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The Montreal Cognitive Assessment (MoCA) is routinely used during the early assessment of people after stroke to indicate cognitive effects and inform clinical decision-making.
Aim:
The purpose of this study was to examine the relationship between cognition in the first week post-stroke and personal and instrumental activities of daily skills at 1 month and 3 months post-stroke.
Method:
A prospective cohort study consecutively recruited people admitted to the acute stroke ward. Acute cognitive status was measured using the MoCA within 1 week post-stroke onset. Functional outcomes were measured using the Functional Independence Measure (FIM) and the Australian Modified Lawton’s Instrumental Activities of Daily Living Scale (Lawton’s) at 1 month and 3 months post-stroke.
Results:
Fifty participants with predominantly mild stroke (n = 47) and mean age of 69.8 achieved a mean MoCA score of 23.1. Controlling for age, the MoCA was associated with the overall FIM score at 1 month (P = 0.02). It was nearing significance for the Lawton’s at 1 month (P = 0.06) but was not associated with either outcome at 3 months. A score of less than 23 on the MoCA was indicative of lower scores on both outcomes.
Conclusions:
A low MoCA score within 1 week of stroke may indicate need for support or rehabilitation due to early impacts on personal activities of daily living, but is not associated with poor functional outcomes at 3 months.
This chapter discusses how states ought to behave in tiems of armed conflict, highlighting the role of such mechanisms as proportionality and military necessity
This chapter documents the relevance of the ‘standard of civilisation’ for contemporary international law, despite the marked decline of explicit invocations of the concept. It does so by documenting the continuing existence and purchase of arguments that oscillate between the ‘logic of improvement’ and the ‘logic of biology’. By focusing on two distinct legal fields that have been highly relevant to the war on terror, the laws of occupation and jus ad bellum, this chapter documents the importance of conforming with the imperatives of the neoliberal state in order to be recognised as a subject of international law. In the first part, the chapter offers a detailed examination of the neoliberal reforms imposed in occupied Iraq by the Coalition Provisional Authority. It details both the promises anchored to the adoption of neoliberal capitalism and the constant negation of such promises based on Orientalist stereotypes based on Iraqis’ purported incapacity to government themselves. In the second part, this chapter focuses on the controversial ‘unwilling or unable’ doctrine situating it within the political economy of the ‘war on terror’ and the demand that post-colonial states subscribe to its imperatives.
Since 1996 the Islamic Movement in Israel has organized a popular mobilization campaign under the slogan “al-Aqsa is in Danger.” The movement has re-centered al-Aqsa Mosque as the central religious-nationalist symbol of the Palestinian struggle. In the process, it has tried to enlist the Palestinian community inside Israel, Jerusalem, and the occupied Palestinian territories as well as the Arab and Muslim worlds. Pious Muslim women have joined this campaign en masse, participating in the kind of public protest action that goes well beyond the traditional gendered division of labor advocated formally by the Islamic Movement. The chapter examines these and other women’s activities for al-Aqsa to trace their strategies of the removal of intra-communal divisions and the domestication of the holy – which are in many ways similar to their deployment in the Jewish Israeli cases. Activities include organizing religious, educational, and recreational activities for women, students, and children, celebrating personal occasions such as marriages, utilizing social media to articulate the bond between women and al-Aqsa, and other activities that enhance Muslim presence at the site and transform it from a distant, divided, and exclusive place of worship to one enmeshed in the everyday.
This chapter is about Allied plans to ‘wear down’ Greater Germany by strategic bombing, and to weaken its hold on occupied territory by encouraging an underground Resistance; some Allied leaders saw these methods as an alternative to a direct ground attack. Resources of the German war economy. Food production and war industry. The limited economic utilisation by the Germans of occupied territory. Forced (slave) labour as a key German asset. Albert Speer and the efforts to intensify the war economy. German technical innovation and ‘miracle weapons’. The Allied war economies in comparison. Development of strategic bombing by Britain and the USA. Relationship between strategic bombing and the ground campaigns. German missile programmes; the American the atomic bomb project. Occupation by Germany and collaboration with the occupiers. Development of the European Resistance, supported from Britain by the SOE. Role of the Communists in the Resistance. The Partisan movement in Russia and Yugoslavia. The effectiveness of the Resistance, relative to Allied conventional forces. Lack of large-scale opposition to Hitler in Germany, despite the July 1944 bomb plot. The resilience of the Nazi regime requires, in the end, occupation by ground armies; ‘wear down’ by underground movements and air bombing is not enough.
