To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The economic literature is clear that transparent and impartial rule of law is crucial for successful economic outcomes. However, how does one guarantee rule of law? This paper uses the idea of ‘self-reinforcing’ institutions to show how political institutions may derail rule of law if associated judicial institutions are not self-reinforcing. We illustrate this using the contrasting examples of Estonia and Poland to frame the importance of institutional context in determining both rule of law and the path of legal institutions. Although starting tabula rasa for a legal system is difficult, it worked well for rule of law in Estonia in the post-communist transition. Alternately, Poland pursued a much more gradualist strategy of reform of formal legal institutions; this approach meant that justice institutions, slow to shed their legacy and connection with the past, were relatively weak and susceptible to attack from more powerful (political) ones. We conclude that legal institutions can protect the rule of law but only if they are in line with political institutions, using their self-reinforcing nature as a shield from political whims of the day.
Bacteriophages are the most abundant form of life on earth and are present everywhere. The total number of bacteriophages has been estimated to be 1032 virions. The main division of bacteriophages is based on the type of nucleic acid (DNA or RNA) and on the structure of the capsid. Due to the significant increase in the number of multi-drug-resistant bacteria, bacteriophages could be a useful tool as an alternative to antibiotics in experimental therapies to prevent and to control bacterial infections in people and animals. The aim of this review was to discuss the history of phage therapy as a replacement for antibiotics, in response to EU regulations prohibiting the use of antibiotics in livestock, and to present current examples and results of experimental phage treatments in comparison to antibiotics. The use of bacteriophages to control human infections has had a high success rate, especially in mixed infections caused mainly by Staphylococcus, Pseudomonas, Enterobacter, and Enterococcus. Bacteriophages have also proven to be an effective tool in experimental treatments for combating diseases in livestock.
Clozapine is the least likely anti-psychotic to induce extrapyramidal symptoms (EPS). We present a surprising case of a woman schizophrenic patient treated with clozapine suffering from EPS. Single photon emission computed tomography (SPECT) revealed a low density of presynaptic dopamine transporters in our patient's brain. A comorbid diagnosis of Parkinson's disease in schizophrenia was confirmed in this way. This helped us to find a proper therapeutic strategy for our patient.
Venous thromboembolism (VTE) has been associated with the diagnosis of a psychiatric disease, as well as with the treatment with psychotropic drugs. Recent reports suggest an association between several atypical antipsychotics agents (eg. olanzapine) and an increased risk for VTE.
We prospectively analysed and consequently followed-up olanzapine users in a cohort of 138 consecutive patients under 60 years of age (male=72, mean age 45 years) suffering from objectively confirmed VTE over a three-year period (2004 - 2006). Data on known acquired or genetic risk factors for VTE were recorded for each patient.
Four Caucasian patients (one female, three males; mean age 49 years, range 37-55 years) with spontaneous VTE treated with olanzapine were registered. Two patients were obese. The hospitalization was extended in the female patient. We found coagulation abnormalities in all our subjects (elevated levels of factor VIII:C, mild hyperhomocysteinemia, FV Leiden and prothrombin gene G20210A mutations).
These cases indicate that VTE might be associated with the use of olanzapine, at least in the presence of several acquired or inherited risk factors such as immobilization, obesity and disorders of coagulation homeostasis including factor V Leiden, prothrombin gene G20210A mutations, high levels of factor VIII and hyperhomocysteinemia. Subjects treated with olanzapine should be monitored clinically for VTE. Interestingly, in three patients symptoms occurred in the first six months of olanzapine treatment.
Comorbidity of schizophrenia and transsexualism is still controversial. Some authors exclude diagnosis of transsexualism in patients with psychosis others report this coexistence as very rare.
Delusions of sex change have been described by some authors in about 20-25% of schizophrenic patients. Patient's “pseudotranssexual” beliefs are usually bizarre and do not cause diagnostic doubts. In some cases complaints of gender dysphoria are predominant and psychotic symptoms can be underestimated or even unnoticed before sex reassignment procedure.
