Spasticity and muscle weakness is common in children with cerebral palsy (CP). Spasticity can be treated with Botulinum Neurotoxin-A (BoNT-A), but this drug has also been reported to induce muscle weakness. Our purpose was to describe the effect on muscle strength in the lower extremities after BoNT-A injections in children with cerebral palsy. A secondary aim was to relate the effect of BoNT-A to gait pattern and range of motion. Twenty children with spastic cerebral palsy were included in the study, (...) eight girls and 12 boys (mean age 7.7 years). All were able to walk without support, but with increased muscle tone interfering with motor function and gait pattern. Sixteen children had unilateral spastic CP and four bilateral spastic CP. Twenty-four legs received injections with BoNT-A in the plantar flexor muscles. The children were tested before treatment, around six weeks after at the peak effect of BoNT-A, and at six months after treatment, with measurement of muscle strength, gait analysis and range of motion. There were no differences in muscle strength in plantar flexors of treated legs at peak effect compared to baseline. Six months after treatment, there was still no change in untreated plantar flexor muscles, but an increasing trend in plantar flexor strength in legs treated with BoNT-A. Parents reported positive effects in all children, graded as: small in three children, moderate in eight, and large in nine children. The gait analysis showed a small improvement in knee extension at initial contact, and there was a small increase in passive range of motion for ankle dorsiflexion. Two children had a period with transient weakness and pain. We found that voluntary force production in plantar flexor muscles did not decrease after BoNT-A, instead there was a trend to increased muscle strength at follow-up. The increase may be explained as an effect of the blocking of involuntary nerve impulses, leading to an opportunity to using and training the muscles with voluntary control. Adequate muscle strength is important for maintaining the ability to walk and knowledge of how a treatment affects muscle strength is useful when selecting interventions. (shrink)

We introduce a new and time-efficient memory-encoding paradigm for functional magnetic resonance imaging. This paradigm is optimized for mapping multiple contrasts using a mixed design, using auditory and visual stimuli. We demonstrate that the paradigm evokes robust neuronal activity in typical sensory and memory networks. We were able to detect auditory and visual sensory-specific encoding activities in auditory and visual cortices. Also, we detected stimulus-selective activation in environmental-, voice-, scene-, and face-selective brain regions. A subsequent recognition task allowed the detection (...) of sensory-specific encoding success activity in both auditory and visual cortices, as well as sensory-unspecific positive ESA in the hippocampus. Further, sensory-unspecific negative ESA was observed in the precuneus. Among others, the parallel mixed design enabled sustained and transient activity comparison in contrast to rest blocks. Sustained and transient activations showed great overlap in most sensory brain regions, whereas several regions, typically associated with the default-mode network, showed transient rather than sustained deactivation. We also show that the use of a parallel mixed model had relatively little influence on positive or negative ESA. Together, these results demonstrate a feasible, versatile, and brief memory-encoding task, which includes multiple sensory stimuli to guarantee a comprehensive measurement. This task is especially suitable for large-scale clinical or population studies, which aim to test task-evoked sensory-specific and sensory-unspecific memory-encoding performance as well as broad sensory activity across the life span within a very limited time frame. (shrink)

In controlled human infection (CHI) studies, investigators deliberately infect healthy individuals with pathogens in order to study mechanisms of disease or obtain preliminary efficacy data on investigational vaccines and medicines. CHI studies offer a fast and cost‐effective way of generating new scientific insights, prioritizing investigational products for clinical testing, and reducing the risk that large numbers of people are exposed to ineffective or harmful substances in research or in practice. Yet depending on the pathogen, CHI studies can involve significant risks (...) or burdens for participants, pose risks to individuals or communities not involved in the research, and lead to public controversy. It is therefore essential to ensure that the risks of CHI studies are justified by their social value—that is, their potential to generate benefits for society—and that public trust can be maintained. In this paper, we aim to clarify how research sponsors, research ethics committees and other reviewers should judge the social value of CHI studies. We develop a list of relevant considerations for making social value judgments based on the standard view of social value. We then use this list to discuss the example of potentially conducting dengue virus CHI studies in endemic settings. We argue that dengue virus CHI studies in endemic settings would fall on the higher end of the spectrum of social value, mostly because of their potential to redirect all fields of future dengue research. Drawing on this discussion, we derive several general recommendations for how reviewers should judge the social value of CHI studies. (shrink)

