Background and aimsIn 2013, Uruguay became the first country in the world to fully regulate its marijuana market. This ambitious policy was also an unexpected one: none of the usual explanations for legalization of marijuana in other contexts was present in the Uruguayan case. This paper offers an explanation of why Uruguay legalized marijuana. Drawing on Kingdon's theoretical approach, we argue that a window of opportunity opened in mid‐2012, making it both necessary and possible for the government to move towards legalization.MethodsA congruence case study using evidence from a series of interviews with political actors and policy makers, media reports and official documents.ResultsThere is evidence that marijuana legalization was possible in Uruguay because of the coincidence of a demand for more public safety (problem stream) with the presence of pro‐legalization leaders in strategic political positions (policy stream) and a favorable political environment (political stream)ConclusionsApplying Kingdon's theory of windows of opportunity, Uruguay may have moved towards full regulation of its marijuana market in 2013 because of the convergence of a specific set of problem, policy and political circumstances in May 2012.
Context: Unilateral training of the uninjured limb could be a useful therapeutic tool to induce cross-education in periods of immobilization, however, the effectiveness of this training in patients with anterior cruciate ligament (ACL) reconstruction is unknown. Objective: To determine the effectiveness of unilateral training of the uninjured limb on muscle strength and knee function in patients with ACL reconstruction. Design: Systematic review and meta-analysis. Evidence Acquisition: An electronic search was performed in the MEDLINE, LILACS, CENTRAL, Embase, Scopus, Web of Science, CINAHL, SPORTDiscus, and PEDro databases from inception until March 2021. The authors included randomized clinical trials that evaluated the effectiveness of unilateral training of the uninjured limb on muscle strength and knee function in patients after ACL reconstruction. Evidence Synthesis: Seven clinical trials met the eligibility criteria, and for the quantitative synthesis, 5 studies were included. The standardized mean difference for isometric quadriceps strength was 0.60 at 8 to 12 weeks (95% confidence interval, 0.29 to 0.92; P = .01; I2 = 6%). There was a high quality of evidence according to the Grading of Recommendation, Assessment, Development and Evaluation rating. Four studies assessed knee function through different self-administered questionnaires at 8, 24, and 26 weeks. Only one study reported significant differences in knee function at 8 weeks, favoring the unilateral training group. Conclusions: There was a moderate to high quality of evidence, with statistical significance that the addition of unilateral training to standard rehabilitation improved the cross-education of quadriceps strength after ACL reconstruction. More research is needed to assess the consistency of these results. International Prospective Register of Systematic Reviews registration number: CRD42020199950.
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