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)

Only a few studies explore the lifeworld of the spouses of persons affected by early-onset Alzheimer disease. The aim of this study is to explore the lifeworld of spouses when their partners are diagnosed with AD, focusing on spouses’ lived experience. The study employs an interpretative phenomenological framework. Ten in-depth interviews are performed. The results show that spouses’ lifeworld changes with the diagnosis. They experience an imprisoned existence in which added obligations, fear, and worry keep them trapped at home, both (...) physically and mentally. In their longing for freedom, new strategies and attitudes helps the spouses to create an extended “lived space” with their partner. The findings stress the importance of paying attention to the lifeworld of spouses and making clinical recommendations on this basis. Most importantly, the lifeworld perspective has implications for how we understand what care is. We hope to challenge all different healthcare professionals and invite them to discuss the deep meaning of care and the definition of being professional in encounters with vulnerable others from a lifeworld perspective. (shrink)

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)

Traditional rehabilitation strategies become difficult in the chronic phase stage of stroke prognosis. Brain–computer interface combined with external devices may improve motor function in chronic stroke patients, but it lacks comprehensive assessments of neurological changes regarding functional rehabilitation. This study aimed to comprehensively and quantitatively investigate the changes in brain activity induced by BCI–FES training in patients with chronic stroke. We analyzed the EEG of two groups of patients with chronic stroke, one group received functional electrical stimulation rehabilitation training and (...) the other group received BCI combined with FES training. We constructed functional networks in both groups of patients based on direct directed transfer function and assessed the changes in brain activity using graph theory analysis. The results of this study can be summarized as follows: after rehabilitation training, the Fugl–Meyer assessment scale score was significantly improved in the BCI–FES group, and there was no significant difference in the FES group. Both the global and local graph theory measures of the brain network of patients with chronic stroke in the BCI–FES group were improved after rehabilitation training. The node strength in the contralesional hemisphere and central region of patients in the BCI–FES group was significantly higher than that in the FES group after the intervention, and a significant increase in the node strength of C4 in the contralesional sensorimotor cortex region could be observed in the BCI–FES group. These results suggest that BCI–FES rehabilitation training can induce clinically significant improvements in motor function of patients with chronic stroke. It can improve the functional integration and functional separation of brain networks and boost compensatory activity in the contralesional hemisphere to a certain extent. The findings of our study may provide new insights into understanding the plastic changes of brain activity in patients with chronic stroke induced by BCI–FES rehabilitation training. (shrink)

Objects: To evaluate the feasibility and effectiveness of in-bed wearable elbow robot training for motor recovery in patients with early and late subacute stroke.Methods: Eleven in-patient stroke survivors received 15 sessions of training over about 4 weeks of hospital stay. During each hourly training, participants received passive stretching and active movement training with motivating games using a wearable elbow rehabilitation robot. Isometric maximum muscle strength of elbow flexors and extensors was evaluated using the robot at the beginning and end of (...) each training session. Clinical measures including Fugl-Meyer Assessment of upper extremity, Motricity Index for upper extremities, Modified Ashworth Scale were measured at baseline, after the 4-week training program, and at a 1-month follow-up. The muscle strength recovery curve over the training period was characterized as a logarithmic learning curve with three parameters.Results: At the baseline, participants had moderate to severe upper limb motor impairment {FMA-UE [median ]: 28 } and mild spasticity in elbow flexors {MAS [median ]: 0 }. After about 4 weeks of training, significant improvements were observed in FMA-UE and MI, and the improvements were sustained at the follow-up. The elbow flexors MVC significantly increased by 1.93 Nm and the elbow extensor MVC increased by 0.68 Nm. Muscle strength recovery curve showed that patients with severe upper limb motor impairment had a greater improvement rate in elbow flexor strength than those with moderate motor impairment.Conclusion: In-bed wearable elbow robotic rehabilitation is feasible and effective in improving biomechanical and clinical outcomes for early and late subacute stroke in-patients. Results from the pilot study suggested that patients with severe upper limb motor impairment may benefit more from the robot training compared to those with moderate impairment. (shrink)

BackgroundPost-stroke depression is one of the most common neuropsychiatric diseases in patients with stroke, and it can increase the disability rate, mortality, and recurrence rate of stroke. Currently, many clinical studies have indicated that traditional Chinese medicine, such as acupuncture and herbs, Western medicine, rehabilitation, repeated transcranial magnetic stimulation, and other treatment methods, are effective in treating PSD. However, no study has formulated a comprehensive treatment plan that integrates TCM, Western medicine, and rehabilitation for PSD. Thus, this trial aims to (...) assess the efficacy and safety of integrative medicine for treating PSD.MethodsThis multicenter, prospective, randomized, controlled study aims to form a set of effective clinical treatment schemes that integrate TCM, Western medicine, and rehabilitation for PSD. A total of 202 participants recruited from four centers will be randomized into either the integrative medicine or standard care group. Standard care—basic treatment, general nursing care, and exercise therapy—will be provided to all participants. The integrative medicine group will also receive acupuncture, Chinese herbs, and repeated transcranial magnetic stimulation. Participants will receive acupuncture and rTMS treatments five times per week for 4 weeks and will be administered Chinese herbs, basic treatment, general nursing care, and exercise therapy for 4 weeks. The primary outcomes include the Hamilton Depression Scale, Self-Rating Depression Scale, and Activity of Daily Living Scale. And the secondary outcomes include the Montreal Cognitive Assessment Scale, the Fugl-Meyer Assessment Scale, and the Pittsburgh Sleep Quality Index. All outcome measures will be evaluated at baseline, week 4, and week 8. Safety assessments will be performed throughout the study.DiscussionThis study is expected to verify the efficacy and safety of integrative medicine for treating PSD, providing an evidence-based clinical reference for the future development of a standardized scheme.Clinical trial registrationClinicalTrials.gov, identifier: NCT05187975. (shrink)