Presentation of various clinical manifestation of gender dysphoria in patients with schizophrenia.
Three clinical cases are described.
Two patients have developed “pseudotranssexual” beliefs during course of psychosis. The first of them is an example of gender identity disorders related to psychotic process. The second patient presented complex psychopathology of schizophrenia and somatic symptoms which can hinder the diagnosis. The third patient has been diagnosed as a transsexual woman after diagnosis of severe schizophrenia and has undergone sex reassignment. Next she was hospitalized several times because relapses of psychosis but also because of alcohol withdrawal. Currently this patient has symptoms of dementia and a few severe somatic diagnoses.
The experiences of practitioners indicate that coincidence of schizophrenia and gender identity disorder is possible. Nevertheless, the consequence of misdiagnosis and sex reassignment can be serious and unconvertible. That is why the diagnosis of transsexualism in patients with psychosis should not be made hastily. It needs time, careful observation, examination and cooperation of psychiatrist and sexologist.
The relationship between olfactory and emotional processing is an area of increasing interest in schizophrenia research.
The brain regions like orbitofrontal cortex and amygdala are involved in the processing of olfactory information.
Evaluation of odor identification performance and valence interaction in patients with schizophrenia. Assessment of influence blood concentration of β-endorphin and calcitonin gene-related peptide(CGRP) on odors identification.
50 patients with schizophrenia and 50 healthy controls were included in the study. Schizophrenia symptoms were evaluated using PANSS. University of Pennsylvania Smell Identification Test (UPSIT) was performed in both study groups. Moreover blood concentrations of β-endorphin and CGRP were measured in all participants.
The concentration of CGRP was significantly higher in patients sample (p<0,001). The concentration of β-endorphin was higher but without statistical significance. Controls achieve significantly higher UPSIT score than patients (mean UPSIT 32,48 vs 26,82). Odor identification performance by valence interaction in patients sample revealed significantly more identification errors in response to both pleasant and neutral odors relative to unpleasant odors (p=0,000 vs p=0,055). Patients with higher β-endorphin concentration made more identification errors on pleasant (R<sub>s</sub>= −0,292; p= 0.04) and neutral odors (R<sub>s</sub>= −0,331; p= 0,019). No relationship between CGRP concentration and UPSIT performance was observed.
Schizophrenic patients present a unique pattern of smell identification characterized by aberrant hedonic ratings for pleasant but not unpleasant odors. Individuals with predominant negative symptoms and higher β-endorphin concentration would also be those with the greatest ability to identify negative odors.
Links between endorphins and dopaminergic transmission have not been fully explored in schizophrenia.
Both endorphins excess and deficiency were postulated in schizophrenia. CGRP is probably involved in dopaminergic transmission.
Evaluation of β-endorphin and CGRP blood concentrations before and after treatment of severe schizophrenia.
70 patients treated with various antipsychotics, with severe symptoms of schizophrenia (51 with positive symptoms, 19 with negative symptoms), 15 first degree relatives and 44 healthy controls were included to the study. β-endorphin and CGRP blood concentrations were measured in severe schizophrenia and in stable mental state. The results were compared with relatives and controls.
β-endorphin and CGRP concentrations in patients with negative symptoms were higher than in relatives and controls. β-endorphin levels in patients with positive symptoms were lower than in patients with negative symptoms (p< 0,000005) and controls (p< 0,0006). No significant changes in CGRP concentration were found in patients samples. CGRP levels in these samples were independent of treatment but they were significantly higher than in relatives and controls. After the treatment β-endorphin levels decreased in patients with negative symptoms (p< 0.0001) and increased in patients with positive symptoms (p< 0,000002). No differences in β-endorphin concentration between patients in stable mental state, relatives and controls were found.
Effective antipsychotic treatment results in “normalization” of β-endorphin level. Specific changes in β-endorphin concentration could be involved in dopaminergic transmission and related to some symptoms of schizophrenia.
Altered sensitivity to pain in schizophrenia has been described in literature, but the knowledge of this issue is insufficient.
