Public Interest Law Initiative


By O. Onatas. Augsburg College.

In particular research carefully what the organizers want: this means looking carefully through all the advance material you can get hold of buy cheap hoodia 400mg line herbals teas safe during pregnancy. Look also at the topics dealt with in the past; try to find something that will develop these ideas and discussions best hoodia 400 mg juvena herbals. You clearly cannot cover everything and everyone, so these reports are neither a précis nor a set of minutes. Avoid also using the shape of a scientific article (see IMRAD structure). Prefer the feature article structure: from all the informa- tion you will have collected, formulate a message and then choose to put in only the information that will support and elaborate that message. Make sure you get detailed informa- tion from whoever asks you to write the report (see commis- sioning). These could provide detail and colour to lift your report out of the mundane. As with all types of writing, start with the basics: construct a 12 word message from the conference, then go through the usual stages (see process of writing). Conflict of interest Many travel articles are followed by a brief statement stating whether their tickets have been paid for, and if so by whom. Similarly, many papers in scientific journals make it clear if the work has been supported by the pharmaceutical company whose product is being tested. The point is that readers have the right to assume that the views expressed in an article are honestly held, and are not being expressed for other reasons, such as an expenses-paid trip to Monte Carlo. If publications are not trusted, they lose their usefulness (see Pravda effect). If there is any reason for anyone to suppose that bias could take place, then it must be declared. Confusing pairs Some words are troublesome because they sound the same as other words (see homophones); others give trouble because they are confused with other words that sound different – but not too different. Here is a sample: • affect and effect: (1) to influence, and (2) to accomplish, • alleviate and elevate: (1) to lessen, and (2) to raise or increase, 28 CONFUSING PAIRS • continual and continuous: (1) very often, and (2) unbroken, • flaunt and flout: (1) to display ostentatiously, and (2) to display contempt for (the law etc. Controversy Editors realize that there is nothing better for readership than a good row. Copy-editors People used by book publishers (mainly) to put text into house style, correct grammar and spelling, and to point out infelicities (such as, in this case, my failure in the first draft to give copy-editors an entry of their own). Copyright This establishes the creator of a piece of original work and protects authors against others stealing the idea or making money out of copying it, often badly. First, you must seek permission if you want to use substantial pieces of text, charts or tables from another article. Most publishers ask authors to assign the copyright to them, so this task is fairly straightforward. Then there is the question of how authors, particularly those working on their own, can ensure that they, and not their publisher, will make the money their brilliance deserves. This has always been difficult, and the new freedoms of the World Wide Web will make it more so. I suspect that this is one of those areas where the amount of effort (and loss of goodwill) is usually outweighed by the actual amount of money involved. The simple answer is that, if your idea is 29 THE A–Z OF MEDICAL WRITING that good, then you should immediately get yourself an agent, who can carry out these unpopular arguments on your behalf. In fact they are usually changes, and not corrections (see balanced feedback). Corrections Publishing anything is a complicated business, and mistakes are inevitable (see law of late literals). Editors clearly have a duty to their readers to correct information that has been proved to be wrong. Covering letter Presentation is an important part of the battle to impress an editor, and the covering letter offers an excellent opportunity to make a good impression from the start. If you are submitting to magazines and newspapers for the first time, you may wish to enclose some cuttings of previous articles you have had published in similar publications. But you may wish to drop in the fact that your research gives the next step in a series of findings published by the journal, or that it genuinely adds to the debate on an important topic.

