Managing Intra-Party Democracy: Comparing the French Socialist and British Labour Party Conferences

The French Socialists and British Labour consider intra-party democracy as a central tenet of their philosophies. It is a core value that orientates their political attitudes and defines their identity. Traditionally, they have privileged a particular type of decision-making, based on the sovereignty of the party conference. However, at the beginning of the 1990s, these meetings projected a damaging image of division and chaos. Confronted with the intense scrutiny of their internal debates by the media, the two parties had to find a better balance between their culture and practices, and the need to promote an image of unity and efficiency. They introduced a number of reforms that, they claim, have expanded the possibilities for individual members to participate while at the same time giving the two leaderships a firmer grip on decision-making. Based on qualitative research conducted over many years, this paper explores the parties' new attitudes to internal democracy and analyses the process of power redistribution within the organizations

北陸地方における工業都市発達の要因についての一考察

OBJECTIVE: We aimed to investigate the current practices guiding surgical resection strategies involving epileptogenic zones (EZs) near or in eloquent cortex (EC) at pediatric epilepsy surgery centers worldwide. METHODS: A survey was conducted among 40 respondents from 33 pediatric epilepsy surgery centers worldwide on the weight assigned to diagnostic tests used to define the EZ and EC, how EC is viewed, and how surgeries are planned for foci near or in eloquent cortex. RESULTS: A descriptive analysis was performed that revealed considerable variation in the use of diagnostic tests and resective strategies toward EZ and EC. SIGNIFICANCE: The wide variation in strategies may contribute to undesirable outcomes characterized by poor seizure control with added deficits and underscores the need to establish best practices in pediatric epilepsy surgery. The survey data were used to formulate a set of recommendations to help minimize deficits and to report them consistently

Cognitive outcome two years after frontal lobe resection for epilepsy – A prospective longitudinal study

AbstractPurposeTo investigate cognitive outcomes after frontal lobe resection (FLR) for epilepsy in a consecutive single centre series.MethodsNeuropsychological examinations were performed prior to and two years (mean test interval 2.5 years) after surgery in 30 consecutive patients who underwent FLR. Cognitive outcome was evaluated with particular consideration to the site of surgery (lateral, premotor/SMA [supplementary motor area], mesial/orbital). Cognitive domains assessed were speed, language, memory, attention, executive functions and intelligence. 25 healthy controls were assessed at corresponding time points (mean test interval 3.0 years). Analyses were made both at group and individual levels.ResultsAt baseline the patients performed below controls in variables depending on speed, executive functions, global and verbal intelligence. Two years after surgery, the analyses at the subgroup level indicated that the lateral resection group had less improvement than the controls in global intelligence, FSIQ (p=.037). However, at the individual level, the majority of the change scores (74–100%) were classified as within the normal range for all but one variable. The exception was the variable “Comprehension” (measuring verbal reasoning ability) with reliable declines in 44% (8/18) of the patients. This pattern of decline was observed in the lateral (4/7 patients) and premotor/SMA (4/7 patients) resection groups. Seizure outcome and side of surgery did not influence these results.ConclusionThe main finding was cognitive stability at group level two years after FLR. A reliable decline in verbal reasoning ability was rather common at an individual level, but only in the lateral and premotor/SMA resection groups. The lateral resection group also had less improvement than the controls in global intelligence

Plateau Waves and Baroreflex Sensitivity in Patients with Head Injury: A Case Study

The study aimed to investigate baroreceptor reflex sensitivity in a patient with head injury for whom plateau waves of intracranial pressure (ICP) were recorded. Baroreflex sensitivity index was separately estimated on top of plateau waves and during intermediate intervals between two consecutive waves. The EuroBaVar data set was utilized to verify and validate the results. A very high baroreflex sensitivity associated with dominant parasympathetic activity was observed spontaneous to the acute elevations of ICP. The high vagal afferent discharge was found to be suggestive for the high firing rate of carotid baroreceptors and probably an active Cushing reflex mechanism during plateau waves

Plateau Waves and Baroreflex Sensitivity in Patients with Head Injury: A Case Study

The study aimed to investigate baroreceptor reflex sensitivity in a patient with head injury for whom plateau waves of intracranial pressure (ICP) were recorded. Baroreflex sensitivity index was separately estimated on top of plateau waves and during intermediate intervals between two consecutive waves. The EuroBaVar data set was utilized to verify and validate the results. A very high baroreflex sensitivity associated with dominant parasympathetic activity was observed spontaneous to the acute elevations of ICP. The high vagal afferent discharge was found to be suggestive for the high firing rate of carotid baroreceptors and probably an active Cushing reflex mechanism during plateau waves

Pulse Wave Velocity in Patients with Severe Head Injury: A Pilot Study

The study aimed to determine the potential of pulse wave velocity measurements to reflect changes in compliant cerebral arteries/arterioles in head injured patients. The approach utilizes the electrocardiogram and intracranial pressure signals to measure the wave transit time between heart and cranial cavity. Thirty five clinical records of nineteen head injured patients, with different levels of cerebrovascular pressurereactivity response, were investigated through the study. Results were compared with magnitude of normalized transfer function at the fundamental cardiac frequency. In patients with intact cerebrovascular pressure-reactivity, magnitude of normalized transfer function at the fundamental cardiac component was found to be highly correlated with pulse wave transit time

Cerebrovascular Mechanical Properties and Slow Waves of Intracranial Pressure in TBI Patients

Myogenic autoregulation of cerebral blood flow is one of the mechanisms affecting cerebral hemodynamics. Short or long-lasting changes in intracranial pressure (ICP) are believed to reveal the responses of the cerebral system to myogenic stimuli. Through the incorporation of a theoretical model into the experimental measurements of cerebrovascular distensibility and compliance in patients with traumatic brain injury (TBI), the current study is an attempt to explain ICP dynamics in either presence or absence of cerebral autoregulation. The pulse wave velocity and transfer function between arterial blood pressure and ICP were utilized as the major tools to reflect variations in the mechanical properties of distant cerebral artries/arteriols. The results imply that different states of cerebral autoregulation and associated regimes within the cerebrovascular system can lead to different types of interrelationship between the slow variations of ICP, cerebral arterial distensibility, and compliance. Consequently, each of these classes may require different types of treatment on patients with TBI

Quality of life in patients with glioblastoma and their relatives

Objectives Glioblastoma is the most aggressive primary brain tumour in adults. The rapid decline of physical and cognitive functions is likely to affect patients and relatives during the entire course of disease. The aim of this study was to describe and compare (a) health-related quality of life (HRQoL) and psychological symptoms between patients with glioblastoma and their relatives, and (b) HRQoL between patients and a general population over time. Methods At baseline, 63 patients and 63 relatives were included. The participants completed the Short Form Health Survey (SF-36) and the Hospital Anxiety and Depression scale (HADS) at seven different occasions from pre-surgery until two years post-surgery. A comparison of SF-36 was made between patients and an age- and gender-matched control group. Descriptive analysis, effect size and Wilcoxon signed-rank test were used. Results Relatives scored lower health-related quality of life (HRQoL) and higher symptoms of anxiety than patients, whilst patients scored worse in the physical parts of the SF-36. Three weeks post-surgery, relatives scored their lowest HRQoL and had the highest risk of anxiety symptoms. Comparing patients with controls, the patients rated worse in both the mental and physical component summaries in HRQoL at most time points. Conclusion Both patients and relatives showed deterioration of HRQoL. In addition, relatives showed high frequency of anxiety symptoms. Our data reveal that relatives of patients with glioblastoma need attention throughout the disease trajectory and they also need support at the right time point