Case reports describing schizophrenia patients with painful medical conditions reported little or no pain. In all published studies except one, subjective test methods of pain were used.
The study assessed pain threshold using objective test method and relationship between concentration of β-endorphin, substance P,CGRP and pain insensitivity in schizophrenia. The influence of negative symptoms and cognitive disorders on pain sensitivity was evaluated.
43 patients with schizophrenia, 5 healthy first degree relatives and 34 healthy volunteers were included in the study. All patients were in stable mental state and received neuroleptics. The concentration of β-endorphin, substance P,CGRP was measured and PANSS N , Trail Makin Test and Stroop test were performed. To assess pain threshold nociceptive reflex test (RIII) was used.
Concentration of β - endorphin and CGRP was 20% higher among patients compared with healthy subjects. Study groups did not differ in subjective and objective pain threshold. Negative correlation between Stroop Test performance and subjective pain threshold was found. Negative correlation between TMT performance and nociceptive reflex was observed. A strong negative correlation (p < 0.001) between PANSS N scores and nociceptive reflex was found.
Patients with schizophrenia do not differ in objective pain threshold from healthy control. Insensitivity to pain could be the result of negative symptoms or working memory disorder. It is also possible that increased level of β-endorphin is related to hypoalgesia.
The relationship between olfactory and emotional processing is an area of increasing interest in schizophrenia research.
Olfactory identification deficits are well described in schizophrenia while the results for pleasantness ratings remain unclear.
Evaluation of odor identification and hedonic judgment related to severity of negative symptoms and β-endorphin concentration.
Fifty outpatients with schizophrenia were included in the study: 25 with negative symptoms (PN) and 25 without predominant negative symptoms (P). They were compared with 23 healthy individuals. In all study groups University of Pennsylvania Smell Identification Test (UPSIT) and odor hedonic evaluation were performed. Clinical symptoms severity was evaluated using PANSS. Plasma concentrations of β-endorphin were assayed in all participants.
PN made more odor identification errors than controls (P = 0.000) and P sample (P = 0.001). Hedonic judgments of unpleasant odors were significantly more pleasant in PN sample than in P (P = 0.03) and controls (P = 0.041). PN had significantly higher concentration of β-endorphin than P sample (P = 0.014) and controls (P = 0.009). No relationship between β-endorphin concentration and odors identification and odor hedonic judgment was found in both patient samples and controls.
Increased level of β-endorphin is related to predominance of negative symptoms but probably it is not involved in olfactory identification performance and hedonic judgment in schizophrenia. Patients with predominant negative symptoms revealed different pattern of pleasantness rating – they experience unpleasant odors as more pleasant. Alterations in smell identification and hedonic judgment could be differentially expressed in some subtypes of schizophrenia.
Disclosure of interest
The author has not supplied his/her declaration of competing interest.
Echinococcus multilocularis, the causative agent of human alveolar echinococcosis, is an important emerging parasite in the northern hemisphere. In epidemiological studies, the highest attention is being paid to foxes as the main reservoir hosts responsible for geographic expansion from multiple focal populations and the invasion of urban habitats, but little information is available on the parasite distribution in other carnivores. Hence, the study was designed to obtain updated information about the occurrence and genetic diversity of E. multilocularis in grey wolves and dogs in Slovakia. Faecal samples of wolves were collected from three locations under a certain level of environmental protection in the central and eastern parts of the country, and the presence of the parasite DNA was detected in 35.7% of 112 samples, with the highest rate (51.2%) recorded in the Poloniny National Park in north-eastern Slovakia. Among 110 faecal dog samples, E. multilocularis was detected in three faeces from segregated Roma settlements in the eastern part of the country, which accounted for an overall positivity of 2.7%. Sequence analysis of two mitochondrial genes, 12S rRNA and NADH dehydrogenase subunit 1, revealed four haplotypes in 13 isolates from wolves and dogs originating from four sites in eastern and central Slovakia, with all samples bearing a European-type pattern of E. multilocularis. The more than one-third positivity rate of E. multilocularis in wolf faecal samples dispersed over a large part of the country has corroborated the extensive circulation of the parasite in wildlife and confirmed the need to improve intervention control strategies.
