University of Minnesota-Crookston. I. Uruk, MD: "Purchase cheap Risperidone - Effective online Risperidone".
These motions are monitored in the time domain by simultaneous absorption of two probe-pulse photons which order 2 mg risperidone fast delivery medications for ptsd, in this case generic risperidone 4mg on-line medications in canada, ionise the dissociating molecule order risperidone pills in toronto medicine q10. An initial discount risperidone amex medicine journal impact factor, ultrafast ‘pump’ pulse promotes IBr to the potential energy curve V1, where the electrostatic nuclear and electronic forces within the incipient excited IBr* molecule act to force the I and Br atoms apart. V1 contains a minimum, however, so as the atoms begin to separate the mole- cule remains trapped in the excited state unless it can cross over onto the repulsive potential V1, which intersects the bound curve at an extended Laser snapshots of molecular motions 9 I–Br bond length. Quantum theory does in fact allow such a curve-crossing to occur, with a probability that depends on, amongst other things, the velocity of the escaping atoms, the exact shape of the intersecting poten- tials at their crossing point, and the spacing of vibrational quantum levels available to the excited molecule in its quasi-bound state. From a theoretical perspective, the object that is initially created in the excited state is a coherent superposition of all the wavefunctions encom- passed by the broad frequency spread of the laser. Because the laser pulse is so short in comparison with the characteristic nuclear dynamical time scales of the motion, each excited wavefunction is prepared with a deﬁnite phase relation with respect to all the others in the superposition. It is this initial coherence and its rate of dissipation which determine all spectro- scopic and collisional properties of the molecule as it evolves over a fem- tosecond time scale. For IBr, the nascent superposition state, or wavepacket, spreads and executes either periodic vibrational motion as it oscillates between the inner and outer turning points of the bound poten- tial, or dissociates to form separated atoms, as indicated by the trajectories shown in Figure 1. The time evolution of the wavepacket over the intersecting potentials V1 and V1 is monitored by its interaction with a second ultrashort ‘probe’ pulse, which in this case supplies two ultraviolet photons to ionise the molecule by removal of an outer electron. The key experimental require- ment in this and all other pump-probe measurements is the ability to deliver the two ultrafast laser pulses to the sample separately spaced by a controllable and accurately known difference in time. This is achieved in the laboratory by routing one of the pulses via an interferometric transla- tion stage which can vary the path length between pump and probe pulses prior the sample with a precision of a fraction of a micrometre ( m) (1 m distance equates to about 3. The experiment consists of meas- uring in a mass spectrometer the number of ionised IBr* molecules excited by pump and probe pulses as function of the delay time between the two (see Figure 1. Br] molecule over different coordinates of the potential energy curves V1 and V1; the probe pulse can be thought of as projecting onto the potentials a detection ‘window’, the width of which is determined by the spectral breadth, and hence duration, of the pulse, through which the dynamics of the dissociating molecule can be observed. Experimental and theoretical femtosecond spectroscopy of IBr dissociation. Experimental ionisation signals as a function of pump-probe time delay for different pump wavelengths given in (a) and (b) show how the time required for decay of the initally excited molecule varies dramatically according to the initial vibrational energy that is deposited in the molecule by the pump laser. The calculated ionisation trace shown in (c) mimics the experimental result shown in (b). Laser snapshots of molecular motions 11 recorded as a function of pump-probe time delay: the decrease in signal intensity with increasing pump-probe time delay monitors the loss of initial IBr* to form separated I and Br over the potential V1; and the oscil- lations superimposed upon the decay reﬂect the quantized nature of vibra- tional motion of the quasi-bound [I. A series of measurements in which the pump wavelength is varied reveal that at some energies the oscillations predominate for times beyond 10ps, whilst at others the decay of population by curve-crossing wins out within 400fs or so. The time resolution of the experiment is in this example is determined by the convolution of the two laser pulse widths, here about 125fs. These attributes can be accounted for by theoretical calculations of the motion of the wavepacket over the repulsive potential, which aim to deter- mine the time-resolved ionisation signal from fundamental theory. These are performed by solving the time-dependent Schrödinger equation for the dissociation, which expresses the temporal development of the quantum wavefunction prepared by the laser pulse subject to all the forces that act on the nuclei as it progresses from starting to ﬁnal states. A mathematical analysis of these data using the