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tient s ngers are spread apart, they may undergo a series of changing postures ( piano-playing movements, or pseudoathetosis); in attempting to touch the tip of his nose with his index nger, the patient may miss the target repeatedly, but he corrects his performance with his eyes open The lack of position sense in the legs is demonstrated by displacing the limb from its original position and having the patient, with eyes closed, place the other leg in the same position or point to the great toe If position sense is defective in both legs, the patient will be unable to maintain his balance with feet together and eyes closed (Romberg sign) This test is often interpreted imprecisely In the Romberg position, even a normal person whose eyes are closed will sway slightly, and the patient who lacks balance due to cerebellar ataxia or vestibulopathy or to some other motor disorder will sway considerably more if his visual cues are removed Only a marked discrepancy in balance with eyes open and with eyes closed quali es as a Romberg sign The most certain indication of abnormality is the need to step to the side or backward in order to avoid falling Mild degrees of unsteadiness in a nervous or suggestible patient may be overcome by diverting his attention, eg, by having him touch the index nger of each hand alternately to his nose while standing with eyes closed or by following the examiner s nger with his eyes Perception of passive movement is rst tested in the ngers and toes, since the defect, when present, is re ected maximally in these parts It is important to grasp the digit rmly at the sides, perpendicular to the plane of movement; otherwise the pressure applied by the examiner may allow the patient to identify the direction of movement This applies as well to testing of the more proximal segments of the limb The patient should be instructed to report each movement as being up or down from the previous position (directional kinesthesia) It is useful to demonstrate the test with a large and easily identi ed movement, but once the idea is clear to the patient, the smallest detectable changes should be determined The sensitivity of testing is enhanced by using the third and fourth ngers and toes The part being tested should be moved rapidly Normally, a very slight degree of movement is appreciated in the digits (as little as 1 degree of an arc) The test should be repeated enough times to eliminate chance (50 percent of responses) Defective perception of passive movement is judged by comparison with a normal limb or, if perception is bilaterally defective, on the basis of what the examiner has learned through experience to be normal Rapid movements are more easily detected than are slow ones Slight impairment may be disclosed by a slowness of response or, if the digit is displaced very slowly, by an unawareness or uncertainty that movement has occurred; or, after the digit has been displaced in the same direction several times, the patient may misjudge the rst movement in the opposite direction; or, after the examiner has moved the toe, the patient may make a number of small voluntary movements of the toe in an apparent attempt to determine its position or the direction of the movement Inattentiveness will also cause some of these errors Testing of Vibratory Sense This is a composite sensation comprising touch and rapid alterations of deep-pressure sense The only cutaneous structure capable of registering such stimuli of this frequency is the rapidly adapting pacinian corpuscle The conduction of vibratory sense depends on both cutaneous and deep afferent bers that ascend mainly in the dorsal columns of the cord It is therefore rarely affected by lesions of single nerves but will be disturbed in patients with disease of multiple peripheral nerves,.

the best modern study of sociopathy is that of L N Robins, based on a 30-year follow-up study of 524 cases from a child guidance clinic and 100 controls Other investigations of note are those of Cleckley, of McCord and McCord, and of Guze and coworkers, who studied psychiatric illness in large numbers of felons and their rst-degree relatives The descriptions that follow and the preceding quotation are taken largely from these writings and from those of Reid Clinical Description This condition, unlike the majority of psychiatric disorders, is manifest by the age of 12 to 15 years and frequently earlier The manifestations of sociopathic behavior in children and adults are ve to ten times more frequent in males than they are in females It consists essentially of deviant behavior in which individuals seem driven to make trouble in everything they do Codes imposed by family, school, religion, and society are broken Seemingly, the sociopath acts on impulse, but after committing the unsocial act, he shows no remorse The most frequent antisocial activities are theft, truancy, running away, associating with undesirable characters, indiscriminate sexual relations, repeated ghting, recklessness and impulsivity, lying without cause, vandalism, abuse of drugs and alcohol, and, later, inability to work steadily or keep a job Fire setting and cruelty to animals have been added as common early features by several authors In the study by Robins, of children or adolescents who exhibited 10

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Flickering may be a symptom of a faulty monitor Replace the monitor with another to see if the problem still exists Flickering can also be caused by an inappropriate refresh rate setting The refresh rate configures how often the display gets repainted If the rate is too low for the video system you are using, it can cause the display to flicker On a Windows-based system you can access the Control Panel s Display icon, and choose a different refresh rate The standard refresh rate for monitors is 75Hz Older monitors may not work at this rate and may require a refresh rate of 60Hz An older monitor will usually blank out if run at faster speeds

Paranoid (16) Cyclothymic (3) Schizoid (30) Explosive (4) Obsessive-compulsive (anankastic) (21) Hysterical (103) Asthenic (1) Passive-aggressive (78)

Inadequate (17) Antisocial (32)

Passive-dependent (30) Immature (12) Unspeci ed (14)

Database rolling upgrades The Data Guard standby database can be used to perform rolling database upgrades with near-zero downtime The standby database is upgraded while the primary is still servicing production loads, and the primary database is switched over to the standby, with minimal interruption Migrate to the Database Machine Data Guard can be used to migrate Oracle databases to the Database Machine with minimal downtime, using the physical or the logical standby database The standby database will be instantiated on the Exadata Database Machine and then switched over to the primary role, allowing the migration to happen with the flip of a switch Refer to 10 for further details Data corruption detection and prevention The Data Guard Apply process can detect corruptions, and also provide mechanisms to automatically recover from corruptions This topic is discussed in detail later in the chapter User error protection You can induce a delay in the Redo Apply process to queue the transactions for a specified period (delay) before they are applied on the standby database The delay provides you with the ability to recover from user or application errors on the primary database, since the corruption does not immediately get propagated and can be repaired by using a pristine copy from the standby

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