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Exceptional Circumstances (exceptional + circumstance)
Selected AbstractsEpisodic memory,From brain to mindHIPPOCAMPUS, Issue 9 2006Janina Ferbinteanu Abstract Neuronal mechanisms of episodic memory, the conscious recollection of autobiographical events, are largely unknown because electrophysiological studies in humans are conducted only in exceptional circumstances. Unit recording studies in animals are thus crucial for understanding the neurophysiological substrate that enables people to remember their individual past. Two features of episodic memory,autonoetic consciousness, the self-aware ability to "travel through time", and one-trial learning, the acquisition of information in one occurrence of the event,raise important questions about the validity of animal models and the ability of unit recording studies to capture essential aspects of memory for episodes. We argue that autonoetic experience is a feature of human consciousness rather than an obligatory aspect of memory for episodes, and that episodic memory is reconstructive and thus its key features can be modeled in animal behavioral tasks that do not involve either autonoetic consciousness or one-trial learning. We propose that the most powerful strategy for investigating neurophysiological mechanisms of episodic memory entails recording unit activity in brain areas homologous to those required for episodic memory in humans (e.g., hippocampus and prefrontal cortex) as animals perform tasks with explicitly defined episodic-like aspects. Within this framework, empirical data suggest that the basic structure of episodic memory is a temporally extended representation that distinguishes the beginning from the end of an event. Future research is needed to fully understand how neural encodings of context, sequences of items/events, and goals are integrated within mnemonic representations of autobiographical events. © 2006 Wiley-Liss, Inc. [source] Reluctant Kings and Christian Conversion in Seventh-Century EnglandHISTORY, Issue 306 2007DAMIAN TYLER This article challenges the generally accepted notion that conversion to Christianity was unambiguously beneficial for early Anglo-Saxon kings. It argues that the behavioural requirements of conversion frequently clashed with the social and political norms of early English kingdoms and thus often made it an unattractive option. The article concentrates on the relationships between kings and politically powerful groups within their kingdoms. It is suggested that Christianity often posed a threat to the positions of these groups and that because kings relied on the support of the elites it was only under exceptional circumstances that a ruler would embrace the new religion. [source] The Mazapil meteorite: From paradigm to peripheryMETEORITICS & PLANETARY SCIENCE, Issue 5 2002Martin Beech The simultaneity of these two events has driven speculation ever since. From ,1886 to ,1950 the circumstances of the Mazapil fall were taken, by a number of researchers, as the paradigm that demonstrated the fact that comets were actually swarms of meteoritic boulders. Beginning ,1950, however, most researchers began to adopted the stance that the timing of the Mazapil fall was nothing more than pure coincidence. The reason behind this change in interpretation stemmed from, amongst other factors, the fact that none of the prominent annual meteor showers could be clearly shown to deliver meteorites. Also, with the introduction of the icy-conglomerate model for cometary nuclei, by F. Whipple in the early 1950s, it became increasingly clear that only exceptional circumstances would allow for the presence of large meteoritic bodies in cometary streams. Further, by the mid 1960s it had been shown that meteorites could, in fact, be delivered to the Earth from the main belt asteroid region via gravitational resonances. With the removal of the dynamical "barrier" against the delivery of meteorites from the asteroid region, the idea that the Mazapil meteorite could have been part of the Andromedid stream fell into complete disfavor. This being said, we nonetheless present the results of a study concerning the possible properties of the parent object to the Mazapil meteorite based upon the assumption that it was a member of the Andromedid stream. This study is presented to illustrate the point that while cometary showers do not yield meteorites on the ground, this does not, in fact, substantiate the argument that no meteoritic bodies reside in cometary streams. Indeed, we find no good reason to suppose that an object with the characteristics of the Mazapil meteorite could not have been delivered from the Andromedid stream. However, we argue that upon the basis of the actual reported observations and upon the scientific maxim of minimized hypothesis and least assumption it must be concluded that the timing of the fall of the Mazapil meteorite and the occurrence of the Andromedid outburst were purely coincidental. [source] Strategy for Safe Performance of Magnetic Resonance Imaging on a Patient with Implantable Cardioverter DefibrillatorPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 1 