Entropy-based algorithms have been suggested as robust estimators of electroencephalography (EEG) predictability or regularity. This study aimed to examine possible disturbances in EEG complexity as a means to elucidate the pathophysiological mechanisms in chronic stroke, before and after a brain computer interface (BCI)-motor observation intervention. Eleven chronic stroke subjects and nine unimpaired subjects were recruited to examine the differences in their EEG complexity. The BCI-motor observation intervention was designed to promote functional recovery of the hand in stroke subjects. Fuzzy approximate (...) entropy (fApEn), a novel entropy-based algorithm designed to evaluate complexity in physiological systems, was applied to assess the EEG signals acquired from unimpaired subjects and stroke subjects, both before and after training. The results showed that stroke subjects had significantly lower EEG fApEn than unimpaired subjects (p < 0.05) in the motor cortex area of the brain (C3, C4, FC3, FC4, CP3, CP4) in both hemispheres before training. After training, motor function of the paretic upper limb, assessed by the Fugl-Meyer Assessment-Upper Limb (FMA-UL), Action Research Arm Test (ARAT), and Wolf Motor Function Test (WMFT) improved significantly (p < 0.05). Furthermore, the EEG fApEn in stroke subjects increased considerably in the central area of the contralesional hemisphere after training (p < 0.05). A significant correlation was noted between clinical scales (FMA-UL, ARAT, and WMFT) and EEG fApEn in C3/C4 in the contralesional hemisphere (p < 0.05). This finding suggests that the increase in EEG fApEn could be an estimator of the variance in upper limb motor function improvement. In summary, fApEn can be used to identify abnormal EEG complexity in chronic stroke, when used with BCI-motor observation training. Moreover, these findings based on the fApEn of EEG signals also expand the existing interpretation of training-induced functional improvement in stroke subjects. Entropy-based analysis might serve as a novel approach to understanding the abnormal cortical dynamics of stroke and the neurological changes induced by rehabilitation training. (shrink)

Hand function improvement in stroke survivors in the chronic stage usually plateaus by 6 months. Brain-computer interface (BCI)-guided robot-assisted training has been shown to be effective for facilitating upper-limb motor function recovery in chronic stroke. However, the underlying neuroplasticity change is not well understood. This study aimed to investigate the whole-brain neuroplasticity changes after 20-session BCI-guided robot hand training, and whether the changes could be maintained at the 6-month follow-up. Therefore, the clinical improvement and the neurological changes before, immediately after, (...) and 6 months after training were explored in 14 chronic stroke subjects. The upper-limb motor function was assessed by Action Research Arm Test (ARAT) and Fugl-Meyer Assessment for Upper-Limb (FMA), and the neurological changes were assessed using resting-state functional magnetic resonance imaging. Repeated-measure ANOVAs indicated that long-term motor improvement was found by both FMA (F[2,26]= 6.367,p= 0.006) and ARAT (F[2,26]= 7.230,p= 0.003). Seed-based functional connectivity analysis exhibited that significantly modulated FC was observed between ipsilesional motor regions (primary motor cortex and supplementary motor area) and contralesional areas (supplementary motor area, premotor cortex, and superior parietal lobule), and the effects were sustained after 6 months. The fALFF analysis showed that local neuronal activities significantly increased in central, frontal and parietal regions, and the effects were also sustained after 6 months. Consistent results in FC and fALFF analyses demonstrated the increase of neural activities in sensorimotor and fronto-parietal regions, which were highly involved in the BCI-guided training.Clinical Trial Registration:This study has been registered atClinicalTrials.govwith clinical trial registration number NCT02323061. (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)

PurposeTo explore the changes of cerebral blood flow and fractional anisotropy in stroke patients with motor dysfunction after repetitive transcranial magnetic stimulation treatment, and to better understand the role of rTMS on motor rehabilitation of subcortical stroke patients from the perfusion and structural level.Materials and MethodsIn total, 23 first-episode acute ischemic stroke patients and sixteen healthy controls were included. The patients were divided into the rTMS and sham group. The rehabilitation assessments and examination of perfusion and structural MRI were performed (...) before and after rTMS therapy for each patient. Voxel-based analysis was used to detect the difference in CBF and FA among all three groups. The Pearson correlation analysis was conducted to evaluate the relationship between the CBF/FA value and the motor scales.ResultsAfter rTMS, significantly increased CBF was found in the ipsilesional supplementary motor area, postcentral gyrus, precentral gyrus, pons, medulla oblongata, contralesional midbrain, superior cerebellar peduncle, and middle cerebellar peduncle compared to that during the prestimulation and in the sham group, these fasciculi comprise the cortex-pontine-cerebellum-cortex loop. Besides, altered CBF in the ipsilesional precentral gyrus, postcentral gyrus, and pons was positively associated with the improved Fugl-Meyer assessment scores. Significantly decreased FA was found in the contralesional precentral gyrus, increased FA was found in the ipsilesional postcentral gyrus, precentral gyrus, contralesional supplementary motor area, and bilateral cerebellum, these fasciculi comprise the corticospinal tract. The change of FMA score was positively correlated with altered FA value in the ipsilesional postcentral gyrus and negatively correlated with altered FA value in the contralesional precentral gyrus.ConclusionOur results suggested that rTMS could facilitate the motor recovery of stroke patients. High frequency could promote the improvement of functional activity of ipsilesional CPC loop and the recovery of the microstructure of CST. (shrink)

