To see the other types of publications on this topic, follow the link: Restricted and common.
Books on the topic 'Restricted and common'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 43 books for your research on the topic 'Restricted and common.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse books on a wide variety of disciplines and organise your bibliography correctly.
1
Newport International Group│ Restricted Common Stock. Jolly Bee, 2013.
Find full text
2
Downing, Nicholas. Orthopaedic injuries to the hand and wrist. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199533909.003.0028.
Full textAbstract:
Almost any type of hand injury can occur during sport and few, if any, hand-specific injuries occur uniquely during sporting activity. Therefore this chapter will be restricted to injuries that are part of the common spectrum of hand and wrist injuries but are also commonly sustained during sporting activity....
3
Blom, Henk J., Mirian C. H. Janssen, and Manuel Schiff. Cystathionine Beta-Synthase Deficiency or Classical Homocystinuria. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199972135.003.0019.
Full textAbstract:
Inherited homocystinurias have in common accumulation of homocysteine and encompass two distinctive entities: classical homocystinuria due to cystathionine β-synthase (CBS) deficiency and the rare inborn errors of cobalamin and folate metabolism. The natural history of CBS deficiency, the subject of this chapter, is well described compared to the other forms of homocystinurias. Untreated patients may be asymptomatic or have one or more of the following symptoms: severe mental handicaps, psychiatric disturbances, ectopia lentis, osteoporosis, Marfanoid habitus, or thromboembolic complications. Current treatment options are based on therapy with vitamin B6, folate, B12, or betaine and institution of a protein- or methionine-restricted diet.
4
Cohen, Jeffrey A., Justin J. Mowchun, Victoria H. Lawson, and Nathaniel M. Robbins. A 50-Year-Old Woman with Burning Feet. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190491901.003.0020.
Full textAbstract:
Small-fiber neuropathy typically presents with burning pain or with widespread brief stabbing pains, by atypical presentations including asymmetric sensory symptoms are common. Nerve conduction studies are usually normal, as this disorder test only interrogates large fiber function; in small-fiber neuropathy the pathology is restricted to smaller unmyelinated fibers. Autonomic neuropathy can accompany the painful peripheral neuropathy but can be difficult to recognize since the symptoms can be protean. In this chapter, clinical characteristics of small-fiber and autonomic neuropathy are discussed. Various diagnostic modalities are described, including the benefits and pitfalls of available options. The most common conditions causing small-fiber and autonomic neuropathy are reviewed. The controversy surrounding impaired glucose tolerance as an etiological factor is dicusssed. We discuss the available medications and outline a rational approach to treatment.
5
Howe, Peter. Craniosynostosis Repair. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199764495.003.0028.
Full textAbstract:
Craniosynostosis is a condition in which one or more of the fibrous sutures in an infant skull fuses prematurely. This may lead to restricted skull and brain growth and elevated intracranial pressure. Many children with craniosynostosis undergo corrective cranioplasty in infancy, an age when the skull is relatively large in proportion to the rest of the body. Depending on the operation, it is common for blood loss to be substantial and exceed the child's estimated blood volume (EBV). Managing this blood loss is challenging and requires careful planning for fluid and blood product administration. Some children also have craniofacial syndromes that are associated with airway obstruction and difficult intubation.
6
Nissinen, Martti. Ancient Prophecy. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780198808558.001.0001.
Full textAbstract:
This book is a comprehensive treatment of the ancient prophetic phenomenon as it comes to us through biblical, Near Eastern, and Greek sources. Once a distinctly biblical concept, prophecy is today acknowledged as yet another form of divination and a phenomenon that can be found all over the ancient Eastern Mediterranean. Even Greek oracle, traditionally discussed separately from biblical and Mesopotamian prophecy, is essentially part of the same picture. The book gives an up-to-date presentation of textual sources, whether cuneiform tablets from Mesopotamia, the Hebrew Bible, Greek inscriptions, or ancient historians, the number of which has increased substantially in recent times. In addition, the book includes comparative essays on topics such as prophetic ecstasy; temples as venues of prophetic performances; prophets and political rulers; and the prophets’ gender which can be either male, female, or non-gendered. The book argues for a common category of ancient Eastern Mediterranean prophecy, even though the fragmentary and secondary nature of the sources allows only a restricted view to it. The ways prophetic divination manifests itself in ancient sources depend not only on the socio-religious position of the prophets but also on the genre and purpose of the sources. The book shows that, even though the view of the ancient prophetic landscape is restricted by the fragmentary and secondary nature of the sources, it is possible to reconstruct essential features of prophetic divination.
7
Leruth, Benjamin. The Europeanization of the Welfare State. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780198790266.003.0009.
Full textAbstract:
Since the ratification of the Treaty of Rome in 1957, the European integration project has been committed to reducing inequalities between member states. However, social inequalities remain high, and public support for the welfare state varies between countries. Some experts have suggested a common European social policy. This chapter analyses recent developments and future prospects at the European Union level. After discussing the initial ambitions of social policy harmonization, it focuses on the role of the EU during the Great Recession by examining the range of policy responses advocated by Brussels in order to fight against a multi-faceted crisis. These are dominated by the tightening of austerity, but include social investment and greater labour market flexibility. The final section reflects on the future of European integration after Brexit. It argues that further common policy development is only likely through agreements restricted to a particular a number of member states in an ‘ever more differentiated Europe’.
8
Dondorp, Arjen M. Other tropical diseases in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0294.
Full textAbstract:
A wide range of tropical infectious diseases can cause critical illness. Knowledge of the local epidemiology where the disease is acquired is essential. In addition, local resistance patterns of common bacterial pathogens can be very different in tropical countries, so that antibiotic regimens might need adaptation. The ‘surviving sepsis’ guidelines are not always appropriate for the treatment of tropical sepsis. Both diseases require a more restricted fluid management. Leptospirosis is another important tropical disease that can cause sepsis with liver and renal failure or ARDS with pulmonary haemorrhages. Neglected tropical diseases causing neurological syndromes include trypanosomiasis (Sub-Saharan Africa) and rabies. Several viruses in the tropics can cause encephalitis. Recent epidemics of respiratory viruses causing life-threatening pneumonia have had their origins in tropical countries, including severe acute respiratory syndrome, influenza A subtype H5N1 (‘avian influenza’), and recently Middle East respiratory syndrome coronavirus.
