, Carcinoma, Renal Cell complications, Carcinoma, Renal Cell pathology, Carotid Artery, Internal diagnostic imaging, Humans, Kidney Neoplasms complications, Kidney Neoplasms pathology, Magnetic Resonance Angiography methods, Male, Neoplasm Staging, Radiography, Risk Adjustment, Risk Reduction Behavior, Treatment Outcome, Antihypertensive Agents administration & dosage, Diplopia etiology, Headache etiology, Intracranial Aneurysm complications, Intracranial Aneurysm diagnosis, Intracranial Aneurysm physiopathology, Intracranial Aneurysm therapy, Oculomotor Nerve Diseases etiology, Watchful Waiting methods
- Published
- 2015
- Full Text
- View/download PDF
25. DSM-IV combined type ADHD shows familial association with sibling trait scores: a sampling strategy for QTL linkage.
- Author
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Chen W, Zhou K, Sham P, Franke B, Kuntsi J, Campbell D, Fleischman K, Knight J, Andreou P, Arnold R, Altink M, Boer F, Boholst MJ, Buschgens C, Butler L, Christiansen H, Fliers E, Howe-Forbes R, Gabriëls I, Heise A, Korn-Lubetzki I, Marco R, Medad S, Minderaa R, Müller UC, Mulligan A, Psychogiou L, Rommelse N, Sethna V, Uebel H, McGuffin P, Plomin R, Banaschewski T, Buitelaar J, Ebstein R, Eisenberg J, Gill M, Manor I, Miranda A, Mulas F, Oades RD, Roeyers H, Rothenberger A, Sergeant J, Sonuga-Barke E, Steinhausen HC, Taylor E, Thompson M, Faraone SV, and Asherson P
- Subjects
- Attention Deficit Disorder with Hyperactivity diagnosis, Diagnostic and Statistical Manual of Mental Disorders, Family, Female, Humans, Interviews as Topic, Male, Regression Analysis, Twins, Dizygotic genetics, Attention Deficit Disorder with Hyperactivity genetics, Genetic Linkage, Genetic Predisposition to Disease, Quantitative Trait Loci genetics, Sibling Relations
- Abstract
Attention deficit hyperactivity disorder (ADHD) is a discrete clinical syndrome characterized by the triad of inattention, hyperactivity, and impulsivity in the context of marked impairments. Molecular genetic studies have been successful in identifying genetic variants associated with ADHD, particularly with DSM-IV inattentive and combined subtypes. Quantitative trait locus (QTL) approaches to linkage and association mapping have yet to be widely used in ADHD research, although twin studies investigating individual differences suggest that genetic liability for ADHD is continuously distributed throughout the population, underscoring the applicability of quantitative dimensional approaches. To investigate the appropriateness of QTL approaches, we tested the familial association between 894 probands with a research diagnosis of DSM-IV ADHD combined type and continuous trait measures among 1,135 of their siblings unselected for phenotype. The sibling recurrence rate for ADHD combined subtype was 12.7%, yielding a sibling recurrence risk ratio (lambda(sib)) of 9.0. Estimated sibling correlations around 0.2-0.3 are similar to those estimated from the analysis of fraternal twins in population twin samples. We further show that there are no threshold effects on the sibling risk for ADHD among the ADHD probands; and that both affected and unaffected siblings contributed to the association with ADHD trait scores. In conclusion, these data confirm the main requirement for QTL mapping of ADHD by demonstrating that narrowly defined DSM-IV combined type probands show familial association with dimensional ADHD symptom scores amongst their siblings., (Copyright 2008 Wiley-Liss, Inc.)
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- 2008
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26. Risk stratification and the care pathway.
- Author
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Pillay SM, Oliver B, Butler L, and Kennedy HG
- Abstract
Objectives: It was hypothesised that patients admitted to forensic mental health facilities are stratified along the pathway through care according to levels of need. Level of risk and psychopathology should vary with different levels of security., Method: Seventy-five men in a forensic hospital were interviewed by three trained clinicians using the HCR-20 (Historical Clinical Risk Assessment) - clinical and risk items, The Health of the Nation Scales - Secure (HoNOS-SECURE), PANSS (Positive and Negative Syndrome Scale), GAF (Global Assessment of Functioning) and the CANFOR (Camberwell Assessment of need Forensic Version)., Results: The mean scores on a variety of clinical measures were higher in admission/high security areas and progressively lower in rehabilitation and pre-discharge areas. As patients moved through the pathways of care, they improved in a number of areas including psychiatric morbidity, risk, function, unmet needs. The following results stratified significantly; the HCR-20 summated clinical and risk (F = 9.2, df = 5, p < 0.001), the HoNOS secure (F = 18.2, df = 5, p < 0.001), PANSS (positive, general and total), GAF, staff and user unmet needs on the CANFOR., Conclusions: The data indicate that the theoretical organisation of the units of the hospital into high, medium and low security units to form a coherent pathway through care is reflected in practice. This is a transparent route out of secure care in which restrictions are proportionate to risk and supports proportionate to need. It is unclear whether alternative models, consisting of a series of generic unstratified units for admission and discharge, all at the same level of therapeutic security, allow for the provision of treatment programmes and relational interventions appropriate to the patient's stage of recovery and rehabilitation.
- Published
- 2008
- Full Text
- View/download PDF
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