technique of Fourier transformation reveals how quantised vibrational motion of the molecule along the dissociation coordinate is transformed into kinetic energy of separation as the I and Br atoms ﬂy apart. The reason is that, typically, the time between collisions in the gas phase is on the order of nanoseconds. So, with laser pulses of sub-100fs duration, there is only about one chance in ten thousand of an ultrashort laser pulse interacting with the colliding molecules at the instant when the transfer of atoms is taking place; in other words, it is not possible to perform an accurate determination of the zero of time. An ingeneous method to circumvent this problem was ﬁrst devised by Zewail and colleagues, who took advantage of the vibrational and rota- tional cooling properties and collision-free conditions of the supersonic 12 G. The cartoon shown in (a) illustrates how pump and probe pulses initiate and monitor the progress of H CO2→[HO. The build-up of OH product is recorded via the intensity of ﬂuorescence excited by the probe laser as a function of pump-probe time delay, as presented in (b). Potential energy curves governing the collision between excited Na* atoms and H2 are given in (c); these show how the Na* H2 collision can proceed along two possible exit channels, leading either to formation of NaH H or to Na H2 by collisional energy exchange. These workers chose to study collisions between hydrogen atoms H and carbon dioxide CO2 in which the starting materials were pre- pared in a complex of hydrogen iodide and CO2. A cartoon representation of the experiment perfomed by Zewail’s group is given in Figure 1. The wavelength of an ultrafast pump pulse is selected to trigger the reaction by cleaving the H–I bond; this liberates the H atom which trans- lates towards CO2 and, over the course of about 10ps, susequently gener- ates hydroxyl OH and carbon monoxide CO. Product formation is monitored by the detection of ﬂuorescence from OH induced by a time- delayed probe laser pulse. In this example, the collision takes a long time to complete because H and CO2 initially combine to form a metastable [HO. CO] intermediate, which survives long enough to redistribute energy amongst its available degrees of freedom until such time as sufﬁ- cient vibrational motion with the correct energy and phase is localised within the HO–CO mode. When this point is reached, the force of repul- sion between OH and CO exceeds the attractive interactions between the two components and the diatomic moieties spin away from each other. ROBERTS The use of molecular beams to lock reactants together within femtos- econd striking distance is not the only way to perform ultrafast spectros- copy of bimolecular reactions. Another is to initiate the ﬁnal approach trajectory of collision between a metastable atom or molecule in a high- pressure atmosphere of a second partner, thereby reducing the time required for the collisional encounter to below a picosecond. The Na* H2 system serves as a paradigm for transfer of matter and energy in atom–molecule scattering since, as shown in Figure 1. The trajectory of the scattering event again proceeds via one or more curve crossings between potential energy sur- faces, representing the different forces between the atom and molecule at different stages of the collisional evolution. Current research at the Max-Planck-Institut für Quantenoptik in Garching, Germany, is concentrating on the mechanism of collisional deactivation via electronic-to-vibrational energy transfer, in which the temporal progress from initial to ﬁnal states is monitored by the simulta- neous absorption of three 20fs probe photons and re-emission of a fourth by the [Na*. This type of coherent scattering spectroscopy is extremely sensitive and enables the appearance of deactivated sodium atoms to be probed as a func- tion of time as they emerge from the curve crossing. Experimental meas- urements are supported by theoretical calculations of the cross sections for light scattering in real time, from which the wavepacket motion over the intersecting potential energy curves can be deduced. H2] species formed during the initial approach stage persists for durations up to 120fs before it fragments, during which time the excitation energy carried by the Na* atom is funnelled into the H2 coordinate by repeated multidimensional transfer of population between the colliding partners. The collision is said to be ‘sticky’, as the Na* H2 collide, bounce off one another and exchange energy and population over a time scale that is very long compared to the period of H2 vibrations (about 8fs). A cluster is a smallish globule, com- prising up to about 1000 atoms or molecules held together by weak attrac- tive forces, that is supremely well-suited for the study of ultrafast phenomena in which many-body effects dominate the collisional outcome. The most important of these concern the fate of the energy initially depos- ited in the cluster by the laser pulse as a result of intra- and intermolecu- lar energy redistribution, coherence loss of the nascent wavepacket and molecular fragmentation, and how these effects evolve with increasing degrees of freedom. A popular choice for investigation has been the disso- ciation of molecular halogens attached to one or more rare gas atoms. A recent experimental study by the group of Neumark at UC Berkeley, _ USA, on the dissociation of the negatively charged diiodide (I2) ion in the presence of zero, six or 20 argon atoms exempliﬁes marvellously the way in which the issues listed above can be successfully addressed by femtose- cond spectroscopy.