9
Grare, Frédéric. India and Australia’s Paradoxical Strategic Relationship. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190859336.003.0006.
Full textAbstract:
After decades of mutual indifference, India’s and Australia’s strategic interests are converging. Both countries share increasing apprehension about China’s rise. Yet, despite a common concern regarding Chinese assertiveness and growing trade between the two countries, engagement remains limited. Both states see a lot of risk but few security benefits in appearing confrontational toward China. Moreover, their respective partnerships with the United States constrain the development of their bilateral security relations as they feel no need to deviate from their current parallel trajectory. In that sense the relations between India and Australia illustrate the limits of the Look East Policy. Deep ambivalence persists between the two countries and defence cooperation is largely restricted to soft security and dialogue. Both sides remain cautious about giving the relationship a strategic significance that could be interpreted as the beginning of a coalition against China.
10
Sime, Stuart. 2. Funding Litigation. Oxford University Press, 2016. http://dx.doi.org/10.1093/he/9780198747673.003.0107.
Full textAbstract:
This chapter discusses the issue of funding litigation. Solicitors have a professional duty to advise clients on litigation funding options. The advice and agreed funding method should be confirmed in writing in a ‘client care letter’. Most commercial clients pay their lawyers under the traditional retainer, normally with an agreed hourly rate. Conditional free agreements (CFAs) or ‘no win, no fee’ agreements are increasingly common. They allow a lawyer to agree not to charge the client if the proceedings are unsuccessful, but to charge an uplift or ‘success fee’ of up to 100 per cent over the solicitor’s usual costs if the proceedings are successful. Damages-based agreements (DBAs) are a form of contingency fee agreement under which the lawyer is paid out of the sums recovered in the proceedings. Public funding is restricted to individuals with modest income and capital, and there are wide exclusions from the scheme.
11
Sime, Stuart. 2. Funding Litigation. Oxford University Press, 2017. http://dx.doi.org/10.1093/he/9780198787570.003.0107.
Full textAbstract:
This chapter discusses the issue of funding litigation. Solicitors have a professional duty to advise clients on litigation funding options. The advice and agreed funding method should be confirmed in writing in a ‘client care letter’. Most commercial clients pay their lawyers under the traditional retainer, normally with an agreed hourly rate. Conditional free agreements (CFAs) or ‘no win, no fee’ agreements are increasingly common. They allow a lawyer to agree not to charge the client if the proceedings are unsuccessful, but to charge an uplift or ‘success fee’ of up to 100 per cent over the solicitor’s usual costs if the proceedings are successful. Damages-based agreements (DBAs) are a form of contingency fee agreement under which the lawyer is paid out of the sums recovered in the proceedings. Public funding is restricted to individuals with modest income and capital, and there are wide exclusions from the scheme.
12
Lin, Jaime. Talentos e Aptidões: Um olhar sobre o Autismo. Brazil Publishing, 2021. http://dx.doi.org/10.31012/978-65-5861-554-5.
Full textAbstract:
Autism is a medical term that encompasses a broad spectrum of neurodevelopmental disorders characterized by impaired reciprocal socialization and communication, often accompanied by restricted or repetitive patterns of behavior and interests. Due to the enlargement in the clinical diagnostic boundaries and the increased awareness of autism spectrum disorder (ASD), the world has seen a dramatic increase in its prevalence during the last two decades. ASD is currently considered one of the most common neurodevelopmental disorders worldwide. Frequently reported in terms of comorbidities, disabilities, burden and economic costs, the talents, gifts and abilities of people within the autistic spectrum only reaches the media when it amazes the audience. In this review, we want show that the high clinical heterogeneity found in autism can also be applied to the gifts and abilities, and that it must be nurtured with appropriate developmental, educational environment and above all, support and hope.
13
Lycan, William G. On Evidence in Philosophy. Oxford University Press, 2019. http://dx.doi.org/10.1093/oso/9780198829720.001.0001.
Full textAbstract:
This book offers an epistemology of philosophy itself, a partial method for philosophical inquiry. The epistemology features three ultimate sources of justified philosophical belief. First, common sense, in a carefully restricted sense of the term—the sorts of contingent propositions Moore defended against idealists and skeptics. Second, the deliverances of well confirmed science. Third, and more fundamentally, intuitions about cases, in a carefully specified sense of that term. Chapters 1–4 expound a version of Moore’s method and apply it to each of several issues. The version is shown to resist all the standard objections to Moore; most of them do not even apply. Chapters 5 and 6 argue that philosophical method is far less powerful than most have taken it to be. In particular, deductive argument can accomplish very little, and hardly ever is an opposing position refuted except by common sense or by science. Chapters 7 and 8 defend the evidential status of intuitions and the Goodmanian method of reflective equilibrium; it is argued that philosophy always and everywhere depends on them. The method is then set within a more general explanatory-coherentist epistemology, which is shown to resist standard forms of skepticism. In sum, this book advocates a picture of philosophy as a very wide explanatory reflective equilibrium incorporating common sense, science, and our firmest intuitions on any topic—and nothing more, not ever.
14
Dixon, Bradley P., J. Christopher Kingswood, and John J. Bissler. Tuberous sclerosis complex renal disease. Edited by Neil Turner. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0330.
Full textAbstract:
Tuberous sclerosis complex (TSC) is an autosomal dominant genetic disorder affecting almost all organs. It has wider phenotypic variation than often appreciated, with less than half showing the combination of characteristic facial angiofibromas, epilepsy, and mental retardation. Renal angiomyolipomata or cysts are found in 90% and renal failure was historically a common mode of adult death from the disease. Pulmonary lymphangioleiomyomatosis is restricted to females. Angiomyolipomata or cystic disease, or both, may cause renal failure. Angiomyolipomata may also haemorrhage, especially from larger lesions. Manifestations of brain involvement substantially complicate management of many patients with TSC. The causative genes TSC1 and TSC2 encode tuberin and hamartin which are involved in control of the mammalian target of rapamycin pathway. Inhibitors of that pathway, such as sirolimus and everolimus, are therefore logical approaches to therapy and have been shown to be effective in reducing angiomyolipomata volume. It remains to be seen whether they can protect renal function.
