114 resultados para Unilateral Neglect


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Isolated conjugate gaze palsy following unilateral frontal lobe surgery is uncommon. When it does occur, usually it recovers within hours. We report a case of isolated conjugate gaze palsy which persisted for four weeks post-operatively before recovery commenced.

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This paper argues that prior to Adam Smith economic progress was largely conceived as being based on the accumulation of knowledge. The development by Turgot and Smith of a concept of capital that subsumed other factors contributing to development led their followers to focus on capital to the neglect of the independent role of knowledge. The paper demonstrates that this paradigmatic shift was identified and challenged by Bentham, Hodgskin and Rae who argued for the independent role of innovation but without lasting impact. © The Author 2009. Published by Oxford University Press on behalf of the Cambridge Political Economy Society. All rights reserved.

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This review article reveals a long-standing gender bias in academic and policy research on adolescent pregnancy, which has led to the neglect of adolescent men's perspectives. The review summarizes the available literature on adolescent men's attitudes in relation to pregnancy occurrence and pregnancy outcomes in the context of addressing three questions: (1) What are adolescent men's attitudes to an adolescent pregnancy? (2) What are adolescent men's attitudes in relation to pregnancy outcomes? (3) What explanations are offered for the identified attitudes to adolescent pregnancy and resolution? The review establishes a foundation for future quantitative and qualitative research on adolescent men's perspectives. It emphasizes that a greater understanding of adolescent men's perspectives could lead to a re-framing of adolescent pregnancy away from being seen solely as a woman's issue. Furthermore, it is argued that the inclusion of adolescent men would lead to more effective adolescent pregnancy prevention and counseling programmes.

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France’s distinctive reaction towards “cults” is generally described as a result of laïcité’s consubstantial problems with religious diversity. The aim of this article is to present an alternative way of thinking about the French cult controversy and, ultimately, about the concept of “laïcité” as an explanatory framework for France’s response to religious diversity. It draws on empirical data to look at how notions such as “laïcité” and “cults” are used in official discourses and translated into administrative practice. This approach will underline that laïcité is not a driving force that predetermines a unilateral response to “cults”, but that laïcité is as laïcité does, in other words a highly claimed and contested value, reflecting divergent political and administrative approaches of the cult phenomenon. The framework “laïcité versus religious diversity” is also undermined by another crucial observation. While it sees the cult controversy as primarily a religious issue, it seems that the recent revitalisation of the combat against “cults” was made possible by its partial dissociation from the religious sphere and its extension to a wide range of practices and new areas.

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This article provides an overview of the literature on the impact of ‘the Troubles’ on mental health in Nor thern Ireland. It identifies three main phases of professional and policy response from concerns about the effects of the violence in the early 1970s, through many years of collective denial and neglect, until acknowledgment, following the Good Friday Agreement in 1998 (Nor thern Ireland Office, 1998), of high levels of trauma and unmet need. The issues of inequality and stigma are also considered and it is argued that peace is necessary but insufficient for promoting mental health. The development of mental health services in Nor thern Ireland and the relatively recent focus on promoting mental health are also outlined and examined. It is suggested that attempts to address the needs arising as a result of ‘the Troubles’ and more general mental health promotion strategies have, to some extent, developed in parallel and that it may be impor tant to integrate these effor ts. The relative under-development of mental health services, the comprehensive Bamford Review of Mental Health and Learning Disability (2005; 2006) and the positive approach of the Public Health Agency mean that, even in the current economic climate, there are great oppor tunities for progress. Routine screening, in primary care and mental health services for trauma, including Troubles-related trauma, is recommended to identify and address these issues on an individual level. It is also argued, however, that more substantial political change is needed to effectively address societal division, inequality and stigma to the benefit of all.

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There is significant public and professional interest in the non-accidental death of children where abuse and neglect are suspected of being contributory factors. Systems for reviewing these deaths have been developed in each of the four jurisdictions within the UK. The main aims are to ensure that individuals and professionals are held to account if practice falls below the expected standard, whilst also seeking to strengthen the systems for protecting children through reflecting on what lessons, if any, can be learnt from the death of a child through abuse or neglect. Recently, the benefit of such inquiries and the quality of serious case reviews have come under scrutiny. In this paper, the authors report the findings of a Delphi study that sought to explore how the process of conducting reviews following the death of a child could be improved through seeking the views of experienced professionals responsible for child protection in Northern Ireland. The authors conclude that the system does command professional support, but could be improved through greater attention to process issues and a stronger emphasis on translating learning into action. In common with research looking at other recent practice developments, there is a need to focus on process indicators as a means to ensuring that well intentioned policies are translated into workable and functioning practices.

