Carrying a Big Carrot: Linking Multilateral Disarmament and Development Assistance

This article proposes, as a new element of the liberal internationalism that should characterize the post-Cold War world, a simultaneous solution to these three problems. The nations of the world should negotiate a series of multilateral agreements to stop the spread of advanced weaponry, and include in each of them, as an overt incentive for developing states to accept the disarmament and verification obligations, provisions that explicitly require the affluent, developed states to make specified monetary and in-kind transfers to the third world parties. The new regime should also provide stronger-than-customary treaty procedures for clarifying ambiguities, adjudicating claims, and resolving disputes, and should designate one or more multilateral administrative and enforcement agencies dedicated to furthering the agreements. In short, the wealthy countries, which stand to benefit the most from the establishment of a more stable international military environment, should be willing to pay for it. They should provide aid and commercial grants to the developing states that, in turn, should agree to accept significant, verifiable limitations, particularly on high-technology armaments, as an explicit condition for these important financial advantages. While this package approach will not by itself solve all the security difficulties of the next century, it offers the best hope for gaining control over some of them and for channeling our collective energies into productive and mutually beneficial enterprises. The argument of the article is developed in the following six parts. Part I examines the problem of multilateral disarmament, summarizing the progress registered to date and the areas in which more needs to be done. It also demonstrates that the coming decades, even after the ending of the Cold War, will present stark new threats to United States security and world peace, threats that existing arms control institutions and treaty regimes have been unable to anticipate and preempt. Part II addresses the problems of economic development, drawing on the literature describing the importance of judicious foreign assistance in promoting sound economic growth in marginal economies, and assessing the international community\u27s currently inadequate response to this need. It describes the third world\u27s stake in economic development and presents the case for the advanced societies to do more--out of sheer economic and political self-interest, if nothing else. Part III then suggests that future arms control imperatives will present challenges and dangers that are systematically different from those that the world has confronted--and resolved inadequately--in the past. It marshals the evidence for the propositions that the world\u27s current strategies for dampening international conflict through existing types of treaty regimes are already insufficient, and that the trend is worsening. Part IV presents our proposal for a tradeoff, with the developed states frankly buying the arms control they need, and paying for it with guaranteed levels of development assistance that the poor states need. This Part then outlines seven principles that underlie the proposal as a whole and presents some of the nuts and bolts that could make it operational. While the suggestion may seem radical at first blush--legalized bribery or economic imperialism in some eyes--we think it offers a realistic, efficient solution to otherwise intractable global threats. Part V deals with some of the most serious objections that might be raised against our strategy, discussing the morality of the tradeoff, its political acceptability, the precedents for it, and possible alternatives to it. Finally, the Conclusion offers some observations about the proposal as one component in an overdue, more subtle, conceptualization of national security. The author’s thesis is that international agreements linking multilateral disarmament and economic development, though novel and potentially risky, offer the most promising way out of the international community\u27s emerging security impasse. Their program would give both developed and developing states what they need. It would fashion a flexible, enforceable scheme for dealing with the complex fears and incentives that are otherwise unaddressed or confined to under-the-table bargaining. Explicit trading may not seem palatable at first, but equipping future treaties with both positive incentives and negative sanctions, rather than relying exclusively upon negative sanctions alone, could prove to be far more tolerable than any of the alternatives

What contributes to depression in Parkinson's disease?

Background: Depression is a common problem in patients with Parkinson's disease, but its mechanism is poorly understood. It is thought that neurochemical changes contribute to its occurrence, but it is unclear why some patients develop depression and others do not. Using a community-based sample of patients with Parkinson's disease, we investigated the contributions of impairment, disability and handicap to depression in Parkinson's disease. Methods: Ninety-seven patients seen in a population-based study on the prevalence of Parkinson's disease completed the Beck Depression Inventory (BDI). Clinical and historical information on symptoms and complications of Parkinson's disease were obtained from the patients by a neurologist. In addition, clinician and patient ratings of disability on the Schwab and England scale were obtained and a quality of life questionnaire was completed. Results: Moderate to severe depression (BDI [gt-or-equal, slanted] 18) was reported by 19·6% of the patients. Higher depression scores were associated with advancing disease severity, recent self-reported deterioration, higher akinesia scores, a mini-mental score of 50% of the variance of depression scores. Conclusions: Depression in patients with Parkinson's disease is associated with advancing disease severity, recent disease deterioration and occurrence of falls. Regression analysis suggests that depression in Parkinson's disease is more strongly influenced by the patients' perceptions of handicap than by actual disability. The treatment of depression should therefore be targeted independently of treatment of the motor symptoms of Parkinson's disease, and consider the patients' own perception of their disease

