Strokes of Luck provides a detailed and wide-ranging examination of the role of luck in moral and political philosophy. The first part tackles debates in moral luck, which are concerned with the assignment of blameworthiness to individuals who are separated only by lucky differences. ‘Anti-luckists’ think that an agent who, for example, attempts and succeeds in an assassination and an agent who attempts and fails are equally blameworthy. This book defends an ‘anti-anti-luckist’ argument, according to which the successful assassin is (...) more blameworthy than the unsuccessful one. Moreover, the successful assassin is, all things equal, a worse person than the unsuccessful one. The worldly outcomes of our acts can make an all-important difference, not only to how bad our acts can be deemed, but to how bad we are. The second part enters into debates about distributive justice. It is argued that the attempt to neutralize luck in the distribution of advantages among individuals does not deserve its prominence in political philosophy: the ‘luck egalitarian’ programme is flawed. A better way forward is to re-invest in John Rawls’s ‘justice as fairness, which demonstrates a superior way of taming the bad effects of luck and unchosen disadvantage. (shrink)

The impact of stroke on motor functioning is analyzed at different levels. ‘Impairment’ denotes the loss of basic characteristics of voluntary movement. ‘Activity limitation’ denotes the loss of normal capacity for independent execution of daily activities. Recovery from impairment is accomplished by ‘restitution’ and recovery from activity limitation is accomplished by the combined effect of ‘restitution’ and ‘compensation.’ We aimed to unravel the long-term effects of variation in lesion topography on motor impairment of the hemiparetic lower limb (HLL), and (...) gait capacity as a measure of related activity limitation. Gait was assessed by the 3 m walk test (3MWT) in 67 first-event chronic stroke patients, at their homes. Enduring impairment of the HLL was assessed by the Fugl–Meyer Lower Extremity (FMA-LE) test. The impact of variation in lesion topography on HLL impairment and on walking was analyzed separately for left and right hemispheric damage (LHD, RHD) by voxel-based lesion-symptom mapping (VLSM). In the LHD group, HLL impairment tended to be affected by damage to the posterior limb of the internal capsule (PLIC). Walking capacity tended to be affected by a larger array of structures: PLIC and corona radiata, external capsule and caudate nucleus. In the RHD group, both HLL impairment and walking capacity were sensitive to damage in a much larger number of brain voxels. HLL impairment was affected by damage to the corona radiata, superior longitudinal fasciculus and insula. Walking was affected by damage to the same areas, plus the internal and external capsules, putamen, thalamus and parts of the perisylvian cortex. In both groups, voxel clusters have been found where damage affected FMA-LE and also 3MWT, along with voxels where damage affected only one of the measures (mainly 3MWT). In stroke, enduring ‘activity limitation’ is affected by damage to a much larger array of brain structures and voxels within specific structures, compared to enduring ‘impairment.’ Differences between the effects of left and right hemisphere damage are likely to reflect variation in motor-network organization and post-stroke re-organization related to hemispheric dominance. Further studies with larger sample size are required for the validation of these results. (shrink)

This article makes a preliminary attempt to account for the stroke systems of Chinese characters in simplified regular script. The framework utilized is the three meta-functions in Systemic Functional Linguistics. The description observes the cases from the perspectives of the experiential, appraisal, and thematic semiosis of strokes and their constitutional segments to figure out the relevant systems: the line system and the point system. This process witnesses comparisons to seek, in brief though, the traces and origins of stroke (...) development along evolution, and hence the straightening of lines and squaring of character formation. This is the first step towards a rank model of Chinese writing, the whole project of which will highlight a way to study other writing systems in the semiotic respect. (shrink)

