We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Major advances over the past decades have transformed the management landscape of neuromuscular disorders. Increased availability of genetic testing, innovative therapies that target specific disease pathways and mechanisms, and a multidisciplinary approach to care including both transitional and palliative care contribute to timely and more appropriate management of conditions that are associated with a severe disease burden and often also a reduction of life expectancy.
There is an increasing number of consensus recommendations/guidelines that are a useful adjunct for establishing a timely and accurate diagnosis, and enable prognostication of disease-related complications, are a guide for multidisciplinary care and treatment, and expedite initiation of disease-modifying interventions. A number of these guidelines have been referred to in various cases, such as myasthenia gravis (MG), myotonic dystrophy type 1 and 2, chronic inflammatory demyelinating neuropathies (CIDP), and Duchenne muscular dystrophy (DMD), to name a few.
The endemic tree Neltuma caldenia Burk. and the shrub Neltuma flexuosa var depressa F.A. Roig (Fabaceae; subfam: Mimosoideae) are two promising species from the central region of Argentina, with high potential for use in the restoration of disturbed environments, for extensive livestock grazing and apiculture. Both species have seeds with physical dormancy. Ecological study of native species is important from the point of view of rehabilitation of degraded areas by natural regeneration or via seed-based programmes. The objective of this study was to evaluate soil seed bank persistence and seedling traits to understand variation among different populations of each of the study species growing along an ecological gradient and to identify potential components driving this variation. Home environments influenced seed bank persistence, which was higher in populations originating from more arid and unpredictable environments where it could act as a bet-hedging strategy between years and seasons. We also observed differences associated with seedling growth traits between the species and populations. Populations with higher seed persistence were associated with greater seedling growth in N. caldenia. The rapid elongation rate of N. caldenia seedlings growing in large populations and unstable environments could help their ability to escape drought by accessing deeper soil moisture and would confer a high relative competitive ability. In contrast, N. f. var depressa displayed higher seed persistence, which was associated with more arid and unstable conditions and correlated with lower seedling growth, possibly due to an inbreeding depression effect, resulting from the presence of mother plants in low-densities or being isolated from other individuals. There was no effect of population size on seed persistence. To better understand seed persistence and associated seedling trait variation, future studies need to consider the genotype, environment and landscape conditions.
Acquired prosopagnosia is a rare disorder, but it serves as a model for impairments in expert-level visual processing. This review discusses five key observations made over the past 30 years. First, there are variants, an apperceptive type linked to damage to the inferior occipitotemporal cortex and an amnestic type associated with anterior temporal lesions, both either right or bilateral. Second, these variants are clustered in syndromes with other perceptual deficits, the apperceptive type with field defects, dyschromatopsia and topographagnosia, and the amnestic type with topographagnosia and the auditory disorders of phonagnosia and acquired amusia. Third, extensive testing often shows additional problems with recognizing exemplars of other objects, especially when degrees of expertise are taken into account. Fourth, the prosopagnosic impairment does not affect all facial information. For example, the perception of expression and lip-reading likely depends on other neural substrates than those for processing facial identity. Last, face perception in prosopagnosia is not immutable but can improve with extensive training, though as yet this does not represent a cure for the condition. Continuing work with neural networks and animal models will enhance our understanding of this intriguing condition and what it tells us about how our brains process vision.
Cognitive impairment (CI) is one of the most prevalent and burdensome consequences of COVID-19 infection, which can persist up to months or even years after remission of the infection. Current guidelines on post-COVID CI are based on available knowledge on treatments used for improving CI in other conditions. The current review aims to provide an updated overview of the existing evidence on the efficacy of treatments for post-COVID CI.
Methods
A systematic literature search was conducted for studies published up to December 2023 using three databases (PubMed–Scopus–ProQuest). Controlled and noncontrolled trials, cohort studies, case series, and reports testing interventions on subjects with CI following COVID-19 infection were included.
Results
After screening 7790 articles, 29 studies were included. Multidisciplinary approaches, particularly those combining cognitive remediation interventions, physical exercise, and dietary and sleep support, may improve CI and address the different needs of individuals with post-COVID-19 condition. Cognitive remediation interventions can provide a safe, cost-effective option and may be tailored to deficits in specific cognitive domains. Noninvasive brain stimulation techniques and hyperbaric oxygen therapy showed mixed and preliminary results. Evidence for other interventions, including pharmacological ones, remains sparse. Challenges in interpreting existing evidence include heterogeneity in study designs, assessment tools, and recruitment criteria; lack of long-term follow-up; and under-characterization of samples in relation to confounding factors.