To the extent that there is popular support for measures such as revalidation order risperidone australia treatment quality assurance unit, it has largely been fostered by leading medical figures buy risperidone pills in toronto 7 medications emts can give, such as GMC president Donald Irvine buy 4mg risperidone overnight delivery treatment group, in their responses to scandals such as Bristol and the Shipman case buy generic risperidone 4mg on-line medicine lodge kansas. The danger of the revalidation proposals is that they will exacerbate the medical profession’s loss of confidence rather than alleviating it. The problem is not merely that the drive towards revalidation will lead to the creation of scapegoats and a spate of early retirements, though it undoubtedly will. There is an even more serious danger that it will degrade the profession as a whole and do further damage to the relationship between doctor and patient. This statement followed a series of incidents in which environmental protestors had destroyed experimental GM projects and a media campaign for a ban on further developments. The BMA demanded that ‘the precautionary principle should be applied in developing modified crops or foodstuffs, as we cannot at present know whether there are any serious risks to the environment or to human health involved in producing GM crops or consuming GM food products’. The government, squeezed between a recognition of the substantial economic potential of GM products and mounting public anxieties, tried to hold the line. In May the government’s Chief Scientist (Robert May) and Chief Medical Officer (Liam Donaldson) issued a joint statement reassuring the public that there was ‘no current evidence to suggest that the process of genetic modification is inherently harmful’. In early 2000, however, the government crumbled and announced even tighter restrictions on the development of GM foodstuffs. In his classic text, The Mirage of Health, published forty years before the GM controversy, Rene Dubos noted the widespread conviction that maintaining the scientific status quo would safeguard humanity against new threats: ‘It is often suggested that a moratorium on science would give mankind the opportunity to search its soul and discover a solution to the problems that threaten its very survival’ (Dubos 1960:214). He commented that ‘this static formula of survival’ was ‘not new’: ‘indeed it has been used with much biological success by social insects’. Through a highly stratified and efficient mode of organisation, colonies of ants and termites had solved many of 155 CONCLUSION the problems which were the subject of endless discussions and conflicts in human societies. In a similar way, the ‘arrested societies’ of isolated aboriginal groups, which ‘resembled in some respects the societies of bees and ants’, confirmed the possibility of achieving a stable equilibrium with their environment—and ‘an acceptable degree of physical health and happiness’. However, though this stability may have allowed these societies to avoid the problems of adapting to change, it was also ‘incompatible with the growth of their civilisations, indeed, with the very growth of man’ (Dubos 1960:215). The approval of a moratorium on the development of GM food because of possible dangers to health, by prestigious bodies of the medical profession and the scientfic community as well as by the government, is a reflection of the fatalistic outlook of contemporary society. In the current climate, every scientific advance, from test-tube babies to key-hole surgery, provokes more anxiety at the possible adverse consequences than celebration of the potential benefits. Fears about the dangers of science are part of a wider pessimism about the prospects for the advance of humanity through active intervention in nature or in society (Gillott, Kumar 1995). Though the rising influence of environmentalism has not yet led to the promotion of insect colonies as a model for human society, the popular cult of the primitive (as reflected, for example, in the affinity of contemporary environmentalists for the tribal peoples of the rainforests) indicates the scale of disillusionment with achievements of civilisation (Bookchin 1995). Given the impracti-cability of a return to an idealised aboriginal state, this outlook is expressed in demands to call a halt to further attempts at human advance, whether through scientific or social initiatives. In a society of lowered horizons and diminished expectations, security and safety have become the highest values and the goal of preserving health has become the zenith of human aspirations. The idea that to safeguard health it is necessary to restrain, if not stop, scientific advance appears to be in stark contrast to the widely quoted utopian concept of health adopted by the World Health Organisation at its founding conference in 1946: ‘Health