This essay aims to reorient current theorizing about luck as an aid to our discerning this concept's true philosophical significance. After introducing the literature's leading theories of luck, it presents and defends counterexamples to each of them. It then argues that recent luck theorists’ main target of analysis—the concept of an event's being lucky for a subject—is parasitic on the more fundamental notion of an event's being a stroke of luck for a subject, which thesis serves as at least (...) a partial diagnosis of the leading theories’ failure. Next, it develops an analysis of strokes of luck that utilizes insights from the recent luck literature. Finally, having set out a comprehensive new analysis of luck—the Enriched Strokes Account of lucky events—the essay revisits the initial counterexamples to the literature's leading theories and argues that the Enriched Strokes Account properly handles all of them. (shrink)

In a qualitative study, 22 stroke patients undergoing rehabilitation in three nursing homes were interviewed about constraints on and improvements in their autonomy and about approaches of health professionals regarding autonomy. The data were analysed using grounded theory, with a particular focus on the process of regaining autonomy. An approach by the health professionals that was responsive to changes in the patients’ autonomy was found to be helpful for restoration of their autonomy. Two patterns in health professionals’ approach appeared (...) to be facilitatory: (1) from full support on admission through moderate support and supervision, to reduced supervision at discharge; and (2) from paternalism on admission through partial paternalism (regarding treatment) to shared decision making at discharge. The approach experienced by the patients did not always match their desires regarding their autonomy. Support and supervision were reduced over time, but paternalism was often continued too long. Additionally, the patients experienced a lack of information. Tailoring interventions to patients’ progress in autonomy would stimulate their active participation in rehabilitation and in decision making, and would improve patients’ preparation for autonomous living after discharge. (shrink)

Background: In the USA, the Food and Drug Administration waiver of informed consent permits certain emergency research only if community consultation occurs. However, uncertainty exists regarding how to define the community or their representatives.Objective: To collect data on the actual preferences and values of a group—those at risk for stroke—most directly affected by the waiver of informed consent for emergency research.Design: Face to face focused interviews were conducted with 12 patients who were hospitalised with a stroke diagnosis in (...) the previous year. The interviews were audiotaped and a transcript based method was used for their analysis.Results: All 12 participants felt “that it was important that new treatments for stroke be developed”, but they were initially confused about the distinction between “research for stroke” and “emergency research for stroke”. However, after explanation, most expressed willingness to participate in the latter. In the absence of a surrogate to give informed consent in a stroke emergency situation, the majority said they would want the physician to “go ahead and enrol them in the trial”.Conclusions: This study is the first to identify the values and concerns of individuals most directly affected by stroke emergency research. Further interviews and focus groups are needed to develop and test a validated questionnaire on the preferences and values surrounding emergency research for stroke. (shrink)

Medically unexplained symptoms (MUS) are common and costly in both primary and secondary health care. It is gradually being acknowledged that there needs to be a variety of interventions for patients with medically unexplained symptoms to meet the needs of different groups of patients with such chronic long-term symptoms. The proposed intervention described herewith is called The BodyMind Approach (TBMA) and promotes learning for self-management through establishing a dynamic and continuous process of emotional self-regulation. The problem is the mismatch between (...) the patient’s mind-set and profile and current interventions. This theoretical article, based on practice-based evidence, takes forward the idea that different approaches (other than cognitive behaviour therapy) are required for people with MUS. The mind-set and characteristics of patents with MUS are reflected upon to shape the rationale and design of this novel approach. Improving services for this population in primary care is crucial to prevent the iterative spiralling downwards of frequent GP visits, hospital appointments, and Accident and Emergency attendance, all of which are common for these patients. The approach derives from embodied psychotherapy (authentic movement in dance movement psychotherapy) and adult models of learning for self-management. It has been developed from research and practice-based evidence. In this article the problem of MUS in primary care is introduced and the importance of the reluctance of patients to accept a psychological/mental health referral in the first instance is drawn out. A description of the theoretical underpinnings and philosophy of the proposed alternative to current interventions is then presented related to the design, delivery, facilitation and educational content of the programme. The unique intervention is also described to give the reader a flavour. (shrink)