Conclusions
Further research, grounded on shared definitions of the post-COVID condition and on the accurate assessment of COVID-related CI, in well-defined study samples and with longer follow-ups, is crucial to address this significant unmet need.
The physical health comorbidities and premature mortality experienced by people with mental illness has led to an increase in exercise services embedded as part of standard care in hospital-based mental health services. Despite the increase in access to exercise services for people experiencing mental illness, there is currently a lack of guidelines on the assessment and triage of patients into exercise therapy.
Aims
To develop guidelines for the pre-exercise screening and health assessment of patients engaged with exercise services in hospital-based mental healthcare and to establish an exercise therapy triage framework for use in hospital-based mental healthcare.
Method
A Delphi technique consisting of two online surveys and two rounds of focus group discussions was used to gain consensus from a multidisciplinary panel of experts.
Results
Consensus was reached on aspects of pre-exercise health screening, health domain assessment, assessment tools representing high-value clinical assessment, and the creation and proposed utilisation of an exercise therapy triage framework within exercise therapy.
Conclusions
This study is the first of its kind to provide guidance on the implementation of exercise therapy within Australian hospital-based mental healthcare. The results provide recommendations for appropriate health assessment and screening of patients in exercise therapy, and provide guidance on the implementation and triage of patients into exercise therapy via a stepped framework to determine (a) the timeliness of exercise therapy required and (b) the level of support required in the delivery of their exercise therapy.
The aim of this project was to set out recommendations for the section 17 leave form to reflect guidance provided in the Mental Health Act 1983: Code of Practice, following local Care Quality Commission feedback. We reviewed guidance in the Code and publicly available leave forms to identify items to include in the leave form. Then, we determined which publicly available leave forms included each item and reviewed whether the item should be included in the leave form and whether any reformulation was needed.
Results
Using the method described, we identified a list of items that should be included in the leave form. When comparing the leave forms of different trusts, there was considerable variation with respect to which items were included in each form.
Clinical implications
We provide some recommendations for future practice regarding section 17 leave forms to facilitate consistency with the Code and between different trusts.
This chapter introduces some of the justifications for punishment and the purposes it seeks to achieve. It will also consider the wider goals which are claimed for international criminal law, alongside some of the challenges to international criminal law that have arisen.
Mangroves, tidal marshes and seagrasses have experienced extensive historical reduction in extent due to direct and indirect effects of anthropogenic land use change. Habitat loss has contributed carbon emissions and led to foregone opportunities for carbon sequestration, which are disproportionately large due to high ‘blue carbon’ stocks and sequestration rates in these coastal ecosystems. As such, there has been a rapid increase in interest in using coastal habitat restoration as a climate change mitigation tool. This review shows that restoration efforts are able to substantially increase blue carbon stocks, while also having a positive impact on various gaseous fluxes. However, blue carbon increases are spatially variable, due to biophysical factors such as climate and geomorphic setting. While there are potentially hundreds of thousands of hectares of land that may be biophysically suitable for restoration, these activities are still often conducted at small scales and with mixed success. Maximizing potential carbon gains through blue carbon restoration will require managers and coastal planners to overcome the myriad socioeconomic and governance constraints related to land tenure, legislation, target setting and cost, which often push restoration projects into locations that are biophysically unsuitable for plant colonization.
Sidonius Apollinaris’ Epist. 3.12 tells how one day, while leaving Lyons, he caught a couple of gravediggers about to violate his grandfather Apollinaris’ grave, which had become unrecognizable over time. He instructs the addressee, his nephew Secundus, to restore the tomb mound and provide it with a stone for which he attaches the text. Whereas this letter is usually interpreted as a piece of self-promotion by the author for his filial piety and expert storytelling, this article suggests that there is a significant subtext to be found in Lucan's Pharsalia which makes the letter first and foremost a rehabilitation of Apollinaris while strongly suggesting that the latter was executed. There follow some rather more tentative thoughts trying to grasp the precise critical moment in time for this rehabilitation. It is argued that this could be Sidonius’ departure for Clermont, in 469/470 to take on the episcopate, after his term as City Prefect of Rome and a stay in Lyons with Bishop Patiens. The letter is aimed at bolstering family cohesion in the conflict of interests between Auvergne and Provence and at securing Sidonius’ position as incumbent bishop.