is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity’ (MacKenzie 1946) Yet, as Dubos observed, dreams of an imaginary past and utopian visions of the future share a common theme: ‘different as they appear to be, both imply a static view of the world which is 156 CONCLUSION incompatible with reality, for the human condition has always been to move on’ (Dubos 1960:208). It is striking that, after its adoption in that brief period of hope for the future between the end of the Second World War in 1945 and the onset of the Cold War in 1947, the WHO’s definition of health disappeared from public view until it was rediscovered in the 1970s. If, as Dubos noted, myths of a golden age provide mankind with ‘solace in times of despair and with elan during the expansive periods of history’, then we can readily identify the heady days of post-war reconstruction with the latter, and the period of increasing gloom that began with the recession of the 1970s with the former. The defect of utopian visions and static formulas is that they are out of tune with that restless quest for change which distinguishes humanity from the rest of the natural world: Life is an adventure in a world where nothing is static; where unpredictable and ill-understood events constitute dangers that must be overcome, often blindly and at great cost; where man, like the sorcerer’s apprentice, has set in motion forces that are potentially dangerous and may some day escape his control. Far from being an end in itself, health was ‘the condition best suited to reach goals that each individual formulates for himself, in a process guided by social rather than biological urges (Dubos 1960:219). Writing in more optimistic times, he recognised that the pursuit of certain human ideals and goals may have unfavourable consequences for the human species, but accepted that this was a price that must be paid for progress. As he emphasised, ‘it is man’s dignity to value certain ideals above comfort, and even above life’. Indeed it is this human trait that makes medicine a philosophy that goes beyond the conception of man as a living machine to encompass ‘the collective aspirations of mankind’. From this perspective, a ‘perfect policy of public health’ is possible for a colony of insects or a herd of cows, but not for man: ‘human life implies adventure, and there is no adventure without struggles and dangers’. In the widely acclaimed formulation of one contemporary historian, the parallel triumphs of the West over the East, the free market over the planned economy, marked ‘the end of history’ (Fukuyama 1989). Yet, far from inaugurating a new era of social harmony, the victory of capitalism rapidly revealed the profound exhaustion of its ideologues and a sense that their system too had reached the end of the road (Furedi 1992). It appeared that this victory, the outcome of more than a century of more or less intense class conflicts fought on both international and domestic fronts, had been bought at a high cost. In discrediting the goals of communism, any concept of social progress had been put in question. In challenging the values of socialism, the bourgeois principles of liberty and equality had also been disowned. In rolling back the menace of the Russian Revolution, the achievements of the French Revolution too were repudiated. In disputing the possibility of the constructive human intervention in nature and society, the scientific principles of the Enlightenment, indeed the claims of rationality itself, came under deep suspicion. The weary, nihilistic outlook of post-modernism that became increasingly influential in pre- millennial Western society reflected a loss of conviction in history as a human-centred project. Despite claims that history had come to an end, society has not in fact stood still—indeed many have experienced change in a more intense way than ever before. But change in the modern world no longer appears to be the outcome of conscious human direction or purpose—it appears as the unpredictable outcome of the random, chaotic actions of diverse, isolated individuals and uncontrollable social (and natural) forces. Not surprisingly, change perceived in this way provokes fear and anxiety rather than any positive sense of anticipation about the future, let alone any inclination to play an active role in influencing its character. The perception of society as both out of control and increasingly unstable leads to a heightened consciousness of the risks of everyday life and an intensified awareness of ubiquitous threats to health (Beck 1992). The fear of risks and dangers results in both self-imposed restrictions on personal behaviour and in an acceptance of externally-dictated limits on the scope of human activity. Anthony Giddens, sociologist and intellectual guide to New Labour, celebrated the emergence of risk 158 CONCLUSION as a force of moral regulation: ‘We can’t return to nature or to tradition, but, individually and as collective humanity, we can seek to remoralise our lives in the context of a positive acceptance of manufactured uncertainty’ (Giddens 1994:227). A sense of low expectations has converged with a heightened sense of risk to restrict the scope of individual activity and diminish our common humanity. The impasse reached by