15
Ruiz-Villalba, Adrián, Nikolaos Frangogiannis, and José Maria Pérez-Pomares. Origin and diversity of cardiac fibroblasts: developmental substrates of adult cardiac fibrosis. Edited by José Maria Pérez-Pomares, Robert G. Kelly, Maurice van den Hoff, José Luis de la Pompa, David Sedmera, Cristina Basso, and Deborah Henderson. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198757269.003.0012.
Full textAbstract:
Cardiac connective tissues are primarily formed by cardiac fibroblasts (CF) of diverse embryonic origins. Whereas CF specific roles in cardiac morphogenesis remain under-researched, their involvement in adult cardiac fibrosis is clinically relevant. Cardiac fibrosis is a common element of several chronic cardiac conditions characterized by the loss of ventricular wall mechanical function, ultimately driving to heart failure. In the ischaemic heart early reparative fibrosis evidences the very restricted regenerative potential of the myocardium. In non-ischaemic diseases fibrosis is activated by unknown signals. We summarize current knowledge on the origin of CFs and their developmental roles, and discuss the differential disease-dependent response of different CF subpopulations to various pathological stimuli. We also describe the characteristic cell-cell and cell-matrix interactions that determine the fibrotic remodelling of the myocardium. We analyse experimental models for the study of cardiac fibrosis, and suggest future directions in the search for new markers and therapeutic targets.
16
Anghelescu, Andrei, Joash J. Gambarage, Zoe Wai-Man Lam, and Douglas Pulleyblank. Nominal and Verbal Tone in Nata. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190256340.003.0005.
Full textAbstract:
This chapter examines core tonal properties of Nata, a Lacustrine Bantu language (Guthrie E-45) spoken in the Mara region of Tanzania. In most instances, both in nouns and verbs, a Nata word exhibits a single high tone, which is restricted to a small number of locations. Though Nata’s tone system might appear simple, close examination of nouns and verbs uncovers considerable complexity in the system. Nouns exhibit lexically encoded distinctions; verb roots exhibit no lexical distinctions, but inflected verbs differ tonally depending on tense/aspect/mood. The sparse distribution of high tones follows from simple edge effects whereby tones are located relative to well-motivated morphosyntactic boundaries. The analysis, framed in a lexical allomorphy approach, crucially depends on correct identification of the macrostem, with a novel aspect being the extension of the macrostem to nouns. This extension is adopted on the grounds that nouns and verbs share similar surface patterns, captured by reference to a common domain.
17
Chrzanowski, Daniel T., Elisabeth B. Guthrie, Matthew B. Perkins, and Moira A. Rynn. Child and Adolescent Psychiatry. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199326075.003.0015.
Full textAbstract:
Common disorders of children and adolescents include neurodevelopmental disorders (e.g., intellectual disability, autistic spectrum disorder, and learning disorders), internalizing disorders (e.g., mood and anxiety disorders), and externalizing disorders (e.g., oppositional defiant disorder and conduct disorder). The assessment of a child or adolescent patient always includes multiple informants, the context in which the child’s difficulties occur, and a functional behavioral assessment. Patients with autism spectrum disorder tend to have persistent deficits in social communication and social interaction, a restricted repertoire of behaviors and interests, and abnormal cognitive functioning. Children with disruptive mood dysregulation disorder experience chronic and severe irritability and frequent temper outbursts. Attention deficit hyperactivity disorder is characterized by hyperactivity, impulsivity, and inattention before 12 years of age. Behavior therapy has been effectively used to treat children and adolescents with neurodevelopmental disorders, attention deficit hyperactivity disorder, tic disorders, feeding and elimination disorders, and externalizing disorders. Fluoxetine is approved for treatment of depression in children and escitalopram, for adolescents. Methylphenidate and amphetamine preparations are first-line treatment for children with attention deficit hyperactivity disorder.
18
Blisard, Deanna, and Ali Al-Khafaji. Diagnosis and management of variceal bleeding in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0178.
Full textAbstract:
Cirrhosis is the most common cause of portal hypertension, which subsequently leads to development of gastroesophageal varices (GEV). Generally, presence of GEV correlates with the severity of cirrhosis and variceal haemorrhage can develop when hepatic venous pressure gradient exceeds 10–12 mmHg. The gold standard for diagnosis and often treatment of GEV is oesophagogastroduodenoscopy (OGD). Management of GEV is divided into primary prophylaxis, acute haemorrhage control, and secondary prophylaxis. Primary prophylaxis includes surveillance OGD and endoscopic intervention based on the size of the varices. Management of acute variceal haemorrhage includes resuscitation and endoscopic interventions. Basic resuscitative measures to maintain haemodynamic stability, vasoconstricting agents to decrease portal pressure, and the use of prophylactic antibiotics. Endoscopic intervention includes any of variceal band ligation, variceal sclerotherapy, and variceal obturation. Radiological or surgical portosystemic shunting markedly reduces portal pressure and are clinically effective therapy for patients who fail endoscopic or pharmacological therapy. Balloon tamponade is effective in temporarily controlling oesophageal variceal haemorrhage in over 80% of patients. Its use should be restricted to patients with uncontrollable bleeding, where more definitive therapy is planned within 24 hours. Secondary prophylaxis includes endoscopy plus pharmacological therapy of non-selective β−blockers.
19
Cox, F. E. G. Babesiosis and malaria. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780198570028.003.0055.