One of the common domains in health care in which the concept of vulnerability is used is end-of-life care, including euthanasia and assisted suicide (EAS). Since different uses and implications of the notion have been recognised in the literature on EAS, this paper aims to analyse them and reflect on who is the most vulnerable in the context of EAS. A prior exploratory review of the literature has served as a starting point for the discussion. We concluded that vulnerability is (...) a complex, multi-perspective and multi-layered concept, which implies the vulnerability of different stakeholders involved in EAS practices and vulnerability in different aspects of being human (i.e., physical, mental, moral, social and spiritual). A comprehensive understanding of the notion of vulnerability, which balances as well as complements the concept of autonomy, seems to be an indispensable element of the discourse on EAS. (shrink)

(1996). International policy of Albania: 1912–21. The European Legacy: Vol. 1, Fourth International Conference of the International Society for the study of European Ideas, pp. 852-857.

This Open Access book offers a synthetic reflection on the authors’ fieldwork experiences in seven countries within the framework of ‘Authoritarianism in a Global Age’, a major comparative research project. It responds to the demand for increased attention to methodological rigor and transparency in qualitative research, and seeks to advance and practically support field research in authoritarian contexts. Without reducing the conundrums of authoritarian field research to a simple how-to guide, the book systematically reflects and reports on the authors’ combined (...) experiences in getting access to the field, assessing risk, navigating ‘red lines’, building relations with local collaborators and respondents, handling the psychological pressures on field researchers, and balancing transparency and prudence in publishing research. It offers unique insights into this particularly challenging area of field research, makes explicit how the authors handled methodological challenges and ethical dilemmas, and offers recommendations where appropriate. This book is open access under a CC BY 4.0 license. (shrink)

El presente volumen incluye la edición crítica, acompañada de un completo estudio introductorio, del Arte de bien morir, texto en prosa sin autor declarado, y de La contienda del cuerpo y alma, una composición en verso firmada por Antón López de Meta. Ambas obras integraban un mismo libro destinado a preparar al hombre para enfrentar su tránsito final hacia la vida eterna y forman parte de la tradición del Memento mori.

Issues related to controlled human infection studies using Schistosoma mansoni (CHI-S) were explored to ensure the ethical and voluntary participation of potential CHI-S volunteers in an endemic setting in Uganda. We invited volunteers from a fishing community and a tertiary education community to guide the development of informed consent procedures. Consultative group discussions were held to modify educational materials on schistosomiasis, vaccines and the CHI-S model and similar discussions were held with a test group. With both groups, a mock consent (...) process was conducted. Fourteen in-depth key informant interviews and three group discussions were held to explore perceptions towards participating in a CHI-S. Most of the participants had not heard of the CHI-S. Willingness to take part depended on understanding the study procedures and the consenting process. Close social networks were key in deciding to take part. The worry of adverse effects was cited as a possible hindrance to taking part. Volunteer time compensation was unclear for a CHI-S. Potential volunteers in these communities are willing to take part in a CHI-S. Community engagement is needed to build trust and time must be taken to share study procedures and ensure understanding of key messages. (shrink)

There is a parallel between the debate between Gottlob Frege and David Hilbert at the turn of the twentieth century and at least some aspects of the current controversy over whether category theory provides the proper framework for structuralism in the philosophy of mathematics. The main issue, I think, concerns the place and interpretation of meta-mathematics in an algebraic or structuralist approach to mathematics. Can meta-mathematics itself be understood in algebraic or structural terms? Or is it an exception (...) to the slogan that mathematics is the science of structure? (shrink)

Arguments are weakly meta-argumentative when they call attention to themselves and purport to be successful as arguments. Arguments are strongly metaargumentative when they take arguments (themselves or other arguments) as objects for evaluation, clarification, or improvement and explicitly use concepts of argument analysis for the task. The ambitious meta-argumentation thesis is that all argumentation is weakly argumentative. The modest meta-argumentation thesis is that there are unique instances of strongly meta-argumentative argument. Here, we show how the two (...) theses are connected and both are plausible. (shrink)