Falls are a leading cause of serious injury and restricted participation among persons with stroke (PwS). Reactive balance control is essential for fall prevention, however, only a few studies have explored the effects of lesion characteristics (location and extent) on balance control in PwS. We aimed to assess the impact of lesion characteristics on reactive and anticipatory balance capacity, gait, and hemiparetic lower limb function, in PwS. Forty-six subacute PwS were exposed to forward, backward, right and left unannounced horizontal surface (...) translations in 6 increasing intensities, while standing. Fall threshold (i.e., perturbation intensity that results in a fall into the harness system) was measured. In addition, the Berg Balance Scale (BBS), 6 Minute Walk Test (6MWT) and Lower Extremity Fugl-Meyer (LEFM) were measured. Lesion effects were analyzed separately for left- and right-hemisphere damaged (LHD, RHD) patients, using voxel-based lesion-symptom mapping (VLSM). Our results show that voxel clusters where damage exerted a significant impact on balance, gait and lower-limb function were found in the corticospinal tract, in its passage in the corona radiata and in the posterior limb of the internal capsule. Additional significant impact was found to lesions affecting the putamen and the external capsule. Balance, gait, and hemiparetic lower limb function showed much overlap of the corresponding ‘significant’ voxel clusters. Test scores of RHD and LHD patients were affected largely by damage to homologous regions, with the LHD group showing a wider distribution of ‘significant’ voxels. The study corroborates and extends previous findings by demonstrating that balance control, gait, and lower limb function are all affected mainly by damage to essentially the same brain structures, namely - the corticospinal tract and adjacent structures in the capsular-putaminal region. (shrink)

The quality of arm movements typically improves in the sub-acute phase of stroke affecting the upper extremity. Here, we used whole arm kinematic analysis during reaching movements to distinguish whether these improvements are due to true recovery or to compensation. Fifty-three participants with post-acute stroke performed ∼80 reaching movement tests during 4 weeks of training with the ArmeoSpring exoskeleton. All participants showed improvements in end-effector performance, as measured by movement smoothness. Four ArmeoSpring angles, shoulder horizontal rotation, shoulder elevation, elbow rotation, (...) and forearm rotation, were recorded and analyzed. We first characterized healthy joint coordination patterns by performing a sparse principal component analysis on these four joint velocities recorded during reaching tests performed by young control participants. We found that two dominant joint correlations [SH with elbow rotation and SE with forearm rotation] explained over 95% of variance of joint velocity data. We identified two clusters of stroke participants by comparing the evolution of these two correlations in all tests. In the “Recoverer” cluster, both joint correlations converged toward the respective correlations for control participants. Thus, Recoverers relearned how to generate smooth end-effector movements while developing joint movement patterns similar to those of control participants. In the “Compensator” cluster, at least one of the two joint correlations diverged from the corresponding correlation of control participants. Compensators relearned how to generate smooth end-effector movements by discovering various new compensatory movement patterns dissimilar to those of control participants. New compensatory patterns included atypical decoupling of the SE and forearm joints, and atypical coupling of the SH rotation and elbow joints. There was no difference in clinical impairment level between the two groups either at the onset or at the end of training as assessed with the Upper Extremity Fugl-Meyer scale. However, at the start of training, the Recoverers showed significantly faster improvements in end-effector movement smoothness than the Compensators. Our analysis can be used to inform neurorehabilitation clinicians on how to provide movement feedback during practice and suggest avenues for refining exoskeleton robot therapy to reduce compensatory patterns. (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)

To maximize brain plasticity after stroke, several rehabilitation strategies have been explored, including the use of intensive motor training, motor imagery, and action observation. Growing evidence of the positive impact of virtual reality (VR) techniques on recovery following stroke has been shown. However, most VR tools are designed to exploit active movement, and hence patients with low level of motor control cannot fully benefit from them. Consequently, the idea of directly training the central nervous system has been promoted by utilizing (...) motor-imagery (MI) based brain-computer interfaces (BCIs). To date, detailed information on which VR strategies lead to successful functional recovery is still largely missing, and very little is known about how to optimally integrate BCI and VR paradigms for stroke rehabilitation. The purpose of this study was to examine the efficacy of a BCI-VR system using a MI paradigm for post-stroke upper limb rehabilitation on functional assessments, and related changes in MI ability and brain imaging. To achieve this, a 60 years old male chronic stroke patient was recruited. The patient underwent a 3-week intervention in a clinical environment, resulting in 10 BCI-VR training sessions. The patient was assessed before and after intervention, as well as on a one-month follow-up, in terms of clinical scales and brain imaging using functional MRI (fMRI). Consistent with prior research, we found important improvements in upper extremity scores (Fugl-Meyer) and identified increases in brain activation measured by fMRI that suggest neuroplastic changes in brain motor networks. This study expands on the current body of evidence as more data are needed on the effect of this type of interventions not only on functional improvement but also through brain imaging to study the effect of the intervention on plasticity. (shrink)

Alliances and other forms of cooperation between firms often promise great benefits, for example, by the exchange of knowledge or co-specialization of resources. At the same time, the necessary actions to realize these benefits can augment vulnerability to opportunistic behaviour of partners. In addition to formal contracts to mitigate the resulting behavioural uncertainties, often, mechanisms, such as reputation or ethical values, are suggested as important supplements. However, when it comes to assessment of a specific cooperation opportunity, it is difficult (...) to account systematically for the economic consequences of these 'softer factors'. Therefore, this paper aims to surpass mere financial analysis of chance and risk and to integrate systematically both reputation and ethical values into an economic assessment of cooperative relationships. For this purpose, we develop a theoretical framework that is based on a simple-decision model to account for reputation and ethical values of potential partners as drivers of behavioural uncertainty reduction. We also discuss how this framework can be used to assess cooperative relationships and illustrate these ideas with reference to the inter-organizational accounting practices of a large drugstore chain and its suppliers. (shrink)

