A double-blind study of the efficacy of apomorphine and its assessment in "off-periods in Parkinson's disease

Five patients with idiopathic Parkinson's disease with severe response fluctuations were selected for a randomized double-blind placebo-controlled study, concerning the clinical effects of subcutaneous apomorphine and its assessment in `off¿-periods. The study was designed as five n = 1 studies, in which every patient was his own control. The effect of apomorphine was studied by using the Columbia rating scale and quantitative assessments, using tapping, walking and pinboard. There was a significant positive effect of apomorphine, in a mean optimal dose of 2.7 mg, with a mean latency of onset of 7.3 min and a mean duration of response of 96 min. After pretreatment with domperidone, no significant adverse effects were observed. Tapping showed the highest correlation with rigidity and bradykinesia. Walking showed a high correlation with stability and gait. Pinboard testing did not give additional information. The first conclusion was that apomorphine proved to be a significantly effective dopamine agonist, proven now also by a double blind placebo-controlled study. Secondly it was concluded that assessment of clinical effect in parkinsonian patients can be performed best by combining the Columbia item tremor with tapping and walking scores

Splitting a Difference of Opinion:The Shift to Negotiation

Negotiation is not only used to settle differences of interest but also to settle differences of opinion. Discussants who are unable to resolve their difference about the objective worth of a policy or action proposal may be willing to abandon their attempts to convince the other and search instead for a compromise that would, for each of them, though only a second choice yet be preferable to a lasting conflict. Our questions are: First, when is it sensible to enter into negotiations and when would this be unwarranted or even fallacious? Second, what is the nature of a compromise? What does it mean to settle instead of resolve a difference of opinion, and what might be the dialectical consequences of mistaking a compromise for a substantial resolution? Our main aim is to contribute to the theory of argumentation within the context of negotiation and compromise formation and to show how arguing disputants can shift to negotiation in a dialectically virtuous way.</p

Pressure and Argumentation in Public Controversies:A Dialogical Perspective

When can exerting pressure in a public controversy promote reasonable outcomes, and when is it rather a hindrance? We show how negotiation and persuasion dialogue can be intertwined. Then, we examine in what ways one can in a public controversy exert pressure on others through sanctions or rewards. Finally, we discuss from the viewpoints of persuasion and negotiation whether and, if so, how pressure hinders the achievement of a reasonable outcome.Quand le fait de faire pression dans une controverse publique peut-il promouvoir des résultats raisonnables, et quand est-ce plutôt un obstacle? Nous montrons comment la négociation et le dialogue de persuasion peuvent être entrelacés. Ensuite, nous examinons de quelle manière on peut, dans une controverse publique, faire pression sur les autres par le biais de sanctions ou de récompenses. Enfin, du point de vue de la persuasion et de la négociation, nous discutons de la question de savoir si, et si oui, comment la pression empêche la réalisation d’un résultat raisonnable

In the Quagmire of Quibbles:A Dialectical Exploration

Criticism may degenerate into quibbling or nitpicking. How can discussants keep quibblers under control? In the paper we investigate cases in which a battle about words replaces a discussion of the matters that are actually at issue as well as cases in which a battle about minor objections replaces a discussion of the major issues. We survey some lines of discussion dealing with these situations in profiles of dialogue