The ipsilesional arm of stroke patients often has functionally limiting deficits in motor control and dexterity that depend on the side of the brain that is lesioned and that increase with the severity of paretic arm impairment. However, remediation of the ipsilesional arm has yet to be integrated into the usual standard of care for upper limb rehabilitation in stroke, largely due to a lack of translational research examining the effects of ipsilesional-arm intervention. We now ask whether ipsilesional-arm training, tailored (...) to the hemisphere-specific nature of ipsilesional-arm motor deficits in participants with moderate to severe contralesional paresis, improves ipsilesional arm performance and generalizes to improve functional independence. We assessed the effects of this intervention on ipsilesional arm unilateral performance [Jebsen–Taylor Hand Function Test ], ipsilesional grip strength, contralesional arm impairment level [Fugl–Meyer Assessment ], and functional independence [Functional independence measure ]. Intervention occurred over a 3 week period for 1.5 h/session, three times each week. All sessions included virtual reality tasks that targeted the specific motor control deficits associated with either left or right hemisphere damage, followed by graded dexterity training in real-world tasks. We also exposed participants to 3 weeks of sham training to control for the non-specific effects of therapy visits and interactions. We conducted five test-sessions: two pre-tests and three post-tests. Our results indicate substantial improvements in the less-impaired arm performance, without detriment to the paretic arm that transferred to improved functional independence in all three posttests, indicating durability of training effects for at least 3 weeks. We provide evidence for establishing the basis of a rehabilitation approach that includes evaluation and remediation of the ipsilesional arm in moderately to severely impaired stroke survivors. This study was originally a crossover design; however, we were unable to complete the second arm of the study due to the COVID-19 pandemic. We report the results from the first arm of the planned design as a longitudinal study. (shrink)

Chronic stroke survivors with severe contralesional arm paresis face numerous challenges to performing activities of daily living, which largely rely on the use of the less-affected ipsilesional arm. While use of the ipsilesional arm is often encouraged as a compensatory strategy in rehabilitation, substantial evidence indicates that motor control deficits in this arm can be functionally limiting, suggesting a role for remediation of this arm. Previous research has indicated that the nature of ipsilesional motor control deficits vary with hemisphere of (...) damage and with the severity of contralesional paresis. Thus, in order to design rehabilitation that accounts for these deficits in promoting function, it is critical to understand the relative contributions of both ipsilesional and contralesional arm motor deficits to functional independence in stroke survivors with severe contralesional paresis. We now examine motor deficits in each arm of severely paretic chronic stroke survivors with unilateral damage to determine whether hemisphere-dependent deficits are correlated with functional independence. Clinical evaluation of contralesional, paretic arm impairment was conducted with the upper extremity portion of the Fugl-Meyer assessment. Ipsilesional arm motor performance was evaluated using the Jebsen-Taylor Hand Function Test, grip strength, and ipsilesional high-resolution kinematic analysis during a visually targeted reaching task. Functional independence was measured with the Barthel Index. Functional independence was better correlated with ipsilesional than contralesional arm motor performance in the left hemisphere damage group [JTHFT: [r = −0.73, p = 0.017]; grip strength: [r = 0.64, p = 0.047]], and by contralesional arm impairment in the right hemisphere damage group [UEFM: [r = 0.66, p = 0.040]]. Ipsilesional arm kinematics were correlated with functional independence in the left hemisphere damage group only. Examination of hemisphere-dependent motor correlates of functional independence showed that ipsilesional arm deficits were important in determining functional outcomes in individuals with left hemisphere damage only, suggesting that functional independence in right hemisphere damaged participants was affected by other factors. (shrink)

The World Bank is committed to “work[ing] with countries to improve the health, nutrition and population outcomes of the world's poor, and to protect[ing] the population from the impoverishing effects of illness, malnutrition and high fertility”.1 Ethical issues arise in the interpretation of these objectives and in helping countries formulate strategies and policies. It is these ethical issues—which are often not acknowledged by commentators—that are the subject of this paper. It asks why there should be a focus on the poor, (...) and explores the link between improving the health of the poor, and reducing health inequalities between the poor and better-off. It discusses difficult ethical issues at both the global level and the country level. (shrink)

