von Wright`s Therapy to Jorgensen`s Syndrome

In his last papers about deontic logic, von Wright sustained that there is no genuine logic of norms. We argue in this paper that this striking statement by the father of deontic logic should not be understood as a death sentence to the subject. Rather, it indicates a profound change in von Wright`s understanding about the epistemic and ontological role of logic in the field of norms. Instead of a logical constructivism of deontic systems revealing a necessary structure of prescriptive discourse, which marked his earlier efforts, he adopted the view that such systems should be seem as mere objects of comparison, i.e. as providing practical standards of rationality for norm-giving activity. Within such view he proposed an interpretation of standard deontic logic in such a way to free deontic logicians from the philosophical difficulties related to the so-called Jorgensen`s dilemma and deontic paradoxes. This effort, as we claim in the present paper, is an application of Wittgenstein`s therapeutic method to dissolve philosophical difficulties caused by the use of logical tools to model relations between norms.

Longitudinal excursion and strain in the median nerve during novel nerve gliding exercises for carpal tunnel syndrome

Nerve and tendon gliding exercises are advocated in the conservative and postoperative management of carpal tunnel syndrome (CTS). However, traditionally advocated exercises elongate the nerve bedding substantially, which may induce a potentially deleterious strain in the median nerve with the risk of symptom exacerbation in some patients and reduced benefits from nerve gliding. This study aimed to evaluate various nerve gliding exercises, including novel techniques that aim to slide the nerve through the carpal tunnel while minimizing strain (sliding techniques). With these sliding techniques, it is assumed that an increase in nerve strain due to nerve bed elongation at one joint (e.g., wrist extension) is simultaneously counterbalanced by a decrease in nerve bed length at an adjacent joint (e.g., elbow flexion). Excursion and strain in the median nerve at the wrist were measured with a digital calliper and miniature strain gauge in six human cadavers during six mobilization techniques. The sliding technique resulted in an excursion of 12.4 mm, which was 30% larger than any other technique (p 0.0002). Strain also differed between techniques (p 0.00001), with minimal peak values for the sliding technique. Nerve gliding associated with wrist movements can be considerably increased and nerve strain substantially reduced by simultaneously moving neighboring joints. These novel nerve sliding techniques are biologically plausible exercises for CTS that deserve further clinical evaluation. © 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 25:972-980, 2007

Standing wave bed forms at Plage de la Grande Roche, le Verdelet, Pléneuf-Val-André, Cote d’Armor (France)

Coastal Photograph by Hubert Chanson This photograph of standing wave bed forms was taken at very low tide. The tidal range was 10 m. The bed forms were located on the island of Le Verdelet, in a channel between Le Grande Jaune and Le Verdelet. It is likely that these standing wave bed forms were formed during transcritical shallow water flows at the end of ebb tide. The author’s watch is in the foreground for scale. (Coastal Photograph by Hubert Chanson, Division of Civil Engineering, the University of Queensland, Brisbane, Queensland 4072, Australia.)

La Pointe Saint Mathieu, Brittany, France

The "Pointe Saint Mathieu" is one of the most westerly continental landmarks of France. The promontory is located at the entrance of the "Goulet de la Rade de Brest", that is the entrance channel of the harbour of Brest in Brittany (France). It marks also the Southern end of the "Chenal du Four" that is the main navigation channel between the islands of Ouessant, Molène and Béniquet, and Brittany. The "Chenal du Four" is reputed for its dangers. The tidal range is greater than 7 m in spring tides, and the mid-tide current may exceed 5 knots. The Saint Mathieu promontory is equipped with a lighthouse and a semaphore. The former is located in the ruins of an old monastery, founded during the 6th century AD by Saint Tanguy. The present ruins are the remnants of buildings from the 11th to 15th centuries. The first lighthouse was installed in 1689, although the monks of the monastery used to maintain a signal light since the 1250s. Completed in 1835, the present "Phare de la Pointe Saint-Mathieu" is 37 m high and it reaches 58.8 m above sea level During World War 2, the Pointe Saint Mathieu was defended by a series of concrete fortifications built by the Germans. Some were based upon some earlier French bunker systems, like the coastal battery at the Rospects which included 4 main gun bunkers (4*150 mm, or 2*150 mm & 2*105 mm), an observation bunker on the Western side close to sea, and several smaller structures. There was also the large Kéringar Blockhaus system, near Lochrist, located about 1 km inland and designed for 4 guns of 280 mm. Its command bunker remains a landmark along the main road. All this area was very-heavily bombed between 1943 and 1944, and particularly during the battle of Brest in August-September 1944 ("L'Enfer de Brest").

Familial partial epilepsy with variable foci: A new partial epilepsy syndrome with suggestion of linkage to chromosome 2

Familial partial epilepsy with variable foci (FPEVF) joins the recently recognized group of inherited partial epilepsies. We describe an Australian family with 10 individuals with partial seizures over four generations. Detailed electroclinical studies were performed on all affected and 17 clinically unaffected family members. The striking finding was that the clinical features of the seizures and interictal electroencephalographic foci differed among family members and included frontal, temporal, occipital, and centroparietal seizures. Mean age of seizure onset was 13 years (range, 0.75-43 years). Two individuals without seizures had epileptiform abnormalities on electroencephalographic studies. Penetrance of seizures was 62%. A genome-wide search failed to demonstrate definitive linkage, but a suggestion of linkage was found on chromosome 2q with a LOD score of 2.74 at recombination fraction of zero with the marker D2S133. FPEVF differs from the other inherited partial epilepsies where partial seizures in different family members are clinically similar. The inherited nature of this new syndrome may be overlooked because of relatively low penetrance and because of the variability in age at onset and electroclinical features between affected family members.

STD syndrome packets: Improving syndromic management of sexually transmitted diseases in developing countries

Objective: To design, introduce, and evaluate STD syndrome packets containing recommended drugs for each syndrome, four condoms, a partner treatment card, and a patient information leaflet, with the goal of improving sexually transmitted disease (STD) case management. Methods: Packet design evolved around available packaging technology, informed by pilot testing with nurses working in primary care clinics, doctors in private medical practices, and patients with an STD, in Hlabisa, South Africa. Evaluation 1 year later included analysis of distribution records and interviews with 16 nurses and 61 patients. Results: A cheap packet (2 U, S, cents each, excluding contents) compatible with current legislation was designed and introduced to six public sector clinics and as a short pilot to five private medical practices, Four thousand eighty-five packets were distributed to the clinics, equivalent to approximately 115% of the STDs reported over that period. All 16 nurses reported using the packets, but only 63% did so all the time because of occasional supply problems, All believed the packets improved treatment by saving time (75%), improving supply of condoms and partner cards (44%), and making treatment easier (56%), Patients also responded positively, and most said they would buy a packet (up to $5) at a pharmacy (84%) or store (63%) if available. Conclusions: The STD syndrome packets have the potential to improve STD syndromic management by standardizing therapy and improving the supply of condoms, partner cards, and information leaflets. Packets are popular with practitioners and patients, but consistent supply is essential for maximal impact, There may be scope for social marketing of the packets, which could further increase use.