Fish oil (n-3 fatty acids) in drug resistant epilepsy: a randomised placebo-controlled crossover study.

Backgroundn-3 fatty acids inhibit neuronal excitability and reduce seizures in animal models. High-dose fish oil has been explored in two randomised trials in drug resistant epilepsy with negative results. We performed a phase II randomised controlled crossover trial of low-dose and high-dose fish oil in participants with drug resistant epilepsy to explore whether low-dose or high-dose fish oil reduces seizures or improves cardiovascular health.MethodsRandomised placebo-controlled trial of low-dose and high-dose fish oil versus placebo (corn oil, linoleic acid) in 24 participants with drug resistant epilepsy. A three-period crossover design was utilised lasting 42 weeks, with three 10-week treatment periods and two 6-week washout periods. All participants were randomised in double-blind fashion to receive placebo, high dose or low dose in different sequences. The primary outcome was per cent change in total seizure frequency.FindingsLow-dose fish oil (3 capsules/day, 1080 mg eicosapentaenoic acid+docosahexaenoic acid) was associated with a 33.6% reduction in seizure frequency compared with placebo. Low-dose fish oil was also associated with a mild but significant reduction in blood pressure. High-dose fish oil was no different than placebo in reducing seizures or improving cardiac risk factors.InterpretationIn this phase II randomised crossover trial, low-dose fish oil was effective in reducing seizures compared with placebo. The magnitude of improvement is similar to that of recent antiepileptic drug trials in drug resistant epilepsy (DRE). The results indicate that low-dose fish oil may reduce seizures and improve the health of people with epilepsy. These findings justify a large multicentre randomised trial of low-dose fish oil (n-3 fatty acids <1080 mg/day) in drug resistant epilepsy.Trial registration numberNCT00871377

Flattening fixed-angle chains is strongly NP-hard

12th International Symposium, WADS 2011, New York, NY, USA, August 15-17, 2011. ProceedingsPlanar configurations of fixed-angle chains and trees are well studied in polymer science and molecular biology. We prove that it is strongly NP-hard to decide whether a polygonal chain with fixed edge lengths and angles has a planar configuration without crossings. In particular, flattening is NP-hard when all the edge lengths are equal, whereas a previous (weak) NP-hardness proof used lengths that differ in size by an exponential factor. Our NP-hardness result also holds for (nonequilateral) chains with angles in the range [60° − ε,180°], whereas flattening is known to be always possible (and hence polynomially solvable) for equilateral chains with angles in the range (60°,150°) and for general chains with angles in the range [90°,180°]. We also show that the flattening problem is strongly NP-hard for equilateral fixed-angle trees, even when every angle is either 90° or 180°. Finally, we show that strong NP-hardness carries over to the previously studied problems of computing the minimum or maximum span (distance between endpoints) among non-crossing planar configurations

Managing the Socially Marginalized: Attitudes Towards Welfare, Punishment and Race

Welfare and incarceration policies have converged to form a system of governance over socially marginalized groups, particularly racial minorities. In both of these policy areas, rehabilitative and social support objectives have been replaced with a more punitive and restrictive system. The authors examine the convergence in individual-level attitudes concerning welfare and criminal punishment, using national survey data. The authors\u27 analysis indicates a statistically significant relationship between punitive attitudes toward welfare and punishment. Furthermore, accounting for the respondents\u27 racial attitudes explains the bivariate relationship between welfare and punishment. Thus, racial attitudes seemingly link support for punitive approaches to opposition to welfare expenditures. The authors discuss the implications of this study for welfare and crime control policies by way of the conclusion