In this important addition to the stroke literature, highly experienced clinicians set out the patterns to be expected in patients with stroke, drawing on illustrative case histories where appropriate. The book is intended as a guide to patterns and syndromes for clinicians encountering an unfamiliar presentation in a stroke patient. It will enable them to differentiate between possible locations on the basis of symptoms and signs, recognise lesion patterns found in patients with infarcts and haemorrhages in various (...) vascular territories, and refer to the clinical features associated with rare but important causes of stroke. Drawing on the experience and clinical authority of distinguished international contributors, this is a practical, highly illustrated companion and reference for students, trainees and physicians who wish to improve their skills in the accurate diagnosis of stroke syndromes, and their understanding of its clinical consequences. (shrink)

One of the most striking differences between Frege's Begriffsschrift (logical system) and standard contemporary systems of logic is the inclusion in the former of the judgement stroke: a symbol which marks those propositions which are being asserted , that is, which are being used to express judgements . There has been considerable controversy regarding both the exact purpose of the judgement stroke, and whether a system of logic should include such a symbol. This paper explains the intended role (...) of the judgement stroke in a way that renders it readily comprehensible why Frege insisted that this symbol was an essential part of his logical system. The key point here is that Frege viewed logic as the study of inference relations amongst acts of judgement , rather than – as in the typical contemporary view – of consequence relations amongst certain objects (propositions or well-formed formulae). The paper also explains why Frege's use of the judgement stroke is not in conflict with his avowed anti-psychologism, and why Wittgenstein's criticism of the judgement stroke as 'logically quite meaningless' is unfounded. The key point here is that while the judgement stroke has no content , its use in logic and mathematics is subject to a very stringent norm of assertion. (shrink)

This essay aims to reorient current theorizing about luck as an aid to our discerning this concept's true philosophical significance. After introducing the literature's leading theories of luck, it presents and defends counterexamples to each of them. It then argues that recent luck theorists' main target of analysis—the concept of an event's being lucky for a subject—is parasitic on the more fundamental notion of an event's being a stroke of luck for a subject, which thesis serves as at least (...) a partial diagnosis of the leading theories' failure. Next, it develops an analysis of strokes of luck that utilizes insights from the recent luck literature. Finally, having set out a comprehensive new analysis of luck—the Enriched Strokes Account of lucky events—the essay revisits the initial counterexamples to the literature's leading theories and argues that the Enriched Strokes Account properly handles all of them. (shrink)

Methods available for the axiomatization of arbitrary finite-valued logics can be applied to obtain sound and complete intelim rules for all truth-functional connectives of classical logic including the Sheffer stroke and Peirce’s arrow. The restriction to a single conclusion in standard systems of natural deduction requires the introduction of additional rules to make the resulting systems complete; these rules are nevertheless still simple and correspond straightforwardly to the classical absurdity rule. Omitting these rules results in systems for intuitionistic versions (...) of the connectives in question. (shrink)

By replacement is meant an operation that replaces one sentence by another in a belief set. Replacement can be used as a kind of Sheffer stroke for belief change, since contraction, revision, and expansion can all be defined in terms of it. Replacement can also be defined either in terms of contraction or in terms of revision. Close connections are shown to hold between axioms for replacement and axioms for contraction and revision. Partial meet replacement is axiomatically characterized. It (...) is shown that this operation can have outcomes that are not obtainable through either partial meet contraction or partial meet revision. (shrink)

The risk of stroke for a child with SCD is many times greater than that of a healthy child without SCD or heart disease. There is a technique that allows the identification of the children with SCD who have high risk even within this relatively high-risk group. And there is a highly effective preventive treatment. While this would on the surface appear to be a straightforward medical decision, it is not. One must weigh the benefits of preventing permanent brain (...) damage against the risks of infection from transfused blood, iron overload, which is the result of the frequent transfusions, and rare transfusion reactions. (shrink)

