Contraversive neglect? A modulation of visuospatial neglect in association with contraversive pushing

Objective: Contraversive pushing (CP) is a neurologic disorder characterized by a lateral postural imbalance. Pusher patients actively push toward their contralesional side due to a misperception of the body's orientation in relation to gravity. Although not every patient with CP suffers from spatial neglect (SN), both phenomena are highly correlated in right-hemispheric patients. The present study investigates whether peripersonal visuospatial functioning differs in neglect patients with versus without CP (NP+ vs. NP+ patients). Method: Eighteen right-hemispheric stroke patients with SN were included, of which 17 in a double-blind case-control study and 1 single case with posterior pushing to supplement the discourse. A computer-based visuospatial navigation task, in which lateralized deviation can freely emerge, was used to quantify visuospatial behavior. In addition, visuospatial orienting was monitored using line bisection. Results: Significant intergroup differences were found. The NP+ patients demonstrated a smaller ipsilesional navigational deviation and more cross-over (contralesional instead of ipsilesional deviation) in long line bisection. As such, they demonstrated a contraversive (contralesionally directed) shift in comparison with the NP+ patients. Conclusions: These findings highlight the similarity between 2 systems of space representation. They are consistent with a coherence between the neural processing system that mainly provides for postural control, and the one responsible for nonpredominantly postural, visuospatial behavior

Evidence-based prevention of cannabis use in flanders is there a role for health economic evaluation?

OBJECTIVES: Cannabis is a popular drug in Flanders, in spite of the fact that the prevention of its use lists high on the Flemish political agenda. The Flemish Government aims to prevent cannabis use efficiently and in achieving this, a health economic analysis could be helpful. The possibilities and limitations of applying economic evaluation techniques to the prevention of substance (ab)use, are discussed in this paper. METHODS: A thorough literature search, interviews with key persons, an internet search and an analysis of unpublished reports and documents was performed. RESULTS: The interrelation between various forms of substance use, and of the array of strategies to prevent this (including the costs thereof), seems to demand a joint evaluation of multiple substances. CONCLUSIONS: More than methodological difficulties, the general lack of knowledge on age- and time-specific health and income effects caused by various forms of substance (ab)use, currently makes the evidence-based evaluation of prevention of cannabis use in Flanders a virtually impossible undertaking