There is accumulating evidence that imprisonment is expensive but does little to address the underlying drivers of offending. At the same time, it is now recognised that a large proportion of prisoners are diagnosable with significant psychiatric disorders. In this piece we explore the potential role of psychiatry in addressing the societal challenge of a failing prison system. We argue that core psychiatric skills of engaging in balanced, values-based thinking and implementing sound clinical processes can play an important role in reducing reoffending risk. We briefly discuss some of the key challenges involved and outline several relevant service models.
To explore the experiences pertaining to long-term care services from the perspectives of dyads of stroke survivors and their family caregivers in indigenous and non-indigenous communities.
Background:
Stroke occurrence is a life-changing event associated with quality of life for stroke survivors and their families, especially those who provide primary support. Indigenous people are more likely to experience a stroke at a younger age and have a higher likelihood of hospitalisation and death due to health disparities. Few studies have investigated family dyads or indigenous populations to understand their experiences of coping with changed body-self and to contextualise their reintegration into communities post-stroke.
Methods:
Ethnographic fieldwork over nine months in 2018–2019 with indigenous, urban-based, and non-indigenous populations, resulting in 48 observations and 24 interviews with 12 dyads in three geo-administrative communities.
Findings:
The post-stroke recovery trajectory is illuminated, delineating the dyads’ life transitions from biographical disruption to biographical continuation. The trajectory is shaped by seven states involving four mindsets and three status passages. The four mindsets are sense of loss and worry, sense of interdependence, sense of independence, and wellbeing state. The status passages identified in this study are acceptance, alteration, and identification. A community-based and family-centred long-term care system, aligning with medical healthcare and community resources, underpinned each dyad’s biographical continuation by: (1) providing rehabilitation that afforded time and space for recovery adaptation; (2) acknowledging the individuality of family caregivers and helping to alleviate their multitasking; and (3) reintegrating stroke survivors into their communities. Key to determining the quality of recovery for the indigenous participants was their reintegration into their native community and regaining of identity. Therefore, integrating post-stroke care into various care contexts and incorporating indigenous-specific needs into policymaking can support dyads in adapting to their communities.
Narrative health psychology is a subdiscipline of health psychology that brings narratives into illness to help patients make sense of their illness in the context of their lives. Narrative health psychology can be effective in helping people with chronic conditions and with serious health problems such as cancer and heart disease because these diseases have such a large impact on people's lives (not just patients but carers and families) that it is important to consider how the disease fits in with the whole life experience of the patient.
In this chapter, we review work on a range of bilingual aphasias – the language impairments that occur due to a lesion or atrophy in the brain. We begin the chapter by discussing two theoretical approaches, namely the localizationist and dynamic accounts, which explain the extent to which one or both languages are affected. We see that the severity and type of aphasia that result from a lesion depends on its size and location. Additionally, a number of other nonlesion factors can affect the severity of the resulting aphasia. The premorbid variables that have been most studied are frequency of language use, AoA, and L2 proficiency. We then address how bilinguals are assessed for aphasia (e.g., the Bilingual Aphasia Test), and the possibilities for treatment and recovery. In this regard, the following important questions are discussed: In which language(s) should treatment be provided and what are the differential outcomes? If rehabilitation is given in only one language, is there cross-language generalization to the language not treated? We conclude that the most common pattern is parallel recovery in which both languages improve at a similar rate.
To evaluate the mental health of paediatric cochlear implant users and analyse the relationship between six dimensions (movements, cognitive ability, emotion and will, sociality, living habits and language) and hearing and speech rehabilitation.
Methods
Eighty-two cochlear implant users were assessed using the Mental Health Survey Questionnaire. Age at implantation, time of implant use and listening modes were investigated. Categories of Auditory Performance and the Speech Intelligibility Rating Scale were used to score hearing and speech abilities.
Results
More recipients scored lower in cognitive ability and language. Age at implantation was statistically significant (p < 0.05) for movements, cognitive ability, emotion and will, and language. The time of implant usage and listening mode indicated statistical significance (p < 0.05) in cognitive ability, sociality and language.