Western society in the 1990s was experienced differently by different sections of society. Perceptions were strongly influenced by parallel economic and social developments, in particular by the demise of traditional forms of collectivity and the accelerated erosion of familiar institutions, from the Royal Family to the nuclear family. The decline of old-style class conflict brought an end to long-established patterns of industrial and political conflict. It also removed a key source of cohesion on both sides of the great divide, compounding wider atomising forces to produce an unprecedented degree of individuation in society. If the proletarian solidarity of the trade unions and the labour movement effectively disintegrated, so too did the spirit of class loyalty that had made the Conservative Party such a successful social movement.
Or maybe you have been fascinated by a particular group of people and you would like to immerse yourself within that group generic risperidone 2 mg mastercard treatment hyperthyroidism, taking part in their activities whilst studying their behaviour? What personal characteristics do I have which might help me to complete my research? Think about your personal characteristics order risperidone on line amex treatment plan goals and objectives, likes and dis- likes discount risperidone 2 mg otc treatment 4 hiv, strengths and weaknesses when you’re planning your research cheap risperidone 2mg without prescription treatment spinal stenosis. If you’re very good with people you might like to think about a project which would involve you con- ducting in-depth interviews with people who you ﬁnd fas- cinating. If you absolutely hate mathematics and statistics, steer clear of large survey research. Or do you prefer to hide yourself away and number crunch, or spend hours on the internet? All of these personal characteristics suggest a leaning towards certain types of research. As you read this book you will ﬁnd ideas forming – jot these down so that you can refer to them later when you come to plan your research. If your research is to be employment based, the chances are you will have work experience which you’ll ﬁnd useful HOW TO DEFINE YOUR PROJECT / 3 when conducting your research project. This is valid ex- perience and you should make the most of it when plan- ning your research. Even if your project is not employment based, all of you will have other skills and experience which will help. For example, if you have been a student for three years, you will have developed good literature search skills which will be very useful in the re- search process. Some of you may have developed commit- tee skills, organisation skills and time management expertise. Think about your existing skills in relation to your proposed project as it will help you to think about whether your knowledge, experience and skills will help you to address the problem you have identiﬁed. Many research projects fail because people don’t take en- ough time to think about the issues involved before rush- ing to start the work. It is extremely important to spend time thinking about your project before you move on to the planning stage. Through careful thought you should stop yourself wasting time and energy on inappropriate methods as your research progresses. Consider the follow- ing example: EXAMPLE 1: JAMES James wanted to ﬁnd out about students’ experiences of housing in his university town. When the replies started to come in, he realised that the questionnaires weren’t generating the type of information in which he was interested. When he talked through his concerns 4 / PRACTICAL RESEARCH METHODS with his tutor, it emerged that James was really inter- ested in attitudes towards, and experiences of, rented accommodation. His questionnaire had been poorly de- signed and was not generating this type of information. He had to scrap the questionnaire and construct an- other which he combined with a number of one-to- one interviews to get more in-depth information. He had spent three months designing and administering a questionnaire which had not produced the type of infor- mation he required. If he had spent more time thinking about the research, especially coming to terms with the diﬀerence between qualitative and quantitative research, he would have saved himself a lot of time and energy (see Chapter 2). THE FIVE ‘WS’ When you start to think about your research project, a useful way of remembering the important questions to ask is to think of the ﬁve ‘Ws’: X What? Once you have thought about these ﬁve ‘Ws’ you can move on to think about how you are going to collect your data. One of the hardest parts in the early stages is to be able to deﬁne your project, so much research fails because the researcher has been un- able to do this. If you are unable to do this, the chances are your research topic is too broad, ill thought out or too obscure. Okay, you might have been told to do some research by your tutor or by your boss, but there should be another reason why you have chosen your particular subject. It might be solely to do with the fact that you are interested in the topic. This is a good start as you need to be inter- ested in your research if you are to keep up your enthu- siasm and remain motivated. Or