Chinese mind-body exercises are positively associated with executive function, but their effects on EF, from synthesized evidence using systematic and meta-analytic reviews, have not been conducted. Therefore, the present systematic review with meta-analysis attempted to determine whether CMBEs affect EF and its sub-domains, as well as how exercise, sample, and study characteristics moderate the causal relationship between CMBEs and EF in middle-aged and older adults. Seven electronic databases were searched for relevant studies published from the inception of each (...) database through June 2020. Randomized controlled trials with at least one outcome measure of CMBEs on EF in adults of mean age ≥ 50 years with intact cognition or mild cognitive impairment and with or without chronic diseases were included. A total of 29 studies ultimately were included in this study. The results indicated that CMBEs improved overall EF, as well as its sub-domains of working memory and shifting. The beneficial effects of CMBEs on EF occurred regardless of type, frequency of group classes, session time, total training time, and length of the CMBEs, in addition to that more frequent participation in both group classes and home practice sessions resulted in more beneficial effects. The positive effects of CMBEs on EF were also demonstrated, regardless of participants mean age, sex, and cognitive statuses, health status, as well as training mode and study language. This review thus suggests that CMBEs can be used as an effective method with small to moderate and positive effects in enhancing EF, and that more frequent group classes and home practice sessions may increase these effects. However, certain limitations, including strictly design studies, limited ES samples for specific variables, and possible biased publications, required paying particular attention to, for further exploring the effects of CMBEs on EF. (shrink)

The paper starts with the distinction between conjunction-of-parts accounts and disjunction-of-possibilities accounts to truthlikeness. In Sect. 3, three distinctions between kinds of truthlikeness measures are introduced: comparative versus numeric t-measures, t-measures for qualitative versus quantitative theories, and t-measures for deterministic versus probabilistic truth. These three kinds of truthlikeness are explicated and developed within a version of conjunctive part accounts based on content elements. The focus lies on measures of probabilistic truthlikeness, that are divided into t-measures for statistical probabilities and single (...) case probabilities. The logical notion of probabilistic truthlikeness can be treated as a subcase of deterministic truthlikeness for quantitative theories. In contrast, the epistemic notion of probabilistic truthlikeness creates genuinely new problems, especially for hypotheses about single case probabilities that are evaluated not by comparison to observed frequencies, but by comparison to the truth values of single event statements. By the method of meta-induction, competing theories about single case probabilities can be aggregated into a combined theory with optimal predictive success and epistemic truthlikeness. (shrink)

O Katulu vemo zelo malo zanesljivega in celo večino tega je treba razbrati iz njegovega lastnega literarnega dela. To je vedno tvegan pristop, ki mu kritika danes večinoma nasprotuje (četudi je kritika vedno spremenljiva in znaki teh sprememb so že v zraku). Toda po drugi strani vemo kar precej o zadnjem stoletju rimske republike, o času torej, v katerem je Katul preživel svoje kratko, a intenzivno življenje, in o številnih javnih osebnostih, tako iz sveta književnosti kot politike, ki jih je (...) štel med svoje prijatelje ali sovražnike. Tako kot Byron, ki je bil Katulu v nekaterih pogledih podoben, se je gibal v krogih visoke družbe, imel je radikalna stališča, ne da bi se aktivno politično udejstvoval, ter je pisal poezijo, ki daje vtis, da je nastala kot odziv na družbeno dogajanje, literarne tokove ali zasebne škandale takratne aristokracije. (shrink)

Pure causal theories of reference cannot account for cases of theoretical term reference failure and do not capture the scientific point of introducing new theoretical terminology. In order to account for paradigm cases of reference failure and the point of new theoretical terminology, a descriptive element must play a role in fixing the reference of theoretical terms. Richard Boyd's concept of theory constituitive metaphors provides the necessary descriptive element in reference fixing. In addition to providing a plausible account of reference (...) failure and success, a metaphor approach to reference fixing provides the basis for a plausible realist account of the progress of science. Indeed, the metaphor approach undermines the sceptical force of the meta-induction and Laudan's objections to scientific realism. (shrink)