The Buddhist school is aimed at liberating the mind through the Qigong exercises proven 400 mg hoodia biotique herbals. Many Buddhist exercises are inwardly oriented to focus your attention on the spiritual aspects of your life generic hoodia 400 mg fast delivery yashwant herbals. As a result, these are often described as static, or non-moving, Qigong exercises. Confucian Qigong has not, to this point, been utilized extensively in the United States, but is still practiced in China. The Medical school teaches patients how to take control of their own illnesses, and also how to prevent them. It also teaches medical people how to use the inner Qi in a dynamic way for healing the aches and pains of others. The Martial school of Qigong focuses on protecting the body from sword cuts, blunt trauma from other-than-edged weapons, and safety from attack by fist or foot. It also trains the body to deliver fatal blows that are enhanced with Qi, such as those found in Burning Palm or Iron Palm methods. Within the various schools of Qigong, you will find very simple and easy-to-do sets, such as the 18-Movement Qigong and Eight Pieces of Brocade, to more com- plicated methods such as Wild Goose Qigong and Falun Gong. All have their rela- tive merits and drawbacks, so once you progress to the stage where you are looking for a new Qigong form, choose carefully. TLFeBOOK Q igong B asics / 39 Introduction to Medical Qigong Traditional Chinese Medicine (TCM) is a holistic system for promoting health through the use of several therapies such as acupuncture, herbal medicine, acupressure massage, and Medical Qigong. The central theory of TCM is to balance the Qi (the vital energy in the body) according to several theories such as Yin-Yang, Five Element, and Six Stages. These theories are used in TCM in general as well as in Medical Qigong in particular. In the Yin-Yang Theory, all of life is composed of two opposing yet comple- mentary forces: the yin (feminine, dark, weak) and the yang (masculine, light, strong). At birth, the human body normally contains equal amounts of both traits. When sickness develops, it can be attributed to a deficiency or excess of either of the two forces. Medical Qigong seeks to restore this balance through movement and breathing exercises. The Five Element Theory states that all things in the universe, including hu- mans, have a collection of traits that correspond to five natural Elements: Wood, Fire, Metal, Earth, and Water. Within each of these elements is found a certain physical and mental representation: Wood: Liver, growth at birth, yang. Qigong exercises affect the actions of the five Elements in the body through Qi flow. Thus, a person who is diagnosed as being Water deficient may have exercises prescribed to improve that Element, thus aiding kidney function. An expert in Medical Qigong is often also a Chinese medicine practitioner, as the ability to di- agnose the five Element signs is vital to both fields. The Six Stages Theory uses the idea that disease attacks certain organs and organ systems according to severity and level of infection. For example, the Great Yang Stage sickness affects the exterior of the body, in addition to the small intes- tine and bladder, while the Terminal Yin Stage affects the pericardium and liver organs and strikes deep within the body. According to the proper diagnosis using this theory, exercises would again be prescribed to alleviate the disease. A more detailed account of Traditional Chinese Medicine can be found in Chap- ter12. The exercises that you will learn here are designed to give your body a tune up at many different levels. They have been refined and tested over thousands of years specifically with medical concerns in mind. So when you do the exercises in their proper form and sequence, you will be stimulating the meridians and channels in the body to enhance the flow of healthy energy (Qi) while at the same time eliminating the unhealthy energy (Sha Qi). Because of the positions assumed during the movements, you are alternately com- pressing and expanding the energy rivers, in addition to exercising the muscles, tendons, ligaments, and joints. By learning proper posture and diaphragmatic breath- ing, you are aiding your body in maintaining optimal health and fitness.

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The latency of the facilitation is compatible with an oligosynaptic group I effect buy hoodia 400 mg line herbals meds. The observed reflex reversal presumably results from the opening of an Peroneal-induced changes in excitability of excitatory group I pathway in the early stance of biceps motoneurones during standing walking with a concomitant shut-down of heterony- At rest a group I volley to the deep peroneal nerve mous group I inhibition generic hoodia 400 mg otc ayur xaqti herbals. During a tonic voluntary co-contraction In early stance there is a lengthening contraction of biceps and tibialis anterior while standing, a deep from pretibial flexors and this results in a significant Studies in