Search results

In South Africa, many illicit drugs have only recently been introduced and drug-related complications are often new to treating physicians. Heroin-induced leukoencephalopathy has been reported elsewhere in patients who inhale heated heroin vapors, a method known as “chasing the dragon.” The purpose of this paper is to present two patients, known to have inhaled heroin a few weeks prior to presenting with progressive neurological deficits.

Case presentations: two young males presented independently within eight weeks of one another with progressive slurring of speech, incoordination and weakness of the limbs over a period of two to three weeks. Both were known heroin addicts, and were known to one another, and both had inhaled heroin prior to the onset of symptoms.

The patients presented with a pancerebellar syndrome with marked bilateral upper motor neuron signs. CT scans showed diffuse symmetrical hypodense lesions involving the cerebral and cerebellar white matter with normal CSF. Both patients deteriorated neurologically, became cardiovascularly unstable and demised. Postmortem in one of the patients showed a prominent spongiform leukoencephalopathy consistent with reports of heroin-inhalation injury to the brain.

Toxic leukoencephalopathy due to heroin vapor inhalation was first described in the Netherlands in 1982. It has not been reported to occur with other modes of heroin use; an unknown toxin contained in heroin pyrolysate which forms when heroin is heated, may be causative. Brain MRI typically shows diffuse, symmetrical white matter hyperintensities on T2 and fluid-attenuated inversion recovery sequences in the cerebellum, posterior cerebrum and posterior limbs of the internal capsule with a posterior-anterior gradient. Pathologically, spongiform degeneration with relative sparing of subcortical U-fibers is seen. No treatment has been proven effective, but antioxidants and Vitamin E may be beneficial. Mortality is high at 23-48 percent.

This report emphasizes that spongiform leukoencephalopathy as a rare consequence of inhaling heroin vapors does occur in South Africa and clinicians should consider this disorder in their differential diagnosis of acutely developing leukoencephalopathy.

An awareness program regarding this grave condition is planned.

The cardiovascular complications of patients inhaling heroin vapor has not been highlighted previously. These are the first patients from Africa described with this condition. A toxic component appears likely.

Two hundred and four countries are ranked by infrastructure characteristics including transportation, health, education, and communications. The mean and standard deviation of the 204 countries were computed for each infrastructure variable. For each country and each variable, the standard normal deviate was computed as was the associated area of the standard normal deviate and added (or subtracted) to unity to create a score for each country. To ease analysis of the data, each country was placed into one of 11 geographic regions and analyzed by quartiles. Results are depicted in tabular forms.

‘As Gregor Samsa awoke one morning from uneasy dreams, he found himself transformed in his bed into a gigantic insect. He was laying on his hard, as it were armour-plated, back and when he lifted his head a little, he could see his domelike brown belly divided into stiff arched segments on top of which the bed quilt could hardly keep in position and was about to slide off completely. His numerous legs, which were pitifully thin compared to the rest of his bulk, waved helplessly before his eyes’ (Kafka, The Metamorphosis, 1915, p. 19).

Kafka's The Metamorphosis (1915) appears in disability theory to aid explanation for those who experience acquired disability. This allegory offers a visceral picture of what a person can go through; there is a before and an after, a death and a life. I was able-bodied, capable, bursting with energy and then I woke up one morning utterly transformed. I no longer recognise myself; my consciousness mourns my previous existence, and I must come to terms with my reconstituted self.

It is that ‘other’ that I identify with now and, to discover what that means, I began composing a Requiem Mass. I have a long love affair with them; I have sung and conducted them and their ability to pierce the veil between life and death is of particular significance to me. This chapter examines the ways in which my acquired disability, this mystical death, impacts and informs my composition.

Objective. The objective of this study was to examine practices and policies in place for the provision of targeted prevention and treatment of cocaine and Amphetamine Type Stimulant (ATS) users in prison in nine European countries. Methodology. Across nine European member states (Belgium, the Netherlands, Czech Republic, Lithuania, Slovenia, Sweden, Malta, Ireland and Portugal), interviews were conducted with ministerial representatives and professionals (i.e. service providers and security officials) working in prisons and a total of 16 focus groups with a total of 125 prisoners. Results. The use of stimulants in prison is associated with aggression and violence, financial problems, and psychological and physical problems in prisoners (depression, anxiety and psychological craving). Both security and healthcare staff in prison often feel ill‐equipped to deal with stimulant‐related problems, leading to a lack of equivalence of care for stimulant users in prison, therefore the variety and quality of drug services outside is not reflected sufficiently inside prison. There is a need for more specific product information and harm reduction material on stimulants, for clear guidelines for the management of acute stimulant intoxication and stimulant withdrawal, for structural adjustments to improve potential diagnosis of personality and psychiatric disorders, for more non‐pharmacological treatment strategies and more opportunities for prisoners to engage in purposeful activities.