“Meta-argument allegations” consist of protestations that an interlocutor’s speech is wrongfully offensive or will trigger undesirable social consequences. Such protestations are meta-argument in the sense that they do not interrogate the soundness of an opponent’s argumentation, but instead focus on external features of that argument. They are allegations because they imply moral wrongdoing. There is a legitimate place for meta-argument allegations, and the moral and epistemic goods that can come from them will be front of mind for (...) those levelling such allegations. But I argue there is a dark side to such allegations, and their epistemic and moral costs must be seriously weighed. Meta-argument allegations have a concerning capacity to derail discussions about important topics, stymieing argumentational interactions and the goods they provide. Such allegations can license efforts to silence, punish and deter—even as they provoke the original speaker to retaliate in kind. Used liberally, such allegations can escalate conflicts, block open-mindedness, and discourage constructive dialogues. In response, I defend “argumentational tolerance”—a principled wariness in employing meta-argument allegations—as a virtue of ethical argument. (shrink)

It is well established that math anxiety has a negative relationship with math performance. A few theories have provided explanations for this relationship. One of them, the Attentional Control Theory, suggests that anxiety can negatively impact the attentional control system and increase one's attention to threat-related stimuli. Within the ACT framework, the math anxiety —working memory relationship is argued to be critical for math performance. The present meta-analyses provides insights into the mechanisms of the MA—MP relation and the mediating (...) role of WM. Through database searches with pre-determined search strings, 1,346 unique articles were identified. After excluding non-relevant studies, data from 57 studies and 150 effect sizes were used for investigating the MA—MP correlation using a random-effects model. This resulted in a mean correlation of r = −0.168. The database search of WM as a mediator for the MA—MP relation revealed 15 effects sizes leading to a descriptive rather than a generalizable statistic, with a mean indirect effect size of −0.092. Overall, the results confirm the ACT theory, WM does play a significant role in the MA—MP relationship. (shrink)

Counterproductive academic behaviors are a complex phenomenon that affects academic institutions in multiple geographical areas with different cultures, values, and social norms. The high incidence of CAB causes problems of critical importance that transcend the educational domain. The current study aims to contribute to the knowledge of the CAB consequences by focusing on its impact on academic performance. For this purpose, a meta-analysis was conducted in order to examine the relationship between CAB, its facets, and AP. The results show (...) that overall CAB and students' performance are negatively related with a true effect size of ρ = −0.40. Particularly, absenteeism appeared to be the facet most strongly related to AP. A meta-analytic path analysis model was carried out in order to test the predictive validity of CAB, students' personality characteristics, and intelligence on AP. Results show that conscientiousness and cognitive intelligence have a negative relationship with CAB, and that conscientiousness, openness to experience, intelligence, and CAB can explain 58% of AP true variance. Meta-analyses of moderator variables and hierarchical meta-analyses are also presented. The implications for research and practice are discussed at the end. (shrink)

The purpose of this paper is to set out a structured meta‐methodology, named DIODE, for the ethical assessment of new and emerging technologies. DIODE has been designed by a mixture of academics, governmental people and commercial practitioners. It is designed to help diverse organisations and individuals conduct ethical assessments of new and emerging technologies. A framework discussion paper was developed for consultation to ensure that DIODE addresses fundamental ethical concerns, has appropriate and manageable scope and is comprehensive in its (...) ethical compass. The resulting DIODE meta‐methodology uses flowcharts and templates, encompassing the use of diverse tools and techniques. There are two different angles for the ethical assessment of new technologies; a strategic-abstract angle and a project-application specific angle. DIODE includes two channels to accommodate this distinction. Early stage testing yielded positive feedback and mostly favourable comment. Additional guidance materials are being developed in response to the feedback. Without training and guidance, it is difficult for technologists to take ethical concerns into account during the development and deployment of new technologies. DIODE can provide that training and guidance through a practical meta‐methodology which should help ICT professionals, policy makers and academics. There is very little structured methodology material available on the ethical assessment of new technologies. The depth and sophistication contained in DIODE is therefore believed to be unique. DIODE provides practical help while remaining rooted in the philosophical and theoretical concepts of ethics. (shrink)

Researchers have proposed that blocking facial feedback via glabellar-region botulinum toxin injections can reduce depression. Random-effects meta-analyses of studies that administered GBTX...