Theoretical analysis of the electrical aspects of the basic electro-impulse problem in aircraft de-icing applications

A method of modelling a system consisting of a cylindrical coil with its axis perpendicular to a metal plate of finite thickness, and a simple electrical circuit for producing a transient current in the coil, is discussed in the context of using such a system for de-icing aircraft surfaces. A transmission line model of the coil and metal plate is developed as the heart of the system model. It is shown that this transmission model is central to calculation of the coil impedance, the coil current, the magnetic fields established on the surfaces of the metal plate, and the resultant total force between the coil and the plate. FORTRAN algorithms were developed for numerical calculation of each of these quantities, and the algorithms were applied to an experimental prototype system in which these quantities had been measured. Good agreement is seen to exist between the predicted and measured results

Theoretical analysis of the electrical aspects of the basic electro-impulse problem in aircraft de-icing applications

A summary of modeling the electrical system aspects of a coil and metal target configuration resembling a practical electro-impulse deicing (EIDI) installation, and a simple circuit for providing energy to the coil, was presented. The model was developed in sufficient theoretical detail to allow the generation of computer algorithms for the current in the coil, the magnetic induction on both surfaces of the target, the force between the coil and target, and the impulse delivered to the target. These algorithms were applied to a specific prototype EIDI test system for which the current, magnetic fields near the target surfaces, and impulse were previously measured

Limb amputations in fixed dystonia: a form of body integrity identity disorder?

Fixed dystonia is a disabling disorder mainly affecting young women who develop fixed abnormal limb postures and pain after apparently minor peripheral injury. There is continued debate regarding its pathophysiology and management. We report 5 cases of fixed dystonia in patients who sought amputation of the affected limb. We place these cases in the context of previous reports of patients with healthy limbs and patients with chronic regional pain syndrome who have sought amputation. Our cases, combined with recent data regarding disorders of mental rotation in patients with fixed dystonia, as well as previous data regarding body integrity identity disorder and amputations sought by patients with chronic regional pain syndrome, raise the possibility that patients with fixed dystonia might have a deficit in body schema that predisposes them to developing fixed dystonia and drives some to seek amputation. The outcome of amputation in fixed dystonia is invariably unfavorable

Mild Cognitive Impairment in Parkinson's Disease - What Is It?

PURPOSE OF REVIEW: Mild cognitive impairment is a common feature of Parkinson’s disease, even at the earliest disease stages, but there is variation in the nature and severity of cognitive involvement and in the risk of conversion to Parkinson’s disease dementia. This review aims to summarise current understanding of mild cognitive impairment in Parkinson’s disease. We consider the presentation, rate of conversion to dementia, underlying pathophysiology and potential biomarkers of mild cognitive impairment in Parkinson’s disease. Finally, we discuss challenges and controversies of mild cognitive impairment in Parkinson’s disease. RECENT FINDINGS: Large-scale longitudinal studies have shown that cognitive involvement is important and common in Parkinson’s disease and can present early in the disease course. Recent criteria for mild cognitive impairment in Parkinson’s provide the basis for further study of cognitive decline and for the progression of different cognitive phenotypes and risk of conversion to dementia. SUMMARY: Improved understanding of the underlying pathology and progression of cognitive change are likely to lead to opportunities for early intervention for this important aspect of Parkinson’s disease

