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To determine if the intention to perform an exercise at speed leads to beneficial alterations in kinematic and kinetic components of the movement in people with post-stroke hemiplegia.
Design:
Comparative study.
Setting:
Subacute metropolitan rehabilitation hospital.
Participants:
Convenience sample of patients admitted as an inpatient or outpatient with a diagnosis of stroke with lower limb weakness, functional ambulation category score ≥3, and ability to walk ≥14metres.
Methods:
Participants performed a single leg squat exercise on their paretic and nonparetic legs on a leg sled under three conditions: 1) self-selected speed (SS), 2) fast speed (FS), 3) jump squat (JS). Measures of displacement, flight time, peak concentric velocity, and muscle excitation (via electromyography) were compared between legs and conditions.
Results:
Eleven participants (age: 56 ± 17 years; median time since stroke onset: 3.3 [IQR 3,41] months) were tested. All participants achieved a jump during the JS, as measured by displacement and flight time respectively, on both their paretic (0.25 ± 0.16 m and 0.42 ± 0.18 s) and nonparetic (0.49 ± 0.36 m and 0.73 ± 0.28 s) legs; however it was significantly lower on the non-paretic leg (p < 0.05). Peak concentric velocity increased concordantly with intended movement speed (JS-FS paretic: 0.96 m/s, non-paretic: 0.54 m/s; FS-SS paretic 0.69 m/s, nonparetic 0.38 m/s; JS-SS paretic 1.66 m/s, non-paretic 0.92 m/s). Similarly, muscle excitation increased significantly (p < 0.05) with faster speed for the paretic and nonparetic vastus lateralis. For gastrocnemius, the only significant difference was an increase during nonparetic JS vs. SS and FS.
Conclusions:
Speed affects the kinematic and kinetic components of the movement. Performing exercises ballistically may improve training outcomes for people post-stroke.
Introduces the motivating questions of the book and discusses the concept of human rights as an international practice. What is the relationship of care to justice; how did human rights advocates develop important practices to advance justice; and why did anti-povery groups adopt rights-based language in development practice? My working hypothesis is that human rights advocates have developed a lasting set of tools for pursuing justice, amounting to a justice-seeking practice. Offers an overview of the book.
Considers how rights have been used to address economic and social justice. Social and economic justice advocates turned toward what is commonly called a rights-based approach to development, beginning in the 1990s. The case study in this chapter traces how and why Oxfam recast its goals as a set of what it called “basic rights.” Incorporated original interviews and archival research to outline Oxfam’s adoption of human rights language in its aid and economic justice advocacy work. Rights-based advocacy by development groups was taken up at the same time that traditional human rights NGOs hotly debated how and whether to take up economic, social, and cultural rights more directly. Argues that the emergence of rights arguments in development work demonstrate the potential flexibility of human rights tools in justice-seeking.
Incorporates first-person interviews with people who invented and implemented Amnesty International’s Urgent Action approach to demonstrate how early human rights advocacy implemented three tools of the justice of neighborhood - active care, habit, and appeals - and became a bridge to further political realization of justice. The chapter begins with a focus on a critical period in the early 1970s, when Amnesty International transitioned from working only for people imprisoned for nonviolent speech or beliefs, protected as “human rights” in articles 18 and 19 of the Universal Declaration of Human Rights, to fighting to protect all people from torture and other forms of ill-treatment. Discusses the development of the Urgent Action approach in the USA and Germany. Discusses Amnesty International’s present-day Urgent Action approaches and questions related to effectiveness.
Discusses the book’s findings and sums up lessons of the study for the conduct of international politics. Argues that human rights work has contributed significant, politically embedded global resources for justice-seeking. The resources as they now exist support active transnational concern for individuals in diverse circumstances, offer a language of appeals for issues related to justice, and inspire the search for more justice in global politics.
