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Edited by
Rebecca Leslie, Royal United Hospitals NHS Foundation Trust, Bath,Emily Johnson, Worcester Acute Hospitals NHS Trust, Worcester,Alex Goodwin, Royal United Hospitals NHS Foundation Trust, Bath,Samuel Nava, Severn Deanery, Bristol
In this section we discuss fluid balance, acid-base physiology and some principles of renal physiology. Fluid balance encompasses the distribution of fluid compartments in the body as well as intravenous fluid therapy used in anaesthesia and critical care. Acid-base balance covers the core principles behind calculation of pH, buffer systems and physiological consequences of acid-base disturbance. The discussion around renal physiology focuses on glomerular filtration and renal blood flow. All of the topics in this chapter can be difficult to describe clearly in the exam and hence is extremely valuable to readers.
The important role of the saccule is the sensing of gravity. In other words, gravity always stimulates the macula of the saccule.
Objectives
The aim of this study was to clarify whether nystagmus and dizziness occur by intentional changes upon stimulation to the saccules.
Methods
The subjects were eight healthy humans. Experiment 1: Subjects were asked to maintain a supine position to check for nystagmus and dizziness. Experiment 2: Subjects were asked to tilt their heads 45º to the left in the supine position to check for nystagmus and dizziness. Experiment 3: Subjects were asked to maintain a left-ear-down 90º position to check for nystagmus and dizziness.
Results
In all the experiments, no one revealed nystagmus and no one complained of dizziness.
Conclusion
Neither nystagmus nor dizziness occurs by intentional changes in the stimulation to the saccules.
The aim of this study was to evaluate the vestibular system in substance addicts.
Methods
A total of 34 substance addicts were included in the study. A demographic data form, the Dizziness Handicap Inventory, the Addiction Profile Index Screening – Short Form, the Video Head Impulse Test, videonystagmography, and cervical and ocular vestibular evoked myogenic potentials tests were administered in all participants.
Results
A statistically significant difference was found between the study group and the control group (p < 0.05) in terms of gaze, saccade, pursuit and optokinetic results in the videonystagmography test; lateral, anterior and posterior semicircular canal gain values in the Video Head Impulse Test; P1 latency, P1–N1 interlatency, P1–N1 amplitude and asymmetry values in the cervical vestibular evoked myogenic potentials test; and N1–P1 interlatency, N1–P1 amplitude and asymmetry values in the ocular vestibular evoked myogenic potentials test (p < 0.05).
Conclusion
As a result of our study, it was observed that the vestibular system was affected in substance addicts.
The analysis of data from experiments in economics routinely involves testing multiple null hypotheses simultaneously. These different null hypotheses arise naturally in this setting for at least three different reasons: when there are multiple outcomes of interest and it is desired to determine on which of these outcomes a treatment has an effect; when the effect of a treatment may be heterogeneous in that it varies across subgroups defined by observed characteristics and it is desired to determine for which of these subgroups a treatment has an effect; and finally when there are multiple treatments of interest and it is desired to determine which treatments have an effect relative to either the control or relative to each of the other treatments. In this paper, we provide a bootstrap-based procedure for testing these null hypotheses simultaneously using experimental data in which simple random sampling is used to assign treatment status to units. Using the general results in Romano and Wolf (Ann Stat 38:598–633, 2010), we show under weak assumptions that our procedure (1) asymptotically controls the familywise error rate—the probability of one or more false rejections—and (2) is asymptotically balanced in that the marginal probability of rejecting any true null hypothesis is approximately equal in large samples. Importantly, by incorporating information about dependence ignored in classical multiple testing procedures, such as the Bonferroni and Holm corrections, our procedure has much greater ability to detect truly false null hypotheses. In the presence of multiple treatments, we additionally show how to exploit logical restrictions across null hypotheses to further improve power. We illustrate our methodology by revisiting the study by Karlan and List (Am Econ Rev 97(5):1774–1793, 2007) of why people give to charitable causes.
Intellectual property rights (IPR) regulation in preferential trade agreements (PTAs) has often been controversial. The increased appetite to strengthen multilateral standards for protection, as well as, in some cases, to expand the subject matter of IPR protection, often serving commercial interests, has been seen as conflicting with larger public interests. When faced with twenty-first century challenges, such as the digital revolution, climate change, or pandemics, the international IPR framework needs to adapt to reconcile with contemporary commercial, political, and public interests.