Joule’s Energy Conservation Law was the first “meta-law”: a general principle that all physical equations must satisfy. It has led to many important and useful physical discoveries. However, a recent analysis seems to indicate that this meta-law is inconsistent with other principles—such as the existence of free will. We show that this conclusion about inconsistency is based on a seemingly reasonable—but simplified—analysis of the situation. We also show that a more detailed mathematical and physical analysis of the situation (...) reveals that not only Joule’s principle remains true—it is actually strengthened: it is no longer a principle that all physical theories should satisfy—it is a principle that all physical theories do satisfy. (shrink)

Objectives: The corona virus disease-2019 pandemic spread globally, and we aimed to investigate the psychosocial impact on healthcare workers in China during the pandemic.Methods: In this systematic review and meta-analysis, we searched seven electronic databases for cross-sectional studies on psychosocial impact on HWs in relation to COVID-19 from January 1, 2020 to October 7, 2020. We included primary studies involving Chinese HWs during the pandemic, and data were extracted from the published articles. Our primary outcome was prevalence of anxiety, (...) depression, and stress disorders. We pooled prevalence value with their 95% confidence interval using random effect models and assessed study quality on the basis of an 11-item checklist recommended by the Agency for Healthcare Research and Quality. The study protocol was registered in PROSPERO.Results: We identified 25 articles comprising a total of 30,841 completed questionnaires and 22 studies for meta-analysis. The prevalence of anxiety, depression, and stress disorders was 34.4%, 31.1%, and 29.1% for HWs. The pooled prevalence of anxiety disorders for HWs from late January to early February was 46.4%, significantly higher than those in mid-term February and after late February. The pooled prevalence of depression disorders for HWs from late January to early February was 46.5%, significantly higher than those in mid-term February and after late February. HWs working in Hubei Province had a higher prevalence of anxiety and a lower prevalence of depression than those working in other regions. Nurses had a higher prevalence of anxiety and depression than other HWs.Conclusions: About one-third of HWs in China suffered anxiety, depression, and stress at the early epidemic of COVID-19. HWs in Hubei Province, especially nurses, had a higher prevalence of psychological disorders. During the pandemic, a negative psychological state may persist in a proportion of Chinese HWs, fluctuating with the control of the pandemic. The long-term impact should continue to be observed. Attention should be paid to HWs for their psychological impact due to the pandemic.Systematic Review Registration: The study protocol was registered with PROSPERO. (shrink)

ObjectiveThis systematic review aims to make a mixed comparison of interventions for kinesiophobia and individuals with musculoskeletal pain.MethodsA comprehensive search strategy was conducted in the database of PubMed, MEDLINE, and Web of Science with the inclusion criteria: randomized controlled design; patients with musculoskeletal pain as participants; treatments protocols of kinesiophobia as interventions or comparisons; the score of Tampa Scale Kinesiophobia as outcome measures. A network meta-analysis was used to synthesize the data after checking the model consistency. The risk of (...) bias was assessed by the Cochrane Collaboration Risk of Bias Assessment Tool.ResultsThirty-one studies were included in this review after a comprehensive search strategy with a low risk of bias and good consistency. According to the results of the network meta-analysis, a multi-modal treatment protocol had the highest probability to become the best choice in dealing with kinesiophobia caused by musculoskeletal pain, whereas psychological treatment protocols also showed a potentially positive effect on musculoskeletal pain-induced kinesiophobia.ConclusionMulti-modal protocols could be recommended as the preferred option when dealing with kinesiophobia caused by musculoskeletal pain. However, it is still worth mentioning that there are also potentially positive therapeutic effects of psychological interventions. Since the concept of kinesiophobia is based on the fear-avoidance model, the psychological mechanism should be paid enough attention to during treatment.Registration NumberCRD42021286450. (shrink)

