A novel paradigm for patient-cooperative control of upper-limb rehabilitation robots

Early intervention and intensive therapy improve the outcome of neuromuscular rehabilitation. There are indications that where a patient is motivated and premeditates their movement, the recovery is more effective. Therefore, a strategy for patient-cooperative control of rehabilitation devices for upper extremities is proposed and evaluated. The strategy is based on the minimal intervention principle allowing an efficient exploitation of task space redundancies and resulting in user-driven movement trajectories. The patient's effort is taken into consideration by enabling the machine to comply with forces exerted by the user. The interaction is enhanced through a multimodal display and a virtually generated environment that includes haptic, visual and sound modalities.

Drivers of collaboration to mitigate climate change: An illustration of Swiss climate policy over 15 years

Climate change mitigation policy is driven by scientific knowledge and involves actors from the international, national and local decision-making levels. This multi-level and cross-sectoral context requires collaborative management when designing mitigation solutions over time and space. But collaboration in general policymaking settings, and particularly in the complex domain of climate mitigation, is not an easy task. This paper addresses the question of what drives collaboration among collective actors involved in climate mitigation policy. We wish to investigate whether common beliefs or power structures influence collaboration among actors. We adopt a longitudinal approach to grasp differences between the early and more advanced stages of mitigation policy design. We use survey data to investigate actors’ collaboration, beliefs and power, and apply a Stochastic Actor-oriented Model for network dynamics to three subsequent networks in Swiss climate policy between 1995 and 2012. Results show that common beliefs among actors, as well as formal power structures, have a higher impact on collaboration relations than perceived power structures. Furthermore, those effects hold true for decision-making about initial mitigation strategies, but less so for the implementation of those measures.

New ruralities – old gender dynamics?: A reflection on high-value crop agriculture in the light of the feminisation debates

While a remarkable continuity in smallholder agricultural production has been identified, the shift from subsistence orientation towards more wage dependence appears in a different light when analysed under a gender perspective. "Feminisation" has been a catchphrase to characterise some of these processes; however, the debate has been subject to overgeneralisation, and can only inadequately grasp the gender dynamics in what has been referred to as "new ruralities". Illustrated for high-value crop production as an expression of agricultural transition in the Global South, this contribution offers a critical account of the feminisation thesis. Instead of discarding the notion of feminisation, it advocates a reassessment of its potential as a comprehensive framework against which empirical findings can be reflected. While conventional uses of the feminisation thesis have, in their great majority, come up with the conclusion that for women it can always only get worse, I propose a perspective which reveals gains and risks and how they are shared between men and women as they engage in new agricultural labour markets. This perspective rests on a methodology for case-based, comparative studies developed in this paper as a contribution for assessing the nature of agricultural transition and to investigate the qualitative change associated with new ruralities. A distinctive appreciation of the substance of agricultural change for different members of the rural society – namely men and women, but also different men, and different women – is the premise for overcoming barriers to shared development, and for framing effective governance in the context of global development.