Full textAbstract:
Babesiosis and malaria are rare zoonoses that, with new developments in diagnosis and the application of molecular techniques, are becoming increasingly frequently recognised. Babesia species infect millions of cattle and unknown numbers of sheep, dogs, horses, and wildlife throughout the world but human infections are very uncommon. There are two distinct forms of human babesiosis. In Europe the causative agent is Babesia divergens, a natural parasite of cattle transmitted by the tick Ixodes ricinis. B. divergens infections in humans are extremely rare and nearly all have been recorded from asplenic or otherwise immunocompromised patients. In the USA, human babesiosis is more common than in Europe, although still very rare, and is not restricted to immunocompromised individuals. The causative agents are Babesia microti and B. duncani, common parasites of rodents, transmitted by the tick Ixodes scapularis. In addition there have been sporadic reports of human babesiosis from other parts of the world but in most cases the species of Babesia involved has not been characterised. Malaria parasites and Babesia both inhabit red blood cells during part of their life cycles and these stages cause the diseases, malaria and babesiosis, which are similar in many respects. The facts that humans can occasionally acquire malaria and babesiosis from animals, that both parasites appear similar when seen in blood films and that both cause similar symptoms can cause problems in diagnosis and these rare infections are, therefore, of interest to clinicians and epidemiologists.
20
Ostermann, Marlies, and Ruth Y. Y. Wan. Diuretics in critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0058.
Full textAbstract:
Fluid overload and chronic hypertension are the most common indications for diuretics. The diuretic response varies between different types and depends on underlying renal function. In patients with congestive heart failure, diuretics appear to reduce the risk of death and worsening heart failure compared with placebo, but their use in acute decompensated heart failure is questionable. Diuretics are also widely used in chronic kidney disease to prevent or control fluid overload, and treat hypertension. In acute kidney injury, there is no evidence that they improve renal function, speed up recovery, or change mortality. In patients with chronic liver disease and large volume ascites, paracentesis is more effective and associated with fewer adverse events than diuretic therapy, but maintenance treatment with diuretics is indicated to prevent recurrence of ascites. Mannitol has a role in liver patients with cerebral oedema and normal renal function. The use of diuretics in rhabdomyolysis is controversial and restricted to patients who are not fluid deplete. In conditions associated with resistant oedema (chronic kidney disease, congestive heart failure, chronic liver disease), combinations of diuretics with different modes of action may be necessary. Diuresis is easier to achieve with a continuous furosemide infusion compared with intermittent boluses, but there is no evidence of better outcomes. The role of combination therapy with albumin in patients with fluid overload and severe hypoalbuminaemia is uncertain with conflicting data.
21
Popescu, Bogdan A., Shantanu P. Sengupta, Niloufar Samiei, and Anca D. Mateescu. Heart valve disease (mitral valve disease): mitral stenosis. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198726012.003.0035.
Full textAbstract:
The most common cause of mitral stenosis (MS) is rheumatic fever followed by degenerative MS. Echocardiography is the key method to diagnose and evaluate MS. Echocardiographic findings are closely related to aetiology. In rheumatic disease echocardiography shows thickening of leaflet tips with restricted opening caused by commissural fusion resulting in ‘doming’ of the mitral valve in diastole. Quantitation of MS severity includes measuring mitral valve area (MVA) by planimetry (anatomical area, by two-/three-dimensional echo), or by the pressure half-time (PHT) method (functional area, by Doppler), and the mean pressure gradient. Planimetry is considered the reference method to determine MVA as it is relatively load independent. The PHT method is widely used due to its simplicity, but different factors influence the relationship between PHT and MVA. Other indices of MS severity are rarely used in clinical practice. Echocardiography also helps in the assessment of consequences of MS, and of associated valvular lesions. Exercise Doppler is recommended when there is discrepancy between the resting echocardiography findings and the clinical picture. Echocardiography is crucial in determining the timing and type of intervention in patients with MS. When considering percutaneous mitral commissurotomy (PMC) valve morphology should be comprehensively evaluated for mobility, thickness, calcifications, and subvalvular apparatus. The echo findings may determine the suitability for PMC, guide the procedure, and assess its results.
22
Chaiken, Shama, and Brittany Brizendine. Group psychotherapy. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0042.
Full textAbstract:
Group psychotherapy has become a standard practice in community settings, prisons, and to a lesser degree in jails. While simple process groups may still play a limited role in some settings, the field of group therapy has evolved substantially, with some significant work adapting evidence-based therapies for use in correctional settings, or designing them de novo. Logistics and support of group therapy are critical core elements for successful implementation in jails or prisons. These elements include appropriate training and supervision of group facilitators, a structured approach to patient selection and pre-group interviewing, and appropriate support for cultural and language diversity. The specifics of group member confidentiality and development of groups for patients with severe mental illness, intellectual, or learning disabilities are particularly important in this context. Some of the unique challenges of correctional settings include the need for design of treatment modalities for those in maximum security and restricted housing environments. Gender-specific and trauma-informed care are important treatment options still in evolution for the incarcerated population. Implementation of evidence-based, manual-guided treatment in corrections is challenging but achievable with adequate planning and support. Integration of the recovery model, reentry planning groups, and other special purpose groups are becoming more common. This chapter presents the range of evidence based practices and best practices in use, and discusses issues of appropriate patient selection, therapist training required, sustainability, and outcomes.
23
van Prooijen, Jan-Willem. The Moral Punishment Instinct. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190609979.001.0001.
Full textAbstract:
Across time and cultures, ranging from ancient hunter-gatherers, to holy scriptures, to contemporary courts of law, it has been common for people to punish offenders. Furthermore, punishment is not restricted to criminal offenders but emerges in all spheres of social life, including corporations, public institutions, traffic, sports matches, schools, and parenting. Why is punishment so ubiquitous? One cannot find a satisfactory explanation for the universality of punishment in the social science literature focusing on human morality in general. Punishment also occurs among nonhuman animals for which one can question their sense of morality, including rodents, fish, and insects. Apparently, there is something specific and unique about punishment that warrants a more focused discussion. This book proposes that people possess a moral punishment instinct, that is, a hard-wired tendency to aggress against those who violate the norms of the group. People evolved this instinct due to its power to control behavior by curbing selfishness and free-riding, thereby providing incentives to stimulate the mutual cooperation that small tribes of ancient hunter-gatherers needed to survive in a challenging natural environment. To examine this idea, the book describes how punishment originates from moral emotions, stimulates cooperation, and shapes the social life of human beings. Guided by many recognizable examples, the book illuminates how the moral punishment instinct manifests itself among nonhuman animals, children, cultures of modern humans, and tribes of hunter-gatherers, while accounting for the role of this instinct in religion, war, racial bias, restorative justice, gossip, torture, and radical terrorism.