As support for his position, Rachlin refers to the writings of Aristotle. However, Aristotle, like many social psychological theorists, would dispute the assumptions that altruism always involves self-control, and that altruism is confined to acts that have group benefits. Indeed, for Aristotle, as for equity theory and sociobiology, justice exists partly to curb the unrestrained actions of those altruists who are a social liability.

The fortress of Kelefa on the western side of the Mani peninsula in southern Greece is one of a series of fortifications constructed or refurbished to defend the Ottomans' maritime frontier against Venice in the late seventeenth century. This chapter addresses whether the castle is indeed of Ottoman construction, or whether it is in fact an earlier, Frankish, structure that was merely restored by the Ottomans. It outlines what The Chronicle of the Morea says and how it can be interpreted. (...) It looks at what light later literary and other sources can throw on the problem, discussing Evliya Çelebi in the process. It identifies Grand Magne with a fortress which others have claimed is of Ottoman construction and dates from the seventeenth rather than the thirteenth century. The chapter also provides a sketch of the Mani as part of the Ottoman frontier zone in the Mediterranean region. (shrink)

Using Leventhal’s (Social exchange: Advances in theory and research, Plenum Press, New York, 1980 ) rules of procedural justice as well as deontic justice (Folger in Research in social issues in management, Information Age, Greenwich, CT, 2001 ), we examine how personal value for diversity moderates the negative relationship between perceived discrimination against minorities (i.e., racial minorities and females) at work and the perceived procedural justice of minorities’ treatment by the organization. Through a field survey of 190 employees, we found (...) that observers high in personal value for diversity have stronger negative reactions to the mistreatment of women and racial minorities than observers low in personal value for diversity. These findings support and extend the deontic justice perspective because those who personally value diversity had the strongest negative reactions toward the discriminatory treatment of minorities. (shrink)

This brief report raises the ethical dilemma encountered by an obstetrician involved in the care of a pregnant woman with life-threatening disease. This is a particularly difficult issue if the maternal well-being is in conflict with the survival of the unborn child.

Les Prolegomenes a la Philosophie de Platon sont un manuel d'ecole neoplatonicien. Il s'inspire d'un modele dont Proclus a du etre l'auteur, mais l'origine de ce texte est presque surement alexandrine et doit dater de la premiere moitie du Vle siecle. Cette oeuvre est essentielle pour comprendre comment etait diffuse l'enseignement platonicien, et pour mieux saisir le mouvement des idees de l'Antiquite finissante. Dans une importante introduction, L. O. Westerink a retrace l'histoire de l'ecole d'Alexandrie et celle du genre litteraire (...) de ces introductions a Platon et a Aristote. (shrink)

Tuberculosis (TB) is a potentially fatal infectious disease that, in Aotearoa New Zealand (NZ), inequitably affects Asian, Pacific, Middle Eastern, Latin American, and African (MELAA), and Māori people. Medical research involving genome sequencing of TB samples enables more nuanced understanding of disease strains and their transmission. This could inform highly specific health interventions. However, the collection and management of TB isolate samples for research are currently informed by monocultural biomedical models often lacking key ethical considerations. Drawing on a qualitative kaupapa (...) Māori–consistent study, this paper reports on preliminary discussions with groups of Māori, Pacific, and Afghan people in NZ, whose communities have been harmed by TB and TB stigma. Participants’ discussions highlight key concerns and meanings that ought to inform the development of guidelines and a more robust consultative process for the governance of how TB isolate samples are collected and used both retrospectively and in future research. We argue for ethical processes to be culturally nuanced and community-generated, flexible and meaningful, and situated in relation to the physical and symbolic effects of TB. We discuss the significance of Indigenous data sovereignty, rights, and kāwanatanga (governorship) in shaping a multicultural data sovereignty model. (shrink)

are synthetic a priori judgements possible?" In both cases, i~thas usually been t'aken for granted in fife one case by Kant that synthetic a priori judgements were possible, and in the other case in contemporary,'d-". philosophical literature that contingent statements of identity are ppss. ible. I do not intend to deal with the Kantian question except to mention:ssj~".