In this chapter, we discuss how the future design of PTAs can contribute towards this objective. First, we introduce the current international IPR framework and trace the main trade-offs for policymaking in this area, including those particular to PTAs. We emphasise the need for a balanced approach for IPR negotiation and protection in PTAs. Second, we discuss the role of trade secrets in the context of the digital economy, technology transfer in the context of climate change, and, lastly, the role of private–public partnerships in providing equitable access to medicines.
This chapter crosses the bridge from music industry practice to the analysis of the legal regimes deemed most relevant in securing a fair(er) balance in music contracts in the streaming age. Particular focus lies with the effect of the law on contracts entered into between musicians and record companies and/or music publishers as to individually managed exclusive rights. First, the chapter analyses the role of the legal framework in achieving this book’s policy objective of moving towards a fair(er) balance in the streaming age, fleshing out both the substantive and procedural dimensions of what may be perceived as ‘fair’ in this particular context. It then goes on to provide a typology of the relevant legal regimes, categorising these limitations to parties’ freedom of contract in terms of substantive, geographical and temporal scope and analysing the interplay between them. Finally, the chapter sets out to establish the appropriate level(s) and method(s) of further potential policy initiatives aimed at contributing to the elusive fair balance that this book advocates.
This study aimed to predict the risk of falling using patient characteristics, computerized dynamic posturography and functional balance tests in machine learning.
Methods
One hundred twenty elderly individuals were included in this study. The fall status, physical characteristics and medical history of individuals were investigated. Pure tone audiometry test, simple functional balance tests and sensory organization test were applied to the individuals.
Results
The machine learning model that incorporated co-morbidities, physical characteristics and functional balance tests achieved a 100 per cent accuracy in predicting fall risk. Models using only co-morbidities and physical characteristics, functional balance tests or the sensory organization test had accuracies of 87.5 per cent, 83.34 per cent and 91.66 per cent, respectively.
Conclusion
Advanced balance systems are not always necessary to assess fall risk. Instead, fall risk can be effectively determined using simple balance tests, co-morbidities, and patient characteristics in machine learning.
A theme that comes up time and again in our research is the importance of balance. Being with people 24/7/365 doesn’t benefit anyone, not the person doing it nor the people they’re hanging out with. If we’re constantly marinating in others’ thoughts and opinions, we can lose track of our own. By the same token, being on our own day-in-and-day-out isn’t good either. The trick is to have equilibrium between the two, the right amount of social time to fulfill an evolutionary imperative and the ideal amount of solitude to reap its reward. Ultimately, the needs for both belonging and separation are not opposing drives so, how can we achieve psychological integration? This chapter elaborates on how to do that and on the true cause of loneliness.
Towards developing more effective interventions for fall-related injuries, this study analysed a novel database from six retirement home facilities over a 4-year period comprising 1,877 fallers and 12,445 falls. Falls were characterized based on location, activity, injury site, and type, and the database was stratified across four levels of care: Independent Living, Retirement Care, Assisted Care, and Memory care. Falls most occurred within the bedroom (62.8%), and during unknown (38.1%), walking (20.2%), and transfer tasks (14.6%). Approximately one in three (37%) of all falls resulted in an injury, most commonly involving the upper limb (31.8%), head (26.3%), and lower limb (22.2%), resulting in skin tears (35.3%), aches/pains (29.1%), or bruises (28.0%). While fall location, activity, and injury site were different across levels of care, injury type was not. The data from this study can assist in targeting fall-related injury prevention strategies across levels of care within retirement facilities.
“Interface” in present usage is a modern concept whose roots lie in physical science and engineering disciplines. For serendipitous reasons it happens to work well as a conceptual tool for structuring Sun Tzu’s approach to leadership topics, starting with the political level (the ruler) and extending in the military realm down to the level of common soldiers. That is the focus of Theme #13.
Susan Kellogg's history of the Aztecs offers a concise yet comprehensive assessment of Aztec history and civilization, emphasizing how material life and the economy functioned in relation to politics, religion, and intellectual and artistic developments. Appreciating the vast number of sources available but also their limitations, Kellogg focuses on three concepts throughout – value, transformation, and balance. Aztecs created value, material, and symbolic worth. Value was created through transformations of bodies, things, and ideas. The overall goal of value creation and transformation was to keep the Aztec world—the cosmos, the earth, its inhabitants—in balance, a balance often threatened by spiritual and other forms of chaos. The book highlights the ethnicities that constituted Aztec peoples and sheds light on religion, political and economic organization, gender, sexuality and family life, intellectual achievements, and survival. Seeking to correct common misperceptions, Kellogg stresses the humanity of the Aztecs and problematizes the use of the terms 'human sacrifice', 'myth', and 'conquest'.