Conclusion
Timely attention should be paid to the mental health of paediatric cochlear implant users, and corresponding psychological interventions should be implemented to make personalised rehabilitation plans.
The effectiveness of neuropsychological rehabilitation is supported by the evidence found in previous reviews, but there is a lack of research regarding the effectiveness of remotely conducted neuropsychological rehabilitation. This review aimed to identify and evaluate the results of studies investigating the effectiveness of teleneuropsychological rehabilitation.
Methods:
Relevant articles were extracted from electronic databases and filtered to include studies published in 2016 or later to focus on recent practices. Data were synthesized narratively.
Results:
A total of 14 randomized controlled studies were included in the synthesis (9 for children/adolescents, 5 for adults). The most common type of intervention was computerized cognitive training with regular remote contact with the therapist (seven studies). Regarding children and adolescents, the evidence for the effectiveness was found only for these types of interventions with improvements in cognitive outcomes. The results regarding the family-centered interventions were mixed with improvements only found in psychosocial outcomes. No support was found for the effectiveness of interventions combining cognitive and motor training. Regarding adults, all included studies offered support for the effectiveness, at least to some extent. There were improvements particularly in trained cognitive functions. Long-term effects of the interventions with generalization to global functioning remained somewhat unclear.
Conclusion:
Remote interventions focused on computerized cognitive training are promising methods within teleneuropsychological rehabilitation. However, their impact on long-term meaningful, everyday functioning remained unclear. More research is needed to reliably assess the effectiveness of teleneuropsychological interventions, especially with more comprehensive approaches.
The Afterword reflects on the peculiarities of the CCP’s politics of historical justice. Placing the results of the volume in the larger context of transitional justice research, it discusses the reasons why the policies of “bringing order out of chaos” (boluan fanzheng) generated short-term cohesion but did not result in meaningful political reconciliation. The party leadership, despite a few alternative statements by high-ranking leaders in the early 1980s, did not allow for multivocal discussions of guilt and responsibility. Instead, it attempted to pacify the populace through financial subsidies, symbolic rehabilitations, and highly selective persecutions of supposed perpetrators. The core strategy under Deng Xiaoping was to overcome the legacies of the past through a focus on economic development and the depoliticization of past conflicts. An increasingly rigid truth regime was installed and enshrined in the 1981 resolution on party history. The contradictions between lived experience and these official formulae resulted in a pronounced shift toward historical amnesia in the following decades, as the legacies of the Mao era have become increasingly incorporated into a larger narrative of national rejuvenation and regaining great power status.
This chapter explores the changing nature of property rights over more than five decades in China through a case study of an individual family. Tracing the Zhu family’s demand for justice in the post-Mao era for the six houses it had owned and lost – the first five to Mao’s 1950s socialist reforms and the last one to post-Mao urbanization – the chapter notes how the post-Mao transition initially brought a small measure of justice when the family was allowed to reclaim their house and offered a token payment for their prior losses. This was undone in the rapid urbanization that led to the eviction of the family and the destruction of their home in 2005 to make way for a twenty-four-storey grand hotel that now stands in its place. The case demonstrates how the concept of transitional justice and limited past success in regaining property continue to motivate the family to engage in an ongoing struggle for justice.
The Introduction broadly contextualizes how the CCP dealt with historical injustices after Mao Zedong’s death. It provides the necessary framework for understanding the processes and practices that are further explored and examined in the following sections and chapters of the book while shedding light on how selectively applied approaches today associated with the concept of transitional justice may serve to strengthen rather than subvert authoritarian rule. It also highlights the most outstanding features of the CCP’s politics of historical justice before placing these strategies against the backdrop of recent debates on crucial paradigms of transitional justice. Specifically, it introduces two key channels (“property” and “the mechanics of rehabilitation”) through which the government and public sought to concretely redress Mao-era historical injustices and efforts to construct meaningful “truths” of these injustices (“the politics of truth” and “memory”)
This chapter relies on official and unofficial sources that have recently been made available to examine how the Chinese Communist Party introduced methods of reparation to deal with deaths that resulted from the egregious killings that took place in Guangxi between 1967 and 1968. Newly regrouped party leadership in the early post-Mao era designed a special reparation strategy and framework that included compensation, restitution, rehabilitation, implicit state apology, and commemorative acts; of these, the government prioritized rehabilitation while marginalizing the role of material reparation, largely because of final constraints.