2006CLAAS PHILIP NAEHLE Clinically indicated magnetic resonance imaging (MRI) of the brain was safely performed at 1.5 T on a patient with an implantable cardioverter defibrillator (ICD). The ICD was reprogrammed to detection only, and imaging hardware and protocols were modified to minimize radiofrequency power deposition to the ICD system. The integrity of the ICD system was verified immediately post-MRI and after 6 weeks, including an ICD test with induction of ventricular fibrillation. This case demonstrates that in exceptional circumstances, in carefully selected patients, and using special precautions, an MRI exam of the brain may be possible in patients with ICDs. [source] Latest news and product developmentsPRESCRIBER, Issue 4 2007Article first published online: 3 APR 200 Low-dose aspirin may reduce asthma risk Low-dose aspirin may reduce the risk of new-onset asthma, according to a US analysis (Am J Respir Crit Care Med 2007;175:120-5). Prompted by speculation of such a link, the authors conducted a post-hoc analysis of the Physicians' Health Study, a placebo-controlled study of aspirin 325mg on alternate days involving 22 071 men aged 40-84. The risk of developing a new diagnosis of asthma during the five-year study was reduced by 22 per cent (p=0.045) among those taking aspirin. However, the number of cases was low: 113 among aspirin recipients and 145 with placebo. The clinical importance of this finding is therefore uncertain, though it received wide coverage in the lay media. Lifestyle changevsdrugs in type 2 diabetes Modifying lifestyle is at least as effective as drugs in delaying the onset of type 2 diabetes in people with impaired glucose tolerance, according to a study from Leicester (BMJ online. doi: 10.1136/bmj.39063.689375.55). The meta-analysis of 17 trials involving 8084 participants found that lifestyle change or orlistat approximately halved the risk of progressing to diabetes, whereas oral hypoglycaemic agents reduced the risk by 30 per cent. A Chinese herb, jiang tang bushen, reduced the risk by two-thirds. The analysis was conducted before the findings of major trials of rosiglitazone (Avandia) , DREAM and ADOPT , were published. Optician prescribing The diagnosis and treatment of disorders such as conjunctivitis by opticians is to be an enhanced service that PCTs can commission according to local need, a Department of Health review has concluded. The General Ophthalmic Services Review considered new arrangements to support PCTs provide ophthalmic services. Professional representatives proposed that the diagnosis and treatment of some eye conditions should be classed as ,additional services' that PCTs should be obliged to commission. While the Department agreed that opticians can play an important role, it found a lack of evidence of benefits and concluded that PCTs should be able to determine their level of services. A commissioning toolkit has been produced to help implement the review's findings. Warfarin stroke risk A four-fold increase in warfarin use has been linked with an increased incidence of intracerebral haemorrhage in a US study (Neurology 2007;68:116-21). Reviewing all first admissions for haemorrhagic stroke in the Cincinnati area, the study found that the proportion of cases associated with warfarin or heparin increased from 5 per cent in 1988 to 9 per cent in 1993/94 and 17 per cent in 1999. The annual incidence among patients aged 80 or older increased from 2.5 to 46 per 100 000 from 1988 to 1999. During the same period, warfarin distribution increased four-fold and there was no change in the incidence of thromboembolic strokes. Co-proxamol will go, MHRA reaffirms The MHRA has confirmed that it still intends to withdraw co-proxamol from the market despite protestations from MPs. The issue was raised by two MPs , one a member of the Health Select Committee , in a House of Commons debate. Both called for the withdrawal process to be abandoned, arguing that GPs should have the right to prescribe a drug for which there may be no alternative. The MHRA has restated its view that the risk from overdose with co-proxamol outweighs its benefits, adding: ,The avoidable death toll from co-proxamol overdose cannot be ignored. Sometimes regulation has to balance the needs of the individual against the benefits at a population level. In this case the removal of marketing authorisations with continued use possible in exceptional circumstances is the best balance that could be achieved. The public health gain is already becoming apparent.' Co-proxamol may still be prescribed as an unlicensed drug after its product licence is withdrawn at the end of this year. Guide to pharmacy services A guide to community pharmacy services has been published for patients, carers and members of patient organisations. Developed by the South East Local Pharmaceutical Committee Forum, Understanding and Making the Best Use of Community Pharmacy explains what pharmacies offer and the services available under the 2005 pharmacy contract. Copies can be downloaded from www.psnc.org.uk/resources. Little benefit from opioids for back pain There is little evidence that opioids relieve chronic back pain but the risk