Sickle cell anemia is a disease characterized by abnormal hemoglobin structure. There is a mutation in the beta-globin gene that changes the sixth amino acid from glutamic acid to valine causing the mutated hemoglobin to polymerize reversibly when deoxygenated to form a gelatinous network of fibrous polymers that stiffen and distort the red blood cell membrane. This leads to episodes of microvascular vasoocclusion and premature RBC destruction leading to hemolytic anemia. For reasons that are unclear, some children develop a large (...) artery vasculopathy involving the intracranial arteries supplying the brain.The risk of stroke for a child with SCD is many times greater than that of a healthy child without SCD or heart disease. There is a technique that allows the identification of the children with SCD who have high risk even within this relatively high-risk group. And there is a highly effective preventive treatment. (shrink)

The syntax of Frege's scientific language is commonly taken to be characterized by two oddities: the representation of the intended illocutionary role of sentences by a special sign, the judgement-stroke, and the treatment of sentences as a species of singular terms. In this paper, an alternative view is defended. The main theses are: the syntax of Frege's scientific language aims at an explication of the logical form of judgements; the judgement-stroke is, therefore, a truth-operator, not a pragmatic operator; (...) in Frege's first system, '⊦ Δ' expresses that the circumstance Δ is a fact, and in his second system that the truth-value - Δ is the True; in both systems, the judgement-stroke is construed as a sign sui generis, not as a genuine predicate; its counterpart in natural language is the syntactic "form of assertoric sentences", not the truth-predicate; neither in Frege's first nor in his second system sentences are treated as singular terms. (shrink)

BackgroundUpper limb impairment is common after stroke, and many will not regain full upper limb function. Different technologies based on surface electromyography (sEMG) have been used in stroke rehabilitation, but there is no collated evidence on the different sEMG-driven interventions and their effect on upper limb function in people with stroke.AimSynthesize existing evidence and perform a meta-analysis on the effect of different types of sEMG-driven interventions on upper limb function in people with stroke.MethodsPubMed, SCOPUS, and PEDro (...) databases were systematically searched for eligible randomized clinical trials that utilize sEMG-driven interventions to improve upper limb function assessed by Fugl-Meyer Assessment (FMA-UE) in stroke. The PEDro scale was used to evaluate the methodological quality and the risk of bias of the included studies. In addition, a meta-analysis utilizing a random effect model was performed for studies comparing sEMG interventions to non-sEMG interventions and for studies comparing different sEMG interventions protocols.ResultsTwenty-four studies comprising 808 participants were included in this review. The methodological quality was good to fair. The meta-analysis showed no differences in the total effect, assessed by total FMA-UE score, comparing sEMG interventions to non-sEMG interventions (14 studies, 509 participants, SMD 0.14, P 0.37, 95% CI –0.18 to 0.46, I255%). Similarly, no difference in the overall effect was found for the meta-analysis comparing different types of sEMG interventions (7 studies, 213 participants, SMD 0.42, P 0.23, 95% CI –0.34 to 1.18, I273%). Twenty out of the twenty-four studies, including participants with varying impairment levels at all stages of stroke recovery, reported statistically significant improvements in upper limb function at post-sEMG intervention compared to baseline.ConclusionThis review and meta-analysis could not discern the effect of sEMG in comparison to a non-sEMG intervention or the most effective type of sEMG intervention for improving upper limb function in stroke populations. Current evidence suggests that sEMG is a promising tool to further improve functional recovery, but randomized clinical trials with larger sample sizes are needed to verify whether the effect on upper extremity function of a specific sEMG intervention is superior compared to other non-sEMG or other type of sEMG interventions. (shrink)