Alliances and other forms of cooperation between firms often promise great benefits, for example, by the exchange of knowledge or co‐specialization of resources. At the same time, the necessary actions to realize these benefits can augment vulnerability to opportunistic behaviour of partners. In addition to formal contracts to mitigate the resulting behavioural uncertainties, often, mechanisms, such as reputation or ethical values, are suggested as important supplements. However, when it comes to assessment of a specific cooperation opportunity, it is difficult (...) to account systematically for the economic consequences of these ‘softer factors’. Therefore, this paper aims to surpass mere financial analysis of chance and risk and to integrate systematically both reputation and ethical values into an economic assessment of cooperative relationships. For this purpose, we develop a theoretical framework that is based on a simple‐decision model to account for reputation and ethical values of potential partners as drivers of behavioural uncertainty reduction. We also discuss how this framework can be used to assess cooperative relationships and illustrate these ideas with reference to the inter‐organizational accounting practices of a large drugstore chain and its suppliers. (shrink)

This is the first comprehensive guide and only substantial undergraduate level introduction to ancient Greek and Roman ethics. It covers the ethical theories and positions of all the major philosophers and schools from the earliest times to the Hellenistic philosophers, analyzing their main arguments and assessing their legacy. This book maps the foundations of this key area, which is crucial knowledge across the disciplines and essential for a wide range of readers.

The assessment of text quality is a transdisciplinary issue concerning the research areas of educational assessment, language technology, and classroom instruction. Text length has been found to strongly influence human judgment of text quality. The question of whether text length is a construct-relevant aspect of writing competence or a source of judgment bias has been discussed controversially. This paper used both a correlational and an experimental approach to investigate this question. Secondary analyses were performed on a large-scale dataset (...) with highly trained raters, showing an effect of text length beyond language proficiency. Furthermore, an experimental study found that pre-service teachers tended to undervalue text length when compared to professional ratings. The findings are discussed with respect to the role of training and context in writing assessment. (shrink)

Name der Zeitschrift: Jahrbuch für Wissenschaft und Ethik Jahrgang: 21 Heft: 1 Seiten: 197-220. -/- There seem to be good reasons that democratic institutions must be reformed in order to minimize the danger of unsustainable policy decisions infringing upon duties of intergenerational justice. This is why there exist a number of different proposals of how to reform democratic states in order to foster their duties towards the future. However, the debate lacks a systematic assessment of these suggested reforms within (...) a coherent theoretical and norma-tive framework. This paper aims at developing such a framework. We suggest two conceptual dimensions defining the spectrum of different justi-fiable institutional reforms: the relation between democracy and justice as one dimension and the conditions considered relevant for viewing democracies as responsible collective agents as the other. Depending on how we understand this relation and these conditions, it is possible to substantiate a set of types of institutional reforms that will promote democracies? capacities to comply with their responsibilities towards the future. (shrink)

In 1996, the anthropologist Eduardo Viveiros de Castro chose a sentence by Gilles Deleuze as the epigraph for an article, published in the Brazilian journal Mana, on Amerindian perspectivism. (A modified version of the article appeared in English two years later, in the Journal of the Royal Anthropological Institute.) Since then, Deleuze's name has appeared often in works about perspectivism, but Chamois's new book is the first monograph to focus on perspectivism and Deleuze. Among the most important contributions of Chamois's (...) analysis is to draw our attention to a little-known passage in a course, “Truth and Time,” that Deleuze taught in 1983 (and that is available for listening online). In it, he criticizes the example of the cube used as a paradigm, at least since Edmund Husserl's day, to conceptualize what a perspective is. It is impossible to see all six faces of a cube at the same time; thus, to “intuit” the cube as a cube, we must add to our own perception of a profile of the cube more possible points of view on it. The problem with this example and description is that it takes for granted that the subject already knows what she needs to see (a cube).Inspired, however, by the process philosophy of Alfred North Whitehead, Deleuze holds that each perception is an invitation to other perceptions: “To perceive is to become capable of perceiving more and more things that were initially not perceived” (percevoir, c'est devenir apte à percevoir de plus en plus de choses qui d'abord n’étaient pas perçues). Deleuze contrasts the “spatial” or “frozen” notion of perspective to the “temporal perspective” that he seeks to emphasize: “It's time that acts as perspective” (C'est le temps qui agit comme perspective). The question, therefore, at the heart of Deleuze's perspectivism is how a perspective changes over time. Chamois goes through the early texts of Deleuze to show how the idea of the temporal perspective emerged from the concept of the structure Autrui. The “structure-Other” is best exemplified by someone else's emotive face—the frightened face of my friend, for instance. If I perceive that face while, say, I am laughing, another possible world would slip into my own: a frightening world penetrates my humorous one, and perhaps I should turn my head to see what danger may be en route. As in the case of the cube, my own limited perception is supplemented by others’ limited perceptions. The object of perception in this case, however, is not presupposed to be stable (the world is changing), and what I am about to see is not known in advance.But what, precisely, in the face of the other must I notice to become aware of the world she perceives? Deleuze does not explore that question in any detail, but Chamois reviews recent anthropological and psychological research that supplies some elements of a response. To confront the writings of Deleuze with relevant scientific data is fruitful. I must admit, though, that I was a bit embarrassed by the framing of the discussion: Chamois presents Deleuze's concepts as hypotheses demanding verification that they are “corroborated by the facts.” For Deleuze, concepts are inseparable from percepts and affects; as opposed to a hypothesis, a concept is true not because it correlates to a set of relevant facts but because it helps us to perceive other aspects of the world (percept) and induces us to act better (affect). Thus, the minute and rewarding analysis of Chamois should be complemented with an assessment of what we learn to focus on and of how we change our actions thanks to the perspectivism of Deleuze—in contrast to other forms of perspectivism (or indeed to other cosmologies). (shrink)