Natural course of pontocerebellar hypoplasia type 2A

INTRODUCTION Pontocerebellar hypoplasia Type 2 (PCH2) is a rare autosomal recessive condition, defined on MRI by a small cerebellum and ventral pons. Clinical features are severe developmental delay, microcephaly and dyskinesia.Ninety percent carry a p.A307S mutation in the TSEN54-gene. Our aim was to describe the natural course including neurological and developmental features and other aspects of care in a homogeneous group of PCH2 patients all carrying the p.A307S mutation. PATIENTS AND METHODS Patients were recruited via the German patients' organizations. Inclusion criteria were imaging findings of PCH2 and a p.A307S mutation. Data were collected using medical reports and patient questionnaires discussed in a standardized telephone interview. RESULTS Thirty-three patients were included. When considering survival until age 11 years, 53% of children had died Weight, length and head circumference, mostly in the normal range at birth, became abnormal, especially head circumference (-5.58 SD at age 5 yrs). Neurologic symptoms: Choreathetosis was present in 88% (62% with pyramidal signs), 12% had pure spasticity. Epileptic seizures were manifest in 82%, status epilepticus in 39%. Non-epileptic dystonic attacks occurred in 33%. General symptoms: feeding difficulties were recorded in 100%, sleep disorder in 96%, apneas in 67% and recurrent infections in 52%; gastroesophageal reflux disease was diagnosed in 73%, 67% got percutaneous endoscopic gastrostomy and 36% a Nissen-fundoplication. Neurodevelopmental data: All children made progress, but on a low level: such as fixing and following with the eyes was seen in 76%, attempting to grasp objects (76%), moderate head control (73%), social smile (70%), rolling from prone to supine (58%), and sitting without support (9%). Ten percent lost achieved abilities on follow-up. The presence of prenatal symptoms did not correlate with outcome. CONCLUSION Phenotype of this genetically homogeneous group of PCH2 children was severe with reduced survival, but compatible with some developmental progress. Our data support the hypothesis of an early onset degeneration which thereafter stabilizes.

How do sport clubs recruit volunteers? Analyzing and developing a typology of decision-making processes on recruiting volunteers in sport clubs.

Effective strategies for recruiting volunteers who are prepared to make a long-term commitment to formal positions are essential for the survival of voluntary sport clubs. This article examines the decision-making processes in relation to these efforts. Under the assumption of bounded rationality, the garbage can model is used to grasp these decision-making processes theoretically and access them empirically. Based on case study framework an in-depth analysis of recruitment practices was conducted in nine selected sport clubs. Results showed that the decision-making processes are generally characterized by a reactive approach in which dominant actors try to handle personnel problems of recruitment in the administration and sport domains through routine formal committee work and informal networks. In addition, it proved possible to develop a typology that deliver an overview of different decision-making practices in terms of the specific interplay of the relevant components of process control (top-down vs. bottom-up) and problem processing (situational vs. systematic).

Minimally invasive surgery technique for re-enclavation of prepupillary iris-claw IOLs

BACKGROUND Disenclavation is a common complication of prepupillary iris-claw intraocular lenses (IOL). We present a new minimally invasive revision surgery technique for reenclavation of prepupillary iris-claw IOLs using standard 23 Gauge (G) vitrectomy instruments. HISTORY AND SIGNS Three cases of revision surgery by unilaterally dislocated prepupillary iris-claw IOLs are presented. THERAPY AND OUTCOME Two 20 G sideports 90 degrees apart were constructed. Healon 10® was injected to maintain the anterior chamber. A standard enclavation needle was introduced to rotate the optic into correct position and a 23 G endgrasping forceps was used to grasp and stabilize the IOL for enclavation. The reenclavation was successful in all three cases and the mean visual acuity improved from preoperatively 0.1 (range counting fingers [CF] to 0.25) to 0.6 (range 0.4 to 0.8) with no significant induction of astigmatism. CONCLUSIONS This minimally invasive reenclavation technique for repositioning of the prepupillary iris claw IOL appears to lead to successful and rapid visual rehabilitation.

Quinoa production in the Nor Lipez province (Bolivia): Gender roles in export-led agriculture and challenges for research on rural employment

The recent increase in prices and production of quinoa have had important effects on the employment structures and livelihoods of rural communities in the Nor Lipez Province (Bolivia). The "quinoa boom" resulted in significant changes in household incomes and in gender roles in the context of increasing market integration. The nature of these changes however is not easy to grasp, as new official narratives on gender and on traditional systems of labour divisions and shared access to land have surfaced since the election of Evo Morales (2006) and the adoption of a new constitution (2009). Furthermore, rural employment is found to be much more diverse than the term suggests. Women have always participated in the production of quinoa when it was widely considered as a subsistence crop. Our research takes place in the Nor Lipez Province, Bolivia with exploratory studies that were conducted in January and February 2015 in 8 rural communities of quinoa producers. Preliminary results suggest positive effects for local women in that they managed to earn additional income which might have contributed to their empowerment. This article will present both preliminary results, challenges for gender-oriented research in Bolivia and the methodology aiming to capture changes at the individual, the household and the community level through a survey that will be conducted from September to November 2015 in 500 households.