Purpose. To examine the existential anthropology of G. Marcel and E. Minkowski, in order to demonstrate the necessity of distinguishing the universal-spiritual, as human in human being, apart from the individual-existential in him, and to reveal the hierarchical correlation of biosocial, existential and spiritual spheres in personality. Theoretical basis. Within existential philosophy the author differentiates two separate traditions and proceeds from the insufficiency of the distinction of existential sphere, proposed by phenomenological tradition, showing the necessity of its correlation with the (...) spiritual sphere as a sphere of humanity, proposed by non-phenomenological tradition of G. Marcel and E. Minkowski. Originality. The author presents the anthropological conception of G. Marcel and E. Minkowski, in which human personality is understood as unity of individual-existential and universal-spiritual, which requires a special trans-empirical field of culture, which contains senses, images and symbols of humanity. Also, the author presents the recent developments of existential thinkers in distinguishing existential and spiritual dimensions, both not reducible to the physical and social dimensions. Conclusions. In both existential traditions, the specifically human was founded as a trans-biological and trans-social phenomenon, which appears as indefinable and non-predetermined. But in first tradition, humanity is understood as an existence, as a unique individuality, "project", variant of humanity, equivalent to other variants, and universal is understood as a community of human condition in the world. While in the second tradition, the universal is understood as spiritual. Thus, horizontal level of our private existence, as the process of movement from birth to death, is supplemented by vertical of human, universal ideals and images. Humanity appears as a task, on the way to which human being transcends beyond the limits of his individual "self" to the "super-individual", through inclusion into spiritual community, into universal culture. (shrink)

Trope theory is a leading metaphysical theory in analytic ontology. One of its classic statements is found in the work of Donald C. Williams who argued that tropes qua abstract particulars are the very alphabet of being. The concept of an abstract particular has been repeatedly attacked in the literature. Opponents and proponents of trope theory alike have levelled their criticisms at the abstractness of tropes and the associated act of abstraction. In this paper I defend the concept of a (...) trope qua abstract particular by rejecting arguments that purport to show that tropes should not be understood as abstract and by arguing that the abstractness of tropes plays an indispensable role in one of our more promising trope-theoretic analyses of universals and of concrete objects. (shrink)

Modern scholars have been concerned with the hostility shown to Alexander by the Hellenistic schools of philosophy. Two literary portraits have been distinguished, the Peripatetic and the Stoic, the former deriving from Theophrastus' book on Callisthenes, or starting with this work the Peripatetics worked out a theory of and applied it to Alexander, in order to belittle his achievements. It was a case of giving sophisticated expression to the kind of crude resentment expressed by Demades.

The locus classicus for Plutarch's own views on his methods is in the Alexander He has begun by asking for the indulgence of his readers if they do not find all the exploits of Alexander and Caesar recounted by the biographer or if they discover him not reporting some famous incident in detail (); and he goes on to compare his own search for evidence which will indicate the kind of soul, with the activity of the painter, who, in order (...) to create a likeness, concentrates on the eyes and pays little attention to the other parts. Commentators and critics have been right to take this as a key text for the purpose of understanding Plutarch's attitude towards his biographical work; nevertheless there are other passages in the Lives where we can at least glimpse his attitude to his subject, and we can only see the Alexander-remarks in correct perspective if we take these other passages into account. I propose therefore, starting with the Alexander, to see how far these critical remarks apply to Plutarch's theory and practice elsewhere in the Lives. (shrink)