Mind-wandering is a psychological process involving the emergence of spontaneous thoughts in daily life. Research has shown that mind-wandering influences diverse psychological outcomes; however, less is known about possible individual differences that may drive mind-wandering. In this study, we argue that personality traits, expressed in neuroticism and openness to experience, may lead to the individual’s self-perception of their mind-wandering activity, due to meta-awareness processes. In a three-wave survey study with 273 college students, we gathered data which supported a positive (...) association of both neuroticism and openness to experience with mind-wandering self-perception, mediated by the individual’s meta-awareness. Thus, this study contributes to the literature on spontaneous thinking by showing that mind-wandering processes may be a function of individual differences expressed in personality traits. (shrink)

Objective: To systematically analyze the effectiveness of technology-based interventions for reducing loneliness in older adults.Methods: We searched relevant electronic databases from inception to April 2021, which included Cochrane Library, PubMed, Web of Science, SpringerLink, EMBASE, CNKI, and Wanfang. The following criteria were used: study design—randomized controlled trial designs, people—older adults, intervention—technology-based interventions in which a core component involved the use of technology to reduce loneliness in older adults; and outcome—reduction of loneliness level in terms of rating scale scores. Two reviewers (...) independently identified eligible studies, extracted data, and assessed the risk of bias in the included studies. A third reviewer resolved any conflicts. The Cochrane Collaboration's bias assessment tool was used to evaluate the risk of bias for the included studies, and Review Manager 5.4 software was used for the meta-analysis. A random effects model was adopted to measure estimates of loneliness reduction, and standard mean differences with a 95% confidence interval were calculated for each intervention-control contrast, and the I2 statistic was applied to examine heterogeneity.Results: A total of 391 participants from six RCTs were included in the review. Of these, three studies were rated as low-quality, and the remaining three were rated as moderate-quality studies. The meta-analysis showed that the evidence regarding the effects on loneliness of technology-based interventions compared with control groups was uncertain, and suggested that technology-based interventions resulted in little to no difference in loneliness reduction compared to control groups. Two types of technology-based interventions were identified: smartphone-based video calls and computer-based training with Internet usage. The subgroup analysis found low-quality evidence to support the effectiveness of both intervention types.Conclusions: We found no current evidence to support that technology-based interventions were effective compared to different control conditions in reducing loneliness in older adults. This suggests that more research is needed to investigate the effects of technology-based interventions on loneliness in older adults. (shrink)

Meta‐synthesis of qualitative research can be an important way to consolidate and grow nursing knowledge and theory. However, from recent readings of such works in the nursing literature, one can observe that there is increasing use of meta‐synthesis being used as a way to simply aggregate qualitative research findings in a manner claimed to be similar to quantitative meta‐research while also remaining compatible with the qualitative research tradition. The aim of this paper is to discuss whether this (...) meta‐aggregation form of research has a sound epistemological foundation and should be considered a viable form of meta‐synthesis. The conclusion drawn is that meta‐aggregation falls short of being a sound method and is not compatible with the qualitative research philosophy. It is also concluded that meta‐aggregation should not be seen as a form of qualitative meta‐synthesis. Meta‐synthesis is best understood as a way to re‐interpret, compare and translate disparate qualitative studies using different conceptual apparatus into a consolidated knowledge of fundamental importance to nursing care practitioners. To conclude, aggregating qualitative research tends to turn rich descriptions into thin abstractions that are of little use to nursing practice knowledge and does not advance nursing science. (shrink)

This paper explores the phenomenon of meta-emotions. Meta-emotions are emotions people have about their own emotions. We analyze the intentional structure of meta-emotions and show how psychological findings support our account. Acknowledgement of meta-emotions can elucidate a number of important issues in the philosophy of mind and, more specifically, the philosophy and psychology of emotions. Among them are (allegedly) ambivalent or paradoxical emotions, emotional communication, emotional self-regulation, privileged access failure for repressed emotions, and survivor guilt.

In evolutionary psychology predictions, women’s mate preferences shift between fertile and nonfertile times of the month to reflect ancestral fitness benefits. Our meta-analytic test involving 58 independent reports (13 unpublished, 45 published) was largely nonsupportive. Specifically, fertile women did not especially desire sex in short-term relationships with men purported to be of high genetic quality (i.e., high testosterone, masculinity, dominance, symmetry). The few significant preference shifts appeared to be research artifacts. The effects declined over time in published work, were (...) limited to studies that used broader, less precise definitions of the fertile phase, and were found only in published research. (shrink)