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Following resistance exercise in the fasted state, both protein synthesis and degradation in skeletal muscle are increased. The addition of essential amino acids potentiates the synthetic response suggesting that an amino acid sensor, which is involved in both synthesis and degradation, may be activated by resistance exercise. One such candidate protein is the class 3 phosphatidylinositol 3OH-kinase (PI3K) Vps34. To determine whether mammalian Vps34 (mVps34) is modulated by high-resistance contractions, mVps34 and S6K1 (an index of mTORC1) activity were measured in the distal hindlimb muscles of rats 0.5, 3, 6 and 18 h after acute unilateral high-resistance contractions with the contralateral muscles serving as a control. In the lengthening tibialis anterior (TA) muscle, S6K1 (0.5 h = 366.3 +/- 112.08%, 3 h = 124.7 +/- 15.96% and 6 h = 129.2 +/- 0%) and mVps34 (3 h = 68.8 +/- 15.1% and 6 h = 36.0 +/- 8.79%) activity both increased, whereas in the shortening soleus and plantaris (PLN) muscles the increase was significantly lower (PLN S6K1 0.5 h = 33.1 +/- 2.29% and 3 h = 47.0 +/- 6.65%; mVps34 3 h = 24.5 +/- 7.92%). HPLC analysis of the TA demonstrated a 25% increase in intramuscular leucine concentration in rats 1.5 h after exercise. A similar level of leucine added to C2C12 cells in vitro increased mVps34 activity 3.2-fold. These data suggest that, following high-resistance contractions, mVps34 activity is stimulated by an influx of essential amino acids such as leucine and this may prolong mTORC1 signalling and contribute to muscle hypertrophy.

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This article explores the historical neglect of translation as a consideration in the study and practice of theatre in the United States and Europe. While the study of literature is fairly strictly divided between English-language and Comparative Literature departments, theatre and drama have shown little concern about language as a barrier to reception of the dramatic text. Arguably, this discrepancy may be traced to a fundamental gap between the perceived status of the novel as a completed work of art and the playtext as work of art in progress, waiting to find its completion in performance.

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Aim
The aim of this study was to use a prospective longitudinal study to describe age-related trends in energy efficiency during gait, activity, and participation in ambulatory children with cerebral palsy (CP).

Method
Gross Motor Function Measure (GMFM), Paediatric Evaluation of Disability Inventory (PEDI), and Lifestyle Assessment Questionnaire-Cerebral Palsy (LAQ-CP) scores, and energy efficiency (oxygen cost) during gait were assessed in representative sample of 184 children (112 male; 72 female; mean age 10y 9mo; range 4–16y) with CP. Ninety-four children had unilateral spastic CP, 84 bilateral spastic CP, and six had other forms of CP. Fifty-seven were classified as Gross Motor Function Classification System (GMFCS) level I, 91 as level II, 22 as level III, and 14 as level IV). Assessments were carried out on two occasions (visit 1 and visit 2) separated by an interval of 2 years and 7 months. A total of 157 participants returned for reassessment.

Results
Significant improvements in mean raw scores for GMFM, PEDI, and LAQ-CP were recorded; however, mean raw oxygen cost deteriorated over time. Age-related trends revealed gait to be most inefficient at the age of 12 years, but GMFM scores continued to improve until the age of 13 years, and two PEDI subscales to age 14 years, before deteriorating (p<0.05). Baseline score was consistently the single greatest predictor of visit 2 score. Substantial agreement in GMFCS ratings over time was achieved (?lw=0.74–0.76).

Interpretation
These findings have implications in terms of optimal provision and delivery of services for young people with CP to maximize physical capabilities and maintain functional skills into adulthood.

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We aimed to develop a clinically relevant delayed union/non-union fracture model to evaluate a cell therapy intervention repair strategy. Histology, three-dimensional (3D) micro-computed tomography (micro-CT) imaging and mechanical testing were utilized to develop an analytical protocol for qualitative and quantitative assessment of fracture repair. An open femoral diaphyseal osteotomy, combined with periosteal diathermy and endosteal excision, was held in compression by a four pin unilateral external fixator. Three delayed union/non-union fracture groups established at 6 weeks-(a) a control group, (b) a cell therapy group, and (c) a group receiving phosphate-buffered saline (PBS) injection alone-were examined subsequently at 8 and 14 weeks. The histological response was combined fibrous and cartilaginous non-unions in groups A and B with fibrous non-unions in group C. Mineralized callus volume/total volume percentage showed no statistically significant differences between groups. Endosteal calcified tissue volume/endosteal tissue volume, at the center of the fracture site, displayed statistically significant differences between 8 and 14 weeks for cell and PBS intervention groups but not for the control group. The percentage load to failure was significantly lower in the control and cell treatment groups than in the PBS alone group. High-resolution micro-CT imaging provides a powerful tool to augment characterization of repair in delayed union/non-union fractures together with outcomes such as histology and mechanical strength measurement. Accurate, nondestructive, 3D identification of mineralization progression in repairing fractures is enabled in the presence or absence of intervention strategies. (c) 2007 Orthopaedic Research Society.