As will become evident through the course of this chapter, development in its human rights context is primarily a value that translates into individual and communal well-being. This well-being may be linked to industrial or other financial development, although the correlation between the two is neither self-evident nor necessary. If this right to well-being is to make a difference in the lives of people, whether in poor or rich nations, it must be susceptible to quantifiable measurement through which one is able to assess its progress and realisation. In the last decade experts have developed a list of detailed indicators which allow us to assess well-being more accurately. At the same time, wealthy nations have abandoned ad hoc unilateral efforts to assist their poorer neighbours to escape perpetual cycles of poverty by entering into institutionalised multilateral commitments to contribute part of their annual earnings to developmental goals. These goals are also vigorously pursued by multilateral development banks, such as the World Bank and the African Development Bank.
Treatment with antipsychotic medication is thoroughly investigated in schizophrenia and bipolar disorder but is also widely applied for a diversity of off-label conditions, despite an uncertain risk-benefit ratio. This study examined the relationship between antipsychotic prescribing patterns and labor market affiliation, considering both authority approved and off-label prescriptions and the relation to polypharmacy.
Methods
Register-based cohort study using a dataset of 71,254 new antipsychotic users with a psychiatric diagnosis. Labor market affiliation and duration of welfare payments were analyzed using linear regression models and duration analysis. The analyses were adjusted for the following confounding variables: age, gender, diagnosis, marital status, length of education, and utilization of mental health care services.
Results
The majority of new antipsychotic users received welfare payments for prolonged periods of time during the observation period, even more so for individuals treated with antipsychotic polypharmacy or other antipsychotic combination regimens. The risk of permanently leaving the labor market was also associated with antipsychotic combination regimen.
Conclusions
Antipsychotic treatment, especially in combination with other antipsychotics or other psychotropic drugs, could serve as a marker of subjects with increased need for support to maintain the labor market affiliation. However, causality cannot be inferred from an observational study because of residual confounding that could not be adjusted for in this study.
Chapter 6 describes the crisis of representative politics in the mid- to late 1960s, at the national level, the level of youth organisation, and within the university. This crisis prompted a turn towards the occupation as a political tactic, the general assembly over representative organisations, and a preference for forms of direct democracy. The protest movements demanded autonomy, although they were not always clear how this would operate. However, forms of direct democracy such as the occupation had a short life-span and generated criticism for demagogy and its domination by student leaders. I argue that the protest movements found it difficult to reconcile their anti-hierarchical drive and the intense politicisation that led towards formation of a new political party.
The introduction sketches the scope and nature of Allied internment and outlines the key questions that internment raises. It situates internment within the history and historiography of postwar Germany and the broader study of the history of camps. It shows that internment, especially by the western powers, has often been overlooked. Even studies of post-Nazi transitional justice often neglect it, focusing instead on trials of Nazi and war criminals and on professional and civil sanctions against Nazi Party members and fellow travellers. The introduction argues that including internment reveals post-Nazi transitional justice to have been more severe than has long been believed and that Allied measures did not rest on undifferentiated accusations of German collective guilt, but on a more nuanced approach. The introduction identifies multiple meanings of terms such as ‘denazification’ that are crucial for understanding internment. It also discusses the existing literature on internment and the controversial question of the comparability of the Soviet and western cases. It argues that comparison is legitimate and that black-and-white depictions of brutal, arbitrary Soviets and fair, friendly westerners oversimplify a more complex reality. Finally, the introduction outlines the book’s structure, sources, and scope, which includes some comparison with Austria.
Between 1945 and 1950, approximately 130,000 Germans were interned in the Soviet zone of occupied Germany, including in former Nazi concentration camps. One third of detainees died, prompting comparisons with Nazi terror. But what about the western zones, where the Americans, British, and French also detained hundreds of thousands of Germans without trial? This first in-depth study compares internment by all four occupying powers, asking who was interned, how they were treated, and when and why they were arrested and released. It confirms the incomparably appalling conditions and death rates in the Soviet camps but identifies similarities in other respects. Andrew H. Beattie argues that internment everywhere was an inherently extrajudicial measure with punitive and preventative dimensions that aimed to eradicate Nazism and create a new Germany. By recognising its true nature and extent, he suggests that denazification was more severe and coercive but also more differentiated and complex than previously thought.