you might have identiﬁed a gap in the research literature – this is good as it shows you have carried out careful background re- search. Or perhaps you want to try to obtain funding for a particular service or enterprise and you need to do some research ﬁrst to ﬁnd out if there is demand for what you are proposing. Whatever your reason, think very carefully about why you are doing the research as this will aﬀect your topic, the way you conduct the research and the way in which you report the results. If you’re doing it for a university dis- sertation or project, does your proposed research provide the opportunity to reach the required intellectual stan- 6 / PRACTICAL RESEARCH METHODS dard? Will your research generate enough material to write a dissertation of the required length? Or will your research generate too much data that would be impossible to summarise into a report of the required length? If you’re conducting research for funding purposes, have you found out whether your proposed funding body re- quires the information to be presented in a speciﬁc for- mat? If so, you need to plan your research in a way which will meet that format. However, you should think about the type of people with whom you will need to get in touch with and whether it will be possible for you to contact them. If you have to conduct your research within a par- ticular time scale, there’s little point choosing a topic which would include people who are diﬃcult or expensive to contact. Also, bear in mind that the Internet now pro- vides opportunities for contacting people cheaply, espe- cially if you’re a student with free internet access. Thinking about this question in geographical terms will help you to narrow down your research topic. Also, you need to think about the resources in terms of budget and time that are HOW TO DEFINE YOUR PROJECT / 7 available to you. If you’re a student who will not receive travel expenses or any other out of pocket expenses, choose a location close to home, college or university. If you’re a member of a community group on a limited bud- get, only work in areas within walking distance which will cut down on travel expenses. Also, you need to think about where you’ll be carrying out your research in terms of venue. If you’re going to con- duct interviews or focus groups, where will you hold them? Is there a room at your institution which would be free of charge, or are you going to conduct them in par- ticipants’ own homes?
It has been sug- gested that it should refer specifically to all transient increased writing activity with a noniterative appearance at the syntactic or lexi- cographemic level (cf cheap risperidone 2mg mastercard symptoms 5 days after conception. Hypergraphia may be seen as part of the interictal psychosis which sometimes develops in patients with complex partial seizures from a temporal lobe (especially nondominant hemisphere) focus discount risperidone 4mg with amex medicine ball, or with other nondominant temporal lobe lesions (vascular best buy risperidone anima sound medicine, neoplastic buy risperidone discount treatment management company, demyelinative, neurodegenerative), or psychiatric disorders (schizophrenia). Hypergraphia is a feature of Geschwind’s syndrome, along with hyperreligiosity and hyposexuality. Advances in Neurology 1991; 55: 411-421 Van Vugt P, Paquier P, Kees L, Cras P. Increased writing activity in neurological conditions: a review and clinical study. Journal of Neurology, Neurosurgery and Psychiatry 1996; 61: 510-514 Cross References Automatic writing behavior; Hyperreligiosity; Hyposexuality Hyperhidrosis Hyperhidrosis is excessive (unphysiological) sweating. Localized hyperhidrosis caused by food (gustatory sweat- ing) may result from aberrant connections between nerve fibers sup- plying sweat glands and salivary glands. Other causes of hyperhidrosis include mercury poisoning, phaeochromocytoma, and tetanus. Transient hyperhidrosis contralateral to a large cerebral infarct in the absence of autonomic dysfunction has also been described. Regional syndromes of hyperhidrosis (hands, feet, axillae) are also described. Symptoms may be helped (but not abol- ished) by low dose anticholinergic drugs, clonidine or propantheline. For focal syndromes, botulinum toxin injections or sympathectomy may be helpful. BMJ 2000; 320: 1221- 1222 - 159 - H Hyperkinesia Labar DR, Mohr JP, Nichols FT, Tatemichi TK. Neurology 1988; 38: 1679-1682 Naumann M, Flachenecker P, Brocker EB, Toyka KV, Reiners K. Lancet 1997; 349: 252 Cross References Anhidrosis; Diaphoresis; Holmes-adie pupil, Holmes-adie syndrome Hyperkinesia Hyperkinesia indicates an involuntary movement disorder character- ized by excessive amplitude of movement, such as ballism, or chorea, or the speech disorders occurring with them. Cross References Ballism, ballismus; Chorea, choreoathetosis; Dysarthria Hypermetamorphosis Hypermetamorphosis is an overattention to external stimuli. Patients with hypermetamorphosis may explore compulsively and touch every- thing in their environment. This is one element of the environmental dependency syndrome and may be associated with other forms of uti- lization behavior, imitation behavior (echolalia, echopraxia) and frontal release signs, such as the