24
Vallier, Kevin, and Michael Weber. Prioritizing Religion in Vaccine Exemption Policies. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190666187.003.0011.
Full textAbstract:
The most common method that US state governments use to restrict access to exemptions from school and daycare vaccine mandates is to provide exemptions only to people who object to vaccination for religious reasons. However, there are moral reasons for states not to prioritize vaccine exemptions for religious objectors. They should also offer personal belief exemptions. Furthermore, states should not try to restrict exemptions by focusing on the reasons (religious or otherwise) that people give for objecting to vaccines. It would be better to focus on the intensity of an objector’s commitment to refuse vaccines, which we can assess by making vaccination exemption application processes more burdensome to complete.
25
Reid, Hugh W., and Mark P. Dagleish. Poxviruses. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780198570028.003.0040.
Full textAbstract:
The poxviruses are a large family of complex viruses infecting many species of vertebrates as well as arthropods, and members of the three genera Orthopoxvirus, Yatapoxvirus and Parapoxvirus are the cause of sporadic zoonotic infections originating from both wildlife and domestic livestock. Infections of humans are generally associated with localized lesions, regarded as inconvenient rather than life-threatening, although severe illnesses have occurred, particularly in immunologically compromised individuals.The most celebrated of the orthopoxvirus infections is cowpox — a zoonotic infection which has been exploited to the enormous benefit of mankind as it had a pivotal role in the initiation of vaccination strategies that eventually led to the eradication of smallpox. Cowpox occurs only in Eurasia and in recent years it has become evident that infection of cattle is fortuitous and the reservoir of infection is in wild rodents. Monkeypox is another orthopoxvirus causing zoonotic infections in central and west Africa resembling smallpox and is the most serious disease in this category. While monkeypox does not readily spread between people, the potential of the virus to adapt to man is of concern and necessitates sustained surveillance in enzootic areas.The third orthopoxvirus zoonoses of importance is buffalopox in the Indian subcontinent, which is probably a strain of vaccinia that has been maintained in buffalo for at least 30 years following the cessation of vaccination of the human population. Likewise in Brazil, in recent years widespread outbreaks of vaccinia have occurred in milkers and their cattle.Orf virus, the most common of the parapoxviruses to cause zoonotic infection, is largely restricted to those in direct contact with domestic sheep and goats. Generally, infection is associated with a single localized macule affecting the hand which resolves without complications. Infection would appear to be prevalent in all sheep and goat populations and human orf is a relatively common occupational hazard. Sporadic parapoxvirus infections of man also occur following contact with cattle infected with pseudocowpoxvirus, and wildlife, in particular seals.A final serious consideration with the poxvirus zoonoses is the clinical similarity of such infections with smallpox. In view of the potential for smallpox virus to be employed by bio-terrorists there can be an urgency for laboratory confirmation of unexplained zoonotic poxvirus infections. Thus there is a requirement to maintain the capacity for rapid confirmation of poxvirus infections by molecular technique. As representatives of the known poxviruses have all been sequenced, generic and virus specific Polymerase Chain Reactions (PCR) can readily be performed to ensure rapid confirmation of any suspect infection.
26
Breckenridge, Wylie. Implicit Domain Restriction. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780199600465.003.0006.
Full textAbstract:
According to the proposal made in Chapter 4, we use ‘grey’ in ‘The patch looks grey to you’ to refer to a way of looking by quantifying over events. When we quantify it is very common for us to implicitly restrict the domain of things over which we do so. The author proposes that, as an instance of this general phenomenon, we employ implicit domain restriction when we use ‘grey’ to quantify over events in ‘The patch looks grey to you’. The author uses this to explain various phenomena to do with our use of ‘grey’ and other adjectives in ‘look’ sentences.
27
Sterckx, Sigrid, and Kasper Raus. Continuous Sedation at the End of Life. Edited by Stuart J. Youngner and Robert M. Arnold. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199974412.013.7.
Full textAbstract:
This chapter examines continuous sedation as a way to relieve unbearable suffering in patients at the end of life. After considering consensus and guidelines on continuous sedation, it looks at the debate over terminology and definition. It then discusses the practice of continuous sedation in various countries and how it is performed, along with the importance of patient consent and autonomy in all sedation guidelines. The chapter goes on to analyze some of the commonly invoked justifications for continuous sedation, including the doctrine of double effect, last resort and refractory suffering, autonomy and patient consent, and proportionality. It also reviews contentious issues raised by continuous sedation, such as whether it should be restricted to patients with a very short life expectancy, artificial nutrition and hydration, and existential or psychological suffering.
28
Roach, Lee. 4. The constitution of the company. Oxford University Press, 2016. http://dx.doi.org/10.1093/he/9780198759133.003.0004.
Full textAbstract:
EachConcentraterevision guide is packed with essential information, key cases, revision tips, exam Q&As, and more.Concentratesshow you what to expect in a law exam, what examiners are looking for, and how to achieve extra marks. This chapter discusses the company constitution. A company’s constitution consists primarily of the articles of association, and agreements and resolutions affecting the company’s constitution. The constitution forms a statutory contract between the company and its members, and between the members themselves, but only those provisions relating to membership rights will constitute terms of the statutory contract. A company can alter its articles by passing a special resolution, although statute and the common law restrict a company’s ability to alter its articles.
29
Roach, Lee. 3. The constitution of the company. Oxford University Press, 2018. http://dx.doi.org/10.1093/he/9780198815143.003.0003.
Full textAbstract:
Each Concentrate revision guide is packed with essential information, key cases, revision tips, exam Q&As, and more. Concentrates show you what to expect in a law exam, what examiners are looking for, and how to achieve extra marks. This chapter discusses the company constitution. A company’s constitution consists primarily of the articles of association and agreements and resolutions affecting the company’s constitution. The constitution forms a statutory contract between the company and its members, and between the members themselves, but only those provisions relating to membership rights will constitute terms of the statutory contract. A company can alter its articles by passing a special resolution, although statute and the common law restrict a company’s ability to alter its articles.