Electro-impulse de-icing testing analysis and design

Electro-Impulse De-Icing (EIDI) is a method of ice removal by sharp blows delivered by a transient electromagnetic field. Detailed results are given for studies of the electrodynamic phenomena. Structural dynamic tests and computations are described. Also reported are ten sets of tests at NASA's Icing Research Tunnel and flight tests by NASA and Cessna Aircraft Company. Fabrication of system components are described and illustrated. Fatigue and electromagnetic interference tests are reported. Here, the necessary information for the design of an EIDI system for aircraft is provided

Adolescent and Adult Children of Parents with Parkinson's Disease: Incorporating Their Needs in Clinical Guidelines

Purpose. To compare the quality of life (QoL) and emotional well-being of the offspring of parents with Parkinson's disease (PD) and multiple sclerosis (MS) and to consider results in light of current UK clinical guidelines. Methods. 143 adolescent and adult children of parents with PD and MS were postally administered the Parental Illness Impact Scale and a measure of emotional well-being. Results. Minimal differences were observed between the two groups in both QoL and emotional well-being. Levels of mild to moderate depression were substantially greater than those of the general population. Conclusions. The nonsignificant differences reported indicate a similar degree of impact across the two conditions assessed. A significant body of evidence demonstrates the considerable impact of parental MS, with the needs of children being acknowledged in current clinical guidelines. There is a need to similarly acknowledge the potential impact of parental Parkinson's in UK guidelines for PD

Prediagnostic presentations of Parkinson's disease in primary care: a case-control study

Background: Parkinson’s disease (PD) has an insidious onset and is diagnosed when typical motor features occur. A number of motor and non-motor features may occur during a “pre-diagnostic” phase, reflecting the early disease process. Previously there has been no comprehensive analysis in the general population of the relative magnitude and timing of their association with PD diagnosis. Aim: To assess the association of first presentation of several pre-diagnostic features in primary care with a subsequent diagnosis of PD, and to chart the timeline of these first presentations before diagnosis of PD. Methods: 8,166 individuals with a first diagnosis of PD and 46,755 individuals without PD were identified from 1st January 1996 to 31st December 2012 from The Health Improvement Network, United Kingdom primary care database. Codes were extracted for a wide range of possible pre-diagnostic or early symptoms comprising motor features (tremor, rigidity, balance impairment, neck pain and shoulder pain), autonomic features (constipation, hypotension, dizziness, erectile dysfunction, urinary dysfunction), mental disturbances (memory problems, depression, anxiety) and additional features (fatigue, insomnia) in the years prior to diagnosis. Incidence rates for symptoms recorded in more than 1% of cases per 1000 person years and incidence risk ratio (RR) were calculated and compared for individuals with and without PD at two, five and ten years before diagnosis. Findings: At two years before PD diagnosis the incidence of all examined pre-diagnostic features except neck pain was higher in patients (n=7,232) than in controls (n=40,541). At five years before diagnosis, patients with PD (n=4,769) had higher incidence rates of tremor (RR 13.70 (95%CI 7.82-24.31), balance impairment (RR, 2.19 (95%CI 1.09-4.16), depression (RR 1.76 (95%CI 1.41-2.17), anxiety (RR 1.41 (95%CI 1.09-1.79), constipation (RR 2.24 (95%CI 2.04-2.46), postural hypotension (RR 3.23 (95%CI 1.85-5.52), dizziness (RR 1.99 (95%CI 1.67-2.37), erectile dysfunction (RR 1.30 (95%CI 1.11-1.51), fatigue (RR 1.56 (95%CI 1.27-1.91), and urinary dysfunction (RR 1.96 (95%CI 1.34-2.80) than controls (n=25,544). At ten years before diagnosis of PD the incidence of constipation (RR 2.01 (95%CI 1.62-2.49) and tremor (RR 7.59 (95%CI 1.1-44.8) was already higher in those with later diagnosis with PD (n=1,680) than in controls (n=8,305). Interpretation: This study for the first time provides evidence for a range of pre-diagnostic features that can be detected several years before diagnosis of PD in primary care, estimating the comparative magnitude of risk for each and where they fit in the prodromal timeline. These data on the pre-diagnostic symptoms of PD can be incorporated into ongoing efforts to identify individuals at the earliest stages of the disease in future trials and help understand progression in the earliest phase of PD