BackgroundUpper limb impairment is common after stroke, and many will not regain full upper limb function. Different technologies based on surface electromyography (sEMG) have been used in stroke rehabilitation, but there is no collated evidence on the different sEMG-driven interventions and their effect on upper limb function in people with stroke.AimSynthesize existing evidence and perform a meta-analysis on the effect of different types of sEMG-driven interventions on upper limb function in people with stroke.MethodsPubMed, SCOPUS, and PEDro databases were systematically searched (...) for eligible randomized clinical trials that utilize sEMG-driven interventions to improve upper limb function assessed by Fugl-Meyer Assessment (FMA-UE) in stroke. The PEDro scale was used to evaluate the methodological quality and the risk of bias of the included studies. In addition, a meta-analysis utilizing a random effect model was performed for studies comparing sEMG interventions to non-sEMG interventions and for studies comparing different sEMG interventions protocols.ResultsTwenty-four studies comprising 808 participants were included in this review. The methodological quality was good to fair. The meta-analysis showed no differences in the total effect, assessed by total FMA-UE score, comparing sEMG interventions to non-sEMG interventions (14 studies, 509 participants, SMD 0.14, P 0.37, 95% CI –0.18 to 0.46, I255%). Similarly, no difference in the overall effect was found for the meta-analysis comparing different types of sEMG interventions (7 studies, 213 participants, SMD 0.42, P 0.23, 95% CI –0.34 to 1.18, I273%). Twenty out of the twenty-four studies, including participants with varying impairment levels at all stages of stroke recovery, reported statistically significant improvements in upper limb function at post-sEMG intervention compared to baseline.ConclusionThis review and meta-analysis could not discern the effect of sEMG in comparison to a non-sEMG intervention or the most effective type of sEMG intervention for improving upper limb function in stroke populations. Current evidence suggests that sEMG is a promising tool to further improve functional recovery, but randomized clinical trials with larger sample sizes are needed to verify whether the effect on upper extremity function of a specific sEMG intervention is superior compared to other non-sEMG or other type of sEMG interventions. (shrink)

In his logical treatises, John Mair develops a method and a set of rules for the verification of modal propositions, which is in the spirit of his predecessors Ockham and Buridan, but ultimately goes beyond them. He calls this method positio de inesse. It is also by this method that the truth conditions for divided modal propositions are set out. There is a standard interpretation of it as a form of reductionist method, and scholars have been tempted to think that (...) it was motivated by an implicit rejection of de re modal properties shared by Mair and other sixteenth- century nominalists. After presenting the background to Mair’s writings on the semantics of modal propositions, in this paper we revisit Mair's version of the method of positio de inesse. We argue that it is based on some basic semantic rules and contend that this procedure analyzes divided modal propositions into singular de re sentences referring to possible objects. Consequently, we conclude that this method does not reflect a reductionist approach to modal discourse. We instead provide an alternative interpretation. (shrink)

Background: Clinical ethics committees have been broadly implemented in university hospitals, general hospitals and nursing homes. To ensure the quality of ethics consultations, evaluation should be mandatory. Research question/aim: The aim of this article is to evaluate the perspectives of all people involved and the process of implementation on the wards. Research design and participants: The data were collected in two steps: by means of non-participating observation of four ethics case consultations and by open-guided interviews with 28 participants. Data analysis (...) was performed according to grounded theory. Ethical considerations: The study received approval from the local Ethics Commission (registration no.: 32/11/10). Findings: ‘Communication problems’ and ‘hierarchical team conflicts’ proved to be the main aspects that led to ethics consultation, involving two factors: unresolvable differences arise in the context of team conflicts on the ward and unresolvable differences prevent a solution being found. Hierarchical asymmetries, which are common in the medical field, support this vicious circle. Based on this, minor or major disagreements regarding clinical decisions might be seen as ethical conflicts. The expectation on the clinical ethics committee is to solve this (communication) problem, but the participants experienced that hierarchy is maintained by the clinical ethics committee members. Discussion: The asymmetrical structures of the clinical ethics committee reflect the institutional hierarchical nature. They endure, despite the fact that the clinical ethics committee should be able to detect and overcome them. Disagreements among care givers are described as one of the most difficult ethically relevant situations and should be recognised by the clinical ethics committee. On the contrary, discussion of team conflicts and clinical ethical issues should not be combined, since the first is a mandate for team supervision. Conclusion: To avoid dominance by physicians and an excessively factual character of the presentation, the case or conflict could be presented by both physicians and nurses, a strategy that strengthens the interpersonal and emotional aspects and also integrates both professional perspectives. (shrink)

The first Young Researchers in Human–Robot Interaction Workshop, held on March 1, 2006 in Salt Lake City, Utah, provides insight into how to facilitate the establishment of the HRI community. Organized in conjunction with the first annual ACM/IEEE Human Robot Interaction Conference, the NSF-sponsored workshop assembled 15 graduate students from 5 different countries in computer science, psychology, engineering, and the arts to build the HRI community. This report highlights recommendations from discussion sessions, a synopsis of the plenary address, and representative (...) examples of the participants’ presentations. Participants emphasized that HRI is a unique field, requiring knowledge in computing, psychology, and communications despite the differences in the courses, methods, and philosophies across disciplines. The following are needed for future growth in HRI: stable, canonical robotics platforms for research purposes, a multidisciplinary community infrastructure to connect researchers, and a “Berlitz phrasebook” and collected reference materials for helping understand the “other” disciplines. (shrink)

Schopenhauer organized his philosophy of the world as will and representationsystematically, dividing the work into four sections. The unity of the essence of the worldarises in different ways, according to the four books of the main work, by means of ournatural volitional and purposive cognition (book 1), the recognition of the “objectity” of thewill, experienced on the own body (book 2), the possibility of ideal cognition, freed fromthe will, in aesthetic contemplation (book 3) up to the understanding (“Durchschauung”)of the principium (...) individuationis: the self-knowledge of the will (book 4). In this article,the theory of aesthetic contemplation is regarded as a philosophy of consciousness, whichlegitimizes the central importance of the third Book for Schopenhauer’s philosophical systemas a whole. Our central reflections refer to the specific mental attitude of “Besonnenheit”insofar as it is both a condition of knowledge and a characteristic of human morality. Hencethe human capacity for morality is present in actual aesthetic contemplation – as a conditionof the possibility of acting morally. (shrink)