Do clinicians understand the size of treatment effects? A randomized survey across 8 countries.

BACKGROUND Meta-analyses of continuous outcomes typically provide enough information for decision-makers to evaluate the extent to which chance can explain apparent differences between interventions. The interpretation of the magnitude of these differences - from trivial to large - can, however, be challenging. We investigated clinicians' understanding and perceptions of usefulness of 6 statistical formats for presenting continuous outcomes from meta-analyses (standardized mean difference, minimal important difference units, mean difference in natural units, ratio of means, relative risk and risk difference). METHODS We invited 610 staff and trainees in internal medicine and family medicine programs in 8 countries to participate. Paper-based, self-administered questionnaires presented summary estimates of hypothetical interventions versus placebo for chronic pain. The estimates showed either a small or a large effect for each of the 6 statistical formats for presenting continuous outcomes. Questions addressed participants' understanding of the magnitude of treatment effects and their perception of the usefulness of the presentation format. We randomly assigned participants 1 of 4 versions of the questionnaire, each with a different effect size (large or small) and presentation order for the 6 formats (1 to 6, or 6 to 1). RESULTS Overall, 531 (87.0%) of the clinicians responded. Respondents best understood risk difference, followed by relative risk and ratio of means. Similarly, they perceived the dichotomous presentation of continuous outcomes (relative risk and risk difference) to be most useful. Presenting results as a standardized mean difference, the longest standing and most widely used approach, was poorly understood and perceived as least useful. INTERPRETATION None of the presentation formats were well understood or perceived as extremely useful. Clinicians best understood the dichotomous presentations of continuous outcomes and perceived them to be the most useful. Further initiatives to help clinicians better grasp the magnitude of the treatment effect are needed.

Von der Bezeugung zur narrativen Vergegenwärtigung. Fokalisierung im Reisebuch des Syrers Ḥanna Dyāb (1764)

Travelogues involve different truth claims, depending on whether their authors attempt on the one hand to convey received knowledge about entities and places, or on the other hand, present accounts of the traveler character’s own experiences. This study focuses on a travelogue from 1764 written by the Arabian Nights’ Syrian storyteller, Ḥanna Dyāb. Having written his travelogue more than 50 years after his trip to Paris, he evidently conceived of his narrative as a means to re-enact his experiences as a young traveler. To describe his particular self-staging in this autodiegetic narration “before fiction” (Paige 2011), I argue that an understanding of focalization as a graded visual mediation between the character’s inner life and the reader is needed. This approach helps one grasp how, with reference to Dyāb’s travelogue, truth is not something the traveler witnesses, but rather something the reader is invited to realize. I conclude that, with this shift from witnessing to visualization (Vergegenwärtigung), Dyāb’s travelogue fulfills a core function of literature.

Tattoo: a multifaceted medium of communication

This article suggests the systems theoretical distinction of form/medium as a useful tool for distinguishing social phenomena that might look as if they stem from the same process. This is shown to be the case for the tattoo and tattooing. The tattoo is conceived as a medium of communication through which different forms of communication emerge. Tattooing is one of these forms of communication that shapes the medium in a particular way. The current article sheds a special light on its intricate, communicational constellation, for which the concept of parallax is suggested. Law, medicine and cosmetics as other forms of communication use the medium of tattoo in their own way as well. The form/medium distinction allows us to grasp these different forms of communication, while it shows that they share the tattoo as medium. The article’s ultimate goal is to illustrate that the tattoo figures as a multifaceted medium of communication.