Markets do not arise in a vacuum, nor are they self-sustaining. They are undergirded by foundational institutions. They are sustained by formal and informal rules that are enforced through legal means or public moral suasion (forte of justice). There is a requisite minimum level of trust and mutual solicitude among its participants (forte of agape). Agape and justice complement each other—mutually reinforcing, substituting, or making up for each other’s limitations. Akin to “homeostasis” in biology wherein the human body balances various fluids, cells, and organisms to function properly, there is a delicate equilibrium that must be maintained between agape and justice for a functional socioeconomic life.
This chapter examines trimming as a face of moderation. It starts from the definition of trimming given by the Marquess of Halifax in a famous essay, “The Character of a Trimmer” (1684), and compares trimmers to tightrope walkers. It argues that trimmers tend to support the parties they dislike least and search for a “wise mean between barbarous extremes.”
This chapter focuses on eclecticism as a face of political moderation. Starting from the definition of eclecticism given by Michel de Montaigne in his Essays, it shows that eclecticism has important implications for the ways in whicb we conceive of our political attachments. It then considers the justification of eclecticism given by Daniel Bell in his book The Cultural Contradictions of Capitalism (1976) and compares it to the eclecticism at the heart of the fusionist movement initiated by Frank Meyer in the 1960s. Finally, it presents eclecticism as a way to avoid any form of “blueprint thinking.”
This study explores the relationship between executive functioning (EF) and degree of bilingualism in a sample (N = 79) of 5- to 7-year-old monolingual and bilingual children. The bilingual group included children who are fully fluent in two languages (balanced bilinguals) and children who are still learning their second language (dual-language learners (DLLs). In general, findings revealed mixed associations between bilingualism and EF. There were no language group differences for one type of simple inhibitory control (i.e., go or no-go task). However, a bilingual advantage was demonstrated for another type of simple inhibitory control (the Head–Toes–Knees–Shoulders task), for complex inhibitory control (i.e., the Simon effect), and for cognitive flexibility (Dimensional Change Card Sort). Effects were found when DLLs and balanced bilinguals were analyzed separately, and the latter two effects were found when both types of bilinguals were compared to monolinguals. The findings contribute to the growing literature examining a possible bilingual effect in early childhood.
This chapter, while acknowledging that there are certain differences and similarities in how the law treats standards development organizations (SDOs) that develop voluntary standards, offers a holistic analysis of the procedural principles introduced in the WTO, EU, and US regulatory frameworks, namely, transparency, openness/participation, consensus, impartiality, balance, effectiveness, relevance, coherence, coordination, concerns of developing countries, appeal, and access to standards, which this study collectively refers to as “due process” principles. This chapter further explores the relevance and suitability of these principles to the different types of standards bodies and identifies the shortcomings of each of the legal mechanisms with regard to ICT standardization. It concludes that these principles are formulated rather flexible and, to be effective, need further concretization by SDOs.
Many philosophers now see meaning in life as a key evaluative category that stands alongside well-being and moral goodness. Our lives are assessed not only by how well they go for us and how morally good they are, but also by their meaningfulness. In this article, I raise a challenge to this view. Theories of meaning in life closely resemble theories of well-being, and there is a suspicion that the former collapse into the latter. I develop this challenge showing that it is formidable. I then answer it by offering a novel account of what meaning in life is and how it differs from well-being. The account I offer is able to resist the strongest form of the challenge while also having much intuitive appeal.
This chapter analyses the extent to which the legal instruments discussed in Chapters 3, 4, and 5 apply to the examined SDOs. It also evaluates these organizations’ rules and procedures against the due process requirements of the applicable regulatory frameworks discussed in Chapter 6. While acknowledging the heterogeneity of the organizations’ operational frameworks, this chapter also emphasizes that their organizational rules – while designed in self-regulatory processes – should yet be considered within the legal constraints of the applicable regulatory frameworks. Indeed, SDOs enjoy a wide discretion not only to implement the due process requirements, but also to determine what these requirements mean, defining such terms as “consensus,” “openness,” and “balance” in their procedural rules. While observing that there are different ways to implement due process principles into the organizations’ procedures, this chapter notes that the level of procedural guarantees offered during the different stages of decision-making differs per organization, but is often insufficient from the perspective of legitimacy.