The dominant view of women has changed radically during the last century. These changes have had an important impact on the way of life of women in general and, undoubtedly, on women as patients. So far, gender differences have received little attention when developing healthcare services. Stroke hits a great number of elderly women. Wyller et al. found that women seemed to be harder hit by stroke than men; they achieved lower scores in tests of motor, cognitive and (...) ADL functions, both in the acute phase and 1 year after stroke. It is reasonable to expect that differences in outcome among male and female sufferers may in part be explained by the fact that rehabilitation services are designed primarily to meet the needs of men. de Beauvoir's feminist theory maintains that one's body is fundamental in creating the person, which is a lifelong process. Traditionally, the female body has been exposed to alienation and oppression through life. This has led women to develop a life in immanence. This we feel can be of significance in connection with rehabilitation after a stroke, particularly for elderly women. In this article we will discuss how de Beauvoir's theory can throw new light on the experiences and rehabilitation of elderly women and point to ways of improving the process of rehabilitation. (shrink)

The dominant view of women has changed radically during the last century. These changes have had an important impact on the way of life of women in general and, undoubtedly, on women as patients. So far, gender differences have received little attention when developing healthcare services. Stroke hits a great number of elderly women. Wyller et al. found that women seemed to be harder hit by stroke than men; they achieved lower scores in tests of motor, cognitive and (...) ADL functions, both in the acute phase and 1 year after stroke. It is reasonable to expect that differences in outcome among male and female sufferers may in part be explained by the fact that rehabilitation services are designed primarily to meet the needs of men. de Beauvoir's feminist theory maintains that one's body is fundamental in creating the person, which is a lifelong process. Traditionally, the female body has been exposed to alienation and oppression through life. This has led women to develop a life in immanence. This we feel can be of significance in connection with rehabilitation after a stroke, particularly for elderly women. In this article we will discuss how de Beauvoir's theory can throw new light on the experiences and rehabilitation of elderly women and point to ways of improving the process of rehabilitation. (shrink)

This paper brings to light a new puzzle for Frege interpretation, and offers a solution to that puzzle. The puzzle concerns Frege’s judgement-stroke (‘|’), and consists in a tension between three of Frege’s claims. First, Frege vehemently maintains that psychological considerations should have no place in logic. Second, Frege regards the judgementstroke—and the associated dissociation of assertoric force from content, of the act of judgement from the subject matter about which judgement is made—as a crucial part of his logic. (...) Third, Frege holds that judging is an inner mental process, and that the distinction marked by the judgement-stroke, between entertaining a thought and judging that it is true, is a psychological distinction. I argue that what initially looks like confusion here on Frege’s part appears quite reasonable when we remind ourselves of the differences between Frege’s conception of logic and our own. (shrink)

This study investigated the effect of stroking vs. simple human presence on later reactions of dairy cows to routine veterinary handling. While in two groups of cows the experimenter stroked the ventral part of the neck or the withers for three consecutive weeks, the third group was exposed to close visual presence. After the treatment period the cows were subjected to rectal palpation. The three groups differed significantly in stepping during rectal palpation, which occurred less often in Neck- and Withers-animals (...) than in control animals. Heart rate increase was significantly higher in the control group than in the two stroking groups. Previous stroking led to fewer stress reactions during the rectal palpation, possibly due to a combined effect of improved relationship towards and thus perception of humans and lasting anti-stress effects of tactile stimulation. (shrink)

Background Stroke is a worldwide problem with a limited number of approved treatments. Obtaining informed consent for acute stroke therapy is complicated by the breadth of information that must be communicated in a short period of time, the hectic nature of the emergency environment, the possible lack of understanding by the patient and/or family, and the critically time-sensitive nature of treatment for stroke. Complicating matters even further, patients are often unable to consent for themselves, placing the burden (...) on surrogates to infer patients’ wishes regarding treatment, and potentially limiting acute treatment by practitioners. Innovation An advance directive for acute stroke therapy was created, entitled COAST (Coordinating Options for Acute Stroke Therapy). This clinical initiative is being piloted at a large comprehensive stroke center, including the development of the advance directive form, integration of the form with electronic medical records, training healthcare providers, and outreach to patients. Conclusions COAST is an advance directive for stroke designed to make stroke care more efficient, optimize patients’ autonomy, improve the quality of healthcare, and streamline the ethical management of complex care decisions in acute stroke. The inherent benefit of COAST is in providing patients and their families with more information regarding stroke and its treatment options, allowing them to take a more active role in their care. (shrink)