This study argues that collective memory is a relevant concept that can be used to analyse how the outlooks on industrial futures are shaped in remote northern locations. The case in question is the Sydvaranger iron mine in Kirkenes in the north-easternmost part of Norway. By drawing attention to the long periods of time often involved in forming collective memory, this study questions the viability of top-down processes of forming opinions aiming to set local minds on the track towards either “place-renewal” into an unknown post-industrial future or towards attaining a “social licence to operate” for any new or continued raw material producing industry. This exploration includes a discussion of memory studies, an overview of the industrial history of Kirkenes as part of a Euroarctic borderland and a study of the manifestations of collective memory in the contemporary local media. Revealing insights were obtained in Kirkenes through informal conversations and participant observation.
The daring vision of using big data technology to substantially advance the scientific understanding of human nature, individually and socially, and possibly solve age-old challenges of bridging the subjective and objective sides of human nature, rests on substantial assumptions about the concept of a human being. The daring big data vision may at the same time, in itself, serve to change the very concept of a human, regardless of how well the vision’s assumptions and prospects hold up to scrutiny. This issue of the European Review presents an attempt to critically engage with the question of how this complex situation affects the content and prospects of the vision of reconsidering humanity with the help of big data. In this introduction, the landscape of the issue is sketched and some general remarks of where the emerging map might take future research are made. In general, even if the assumptions of the daring big data vision turn out wanting, pragmatic factors may very well transform our own image of ourselves to fit it.
To analyse the relationship of altered birth weight with metabolic and cardiovascular outcomes among adolescents, as well as to identify if sports participation is able to attenuate or even eliminate the impact of birth weight on health outcomes.
Cross-sectional study (Analysis of Behaviours of Children During Growth [ABCD Growth Study]). Adolescents with age ranging from 11 to 18 years old (14.7±2.1) stratified according to normal (n = 230) and altered (n = 35) birth weight composed the sample. Birth weight was self-reported by adolescent’s parents. Sports participation was assessed by face-to-face interview. Carotid intima–media thickness (CIMT) and femoral intima–media thickness (FIMT) were measured using an ultrasound device. C-reactive protein levels were used to assess the inflammatory status. Blood pressure, Z score of metabolic risk (dyslipidemia and glucose), adiposity, and insulin resistance were covariates.
In the crude model, FIMT (p value = 0.037) and C-reactive protein (p value = 0.029) were affected by altered birth weight. In the adjusted models, altered birth weight affected FIMT (p value = 0.048; small effect size of 1.7%), independently of sports participation. For C-reactive protein, previous time of engagement in sports (p value = 0.001; small effect size of 4.8%) affected C-reactive protein, independently of birth weight.
Vascular structure seems to be affected by birth weight in adolescents, while its impact on inflammation seems to be attenuated by the regular engagement in sports.
This article contributes to the scholarly as well as societal decades-long debate on the state of democracy in the EU. The objective is to problematize, discuss, and come up with constructive ideas on the role of expert groups in the processes of legitimization of decision-making within the EU. The analysis is guided by a general research question: how could expert involvement compensate for an incomplete capability of legitimization through democratic representation? The empirical analysis of expert influence in decision-making is guided by a new modelling of the so-called Epistemic Community approach. The case chosen to illustrate the model is the authorization process of the emergency contraceptive ellaOne, within the institutional setting of the Committee for Medicinal Products for Human Use (CHMP) at the European Medicines Agency. The empirical material consists of interviews with eight members of the CHMP. To guide the empirical analysis the paper introduces a two-dimensional model of the epistemic community approach, which distinguishes between the institutional preconditions and the ideational motivations of expert groups. The results indicate that the experts within the CHMP had an influence on the policy-making process thanks to favourable institutional preconditions as well as ideational motivations of the experts themselves. Our conclusion is that there is a need for ‘institutional engineering’ as regards the involvement of experts in decision-making, to sustain the legitimacy of expert involvement, and level out the institutional conditions for experts’ influence on policy-making within the EU.