Climate change increases the frequency and intensity of certain kinds of natural hazard events in alpine areas. This interdisciplinary study addresses the hypothetical possibility of relocating the residents of three alpine areas in Austria: the Sölk valleys, the Johnsbach valley, and the St. Lorenzen/Schwarzenbach valleys. Our particular focus is on these residents’ expectations about such relocations. We find that (1) many residents expect that in the next decades the state will provide them with a level of natural hazards protection, aid, (...) and relief that allows them to continue to live in these valleys; (2) this expectation receives some legal protection but only when it is associated with fundamental rights; and (3) the expectation is morally significant, i.e., it ought to be considered in assessing the moral rightness or justness of relocation policies. These results suggest legal changes and likely extend to many other (Austrian) alpine areas as well. (shrink)

Precision medicine and molecular systems medicine (MSM) are highly utilized and successful approaches to improve understanding, diagnosis, and treatment of many diseases from bench-to-bedside. Especially in the COVID-19 pandemic, molecular techniques and biotechnological innovation have proven to be of utmost importance for rapid developments in disease diagnostics and treatment, including DNA and RNA sequencing technology, treatment with drugs and natural products and vaccine development. The COVID-19 crisis, however, has also demonstrated the need for systemic thinking and transdisciplinarity and the limits (...) of MSM: the neglect of the bio-psycho-social systemic nature of humans and their context as the object of individual therapeutic and population-oriented interventions. COVID-19 illustrates how a medical problem requires a transdisciplinary approach in epidemiology, pathology, internal medicine, public health, environmental medicine, and socio-economic modeling. Regarding the need for conceptual integration of these different kinds of knowledge we suggest the application of general system theory (GST). This approach endorses an organism-centered view on health and disease, which according to Ludwig von Bertalanffy who was the founder of GST, we call Organismal Systems Medicine (OSM). We argue that systems science offers wider applications in the field of pathology and can contribute to an integrative systems medicine by (i) integration of evidence across functional and structural differentially scaled subsystems, (ii) conceptualization of complex multilevel systems, and (iii) suggesting mechanisms and non-linear relationships underlying the observed phenomena. We underline these points with a proposal on multi-level systems pathology including neurophysiology, endocrinology, immune system, genetics, and general metabolism. An integration of these areas is necessary to understand excess mortality rates and polypharmacological treatments. In the pandemic era this multi-level systems pathology is most important to assess potential vaccines, their effectiveness, short-, and long-time adverse effects. We further argue that these conceptual frameworks are not only valid in the COVID-19 era but also important to be integrated in a medicinal curriculum. (shrink)

This article aims to present four case studies of the different responses to governmental measures to fight the COVID-19 pandemic by supreme and constitutional courts, especially in cases of jurisdictions that have been facing democratic erosion. The spread of the COVID-19 pandemic demanded immediate public policies and other political decisions from the branches of government. Executive authorities were the main actors in effecting constitutional public health norms. The expectation was that they will abide by the rule of law in fulfilling (...) their duties; that has not been the case under governments that promoted democratic erosion. The different contexts of the threats posed to the constitutional democracies led populist and illiberal leaders to opportunistically either try to—and then be contained by courts—or effectively consolidate the expansion of powers under the conditions of the pandemic. Concentrating on four jurisdictions (the USA, Hungary, El Salvador, and Brazil), the article demonstrates that courts can effectively work as bulwarks against waves of democratic erosion, especially in situations of stress, as it was the case in the global COVID-19 pandemic. This hypothesis is also proven by episodes in which courts did not sufficiently operate to curb illiberalism because they were already captured. The analyses enable classifying the court’s responses to the COVID-19 executive measures in a threefold pattern: deferential, restrictive, and of forced capitulation. (shrink)

Recent Anglophone scholarship has successfully shown that Nietzsche's thought makes important contributions to a wide range of contemporary philosophical debates. In so doing, however, scholarship has lost sight of another important feature of Nietzsche's project, namely his desire to challenge the very conception of philosophy that has been used to assess his merits as a philosopher. In other words, contemporary scholarship has overlooked Nietzsche's contributions to metaphilosophy, i.e. debates around the nature, methods, and aims of philosophy. This important new collection (...) of essays brings together an international group of distinguished scholars to explore and discuss these contributions and debates. It will appeal to anyone interested in metaphilosophy, Nietzsche studies, German studies, or intellectual history. (shrink)

The main contention of this paper is that the underlying aim behind efforts to integrate ethics into the business school curriculum is in order to motivate and enable future business leaders to manage ethically and respond effectively to the challenges of sustainable development. Conceptualising ethics education in terms of eliciting behavioural change enables access into the insights provided by social psychological research into factors affecting behaviour, such as self-efficacy, subjective norms, knowledge, awareness, attitudes and role models. MSc students studying entrepreneurship (...) applied their entrepreneurial skills to help social enterprises achieve their objectives as part of their assessed coursework. With reference to a content analysis of their reflections, it is argued that such placements address these key factors identified as predicting behavioural change in a way that more traditional pedagogies cannot. (shrink)

Fifteen leading philosophers explore a set of themes from the pioneering work of Gail Fine and Terence Irwin, in ancient philosophy but also in later periods and in systematic philosophy. The contributors discuss knowledge, rhetoric, freedom and practical reason, virtue and the good life, ethics and politics in Plato and Aristotle and beyond. The editors offer an introduction charting the scholarly contributions of Fine and Irwin and assessing their individual and joint impact, together with a complete bibliography of their writings.