patients 275 (a) Ib INs 24 (c) Tonic TA + Bi Bi Ib MN 0 Ia TA (d ) Swing phase 30 MN DPN 0 (e) 24 120 (b) Stance phase 100 80 0 0 4 8 12 0 40 80 ISI (ms) Latency after DPN stimulation (ms) Fig. Vertical dotted lines indicate the onset of the EMG suppression ((c), (d )) or facilitation (e). At this time of the gait cycle, implications the group I discharge facilitates biceps motoneu- rones. Quadriceps motoneurones would also be Ib inhibition facilitated by the group I–group II discharges (cf. Facilitation of the two antag- Methodology onistic muscles operating at knee level by afferent discharges from ankle dorsiflexors would contribute So far, changes in transmission in Ib inhibitory path- to the co-contraction, and help ensure maximal sta- ways in patients have been investigated only by bilityofthekneejointinearlystance(seeChapter11, assessing the inhibition of the soleus H reflex pro- p. This is, indeed, the best method because normal subjects, the inhibition could be obtained changes in Ib inhibition are not contaminated by with stimulus intensities as low as 0. However, it is necessary to keep the con- 1 × MT, it was quite weak (on average, reducing the ditioning stimulus below 1 × MT to avoid recur- test reflex to 93. In patients with rent inhibition, and few group I afferent fibres will spinal cord lesions, the amount of inhibition of the be recruited by conditioning volleys of such weak soleus H reflex was not significantly different from intensity. This makes it difficult to deter- Hyperekplexia mine the significance of a reduction of the inhibition in patients. Five patients with hyperekplexia (startle disease) havebeeninvestigated,threeofwhomhadadefined mutation in glycine receptors (Floeter et al. Stroke patients Reciprocal Ia inhibition (known to be mediated Modulation of the soleus H reflex by a condi- through a glycinergic inhibitory system; Chapter 5, tioning volley to the gastrocnemius medialis nerve p. However, the tic patients following a stroke (Delwaide & Olivier, results were so variable that they have to be inter- 1988). The reflex was found to be reduced or even replaced by amount of facilitation was moderately correlated facilitation occurring with the same central delay, with the degree of spasticity assessed by the Ash- consistentwithtransmissionthroughanoligosynap- worth scale (r = 0. These results have since been tic group I pathway (Delwaide, Pepin & Maertens de confirmed in a larger number of patients (Del- Noordhout, 1991). The suppression of the inhibition in ues correlated with the intensity of rigidity assessed patients with corticospinal lesions might suggest by the Webster scale: increased rigidity was associ- that there is normally tonic corticospinal facilitation ated, first, with a reduction of inhibition and, from ofIbinterneurones. However,becausetheinhibition a score of 2 or more, with facilitation replacing the tends to be replaced by facilitation, a reduction of normal inhibition. In de novo patients treated with the inhibition does not necessarily mean that trans- L-dopa, the decrease in facilitation paralleled the mission in the Ib inhibitory pathway is suppressed reductionoftherigidity. Because of the strong Gastrocnemius medialis-induced inhibition of the correlation between the decreased Ib inhibition and soleusHreflexhasbeeninvestigatedinpatientswith the increased reciprocal Ia inhibition, a common well-defined (essentially traumatic) chronic spinal mechanism for these two abnormalities has been cord lesions (Downes, Ashby & Bugaresti, 1995). In put forward (increased reticulospinal activation; Studies in patients 277 Delwaide, Pepin & Maertens de Noordhout, 1993). Ib excitation in spastic patients However, again, the reduction of the gastrocne- mius medialis-induced inhibition of the soleus H Peroneal-induced group I facilitation reflex does not necessarily mean that the transmis- sion in the Ib inhibitory pathway is suppressed (see Disynaptic peroneal-induced reciprocal Ia inhibi- below). Delwaide (1985) also mentioned an soleus H reflex is greater in such patients (Fine early peroneal-induced facilitation in a few spastic et al. This could be related to a loss of inhibi- patients, but gave no details of the lesions causing tion of Ib interneurones through degeneration of the thespasticity. Thedecreaseinthegastrocnemiusmedialis-induced The facilitation has the same central delay as recip- Ib inhibition of the soleus H reflex in spastic or rocal Ia inhibition and peaks at the 3–4 ms ISI. In Parkinsonian patients does not necessarily imply individual subjects, the facilitation was seen in two decreased transmission across the Ib inhibitory of four patients with incomplete spinal cord injury, pathway. The inhibition tends to be replaced by four of seven patients with a complete lesion, and a facilitation, and this could indicate that facili- all six stroke patients (Crone et al. A follow- tated group I excitation overwhelms the Ib inhibi- up study performed in hemiplegic patients revealed tion, with or without decreased Ib inhibition.