grasp reflex. It occurs with severe frontal lobe damage and may be observed following recovery from her- pes simplex encephalitis and in frontal lobe dementias including Pick’s disease. Bitemporal lobectomy may also result in hypermetamorpho- sis, as a feature of the Klüver-Bucy syndrome. Cross References Attention; Echolalia; Echopraxia; Frontal release signs; Grasp reflex; imitation behavior; Klüver-bucy syndrome; Utilization behavior Hypermetria - see DYSMETRIA Hypermnesia - see EIDETIC MEMORY; SYNESTHESIA Hyperorality Hyperorality is a neurobehavioral abnormality consisting of drinking more than usual, eating excessively, eating anything in sight, and put- ting objects inappropriately into the mouth. It is one element of the Klüver-Bucy syndrome, along with hypersexuality. Cross References Klüver-bucy syndrome Hyperpathia Hyperpathia is an unpleasant sensation, often a burning pain, associ- ated with elevated threshold for cutaneous sensory stimuli, such as light touch or hot and cold stimuli, especially repetitive stimuli. Clinical features of hyperpathia may - 160 - Hyperreflexia H include summation (pain perception increases with repeated stimula- tion) and aftersensations (pain continues after stimulation has ceased). The term thus overlaps to some extent with hyperalgesia (although the initial stimulus need not be painful itself) and dysesthesia. There is an accompanying diminution of sensibility due to raising of the sen- sory threshold (cf. Hyperpathia is a feature of thalamic lesions, and hence tends to involve the whole of one side of the body following a unilateral lesion, such as a cerebral hemorrhage or thrombosis. Generalized hyperpathia may also be seen in variant Creutzfeldt-Jakob disease, in which poste- rior thalamic (pulvinar) lesions are said to be a characteristic neurora- diological finding. Cross References Allodynia; Dysesthesia; Hyperalgesia Hyperphagia Hyperphagia is increased or excessive eating. Binge eating, particularly of sweet things, is one of the neurobehavioral disturbances seen in cer- tain of the frontotemporal dementias. Hyperphagia may be one fea- ture of a more general tendency to put things in the mouth (hyperorality), for example in the Klüver-Bucy syndrome. Cross References Hyperorality; Klüver-bucy syndrome Hyperphoria Hyperphoria is a variety of heterophoria in which there is a latent upward deviation of the visual axis of one eye. Using the cover-uncover test, this may be observed clinically as the downward movement of the eye as it is uncovered. Cross References Cover tests; Heterophoria; Hypophoria Hyperpilaphesie The name given to the augmentation of tactile faculties in response to other sensory deprivation, for example touch sensation in the blind. Hyperpronation - see CHOREA, CHOREOATHETOSIS; DECEREBRATE RIGIDITY Hyperreflexia Hyperreflexia is an exaggerated briskness of the tendon reflexes. This may be physiological in an anxious patient (reflexes often denoted ++), or pathological in the context of corticospinal pathway pathology (upper motor neurone syndrome, often denoted +++). It is sometimes difficult to distinguish normally brisk reflexes from pathologically brisk reflexes. Hyperreflexia (including a jaw jerk) in isolation cannot be used to diagnose an upper motor neurone syndrome, and asymme- try of reflexes is a soft sign. On the other hand, upgoing plantar - 161 - H Hyperreligiosity responses are a hard sign of upper motor neurone pathology; other accompanying signs (weakness, sustained clonus, absent abdominal reflexes) also indicate abnormality. This may be due to impaired descending inhibitory inputs to the monosy- naptic reflex arc. Rarely pathological hyperreflexia may occur in the absence of spasticity, suggesting different neuroanatomical substrates underlying these phenomena. Hyper-reflexia without spas- ticity after unilateral infarct of the medullary pyramid. Journal of the Neurological Sciences 2000; 175: 145-155 Cross References Abdominal reflexes; Clonus; Incontinence; Jaw jerk; Reflexes; Spasticity; Upper motor neurone (UMN) syndrome; Weakness Hyperreligiosity Hyperreligiosity is a neurobehavioral symptom, manifest as sudden religious conversion, or increased and unswerving orthodoxy in devo- tion to religious rituals. It may be encountered along with hyper- graphia and hyposexuality as a feature of Geschwind’s syndrome. It has also been observed in some patients with frontotemporal demen- tia; the finding is cross-cultural, having been described in Christians, Moslems, and Sikhs. In the context of refractory epilepsy, it has been associated with reduced volume of the right hippocampus, but not right amygdala. Advances in Neurology 1991; 55: 411-421 Wuerfel J, Krishnamoorthy ES, Brown RJ et al. Religiosity is associ- ated with hippocampal but not amygdala volumes in patients with refractory epilepsy. Journal of Neurology, Neurosurgery and Psychiatry 2004; 75: 640-642 Cross References Hypergraphia; Hyposexuality Hypersexuality Hypersexuality is a pathological increase in sexual drive and activity. Recognized causes include bilateral temporal lobe damage, as in the Klüver-Bucy syndrome, septal damage, hypothalamic disease (rare) with or without subjective increase in libido, and drug-treatment in Parkinson’s disease.