30
Cheng, Russell. Change-Point Models. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780198505044.003.0011.
Full textAbstract:
This chapter investigates change-point (hazard rate) probability models for the random survival time in some population of interest. A parametric probability distribution is assumed with parameters to be estimated from a sample of observed survival times. If a change-point parameter, denoted by τ, is included to represent the time at which there is a discrete change in hazard rate, then the model is non-standard. The profile log-likelihood, with τ as profiling parameter, has a discontinuous jump at every τ equal to a sampled value, becoming unbounded as τ tends to the largest observation. It is known that maximum likelihood estimation can still be used provided the range of τ is restricted. It is shown that the alternative maximum product of spacings method is consistent without restriction on τ. Censored observations which commonly occur in survival-time data can be accounted for using Kaplan-Meier estimation. A real data numerical example is given.
31
Taking Stock of Global Democratic Trends Before and During the COVID-19 Pandemic. International Institute for Democracy and Electoral Assistance, 2020. http://dx.doi.org/10.31752/idea.2020.66.
Full textAbstract:
This GSoD In Focus provides a brief overview of the global state of democracy at the end of 2019, prior to the outbreak of the pandemic, and assesses some of the preliminary impacts that the pandemic has had on democracy globally in 2020. Key findings include: • To address the COVID-19 pandemic, starting in March 2020, more than half the countries in the world (59 per cent) had declared a national state of emergency (SoE), enabling them to take drastic temporary (and in most cases necessary) measures to fight the pandemic. These measures have included in most cases temporarily curbing basic civil liberties, such as freedom of assembly and movement, and in some cases postponing elections. • International IDEA’s Global Monitor of COVID-19’s Impact on Democracy and Human Rights finds that more than half the countries in the world (61 per cent) had, by the end of November 2020, implemented measures to curb COVID-19 that were concerning from a democracy and human rights perspective. These violated democratic standards because they were either disproportionate, illegal, indefinite or unnecessary in relation to the health threat. • Concerning developments have been more common in countries that were already non-democratic prior to the pandemic (90 per cent) and less common, although still quite widespread, in democracies (43 per cent). • The democracies that have implemented democratically concerning measures are those that were already ailing before the pandemic. More than two-thirds were democracies that were either backsliding, eroding or weak prior to the pandemic. • Almost a year since the first outbreak of COVID-19, the pandemic seems to have deepened autocratization in most of the countries that were already non-democratic. However, in at least 3 of those countries (Belarus, Kyrgyzstan, Thailand), the pandemic has also tapped into existing simmering citizen discontent and may have been the tipping point in unleashing massive protest waves demanding democratic reform. The pandemic has also seemingly deepened democratic backsliding processes and exposed the democratic weakness and fragility of new or re-transitioned democracies (Malaysia, Mali, Myanmar, Sri Lanka). In a few cases, the pandemic has also exposed countries that showed no apparent sign of democratically ailing prior to the pandemic, but where concerning democratic developments have occurred during the pandemic and which risk seeing a significant deterioration in their democratic quality as a result (i.e. Argentina, El Salvador). • The aspects of democracy that have seen the most concerning developments during the pandemic are freedom of expression, media integrity, and personal integrity and security. However, the freedoms that have been restricted across most countries are freedom of movement and assembly. Another core democratic process that has been heavily affected by the pandemic is the electoral, with half the elections scheduled between February and December 2020 postponed due to the pandemic. • The pandemic has also shown democracy’s resilience and capacity for renovation. Innovation through accelerated digitalization has occurred across most regions of the world. And democratic institutions, such as parliaments, courts, electoral commissions, political parties, media and civil society actors, have fought back against attempts at executive overreach and democratic trampling or collaborated to ensure effective responses to the pandemic. The review of the state of democracy during the COVID-19 pandemic in 2020 uses qualitative analysis and data of events and trends in the region collected through International IDEA’s Global Monitor of COVID-19’s Impact on Democracy and Human Rights, an initiative co-funded by the European Union.
32
Buchanan, Elaine, and Chris Lavy. Low back pain. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0064.
Full textAbstract:
Low back pain (LBP) is pain arising from the structures of the lumbar spine, including joints, discs, connective tissue, and nerves. Symptoms include pain and, muscle tightness or stiffness, with or without referral of pain to the legs. Most (95%) of LBP is managed in primary care; the rest is managed in secondary care. LBP affects nearly everyone at some point in their life and has an annual prevalence of around 40%. It is less common in children but from age 16 onwards the point prevalence for all age groups is around 25%. Many experience milder persisting symptoms interspersed with exacerbations, and 7% of adults have persisting LBP, which restricts function. This chapter discusses LBP, including definitions, differential diagnosis, context, approach to diagnosis, specific clues to the diagnosis, key diagnostic tests, treatment and therapy, prognosis, and how to handle uncertainty in the diagnosis of the symptom.
33
Wordsworth, B. P. Skeletal dysplasias. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0150.
Full textAbstract:
Bone is metabolically active throughout life and metabolic disturbances may have wide-ranging consequences that are not restricted to altering its mechanics. The study of some genetic bone diseases has already provided remarkable insights into the normal regulation of bone metabolism. Skeletal dysplasias are developmental disorders of the chondro-osseous tissues commonly resulting in short stature, which is often disproportionate. The underlying mutations are often in the structural genes encoding components of the matrix but may also involve growth factors or cell signalling. In contrast, the dysostoses tend to affect single bones or groups of bones, reflecting the transient nature of the many different signalling factors to which they are responsive during development. Abnormalities of bone density (high or low) may be due to primary deficiency of bone matrix synthesis (e.g. osteogenesis imperfecta and hypophosphatasia) but may also reflect an imbalance between bone formation and resorption. This may be caused by abnormalities of bone formation (e.g. hyperostosis/sclerosteosis and osteoporosis pseudoglioma syndrome) or bone resorption (e.g. classic osteopetrosis and fibrous dysplasia).