Demands of Justice draws on original interviews and archival research to show how global appeals for human rights began in the 1970s to expand the boundaries of the global neighbourhood and disseminate new arguments about humane concern and law in direct opposition to human rights violations. Turning a justice lens on human rights practice, Clark argues that human rights practice offers tools that enrich three facets of global justice: transnational expressions of simple concern, the political realization of justice through politics and law, and new but still incomplete approaches to social justice. A key case study explores the origins of Amnesty International's well-known Urgent Action alerts for individuals, as well as temporal change in the use of law in such appeals. A second case study, of Oxfam's adoption of rights language, demonstrates the spread of human rights as a primary way of expressing calls for justice in the world.
Theorizes three facets of global justice that were introduced in the preceding chapter. Each is addressed in different aspects of human rights practice, and each has its own repertoire, or set of tools, for justice seeking. Although they overlap, they are also time-ordered and somewhat cumulative. The first aspect of justice is the development of Samaritan-like care and concern for the conditions that prevent people from living free and full lives. Human rights actors linked human rights action to a notion of care that broadens the appropriate subject of care to a global neighborhood. The second aspect pertains to an institutional structure in which legal norms offer independent standards of justice. Human rights actors generated arguments based on law and concern that transformed rights into a language of legal justice and accountability that can be employed in appeals to power holders. The third aspect calls for the integration of social justice into politics as human rights standards upholding economic, social, and cultural equity, including gender and racial inclusion.
Discusses the links between human rights and selected treatments of justice in the scholarly literature. Discusses ideal vs. non-ideal theories of justice. Drawing on this literature, identifies three elements of the search for justice in international politics that are illuminated when we observe the dynamics of human rights work: (1) a justice of care extended to a global neighborhood; (2) a culture of argument incorporating law in appeals to political authority; and (3) social justice.
Explores the contents of the thousands of Urgent Action alerts issued by Amnesty International from 1975-2007 on behalf of individuals at risk from human rights violations. The chapter references to care, law, and justice as part of a distinctive culture of human rights argument. By analyzing references to law and aspects of justice in the thousands of UAs, the chapter charts change and continuity in human rights appeals over many years. Throughout the time period, the alerts give voice to the active care found in the justice of neighborhood by expressing, for example, fear for a person’s safety, and by inquiring about alleged ill-treatment of people by authorities or their agents. Appeals to global human rights norms in the documents indicate the emerging importance of law as a tool for the political realization of justice at the global level.
To examine rural–urban differences in temporal trends and risk of inappropriate antibiotic use by agent and duration among women with uncomplicated urinary tract infection (UTI).
Design:
Observational cohort study.
Methods:
Using the IBM MarketScan Commercial Database (2010–2015), we identified US commercially insured women aged 18–44 years coded for uncomplicated UTI and prescribed an oral antibiotic agent. We classified antibiotic agents and durations as appropriate versus inappropriate based on clinical guidelines. Rural–urban status was defined by residence in a metropolitan statistical area. We used modified Poisson regression to determine the association between rural–urban status and inappropriate antibiotic receipt, accounting for patient- and provider-level characteristics. We used multivariable logistic regression to estimate trends in antibiotic use by rural–urban status.
Results:
Of 670,450 women with uncomplicated UTI, a large proportion received antibiotic prescriptions for inappropriate agents (46.7%) or durations (76.1%). Compared to urban women, rural women were more likely to receive prescriptions with inappropriately long durations (adjusted risk ratio 1.10, 95% CI, 1.10–1.10), which was consistent across subgroups. From 2011 to 2015, there was slight decline in the quarterly proportion of patients who received inappropriate agents (48.5% to 43.7%) and durations (78.3% to 73.4%). Rural–urban differences varied over time by agent (duration outcome only), geographic region, and provider specialty.
Conclusions:
Inappropriate antibiotic prescribing is quite common for the treatment of uncomplicated UTI. Rural women are more likely to receive inappropriately long antibiotic durations. Antimicrobial stewardship interventions are needed to improve outpatient UTI antibiotic prescribing and to reduce unnecessary exposure to antibiotics, particularly in rural settings.