of abuse is high, according to a US analysis (Ann Intern Med 2007;146:116-27). The systematic review of trials of oral, topical and transdermal opioids in the treatment of chronic back pain found no trials lasting more than 16 weeks. There was no significant reduction in pain in placebo-controlled trials and limited, nonsignificant pain reductions in comparative trials. By contrast, estimates of prevalence of current substance misuse were as high as 43 per cent and that of ,aberrant medication-taking behaviours' ranged from 5 to 24 per cent. Dual antiplatelet therapy with drug-eluting stents Patients with drug-eluting stents should not stop dual antiplatelet therapy prematurely (Circulation 2007; published online 15 January; DOI: 10.1161/CIRCUL ATIONAHA.106.180944). Although 12 months' treatment with low-dose aspirin plus a thienopyri- dine, eg clopidogrel (Plavix) and ticlopidine, has been shown to reduce cardiac events after implanting a drug-eluting stent, it is not uncommon for the thienopyridine to be discontinued. Health professionals must do more to educate patients about their treatment and the risks associated with stopping. Scottish approval The SMC (www.scottishmedicines.org.uk) has approved varenicline (Champix) for use within NHS Scotland as part of a smoking cessation programme; it notes that the benefits of extending a course of treatment beyond the initial 12 weeks are modest. Controversially, the SMC has not approved omalizumab (Xolair) as add-on therapy for severe persistent allergic asthma on the grounds that an economic case had not been made. Asthma UK criticised the decision as unjust and inhumane. NICE is due to publish an appraisal of omalizumab later this year. No decline with anti- psychotics Treatment with anti- psychotics does not hasten cognitive decline in patients with Alzheimer's disease, say investigators from London (J Neurol Neurosurg Psychiatry 2007;78:25-9). Their prospective study of 224 patients found no difference in the rate of cognitive decline in those treated with antipsychotics (atypical or otherwise) for at least six months. Label translation online Health IT consultancy Rxinfo has developed a website offering translations of the most common types of labelling. The site (www.translabel.co.uk) offers translations into 13 Asian and European languages for 15 standard labelling phrases covering oral medicines and ENT formulations. A free application can be downloaded to allow direct-to-printer printing. Copyright © 2007 Wiley Interface Ltd [source] Sharing genetic origins information in third party assisted conception: a case for Victorian family values?CHILDREN & SOCIETY, Issue 1 2000Eric Blyth In the United Kingdom (UK) approximately 2500 children are born each year as a result of third party assisted conception. Since formal record keeping by the statutory regulatory body, the Human Fertilisation and Embryology Authority, began in 1991, the total number of children known to have been born from all forms of third party assisted conception exceeds 13 500. Although the records contain information about these children's genetic origins, including the identity of the donor, current legislation severely circumscribes their ability to access this information and, save in very exceptional circumstances, they are not permitted to learn the identity of the donor. Consequently, they are the only individuals in the UK whose inability to learn the identity of both their genetic parents is formally endorsed by statute. This paper identifies different approaches to exchanging genetic origins information in third party assisted conception. It provides a critique of the model currently in force in the UK and advocates its replacement by a system that more closely resembles that introduced in Victoria (Australia) in 1998. Copyright © 2000 John Wiley & Sons, Ltd. [source] Gender, Caste and Matchmaking in Kerala: A Rationale for DowryDEVELOPMENT AND CHANGE, Issue 2 2008Praveena Kodoth ABSTRACT The matrilineal castes of northern Kerala consider dowry demeaning and resort to it only in ,exceptional' circumstances. In local discourse, dowry is transacted when women are considered ,old' by the standards of the marriage market, where over-age is a condition reached usually on account of what is considered a deficit of a normative conception of femininity. Dowry is practised openly only by poor and socially vulnerable households, as the relatively affluent could mask dowry with hidden compensations. This article explores the ways in which gender mediates matchmaking and generates a residual category of women for whom dowry is openly negotiated. Open negotiation on the margins of the marriage market expose the terms of exchange in ,respectable' society, where matchmaking strategies reveal the emphasis placed on conjugality and on caste in the social construction of women's interests and identity. Up to the mid-twentieth century, matrilineal women derived their identity from their natal families. The political economy of marriage in Kerala brought a new emphasis to bear on conjugality and on caste, which generated new restrictions on women and produced a rationale for dowry. [source] | |||||||||||||