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Aim  To report the prevalence, clinical associations, and trends over time of oromotor dysfunction and communication impairments in children with cerebral palsy (CP).

Method  Multiple sources of ascertainment were used and children followed up with a standardized assessment including motor speech problems, swallowing/chewing difficulties, excessive drooling, and communication impairments at age 5 years.

Results  A total of 1357 children born between 1980 and 2001 were studied (781 males, 576 females; median age 5y 11mo, interquartile range 3–9y; unilateral spastic CP, n=447; bilateral spastic CP, n=496; other, n=112; Gross Motor Function Classification System [GMFCS] level: I, 181; II, 563; III, 123; IV, 82; IV, 276). Of those with ‘early-onset’ CP (n=1268), 36% had motor speech problems, 21% had swallowing/chewing difficulties, 22% had excessive drooling, and 42% had communication impairments (excluding articulation defects). All impairments were significantly related to poorer gross motor function and intellectual impairment. In addition, motor speech problems were related to clinical subtype; swallowing/chewing problems and communication impairments to early mortality; and communication impairments to the presence of seizures. Of those with CP in GMFCS levels IV to V, a significant proportion showed a decline in the rate of motor speech impairment (p=0.008) and excessive drooling (p=0.009) over time.

Interpretation  These impairments are common in children with CP and are associated with poorer gross motor function and intellectual impairment.

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James Croll (1821–90) occupies a prominent position in the history of physical geology, and his pioneering work on the causes of long-term climate change has been widely discussed. During his life he benefited from the patronage of leading men of science; his participation in scientific debates was widely acknowledged, not least through his election as a Fellow of the Royal Society in 1876. For all that, the intellectual contribution that Croll himself considered to be of most significance—his articles and two books on metaphysics—has attracted very little attention. In addressing this neglect, it is argued here that Croll's interest in metaphysics, grounded in his commitment to a Calvinist form of Christianity, was central to his life and thought. Examining together Croll's geophysical and metaphysical writings offers a different and fruitful way of understanding his scientific career and points to the wider significance of metaphysics in late-Victorian scientific culture.

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Purpose – This paper aims to examine the antecedent influences and merits of workplace occupations as a tactical response to employer redundancy initiatives.

Design/methodology/approach – The data are based on analysis of secondary documentary material reporting on three workplace occupations in the Republic of Ireland during 2009.

Findings – Perceptions of both procedural (e.g. employer unilateral action) and substantive (e.g. pay and entitlements) justice appear pivotal influences. Spillover effects from other known occupations may also be influential. Workplace occupations were found to produce some modest substantive gains, such as enhancing redundancy payments. The tactic of workplace occupation was also found to transform unilateral employer action into scenarios based upon negotiated settlement supported by third-party mediation. However the tactic of workplace occupation in response to redundancy runs the risks of potential judicial injunction and sanction.

Research limitations/implications – Although operationally difficult, future studies should strive to collect primary data workplace occupations as they occur.

Originality/value – The paper identifies conditions conducive to the genesis of workplace occupations and the extent to which the tactic may be of benefit in particular circumstances to workers facing redundancy. It also contextualises the tactic in relation to both collective mobilisation and bargaining theories in employment relations.

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This study examined the role of prolonged, repeated traumatic experiences such as childhood and sectarian trauma in the development of posttraumatic aggression and self-harm. Forty-four adult participants attending therapy for complex trauma in Northern Ireland were obtained via convenience sampling. When social desirability was controlled, childhood emotional and physical neglect were significant correlates of posttraumatic hostility and history of self-harm. These relationships were mediated by alterations in self-perception (e.g., shame, guilt). Severity of sectarian-related experiences was not related to self-destructive behaviors. Moreover, none of the trauma factors were related to overt aggressive behavior. The findings have implications for understanding risk factors for posttraumatic aggression and self-harm, as well as their treatment. © 2013 Copyright Taylor & Francis Group, LLC.