This study investigated the effect of stroking vs. simple human presence on later reactions of dairy cows to routine veterinary handling. While in two groups of cows the experimenter stroked the ventral part of the neck or the withers for three consecutive weeks, the third group was exposed to close visual presence. After the treatment period the cows were subjected to rectal palpation. The three groups differed significantly in stepping during rectal palpation, which occurred less often in Neck- and Withers-animals (...) than in control animals. Heart rate increase was significantly higher in the control group than in the two stroking groups. Previous stroking led to fewer stress reactions during the rectal palpation, possibly due to a combined effect of improved relationship towards and thus perception of humans and lasting anti-stress effects of tactile stimulation. Keywords: cattle; tactile stimulation; human–animal relationship; animal welfare. (shrink)

How is the painter’s body related to the process of making a beautiful brush stroke? Those interested in this question will benefit from Jianping Gao’s findings, in The Expressive Act in Chinese Painting, a book that presents the aesthetic ideas of Chinese literati painters and art critics. Gao’s assigns five features to the actual practice of painting that results in the making of brush strokes that literati audiences would call “naturally beautiful.” These five are the interaction of idea and (...) body, the concentration on paper, the suspension of the perception of natural objects, the emergence of a “pure self”, and the intersection of self with nature. I begin with the practice of concentration on paper and find that the literati painter observes the whole of the visible paper. After that, I introduce Maurice Merleau-Ponty’s late writings on the flesh of the body that belongs to the working painter. By developing the idea of an innate, interior whole of visibility, which persists through fleeting perceptions and Gestalts, Merleau-Ponty offers us a way to describe the individual painter’s innate corporeality, the transformation of thepainter, and intimate contact with nature. With Merleau-Ponty’s term “flesh of the body,” I return to interpret the five features of the literati process of making naturally beautiful strokes. I conclude that the literati writings help to reshape present-day aesthetics, and I note the philosophical language for a non-physical corporeality helps us appreciate the ideas of Chinese literati painters. (shrink)

Background: Spasticity following a stroke occurs in about 30% of patients. The mechanisms underlying this disorder, however, are not well understood. Method: This review aims to define spasticity, describe hypotheses explaining its development after a stroke, give an overview of related neuroimaging studies as well as a description of the most common scales used to quantify the degree of spasticity and finally explore which treatments are currently being used to treat this disorder.

The history of holography, the technology of three-dimensional imaging that grew rapidly during the 1960s, has been written primarily by its historical actors and, like many new inventions, its concepts and activities became surrounded by myths and myth-making. The first historical account was disseminated by the central character of this paper, George W. Stroke, while a professor of Electrical Engineering at the University of Michigan. His claims embroiled several workers active in the field of holography and information processing during (...) the 1960s, but transcended personality conflicts: they influenced the early historiography of holography and the awarding of the Nobel Prize for Physics to Dennis Gabor in 1971. An extended discussion of these episodes, based on archival research, publications analysis and interviews with participants, reveals the importance and extraordinary allure of intellectual priority for practicing scientists, and how its history and explanations are woven from multiple accounts and contemporary interpretations. (shrink)

In order to explicate Gentzen’s famous remark that the introduction-rules for logical constants give their meaning, the elimination-rules being simply consequences of the meaning so given, we develop natural deduction rules for Sheffer’s stroke, alternative denial. The first system turns out to lack Double Negation. Strengthening the introduction-rules by allowing the introduction of Sheffer’s stroke into a disjunctive context produces a complete system of classical logic, one which preserves the harmony between the rules which Gentzen wanted: all indirect (...) proof reduces to direct proof. (shrink)