For less af- hance activity-dependent plasticity within fected muscles order hoodia 400mg with visa shahnaz herbals, isometric resistance exercise spared representations and newly functioning and conditioning exercises ought to be insti- circuits discount hoodia 400mg overnight delivery planetary herbals quality. So far, however, no published experi- tuted as soon as possible to prevent disuse at- ments have demonstrated growth of new cells rophy and loss of overall fitness. What follows is a selection of highly controlled experimental ma- EXPERIMENTAL INTERVENTIONS nipulations in specific animal models. These FOR REPAIR OF SPINAL experiments serve as stepping stones to a mix CORD INJURY of repair strategies. Their applicability as stand- alone interventions for larger and more com- Some of the more promising applications of bi- plex human injuries is moot. Clinical trials that ologic interventions for reconstituting net- make use of a singlular intervention, however, works and diminishing disability derive from are growing in number (see www. A A potpourri of manipulations may soon find ap- growing number of provocative studies de- plications in patients. The drawing shows potential biologic responses to a spinal cord injury (gray middle). A cortical pyramidal neuron (top) partially retracts from the injury and then extends its axon (dashed line) to an transplanted neural precur- sor, which in turn sends its axon to a motoneuron in the ventral horn. An injured ascending fiber extends through the im- planted milieu to reconnect to a cortical neuron. In response to deafferentation, that cortical neuron had sent out a den- dritic contact to a neighboring neuron (far right). In response to motoneuron denervation in the cord, the cortical cell sprouted a dendritic connection to another spinal mo- toneuron in the ventral horn. One of the implanted neural precursors extended an axon a short distance, but made a con- nection only within the milieu of the transplant. Trials with 21- Neurotrophins do have a sparing effect on aminosteroids and antioxidants such as tirilizad motoneurons when placed within the injury have been disappointing. In ad- vestigators detected no progression of dying dition, perilesion apoptosis occurs for up to 8 back beyond the first 4 weeks after the in- weeks after an experimental spinal cord con- jury. Therapeutic of rats whose axons were cut in the cervical approaches include interrupting the cascade of cord 1 year before, causing profound atrophy apoptosis, such as blocking the release of cy- 120 Neuroscientific Foundations for Rehabilitation tokines, providing caspace inhibitors, and per- modest effects on behavior and histology. Macrophages transplanted into the acutely contused tissue produce neu- The major barriers to axonal regeneration in- rotrophins and inhibit extracellular matrix mol- clude glial scar, molecules in the milieu that in- ecules in the rat. Follow- munity and neuroprotection have had modest ing a SCI in rodents, lesioned corticospinal success in rodent models of SCI. Vaccinations designed to en- tal tissue, peripheral nerve, and Schwann cell hance autoreactive lymphocyte responses after grafts, but tend not to extend beyond these CNS trauma may cause greater injury in pa- stimuli into distal white matter. Olfactory en- tients who are genetically predisposed to au- sheathing cells have led to greater growth into toimmune diseases. Inosine enabled uninjured axons to sprout collaterals into normal white matter. MOLECULES FOR ATTRACTION Other axons, especially serotonergic and nora- AND REPULSION drenergic fibers, have traversed longer dis- tances after injury. Around a SCI contusion and cavity, axons re- tract less than 1 cm and then may sprout. Bres- nahan and colleagues found corticospinal tract LIMIT GLIAL SCAR sprouting between 3 weeks and 3 months af- Immediately after a spinal cord contusion, pe- ter a moderate SCI in rodents. Thus, a modest percentage of injured activated inflammatory cells infiltrate an in- axons may regenerate into the trabecular tis- creasingly necrotic cavity. Neutrophils, mi- sue that thinly bridges the cavity, as well as into croglia, and proinflammatory chemokines and residual gray and white matter around the cyst cytokines initiate macrophage phagocytosis. Within a week, T-lymphocytes and circulating Antibodies to specific myelin-associated in- monocytes enter the region of injury. Neurotrophin-3, but not and bystander damage inflicted by natural and BDNF injected into the lesioned rat spinal autoimmune inflammatory responses. Drugs cord increased the regenerative sprouting of that block cytokines have not had clinical effi- the transected corticospinal tract; neutralizing cacy. Focal irradiation within several days of a the myelin-associated neurite growth in- contusion may quench the influx of inflamma- hibitory proteins resulted in regeneration of up tory cells.

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