34
Nuwer, Marc R., and Stephan Schuele. Electrocorticography. Edited by Donald L. Schomer and Fernando H. Lopes da Silva. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190228484.003.0030.
Full textAbstract:
Electrocorticography (ECoG) is the method of recording electroencephalographic signals directly from surgically exposed cerebral cortex. It detects intraoperatively the cortical regions with substantial epileptiform interictal discharges. Direct cortical stimulation during ECoG provides a method of identifying language, motor, and sensory regions during a craniotomy. Both techniques—the identification of cortex with epileptic activity and cortex with important eloquent functional activity—help determine limits for surgical cortical resection. These are used most commonly during epilepsy and tumor surgery. Anesthetic agents can adversely affect the recording, and ECoG restricts the types of anesthesia that can be used. The amount of spiking from diffuse or remote cortical regions on ECoG can predict the success of postoperative seizure control.
35
Hanna, Jason. The Imposition of Values. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190877132.003.0004.
Full textAbstract:
This chapter critically considers the common objection that paternalism imposes values on people or violates a plausible conception of liberal neutrality. This objection, it is argued, endorses a constraint according to which a rationale cannot provide a good reason to restrict a person’s liberty unless he can accept that it provides such a reason. The first half of the chapter considers several different interpretations of this constraint and argues that none poses a problem for paternalistic intervention that promotes neutral goods such as health or financial security. The second half of the chapter argues that defenders of paternalism can consistently reject rationales that appeal to controversial “perfectionist” values without relying on a problematic distinction between “means-related” and “ends-related” intervention. Moreover, it argues that pro-paternalists are probably right to permit intervention in some religiously motivated choices, such as that of a Jehovah’s Witness who refuses a life-saving blood transfusion.
36
Walker, Greg. John Heywood. Oxford University Press, 2020. http://dx.doi.org/10.1093/oso/9780198851516.001.0001.
Full textAbstract:
John Heywood: Comedy and Survival in Tudor England offers the first comprehensive study of the long and varied career of the Tudor playwright, poet, musician, performer, humourist, and collector of epigrams, John Heywood (c.1497–1578). It roots his life and work in the context of the profound and often violent religious, political, and cultural changes of the Tudor century that variously provoked, enabled, and restricted the scope of his creativity, and makes the case for Heywood as both one of the sixteenth century’s most fascinating dramatic and literary figures and a revealing lens through which to view the cultural history of the period. It goes beyond the clichés of popular history, beyond Shakespeare and the purpose-built playhouses, beyond the canonical Henrician court poets and writers of the Elizabethan ‘Golden Age’, beyond even the experiences of the century’s chief ministers, intellectuals, and martyrs, to a theatrical and literary world less visible in the conventional sources. It opens a window on a culture in which the actions of monarchs, their councillors, and their victims were witnessed and reflected upon at one remove, but subjected to vigorous, witty, and often audacious criticism and comment.
37
Becker, Ulrich, and Anastasia Poulou, eds. European Welfare State Constitutions after the Financial Crisis. Oxford University Press, 2020. http://dx.doi.org/10.1093/oso/9780198851776.001.0001.
Full textAbstract:
At a time when Europe is in the grip of a new crisis, it is especially useful to look back at the experiences of the European welfare states’ constitutions during the most recent financial crisis. This book provides unique insights by analysing social protection reforms undertaken in nine European countries, from both a social law and a constitutional law perspective. It highlights the mixture of short-term cuts in benefits and of structural changes in social protection schemes. The crisis might have helped to further the partial and temporary implementation of reforms, but it certainly cannot spare us from the debates and political compromises that are unavoidable in order to reform social protection thoughtfully and thoroughly. Moreover, the book records the outcome of relevant constitutional review proceedings and thereby demonstrates that, even if corrections remained restricted to relatively few cases, social rights matter. The financial crisis advanced their protection one step further, but left many questions open. One lesson is of paramount importance, also for helping us overcome the current pandemic crisis: we need a substantial and commonly accepted agreement in the Europe Union on how to balance the economy and social protection in the future.
38
Yamashita, Yoshikazu. Formation of Contract in Japan. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198808114.003.0012.
Full textAbstract:
This chapter provides insights into the law on contract formation in Japan. The Japanese approach is traditional, requiring an agreement which, in turn, normally requires an offer and matching acceptance, according to the mirror image rule. Once offers become effective, the 1898 Japanese Civil Code severely restricts their revocability. This is in tune with the mostly German origins of Japanese contract law. However, the drafters of the Code deliberately followed the common law in one respect: the offeree’s acceptance becomes effective as soon as it is dispatched. This is highly controversial and in 2001 was abolished for acceptances by electronic means. Ongoing major reform of Japanese contract law will probably extend this solution to all contracts. Japanese law has no doctrine of consideration and has traditionally eschewed formal requirements as a prerequisite for the validity or enforceability of contracts. More recently, formalities have been introduced, first, for certain consumer contracts, then for contracts of suretyship. A particular feature of Japanese law pertaining to contract formation is the strong duty to negotiate in good faith.
39
Elliott, Perry, and Alexandros Protonotarios. Arrhythmogenic right ventricular cardiomyopathy: management of symptoms and prevention of sudden cardiac death. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0361.
Full textAbstract:
Patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) have arrhythmia-related symptoms or are identified during screening of an affected family. Heart failure symptoms occur late in the disease’s natural history. As strenuous exercise has been associated with disease acceleration and worsening of ventricular arrhythmias, lifestyle modification with restricted athletic activities is recommended upon disease diagnosis or even identification of mutation carrier status. An episode of an haemodynamically unstable, sustained ventricular tachycardia or ventricular fibrillation as well as severe systolic ventricular dysfunction constitute definitive indications for implantable cardioverter defibrillator (ICD) implantation, which should also be considered following tolerated sustained or non-sustained ventricular tachycardia episodes, syncope, or in the presence of moderate ventricular dysfunction. Antiarrhythmic medications are used as an adjunct to device therapy. Catheter ablation is recommended for incessant ventricular tachycardia or frequent appropriate ICD interventions despite maximal pharmacological therapy. Amiodarone alone or in combination with beta blockers is most effective for symptomatic ventricular arrhythmias. Beta blockers are considered for use in all patients with a definite diagnosis but evidence for their prognostic benefit is sparse. Heart failure symptoms are managed using standard protocols and heart transplantation is considered for severe ventricular dysfunction or much less commonly uncontrollable ventricular arrhythmias.