In India, non-communicable diseases (NCDs) accounted for nearly 62% of all deaths in 2016. Four NCDs – high blood pressure, diabetes, asthma and heart disease – together accounted for over 34% of these deaths. Using data from two rounds of the India Human Development Surveys (IHDSs), levels and changes in the prevalence rates of the four NCDs (based on diagnosed cases) among adults aged 15–69 years in India between 2004–05 and 2011–12 were examined by socioeconomic and demographic factors and for five broad occupation categories. The socioeconomic and demographic risk factors for each of these NCDs were determined using multiple linear logistic regression analysis of pooled data from two rounds of the IHDS. The results showed that while urban residence, age, female sex and education were associated with higher odds of high blood pressure, diabetes and heart disease, household economic status was associated with higher odds for all four NCDs. Furthermore, increased higher odds of high blood pressure, diabetes and heart disease were found for the legislator/senior official/professional occupation group compared with non-workers. Skilled agricultural/elementary workers had lower odds of high blood pressure, diabetes, asthma and heart disease. Craft/machine-related trade workers had higher odds of high blood pressure and diabetes, and reduced odds of asthma and heart disease. Compared with non-workers, the odds ratios for asthma were lower for all other occupational categories. During the two study decades, the Government of India implemented several programmes designed to improve the health and well-being of its people. However, more focused attention on the adult population is needed, and special attention should be paid to the issue of the occupational health of the working population through the strict implementation of work place safety protocols and the removal of potential health hazards.
Do the occupational backgrounds of politicians affect the government's agenda? Businesses have long thought so. The first occupational data on state legislators were collected by the Insurance Information Institute, an interest group representing major insurance companies. In this paper, we test one potential motive for these kinds of efforts: the idea that the occupational makeup of governments affects the agendas they pursue, an argument that has been largely neglected in research on politicians' occupational backgrounds. We focus here on the insurance industry. Using original data, we find that state legislatures with more former insurers consider fewer bills regulating insurance (negative agenda control), that former insurers play a disproportionate role in drafting the insurance bills that are introduced (positive agenda control), and that the bills former insurers introduce tend to be more favorable to the industry than those that their colleagues introduce (positive agenda control). The occupational makeup of legislatures may indeed affect their agendas, as industry groups have long suspected.
The Coalition Provisional Authority (CPA) governed Iraq from 2003 following Resolution 1483 of the UN Security Council. This Resolution affirmed that Iraq was in a state of occupation and that there were occupying powers. The Resolution referred to the United States of America and the United Kingdom as ‘occupying powers under the unified command of the “Authority”’, the ‘Authority’ being the CPA. However, the legal status of the CPA and its relationship to the US (the focus of this article) is not entirely clear, both under US domestic law and international law. This lack of clarity could have significant implications for the US’s responsibility for the CPA’s conduct. As with private military companies, a CPA-style administration of territory could become a tool for states to quarantine their risk under the law of occupation. This article contends that the theory of occupation by proxy may help clarify the legal status of the CPA and its relationship to the US and could assist in closing the identified gap in responsibility. To support this argument, this article establishes a legal framework for the theory of occupation by proxy which is then applied to the CPA and US.
Immediately following the Battle of Chamdo in October 1950, during the period between November 1950 and April 1951, the leaders of the new People's Republic of China (PRC) had two priorities in regard to Tibet. The first was to persuade the Tibetan government to send delegates to Beijing as soon as possible in order to start “negotiations,” and the second was to prevent the Dalai Lama from fleeing Tibet. Using Chinese documents that offer a new version of the process that led to these “negotiations,” this study, without addressing the international issues in detail, illustrates how the leaders of the PRC, either with promises, threats or even by bluff, were able to attain their goals.
Since 1967, despite international legal restrictions, Israel has sought to annex Eastern Jerusalem. Fifty-one years later, it publicly declared in its Nation State Law: “Jerusalem, complete and united, is the capital of Israel.” In the West Bank, Israel initiated on the ground changes that furthered annexation without formally declaring any part of it as annexed. For decades, Al-Haq has documented the gradual encroachment of occupation by successive Israeli administrations. And yet the Palestinian leadership failed to successfully utilize the law to support its case. Nor could the 190 states, parties to the Fourth Geneva Convention, be convinced to enforce the provision in the Convention which bids the High Contracting Parties to “ensure respect for the present convention in all circumstances.” During the Oslo negotiations, Israel succeeded in leaving Jerusalem and the Jewish settlements outside of the jurisdiction of the Palestinian Authority. Given these patterns across nearly a half-century of history, it seems likely that Israel will declare the full annexation of the West Bank in part or in its entirety precisely because it has succeeded in accomplishing this in the case of Jerusalem.
