Legislative strengthening meets party support in international assistance: a closer relationship?

Recent reports recommend that international efforts to help strengthen legislatures in emerging democracies should work more closely with support for building stronger political parties and competitive party systems. This article locates the recommendations within international assistance more generally and reviews the arguments. It explores problems that must be addressed if the recommendations are to be implemented effectively. The article argues that an alternative, issue-based approach to strengthening legislatures and closer links with civil society could gain more traction. However, that is directed more centrally at promoting good governance for the purpose of furthering development than at democratisation goals sought by party aid and legislative strengtheners in the democracy assistance industry

Normative data of contact heat evoked potentials from the lower extremities

Contact heat evoked potentials (CHEPs) have become an acknowledged research tool in the assessment of the integrity of the nociceptive system and gained importance in the diagnostic work-up of patients with suspected small fiber neuropathy. For the latter, normative values for CHEP amplitude and latency are indispensable for a clinically meaningful interpretation of the results gathered in patients. To this end, CHEPs were recorded in 100 healthy subjects over a wide age range (20-80 years) and from three different dermatomes of the lower extremities (L2, L5, and S2). A normal baseline (35-52 °C) and increased baseline stimulation (42-52 °C) were applied. Statistical analysis revealed significant effects of stimulation site, stimulation intensity, and sex on CHEP parameters (N2 latency, N2P2 amplitude, and NRS). Significant positive correlations of body height with N2 latency, and pain ratings with N2P2 amplitudes were observed. This is the first time that normative values have been obtained from multiple dermatomes of the lower extremities. The present dataset will facilitate the clinical application of CHEPs in the neurophysiological diagnosis of small fiber neuropathy and by discerning pathological findings help establish a proximal-distal gradient of nerve degeneration in polyneuropathies

New life for an old idea: Assessing tonic heat pain by means of participant controlled temperature

BACKGROUND Temporal changes of pain perception to prolonged tonic heat pain are conventionally assessed using a computerized visual analog scale. Such a rating-based approach is, however, prone to floor and ceiling effects, which limit the assessment of temporal changes in perception. Thus, alternative methods that overcome these shortcomings are warranted. NEW METHOD The aim of this study was to assess the feasibility and reliability of a psychophysical approach, i.e., participant-controlled temperature (PCT), to evaluate ongoing human perception of tonic heat pain. Fifty participants were presented with a 45 °C stimulus on the non-dominant hand, and were instructed to maintain their initial sensation for two minutes via a feedback controller in the dominant hand. A subset of participants (n = 17) performed PCT tonic heat protocols on two different days to determine the test-retest reliability. As participants controlled temperature to maintain a stable pain perception, any adjustments made reflected shifts in their perception of heat. RESULTS In 33 (71.7%) participants, we observed an initial adaptation (participant increased temperature) followed by temporal summation of pain (participant decreased temperature). Twelve participants (26.1%) showed only adaptation and one (2.2%) only temporal summation. No sex differences were observed, nor did the initial rating of pain have an effect on PCT outcomes. Temporal summation of pain showed moderate to substantial reliability upon retest. CONCLUSIONS PCT represents can be reliably performed using a contact heat stimulator to measure the temporal summation of pain. The standardized setup and overall good reliability of the outcome measures facilitate a sound implementation into the clinical work-up of patients with pain conditions

Parliament and Poverty Reduction in Bangladesh: Role of the MP

This article explores the role of Members of Parliament (MPs) in poverty alleviation in Bangladesh. Under the existing party-dominated parliamentary system, MPs do not have really much to do at the national level; their role is to play second fiddle to their party leaders. What most MPs now do is to try to get involved in different kinds of activities at the local level. The government often remains receptive to demands of the MPs for greater local level involvement for two reasons: first, it can be seen as a strategy to compensate the MPs for their lack of genuine involvement in national policymaking; second, it is used as a strategy to exert centralised political control over the locality, especially to discourage the emergence of any ‘autonomous’ local power. Using MPs for centralised control has negative implications for the development of local level representative institutions and democracy deepening in the country

History of the Kleeblattschädel deformity: origin of concepts and evolution of management in the past 50 years

The history and evolution of surgical strategies for the treatment of Kleeblattschädel deformity are not well described in the medical literature. Kleeblattschädel anomaly is one of the most formidable of the craniosynostoses, requiring a multidisciplinary team for surgical treatment. The initial descriptions of this cloverleaf deformity and the evolution of surgical treatment are detailed in the present report. Two illustrative cases of Kleeblattschädel deformity, syndromic and nonsyndromic craniosynostoses treated by the senior authors, are also described along with insights into operative strategies