The author is revisiting the body of his papers on Herman Melville's Moby Dick, which he began writing some 15 years ago. Though these writings have remained an “unwritten book”, Melville's works had a lasting impact on his thinking and writing up to the present. The purpose of this paper is to reveal some of the experiences and emotions concomitant with academic writing that remain more often than not hidden from the reader.

This paper is a personal reminiscence on the experience of academic writing for about four decades. It is a story of how an academic becomes acquainted with and then influenced/inspired by a piece of literature and discovers how many organisational topics may be illuminated by works of literature.

Even an unwritten book does not necessarily lead to completely neglecting what had been written. This may be a relief and an encouragement to others, who realize they are not alone in this respect.

The paper adds some further insight into the not‐so‐obvious and broadly hidden experience of the “production process” of academic writing and illustrates the relevance and importance of literature for further thinking on such topics as management and organization.

China and India, increasingly referred to as the world's emerging giants among emerging economies, represent the second and fourth largest economies in the world, respectively. This paper seeks to provide a comparative assessment of these two countries on selected measures on economic growth and social development.

The paper's approach is a discussion, providing a brief introduction to the approach taken by India and China in pursuing economic growth and social welfare measures. The discussion then focuses on the relationship between economic liberalization and social development against a backdrop of relevant concepts and arguments from the literature. Comparative profiles of India and China on select dimensions using data from World Economic Indicators and other sources are provided.

The paper finds that it is clear that there are areas where India can learn from China and vice versa.

The paper illustrates that these two countries offer a potentially rich and useful canvas for exploring the social implications of free market capitalism.

This study traces the growth of Dragon Boat racing from humble beginnings in 1976 as part of a local tourism strategy by the Hong Kong Tourist Association (HKTA) to position Hong Kong as more distinctive than a destination for shopping or with British colonial history appeal. Dragon Boat racing is now a recognized world sport requiring a global strategy of co-operative alliances and is close to becoming an official sport in the Olympic Games. Emergent strategy and symbolic authenticity of intangible cultural heritage are key concerns for integrating special events as a central tourism experience.

This chapter presents three trends emerging from a review of the literature: concern with balancing authenticity and profit-chasing; the phenomenal fast growth of the sport and the challenge to develop and maintain international control and governance; and seeking evidence of health and well-being benefits of Dragon Boat racing for breast cancer survivors.

Survivors and élite athletes represent a symbolic authenticity connected to ancient Chinese intangible cultural heritage. Chasing profits by including cultural heritage as part of a particular tourism strategy has strengthened and protected the legacy of that heritage in unexpected ways. There are lessons for those charged with designing quality events and tourism experiences linked with intangible culture.

Based on literature review only, but sets a framework for research in several directions.

Demonstrates the blurring of boundaries between tourism, events and sports, and how managers must be adept to shift strategy according to changing unexpected dynamics of threats and opportunities, yet still can adhere to symbolic authenticity to maintain integrity of intangible cultural heritage as a tourism experience.

The purpose of this paper is to describe how China’s rapid growth and increasing resource dependence have changed its relationship with India and their respective defense strategies. In particular, we consider China's Belt and Road Initiative, India's “Act East” policy and the strategic and economic value of the Indian Ocean and South China Sea regions.

The authors find no econometric evidence of interactions between China and India’s military spending using a Richardson-Baumol arms race model. Likewise, in a cross-county panel data study of military spending, they find that China’s military spending has no independent effect on military spending in other countries. The authors also show that once wage costs and other sources of military inflation are accounted for, the pattern of real defense spending growth is much less intense than is suggested by nominal data. Nevertheless, they show that China has been undertaking intense military modernization with rapidly rising capital-labor ratios in its defense spending.

The authors find little evidence of a traditional arms race, but also show that China, and to a lesser extent India, have been realigning their military capabilities to these new security risks while maintaining overall military burden on the economy.

Econometric analysis is limited by data availability and is necessarily historical, whereas the security situation is very fluid and may change in the short term.

The paper identifies factors that are likely to influence China and India's attitudes to defense spending in the coming years.

The paper finds that there is not an arms race in the traditional sense but may be an arms race in terms of new technologies and military modernization.

This is a very much underexplored topic in economics. The authors take an interdisciplinary approach showing how economics tools can be used to help understand this important issue in international relations.