Previous research has documented marked occupational differences in suicide risk, but these estimates are 10 years old and based on potentially biased risk assessments.
Aims
To investigate occupation-specific suicide mortality in England, 2011–2015.
Method
Estimation of indirectly standardised mortality rates for occupations/occupational groups based on national data.
Results
Among males the highest risks were seen in low-skilled occupations, particularly construction workers (standardised mortality ratio [SMR] 369, 95% CI 333–409); low-skilled workers comprised 17% (1784/10 688) of all male suicides (SMR 144, 95% CI 137–151). High risks were also seen among skilled trade occupations (SMR 135 95% CI 130–139; 29% of male suicides). There was no evidence of increased risk among some occupations previously causing concern: male healthcare professionals and farmers. Among females the highest risks were seen in artists (SMR 399, 95% CI 244–616) and bar staff (SMR 182, 95% CI 123–260); nurses also had an increased risk (SMR 123, 95% CI 104–145). People in creative occupations and the entertainment industry – artists (both genders), musicians (males) and actors (males) – were at increased risk, although the absolute numbers of deaths in these occupations were low. In males (SMR 192, 95% CI 165–221) and females (SMR 170, 95% CI 149–194), care workers were at increased risk and had a considerable number of suicide deaths.
Conclusions
Specific contributors to suicide in high-risk occupations should be identified and measures – such as workplace-based interventions – put in place to mitigate this risk. The construction industry seems to be an important target for preventive interventions.
Postmortem human brain studies provide the molecular, cellular, and circuitry levels of resolution essential for the development of mechanistically-novel interventions for cognitive deficits in schizophrenia. However, the absence of measures of premortem cognitive aptitude in postmortem subjects has presented a major challenge to interpreting the relationship between the severity of neural alterations and cognitive deficits within the same subjects.
Methods
To begin addressing this challenge, proxy measures of cognitive aptitude were evaluated in postmortem subjects (N = 507) meeting criteria for schizophrenia, major depressive or bipolar disorder, and unaffected comparison subjects. Specifically, highest levels of educational and occupational attainment of the decedent and their parents were obtained during postmortem psychological autopsies.
Results
Consistent with prior findings in living subjects, subjects with schizophrenia had the lowest educational and occupational attainment relative to all other subject groups, and they also failed to show the generational improvement in attainment observed in all other subject groups.
Conclusions
Educational and occupational attainment data obtained during postmortem psychological autopsies can be used as proxy measures of premortem cognitive function to interrogate the neural substrate of cognitive dysfunction in schizophrenia.
In two recent cases before the Court of Justice of the European Union (CJEU), the General Court (at first instance), the High Court of Justice of England and Wales and the Grand Chamber of the CJEU found that a trade agreement and a fisheries agreement between Morocco and the European Union cannot be applied to occupied Western Sahara without the consent of its people. In spite of the fact that it is the general view that Western Sahara is under belligerent occupation, none of the three courts invoked the law of occupation but based themselves instead on the principle of self-determination and the law governing the administration of non-self-governing territories, including the principle of permanent sovereignty over natural resources. A possible implication of these judgments is that that law and the law of occupation are converging in certain respects, in particular as regards long-term occupation. This pertains not only to the substantive rules on the exercise of authority, which seem to require that the people are heard, but also to the basis for the establishment of that authority, namely bare control.
Edited by
Beatrice de Graaf, Universiteit Utrecht, The Netherlands,Ido de Haan, Universiteit Utrecht, The Netherlands,Brian Vick, Emory University, Atlanta
This chapter investigates the Allied occupation of France, especially the way this occupation was managed politically between 1815 and 1818, as an instance of the new European security system and corresponding culture at work. The preparations for this occupation, mainly through the deliberations and activities of the Allied Council of Ambassadors, provide a perfect case study to show how contentious and conflict-ridden this Allied cooperation was (on matters of finance, French politics and military matters), but also how it moved towards a more collective, consensual method of decision making in a highly volatile environment. This – until the present not fully contextualised and researched – Allied Council of Ambassadors responsible for executing the occupation was arguably the first instance where Europe’s system of collective security was inaugurated on the ground, albeit haphazardly and contested, between 1815 and 1818.