This paper discusses the importance of learning to understand the three-dimensionality of astronomical objects, in particular nebulae. After collecting data from students’ and professors’ discernment of 3D we finds that this is difficult for both students and professors, which highlights the importance of addressing extrapolating three-dimensionality in astronomy education.
In this article Eva Urban describes a historical tradition of Breton enlightenment theatre, and examines in detail two multilingual contemporary plays staged in Brittany: Merc’h an Eog / Merch yr Eog / La Fille du Saumon (2016), an international interceltic co-production by the Breton Teatr Piba and the Theatr Genedlaethol Cymru (the Welsh-language national theatre of Wales); and the Teatr Piba production Tiez Brav A Oa Ganeomp / On avait de jolies maisons (2017). She examines recurring themes about knowledge, enlightenment journeys, and refugees in Brittany in these plays and performances, and presents the argument that they stage cosmopolitan and intercultural philosophical ideas. Eva Urban is Senior Research Fellow at the Senator George J. Mitchell Institute for Global Peace, Security and Justice, Queen's University Belfast. She has held a Région de Bretagne Postdoctoral Research Fellowship at the Centre for Breton and Celtic Studies, University of Rennes 2, a research lectureship in the English Department, University of Rennes 2, and a British Academy Postdoctoral Fellowship at the University of Cambridge. She is the author of Community Politics and the Peace Process in Contemporary Northern Irish Drama (Peter Lang, 2011) and has published articles in New Theatre Quarterly, Etudes Irlandaises, Caleidoscopio, and chapters in book collections.
There are two important features of the Polish system of issuance of development consent for projects requiring the Environmental Impact Assessment that need mentioning for the purpose of this article: the first one is the multi-stage nature of the development consent in Poland and the other is that the first stage thereof is the “environmental decision”, summarizing the findings of the Environmental Impact Assessment. The latter is regulated by the Act of 3 October 2008 on the access to environmental information, public participation and the Environmental Impact Assessment (OJ 2016 item 353 text codified as amended, further referred to as EIA Act).
At the same time, the Polish legal system provides for several sectoral Acts that derogate the general rules of the issuance of environmental decisions and replace them with separate provisions that are more favourable for the investors and at the same time lowering the safeguards for the environment. Those changes encompass the elements as mentioned:
– restrictions imposed on the proceedings of the issuance of the environmental decisions,
– automatic assignment of the immediate enforceability to the environmental decisions,
– stricter rules of challenging the environmental decisions,
– prohibition of the quashing of the administrative decisions issued at the last stage of the development process.
The following reservation has to be made: while it is true that the environmental decisions are in many cases preceded by the Environmental Impact Assessment, it is not a prerequisite for their issuance; even if a project in the course of so-called screening procedure (see Article 4 of Directive 2011/92/EU of the European Parliament and of the Council of 13 December 2011 on the assessment of the effects of certain public and private projects on the environment as amended, OJ L 26, 28 January 2012) was found to be of non-EIA nature, the environmental decision is still required. However, for the sake of the clarity of this dissertation, it is focused solely on the environmental decisions issued for the projects requiring the Environmental Impact Assessment.
In the 2000s, Berlin saw the formation of so-called Baugruppen (construction groups) – associations of small-scale investors who pooled their modest capital to commission an architect and construct a multistorey building in which they would own and occupy a flat. They were mostly middle-class families united by a belief in community values and neighbourly contact as well as the qualities of urban living. This article will present the construction groups as an example of bottom-up architecture in an industrialized western country, in which individual initiatives and user-centred design had to be negotiated within a highly professionalized environment, as well as with contradictory political positions. It will show that construction groups brought together various threads of Berlin's recent urban history: the gradual integration of radical post-1968 lifestyles into mainstream society, the ‘return to the inner city’ connected with the increasing popularity of ‘new tenements’, and the evolution of innovative, post-functionalist architecture.