In this article, we describe the social and economic changes that have contributed to contemporary problems of work—family conflict, gender inequality, and risks to children's healthy development. We draw on feminist welfare state scholarship to outline an institutional arrangement that would support an earner—carer society—a social arrangement in which women and men engage symmetrically in paid work and unpaid caregiving and where young children have ample time with their parents. We present a blueprint for work—family reconciliation policies in three areas—paid (...) family-leave provisions, working-time regulations, and early childhood education and care—and we identify key policy design principles. We describe and assess these work—family reconciliation policies as they operate in six European countries widely considered to be policy exemplars: Denmark, Finland, Norway, Sweden, Belgium, and France. We close with an analysis of potential objections to these policies. (shrink)

Insurance markets have always relied on large amounts of data to assess risks and price their products. New data-driven technologies, including wearable health trackers, smartphone sensors, predictive modelling and Big Data analytics, are challenging these established practices. In tracking insurance clients’ behaviour, these innovations promise the reduction of insurance costs and more accurate pricing through the personalisation of premiums and products. Building on insights from the sociology of markets and Science and Technology Studies, this article investigates the role of economic (...) experimentation in the making of data-driven personalisation markets in insurance. We document a case study of a car insurance experiment, launched by a Belgian direct insurance company in 2016 to set up an experiment of tracking driving style behavioural data of over 5000 participants over a one-year period. Based on interviews and document analysis, we outline how this in vivo experiment was set-up, which interventions and manipulations were imposed to make the experiment successful, and how the study was evaluated by the actors. Using JL Austin’s distinction between happy and unhappy statements, we argue how the experiment, despite its failure not to provide the desired evidence, could be considered a ‘happy’ event. We conclude by highlighting the role of economic experiments ‘in the wild’ for the making of future markets of data-driven personalisation. (shrink)

Abstract.Mandatory risk assessment is intended to reassure concerned citizens and introduce reason into the heated European controversies on genetically modified crops and food. The authors, examining a case of risk assessment of genetically modified oilseed rape, claim that the new European legislation on risk assessment does nothing of the sort and is not likely to present an escape from the international deadlock on the use of genetic modification in agriculture and food production. The new legislation is likely (...) to stimulate the kind of emotive reactions it was intended to prevent. In risk assessment exercises, scientific uncertainty is turned into risk, expressed in facts and figures. Paradoxically, this conveys an impression of certainty, while value-disagreement and conflicts of interest remain hidden below the surface of factuality. Public dialogue and negotiation along these lines are rendered impossible. The only option left to critics is to resort to claims of fear and to call for new risk assessments to be performed, on and on again. Science is allowing itself to be abused by accepting the burden of proof in matters more suited to reflection and negotiation. The specific challenge to science would be to take care of itself – rethinking the role and the limitations of science in a social context, and, thereby gaining the strength to fulfill this role and to enter into dialogue with the rest of society. Scientific communities appear to be obvious candidates for prompting reflection and dialogue on this issue. (shrink)

The Convention on Biological Diversity opens the possibility to negotiate a legally binding Biosafety Protocol to assess and minimize risks in the field of transboundary transfer, handling, and use of organisms modified by genetic engineering. Two principles— the Precautionary Principle and the Principle of Familiarity—guiding the risk assessment as basis of import decisions on such organisms are discussed. Developing and European industrialized countries favor the Precautionary Principle. The U.S., Australia, Japan, and some others call for the Principle of Familiarity. (...) These two principles exhibit opposite effects on scientific progress in general and on scientific methodology of risk assessment in particular. With the example of risk assessment by the U.S. company Monsanto discussed below, it could be illustrated that the Principle of Familiarity opens the way for superficial evaluations based on citing arbitrary references while the Precautionary Principle is an incentive for developing and applying sound methodology in experimental risk assessment. on the transboundary transfer of such LMOs, for example, on the international exchange of and trade with transgenic seeds, grains, animals, or bacteria. The negotiations are based on Articles 19.3 and 8(g) of the Convention on Biological Diversity, elaborated during the Earth Summit in Rio de Janeiro, Brazil, in 1992, and on Decision II/5 of the Second Conference of the Parties to this Convention in Jakarta, Indonesia, in 1995 (see the appendix; for more documents, see www.biodiv.org). Until the Fourth Conference of the Parties in 1998, 172 states ratified this convention. This conference decided to finish the Biosafety Protocol in February 1999. In 1998, transgenic crops were allowed to be planted in eight (75%) countries of the world. As the country with the largest acreage of transgenic crops and as the main trader of LMOs, the United States cannot become a member of the protocol until it has ratified the Convention on Biological Diversity. (shrink)

Definition of the problem: Recent progress in the pharmacological sciences provides a first glimpse of the development of an individual, genotype-based drug therapy in order to improve the efficiency of drug utilization. Genotyping of genetic polymorphisms in genes involved in drug response promises to optimize drug therapy fundamentally by identifying patients for whom a pharmaceutical agent may be effective and safe or contraindicated because of expected adverse drug reactions. Arguments: The new pharmacogenomic treatment strategies raise complex bioethical issues, because genetic (...) screening for drug therapy may identify asymptomatic patients who are at risk for a particular adverse outcome. Thus, pharmacogenomics will affect the relationship between the treating physician and the patient which is traditionally based on privacy, confidentiality, beneficience and non-maleficience. Conclusion: In the article presented some ethical aspects of these new pharmacogenomic approaches concerning the physician-patient relationship are discussed. (shrink)

