Novel and effective treatment modality for medically unexplained symptoms

Medically unexplained symptoms (MUS) confound physicians, and the incidence and prevalence of these conditions is poorly documented.  This is not least due to the complex nature of MUS and mimicry of morbidity with conditions that have common clinical assessment and treatment modalities, e.g. migraine headaches which stress headaches commonly are misdiagnosed as.  Effective treatment modalities for MUS have been more or less non-existent.  In the following we present a modality for the assessment, diagnosis and treatment of MUS that in our experience leads to cure, at least in better than half of these cases measured in terms of allowing the individual back to work.  These results are at least twice as high as those described hitherto (see below), and yet, our treatment modality is beset with many obstacles, not the least of which is the intrasigence of a system that will not and/or can not understand why this modality is so much better than what they are able to offer.  The most importance obstacle is financing, as this modality requires long term and committed financing to work.  The economic implications of not dealing with these issues are described.

Early symptomatic presbyopes - what correction modality works best?

Purpose: To compare the performance of a low-addition silicone hydrogel multifocal soft lens with other soft lens correction options in a group of habitual soft lens wearers of distance correction who are symptomatic of early presbyopia.

Method: This clinical study was designed as a prospective, double-masked, randomized, crossover, dispensing trial consisting of four 1-week phases, one for each of the correction modalities: a low-addition silicone hydrogel multifocal soft lens, monovision, habitual correction, and optimized distance visual correction. The prescriptions of all modalities were finalized at a single fitting visit, and the lenses were worn according to a randomized schedule. All lenses were made from lotrafilcon B material. A series of objective vision tests were conducted: high- and low-contrast LogMAR under high- and low-room lighting conditions, stereopsis, and critical print size. A number of other data collection methods used were novel: some data were collected under controlled laboratory-based conditions and others under real-world conditions, some of which were completed on a BlackBerry hand-held communication device.

Results: All participants were able to be fit with all four correction modalities. Objective vision tests showed no statistical difference between the lens modalities except in the case of low-contrast near LogMAR acuity under low-lighting levels where monovision (+0.29 ± 0.10) performed better than the multifocal (+0.33 ± 0.11, P=0.027) and the habitual (+0.37 ± 0.12, P<0.001) modalities. Subjective ratings indicated a statistically better performance provided by the multifocal correction compared with monovision, particularly for the vision associated with driving tasks such as driving during the daytime (93.3 ± 8.8 vs. 84.2 ± 23.7, P=0.05), at nighttime (88.8 ± 11.7 vs. 74.9 ± 23.6, P=0.001), any associated haloes or glare (92.0 ± 10.6 vs. 78.0 ± 22.8, P=0.003), and observing road signs (90.1 ± 11.8 vs. 79.4 ± 20.2, P=0.027). Preference for the multifocal compared with monovision was also reported when watching television (95.0 ± 6.4 vs. 82.6 ± 20.1, P=0.001) and when changing focus from distance to near (87.0 ± 13.4 vs. 66.1 ± 32.2, P<0.001).

Conclusions: For this group of early presbyopes, the AIR OPTIX AQUA MULTIFOCAL-Low Add provided a successful option for visual correction, which was supported by the results of subjective ratings, many of which were made during or immediately after performing such activities as reading, using a computer, watching television, and driving. These results suggest that making a prediction of success or not based on consulting room acuity tests alone is probably unwise.

Alternância no uso dos modos indicativo e subjuntivo em orações subordinadas substantivas: uma comparação entre o português do Brasil e o francês do Canadá

The purpose of this work is to analyze the use of the indicative mood, instead of the subjunctive prescribed by the normative grammar, in complement clauses introduced by the conjunction que in Brazilian Portuguese. Contexts of use of the subjunctive according to grammatical prescription, and contexts of fluctuation on the use of that verbal mood were analyzed, in an attempt to investigate what interferes on the choice of the mood by the user of the language. This study is based on North-American Functional Linguistics theoretical perspective, oriented to analyzing language in use, in the light of the principles of grammaticalization and markedness. The results obtained support that the contexts that favor the indicative over the subjunctive are those composed by a complement clause functioning as a direct object the unmarked clause of all complement clauses and by a verb on the main sentence that belongs to the semantic field of low certainty, corresponding to the epistemic sub-mode the unmarked category of the deontic sub-mode. The results indicate that pragmatics and semantics factors influence the language user on the choice of the verbal mood. This research also presents comparative data on the use of the indicative mood in place of the subjunctive in Brazilian Portuguese and Canadian French, aiming to providing suggestions on language teaching

Dynamics of inter-modality re-weighting during human postural control

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

La protección del medio marino como una modalidad de cooperación internacional: experiencias de apoyo entre el Plan de Acción del Pacífico Sudeste y la CEPAL = Protection of the marine environment as a modality of international co-operation: the Plan of Action of the South-East Pacific and ECLAC

Incluye Bibliografía

Análise funcional dos evidenciais e modalizadores no discurso da autoajuda da saúde

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Fostering a transport policy paradigm shift: comprehensiveness, sustainability and co-modality

This issue of the FAL Bulletin proposes a paradigm shift away from the traditional approach to transport policy in the region, so as to better address issues associated with development. It suggests working towards an integrated and sustainable infrastructure, logistics and mobility policy structure based on the principle of co- modality.

Convergence and divergence of transport and mobility policies in Latin America: Lack of urban co-modality

This issue of the FAL bulletin analyses transport and mobility policy in Latin America, where the lack of integrated public policies for urban mobility and the failure to take coordinated action over time make it difficult to prioritize investments and coordinate existing initiatives (both public and private).

Institutional framework, co-modality and sustainable transport services

This issue of the FAL bulletin focuses on the problems which public institutions encounter when formulating transport policies and the challenge of designing and implementing systemic, integrated, sustainable transport policies in the current institutional framework in the countries of Latin America.

The expressibility of modality in representational complement clauses in Brazilian Portuguese

This paper deals with the (im)possibility of expressing a variety of modal categories within the context of the layering approach to complementation in Functional Discourse Grammar (FDG).Our hypothesis is that modal expressions in complement clauses only pertain to operator or modifier classes of the highest layer relevant for that type of embedded construction and for all lower levels. In order to test this hypothesis, occurrences of complement clauses in two databases of spoken Brazilian Portuguese are analyzed. The investigation of this hypothesis is restricted to representational complement clauses.

Beta therapy with 90 strontium as single modality therapy for canine squamous cell carcinoma in third eyelid

The purpose was to evaluate the effectiveness of beta-radiation with strontium-90 as single modality treatment of canine third eyelid squamous cell carcinoma (SCC). Nine dogs diagnosed with third eyelid SCC were treated with strontium-90. Radiation therapy was administered in four fractions of 100cGy per site every four days and at a depth of 0.2cm (Strontium-90 build' up) in each fraction. Radiation with beta therapy was well tolerated in all animals with no occurrence of radiation induced cataracts. In all cases, there were increased signs of conjunctival inflammation around the mass, which subsided with topical anti-inflammatory. Two dogs required surgical treatment for local tumor recurrence at 150 days and 352 days. In the remaining seven cases, disease free interval ranged from 1239 days to 2555 days. Beta therapy using 90Sr may be a valid alternative for the treatment of third eyelid SCC in dogs

Uma investigação funcional do verbo modal deber no espanhol falado peninsular

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)