Stimulation of the subthalamic nucleus at an earlier disease stage of Parkinson's disease: Concept and standards of the EARLYSTIM-study

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an established treatment for advanced Parkinson's disease (PD) with disabling motor complications. However, stimulation may be beneficial at an earlier stage of PD when motor fluctuations and dyskinesia are only mild and psychosocial competence is still maintained. The EARLYSTIM trial was conducted in patients with recent onset of levodopa-induced motor complications (<3 years) whose social and occupational functioning remained preserved. This is called 'early' here. The study was a randomized, multicenter, bi-national pivotal trial with a 2 year observation period. Quality of life was the main outcome measure, and a video-based motor score was a blinded secondary outcome of the study. Motor, neuropsychological, psychiatric and psychosocial aspects were captured by established scales and questionnaires. The patient group randomized here is the earliest in the disease course and the youngest recruited in controlled DBS trials so far. The methodological innovation for DBS-studies of this study lies in novel procedures developed and used for monitoring best medical treatment, neurosurgical consistency, best management of stimulation programming, blinded video assessment of motor disability, and prevention of suicidal behaviors.

Transcending Cultural and Language Differences: Ethical Codes of Conduct for Translators and Interpreters in Afghanistan

This project examines what an ethical code of conduct would look like in Afghanistan through analysis of historical, cultural and linguistic aspects found within its regions, as well as an examination of ethical codes of conduct for translators and interpreters in other countries. While numerous ethical guidelines and codes of conduct for translators and interpreters exist throughout global communities, it seems that creating a successful standardized ethical code of conduct in Afghanistan may be difficult to achieve given cultural and linguistic complexities. An ethical code of conduct for translators and interpreters in Afghanistan should include particular focus on: cultural sensitivity and courtesy, impartiality, conflict of interest, options for withdrawal, as well as reflect the importance of Pashtunwali.