The political economy of competitiveness and social mobility

Social mobility has become a mainstream political and media issue in recent years in the United Kingdom. This article suggests that part of the reason for this is that it can serve as a mechanism to discuss policy concerns that appear to be about social justice without questioning important aspects of neo-liberal political economy. The article charts the policy rhetoric on social mobility under both New Labour and the current Coalition Government. It is argued first that under New Labour the apparent commitment to social mobility was in fact subsumed beneath the pursuit of neo-liberal competitiveness, albeit imperfectly realised in policy. Second, the article suggests that under the Coalition Government the commitment to raising levels of social mobility has been retained and the recently published Strategy for Social Mobility promises that social mobility is what the Coalition means when it argues that the austerity programme is balanced with ‘fairness’. Third, however, the Strategy makes clear that the Coalition define social mobility in narrower terms than the previous government. It is argued here that in narrowing the definition the connection with the idea of competitiveness, while still clearly desirable for the Coalition, is weakened. Fourth, a brief analysis of the Coalition's main policy announcements provides little evidence to suggest that even the narrow definition set out in the Strategy is being seriously pursued. Fifth, the international comparative evidence suggests that any strategy aimed at genuinely raising the level of social mobility would need to give much more serious consideration to narrowing levels of inequality. Finally, it is concluded that when considered in the light of the arguments above, the Strategy for Social Mobility – and therefore ‘Fairness’ itself – is merely a discursive legitimation of the wider political economy programme of austerity

The Organization of Discipline: From Performance Management to Perversity and Punishment

Over the past few decades, poverty governance in the United States has been transformed by the convergence of two powerful reform movements. The first, often referred to as “paternalist,” has shifted poverty governance from an emphasis on rights and opportunities to a stance that is more directive and supervisory in promoting preferred behaviors among the poor. The second, often described as “neoliberal,” has shifted governance away from federal government control toward a system that emphasizes policy devolution, privatization, and performance competition. During this period, public officials have proved remarkably willing to hand policy control over to lower jurisdictions and private providers. They have been equally eager to use public policies in ways that overtly promote values, enforce obligations, and curtail deviance among the poor. In the era of neoliberal paternalism, poverty governance has become more dispersed in its organization, more muscular in its normative enforcement, and more firmly rooted in the logics of performance-based accountability and market competition

Confronting Government After Welfare Reform: Moralists, Reformers, and Narratives of (Ir)responsibility at Administrative Fair Hearings

Almost 40 years ago, the Supreme Court, in the landmark case Goldberg v. Kelly (1970), provided welfare participants with a potentially potent tool for challenging the government welfare bureaucracy by requiring pre-termination hearings before welfare benefits were discontinued or reduced. In 1996, with the passage of the Personal Responsibility Work Opportunity Reconciliation Act (PRWORA), the rights talk of Kelly was officially replaced with the discourse of individual responsibility. Using observational data of administrative hearings and interviews with administrative law judges and appellants, this study explores how fair hearings have been affected by this official re-conceptualization of rights. I find that hearings are not a panacea for challenging the more punitive aspects of welfare reform, but nor are they devoid of the possibility of justice. While hearings can replicate in style and substance the inequities, rigid adherence to rules, and moral judgments that characterize welfare relationships under the PRWORA, they can also be used as a mechanism for creating counter narratives to the dominant discourse about welfare. This study identifies two types of judges moralist judges and reformer judges and examines how their differing approaches determine which narrative emerges in the hearing room

Devolution, Discretion, and Local Variation in TANF Sanctioning

No abstract

Distributing Discipline: Race, Politics, and Punishment at the Frontlines of Welfare Reform

Numerous studies have confirmed that race plays an important role in shaping public preferences toward both redistribution and punishment. Likewise, studies suggest that punitive policy tools tend to be adopted by state governments in a pattern that tracks with the racial composition of state populations. Such evidence testifies to the enduring power of race in American politics, yet it has limited value for understanding how disciplinary policies get applied to individuals in implementation settings. To illuminate the relationship between race and the application of punitive policy tools, we analyze sanction patterns in the TANF program. Drawing on a model of racial classification and policy choice, we test four hypotheses regarding client race and sanctioning. Our study does not support a simple story in which racial minorities are always more likely to be targeted for discipline. Rather, we find the impact of race to be contingent on local politics, administrative decentralization, and other client characteristics