Master Sun's _The Art of War_ is by no means the only ancient Chinese treatise on military affairs. One chapter in the _Huainanzi_, an important compendium of philosophy and political theory written in the second century B.C.E., synthesizes the entire corpus of military literature inherited from the Chinese classical era. Drawing on all major, existing military writings, as well as other lost sources, it assesses tactics and strategy, logistics, organization, and political economy, as well as cosmology and the fundamental morality (...) of warfare. This powerful work set out to become the last word on military matters, subsuming and replacing all preceding literature. Written under the sponsorship of Liu An, king of Huainan, the _Huainanzi_'s "military methods" emphasize the preservation of peace as the ultimate value to be served by the military, insisting that the army can be effectively and rightly used only when defending the sacred hereditary position of the emperor and his vassals. This position stands in stark contrast to that of _The Art of War_, which prioritizes the enrichment and empowerment of the state. Liu An's philosophy also argues that military success depends on the personal cultivation of the commander and that deception is not enough to secure victory. Only a commander with the exceptional qualities of insight and cognition, developed through a program of meditative practice and yogic refinement, can effectively control and interpret the strategic situation. Andrew Seth Meyer offers both a full translation of this text and an extensive analysis of its historical context. His thorough treatment relates Liu An's teachings to issues in Chinese philosophy, culture, religion, and history, helping to interpret their uncommon message. (shrink)

This article discusses indigenous rights within the context of global governance. I begin by defining the terms “global governance” and “indigenous peoples” and summarizing the rights that are most important to indigenous peoples. The bulk of this article studies the global governance of indigenous rights in three areas. The first example is the creation of the 2007 UN Declaration on the Rights of Indigenous Peoples. A second example involves violations of indigenous rights brought before the Inter-American Court of Human Rights. (...) A third case looks at a relatively new international regime created by indigenous peoples themselves—the Inuit Circumpolar Council. I conclude by using theories of sovereignty to assess the relative successes and failures of indigenous efforts to secure their rights. (shrink)

For all of the emphasis on quality improvement—as well as the acknowledged overlap between assessment of the quality of healthcare services and clinical ethics—the quality of clinical ethics consultation has received scant attention, especially in terms of empirical measurement. Recognizing this need, the second edition of Core Competencies for Health Care Ethics Consultation identified four domains of ethics quality: (1) ethicality, (2) stakeholders’ satisfaction, (3) resolution of the presenting conflict/dilemma, and (4) education that translates into knowledge. This study is (...) the first, to our knowledge, to directly measure all of these domains. Here we describe the quality improvement process undertaken at a tertiary care academic medical center, as well as the tools developed to measure the quality of ethics consultation, which include post-consultation satisfaction surveys and weekly case conferences. The information gained through these tools helps to improve not only the process of ethics consultation, but also the measurement and assurance of quality. (shrink)

Curriculum programmes are conventionally expected to produce outcomes or specific results demonstrated in the performance of learners. Usually the intended outcomes are expressed in the conceptual framework or design of the curriculum. Programme assessment is intended to collect data that will provide evidence for these effects on learners.

The education system is faced with many demands of justice. What these demands imply and how they are justified is, however, disputed. In this book, international contributors present cutting edge research to discuss the relationship between educational justice and the value of education. By combining reflections on educational justice with reflections on the human good and the aims of education, the book reveals that it is not enough to assess certain patterns of distribution; the value of what is to be (...) distributed must also be clarified. In this respect, deliberations about the value of education have to play an integral part in giving an account of educational justice. Questions addressed in the volume include: - In what sense should justice, fairness and equality be realised in the education system? - How is educational equality related to equality of opportunity? - Is the main concern that everyone should be educated equally well – or just well enough? Education, Justice and the Human Good discusses the positional value of education and its relation to educational justice, emphasising that education is valuable not only for competitive reasons, but in its contribution to human flourishing. The book will appeal to those from the field of the philosophy of education as well as applied political philosophy, from undergraduates to professional academics. (shrink)

In The Good Place, Chidi Anogonye has difficulty making decisions. In fact, that may be his defining characteristic, and it is the one that ultimately led to his demise on Earth. The belief in “fundamental truths” entails a belief in “objective values,” that is, values that exist outside of the frame of human thinking. Simone de Beauvoir calls such a belief “the spirit of seriousness”. Beauvoir also makes a distinction between absurdity—that which has no meaning—and ambiguity—that which has no fixed (...) meaning. Chidi follows one of Beauvoir's favorite principles of existentialism: “Do what one must, come what may”. In order to understand both Chidi's and Beauvoir's meaning of “must” we have to move away from an understanding of right and wrong as existing in the world, independent of human thought and assessment. (shrink)

Do states or individuals stand under duties of international justice to people who live elsewhere and to other states? How are we to assess the legitimacy of international institutions such as the International Monetary Fund and the United Nations Security Council? Should we support reforms of international institutions and how should we go about assessing alternative proposals of such reforms? The book brings together leading scholars of public international law, jurisprudence and international relations, political philosophers and political theorists to explore (...) the central notions of international legitimacy and global justice. The essays examine how these notions are related and how understanding the relationships will help us comparatively assess the validity of proposals for the reform of international institutions and public international law. (shrink)

This article explores how the guidelines for personality assessments in two Danish rehabilitation organizations influence the actual evaluation of clients. The analysis shows how staff members produce institutional identities corresponding to organizational categories, which very often have little or no relevance for the clients evaluated. The goal of the article is to demonstrate how the institutional complex that frames the work of the organizations produces the client types pertaining to that organization. The rehabilitation organizations’ local history, legislation, along with the (...) structural features of the labour market and social work result in a number of contradictions that make it difficult to deliver client-centred care. According to the staff, this is one of the most important aims of “good” social work. (shrink)

