Left or right carotid endarterectomy in patients with atherosclerotic disease: ipsilateral effects on cognition?

We evaluated hemispheric functions ipsilateral to the side of carotid endarterectomy (CEA) in patients with a severe stenosis in the left or right carotid artery. Assessments took place 1 day before and 3 months after CEA. Only right-handed males were included. Nineteen patients underwent surgery of the left carotid artery and 17 of the right. Valid instruments for hemispheric function were included, such as verbal dichotic listening, finger tapping, and a lateralised test for motor planning. Results showed that, preoperatively, patients had lower scores compared to norms on the laterality tests, and on a visuoconstructive test. There was no evidence of ipsilateral improvement related to side of surgery. Left ear dichotic listening improved, which was seen in both left and right surgery groups. Also in both groups, left- and right-hand movement speed in the motor planning test decreased. Conclusion is that beneficial ipsilateral cognitive change after CEA in patients with severe stenosis in one of the carotid arteries may not be demonstrated, even if valid instruments for hemispheric function are included.     

The sacramental nature of peacemaking rituals: a case for a sacramental spirituality of reconciliation

South African scholar and peace activist John de Gruchy sees a close relationship between sacraments and peacemaking processes. Even though a Protestant, he calls the Church a sacramental community and the Truth and Reconciliation Commission (TRC) a ‘civic sacrament’. This raises the question of the relationship between processes and rituals of peacemaking and sacramentality. Moreover, how does reconciliation, as a core doctrine of Christian theology, relate to sacramentality and peacemaking efforts in society? Is reconciliation sacramental? Hans Boersma’s sacramental ontology provides a theological basis for an affirmative answer. Furthermore, the notion of Christ (and the Church) as primal sacrament(s) (Semmelroth, Schillebeeckx) gives a further basis to see processes of peacemaking as sacramental. The article argues for a sacramental spirituality of reconciliation (Schreiter). However, applying the arguments to two concrete cases, the TRC and the twinning of Coventry and Dresden, shows some difficulties in claiming sacramental status for reconciliation efforts.