40
Paul, Drew. Israel/Palestine. Edinburgh University Press, 2020. http://dx.doi.org/10.3366/edinburgh/9781474456128.001.0001.
Full textAbstract:
Since the early 1990s, Israel has greatly expanded a system checkpoints, walls and other barriers in the West Bank and Gaza that restrict Palestinian mobility. As a result, such border spaces have become ubiquitous elements of everyday life, with profound political, socio-cultural, and economic effects. Israel/Palestine examines how authors and filmmakers in the West Bank, Gaza, and Israel have grappled with the spread and impact of these borders in the period since the Oslo Accords of 1994. Focusing on novels by Raba’i al-Madhoun, Ghassan Kanafani, Sami Michael and Sayed Kashua, and films by Elia Suleiman, Simon Bitton, Emad Burnat, and Guy Davidi, Israel/Palestine traces how political engagement in literature and film has shifted away from previously common paradigms of resistance and coexistence. Instead, it has become reorganised around these now ubiquitous physical barriers. Using strategies of narrative fragmentation, multivocality, metafiction, fantasy, and silence to depict the effects of these borders, authors and filmmakers interrogate the notion that such spaces are impenetrable and unbreakable by revealing their deceptive and illusive qualities. In doing so, they also imagine distinct forms of protest, and redefine the relationship between cultural production and political engagement.
41
Hill, Juniper. Becoming Creative. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780199365173.001.0001.
Full textAbstract:
How are an individual’s ability and motivation to be creative shaped by the world around her? Why does creativity seem to flourish in some environments, while in others it is stifled? Many societies value creativity as an abstract concept and many, perhaps even most, individuals feel an internal drive to be creative; however, tremendous social pressures restrict development of creative skill sets, engagement in creative activities, and willingness to take creative risks. Becoming Creative explores how social and cultural factors enable or inhibit creativity in music. The book integrates perspectives from ethnomusicology, education, sociology, psychology, and performance studies, prioritizing the voices of practicing musicians and music educators. Insights are drawn from ethnographic research and in-depth interviews with classical, jazz, and traditional musicians in South Africa, Finland, and the United States. By comparing and analyzing these musicians’ personal experiences, Becoming Creative deepens our understanding of the development and practice of musical creativity, the external factors that influence it, and strategies for enhancing it. The book reveals the common components of how musical creativity is experienced across these cultures and explains why creativity might not always be considered socially desirable. It identifies ideal creativity-enabling criteria—specific skill sets, certain psychological traits and states, and access to opportunities and authority—and illustrates how these enablers of creativity are fostered or thwarted by a variety of beliefs, learning methods, social relationships, institutions, and social inequalities. Becoming Creative further demonstrates formal and informal strategies for overcoming inhibitors of creativity.
42
Lewington, Andrew, and Michael Weston. Imaging the urinary tract in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0210.
Full textAbstract:
Imaging the urinary tract of patients in the intensive care unit (ICU) may assist identifying the cause of acute kidney injury (AKI). By the nature of their illness patients on ICU will often be clinically unstable and this will restrict the choice of imaging. Ultrasound is the most commonly used non-invasive imaging technique used, and is essential for assessing renal anatomy, determining kidney size and the presence of obstruction. New developments hold much promise and there are a number of centres now using this technology. Doppler ultrasonography has become increasingly popular to assess intrarenal blood flow. CT scanning can be used with or without contrast when ultrasonography is non-diagnostic and is very useful in identifying calcification within the renal tract. However, the patient must be stable enough for transfer to the radiology department. It is important to consider the risk of iodinated contrast-induced AKI (CI-AKI) in critically-ill patients and minimize potential renal injury. Magnetic resonance imaging may be preferred where there is risk of CI-AKI, but the logistics may prove even more demanding. Renal arteriography is rarely performed, but may be required for diagnostic and interventional procedures for renal artery stenosis or sites of active haemorrhage.
43
Leonard, Bill J. Baptists in North America. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780199683710.003.0010.
Full textAbstract:
This chapter considers an unlikely trio of groups who opposed the Evangelical Protestant mainstream in nineteenth-century America: the Unitarians, the Quakers, and the Shakers. Each had to navigate two different forms of dissent: the external and the internal. When deciding how best to revise or contradict the hegemonic forms of Protestantism, these groups had certain goals and methods for interacting with those outside their fellowship. In time, they each also had to face a more pernicious adversary, the second generation of dissenters that grew within their own ranks. While these disparate traditions may appear to have little in common, each body faced many of the same questions as they asserted their distinct form of external cultural and religious correction. When articulating a theological vision that went against the mainstream, they had to determine how to serve that particular vision in a culture that did not share their theological views. Some withdrew from contact with outsiders and used their enclaves as a way to practise and preserve their vision of orthodoxy and orthopraxy. On the other hand, there were groups that deliberately sought to model correct religion for others, and thereby hoped to transform other religious groups by disseminating their theological vision beyond the confines of any type of self-imposed seclusion. As the decades passed, though, both sorts of groups were surprised by the inevitable challenges to their founding orthodoxy from within their own membership. This dissent among dissenters was, of course, an outgrowth of the very impulse that stood behind the earlier establishment of the group. Subsequent generations of membership often failed to realize that belonging to a group of dissenters might require adherence to a detailed theological vision. This tension between founding theology and ongoing interpretation could leave a Dissenting group hierarchy in the awkward position of having to restrict innovation, an irony not lost on subsequent generations of members. This chapter asks how Unitarians, Shakers, and Quakers in nineteenth-century America addressed these two aspects of Dissent: external and internal. How did each group perceive their relationship to American culture and other more mainstream religious groups? How did they encounter and negotiate dissent from within their ranks? In each group there was an evolution over the course of the nineteenth century that complicates any interpretation of these multifaceted embodiments of Protestant Dissenting traditions in the United States.