Both daily demands as well as training and competition characteristics in sports can result in a psychobiological state of mental fatigue leading to feelings of tiredness, lack of energy, an increased perception of effort, and performance decrements. Moreover, optimal performance will only be achievable if the balance between recovery and stress states is re-established. Consequently, recovery strategies are needed aiming at mental aspects of recovery. The aim of the study was to examine acute effects of potential mental recovery strategies on (...) subjective-psychological and on cognitive performance outcomes after a mentally fatiguing task. A laboratory-based randomized cross-over study with twenty-four students was applied. Participants were run through a powernap intervention, a systematic breathing intervention, a systematic breathing plus mental imagery intervention, and a control condition with one trial a week over four consecutive weeks. Mental fatigue was induced by completion of the 60-min version of the AX-continuous performance test. The Short Recovery and Stress Scale and Visual Analog Scales were assessed to measure effects on perceptual outcomes. Cognitive performance was measured with a reaction time test of the Vienna Test System. During all three recovery interventions and CC portable polysomnography was applied. Results showed a significant increase from pre-AX-CPT to pre-MR on fatigue states and recovery-stress states indicating that the induction of mental fatigue was effective. Moreover, results underlined that analysis yielded no significant differences between recovery interventions and the control condition but they revealed significant time effects for VAS, SRSS items, and cognitive performance. However, it could be derived that the application of a rest break with 20 min of mental recovery strategies appears to enhance recovery on a mainly mental and emotional level and to reduce perceived mental fatigue. (shrink)

Developmental Coordination Disorder and Attention-Deficit/Hyperactivity Disorder are unique neurodevelopmental disorders with overlaps in executive functions and motor control. The conditions co-occur in up to 50% of cases, raising questions of the pathological mechanisms of DCD versus ADHD. Few studies have examined these overlaps in adults with DCD and/or ADHD. Therefore, to provide insights about executive functions and motor control between adults with DCD, ADHD, both conditions, or typically developed controls, this study used a stop-signal task and parallel EEG measurement. We (...) assessed executive performance via go accuracy and go reaction time, as well as motor response inhibition via stop-signal reaction time. This was complemented with analysis of event-related potentials. Based on existing investigations of adults with DCD or ADHD, we expected groups would not differ in behavioral performance on stop and go trials, but differences in ERPs, particularly in components N200 and P300 would be evident. The sample included N = 50 adults with DCD, ADHD, DCD + ADHD, and control participants. We replicated that there were no between-group differences for behavioral-level executive performance and motor response inhibition. However, on a physiological level, ERP components N200 and P300 differed between groups, particularly during successful response inhibition. These ERPs reflect potential endophenotypic differences not evident in overt behavior of participants with ADHD and/or DCD. This suggests a disorder specific employment of inhibition or general executive functions in groups of adults with DCD, DCD + ADHD, ADHD, or control participants. (shrink)

Objectives: To examine associations of changing employment conditions, specifically switching to working from home or job loss, with mental health, using data collected during the COVID-19 pandemic.Methods: Data from 2,301 US adults in employment prior to COVID-19 were collected April 3rd−7th, 2020. Participants reported whether their employment remained unchanged, they were WFH when they had not been before, or they had lost their job due to the pandemic. Outcomes were symptoms of depression, anxiety, stress, loneliness, and positive mental health assessed (...) using validated questionnaires. Linear regression quantified associations of employment changes with mental health outcomes, controlling for age, sex, race, BMI, smoking status, screen time, physical activity, marital status, chronic conditions, and current COVID-19 containment strategies being followed.Results: Compared to participants whose employment remained unchanged, those who switched to WFH did not differ in any measures of mental health. Participants who had lost their job reported higher symptoms of depression, anxiety, and stress, and lower PMH. Loneliness did not differ between groups.Conclusion: This study demonstrates that concerns around potential adverse mental health effects, particularly increases in loneliness, should not preclude WFH in the general population, while considering each individual's personal circumstances, and the acute adverse association of job loss with mental health. Tailored and sensitive interventions may be required to prevent deteriorations in mental health associated with job loss during periods of societal stress. (shrink)

Klaus Michael Meyer-Abich: Was es bedeutet, gesund zu sein. Philosophie der Medizin Content Type Journal Article Category Book Review Pages 57-59 DOI 10.1007/s10202-011-0096-8 Authors Dorothee Dörr, Europäische Akademie GmbH, Bad Neuenahr-Ahrweiler, Germany Journal Poiesis & Praxis: International Journal of Technology Assessment and Ethics of Science Online ISSN 1615-6617 Print ISSN 1615-6609 Journal Volume Volume 8 Journal Issue Volume 8, Number 1.

The present article discusses remarks and suggestions made by Andrew Meyer and Dennis Schilling on a previous contribution of the author. It assesses the status of the root-branches analogy in the Huainanzi 淮南子, and the compatibility of the said analogy with the composition of the same work as a ring composition. It also discusses the numerology proper to the Huainanzi in view of the principles provided by the Yijing 易經. It compares the structural arrangements of the Huainanzi with the (...) ones found in the various versions of the Daodejing 道德經. It concludes on the relationship that these two works establish between the understanding the Way (dao 道) and knowledge about shapes and numbers. (shrink)

The existence of shoulder abduction (SA) and finger extension (FE) movement capacity shortly after stroke onset is an important prognostic factor, indicating favorable functional outcome for the hemiparetic upper limb. Here we asked whether variation in lesion topography affects these two movements in a similar or a distinct way, and whether lesion impact is similar or distinct for left and right hemisphere damage. SA and FE movements were examined in 77 chronic post-stroke patients using relevant items of the Fugl- (...) class='Hi'>Meyer test. Lesion effects were analyzed separately for left and right hemispheric damage (LHD, RHD) patient groups using voxel-based lesion-symptom mapping. In the LHD group, SA and FE were affected only by damage to the cortico-spinal tract in its passage through the corona radiata. In contrast, following RHD, these two movements were affected not only by cortico-spinal tract damage but also by damage to white matter association tracts, the putamen and the insular cortex. In both groups, voxel clusters have been found where damage affected SA and also FE, along with voxels where damage affected only one of the two movements. The capacity to execute SA and FE movements following stroke is affected significantly by damage to shared and distinct voxels in the cortico-spinal tract in LHD patients and by damage to shared and distinct voxels in a larger array of cortical and subcortical regions in RHD patients. (shrink)