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Technology is transforming the way legal work is being delivered. It is influencing what law firms, clients and legal departments are expecting of their employees and what employees are expecting of their employers. It is reshaping legal education and careers; lawyers are becoming legal knowledge engineers, information professionals and knowledge managers are working closer than ever with IT teams. In this article, Ann Hemming and James Wilkinson will be considering lawyers’ training and BIALL members’ role in the landscape being reshaped by legal technology.
Civil society organizations are often seen as playing a crucial role in helping to mitigate the exclusion of weaker states, giving voice to marginalized communities, and raising environmental and developmental concerns within the trade system. The politicization and demystification of the global trade agenda by civil society also opens up space for a more diverse set of actors to influence trade negotiations. This article examines the evolution of the WTO secretariat's engagement with civil society within this context and argues that the dominant mode of engagement, as manifest in WTO Public Forums and civil society participation in ministerial conferences, is no longer fit for purpose. Rather it reflects an outmoded strategy that once served to underscore the existence and value of the WTO as an international organization and works to neutralize political contestation and publicly promote the benefits of free trade. It is now in need of reform.
To devise a measure of diet quality from a short-form FFQ (SFFFQ) for population surveys. To validate the SFFFQ against an extensive FFQ and a 24 h diet recall.
Population-based cross-sectional survey.
East Leeds and Bolton in Northern England.
Adults (n 1999) were randomly selected from lists of those registered with a general practitioner in the study areas, contacted by mail and asked to complete the SFFFQ. Responders were sent a longer FFQ to complete and asked if they would take part in a telephone-based 24 h diet recall.
Results from 826 people completing the SFFFQ, 705 completing the FFQ and forty-seven completing the diet recall were included in the analyses. The dietary quality score (DQS), based on fruit, vegetable, oily fish, non-milk extrinsic sugar and fat intakes, showed significant agreement between the SFFFQ and the FFQ (κ=0·38, P<0·001). The DQS for the SFFFQ and the diet recall did not show significant agreement (κ=0·04, P=0·312). A number of single items on the SFFFQ predicted a ‘healthy’ DQS when calculated from the FFQ. The odds of having a healthy diet were increased by 27 % (95 % CI 9, 49 %, P<0·001) for an increase in fruit of 1 portion/d and decreased by 67 % (95 % CI 47, 79 %, P<0·001) for an increase in crisps of 1 portion/d.
The SFFFQ has been shown to be an effective method of assessing diet quality. It provides an important method for determining variations in diet quality within and across different populations.
Cardiomyopathy is a rare disorder of the heart muscle, affecting 1.13 cases per 100,000 children, from birth to 18 years of age. Cardiomyopathy is the leading cause of heart transplantation in children over the age of 1. The Pediatric Cardiomyopathy Registry funded in 1994 by the National Heart, Lung, and Blood Institute was established to examine the epidemiology of the disease in children below 18 years of age. More than 3500 children across the United States and Canada have been enrolled in the Pediatric Cardiomyopathy Registry, which has followed-up these patients until death, heart transplantation, or loss to follow-up. The Pediatric Cardiomyopathy Registry has provided the most in-depth illustration of this disease regarding its aetiology, clinical course, associated risk factors, and patient outcomes. Data from the registry have helped in guiding the clinical management of cardiomyopathy in children under 18 years of age; however, questions still remain regarding the most clinically effective diagnostic and treatment approaches for these patients. Future directions of the registry include the use of next-generation whole-exome sequencing and cardiac biomarkers to identify aetiology-specific treatments and improve diagnostic strategies. This article provides a brief synopsis of the work carried out by the Pediatric Cardiomyopathy Registry since its inception, including the current knowledge on the aetiologies, outcomes, and treatments of cardiomyopathy in children.
Systematic collecting through the upper Wenlock (upper Homerian) and lower Ludlow (Gorstian and lowermost Ludfordian) Silurian rock succession of the Long Mountain, Powys, Wales, identifies some 48 chitinozoan species that distinguish four biozones, two subzones and an interregnum. Consideration of the chitinozoan biozones together with those of the graptolites enables a local three-fold subdivision of the late Homerian lundgreni graptolite Biozone, and the distinction of lower and upper intervals for the Gorstian incipiens graptolite Biozone. The base of the Ludlow Series in the Long Mountain more or less equates to the base of the Cingulochitina acme chitinozoan Biozone, although no key chitinozoan first or last appearance datums are associated with the series boundary itself. The new graptolite–chitinozoan biozonation allows enhanced correlation between upper Wenlock and lower Ludlow sedimentary deposits of the Lower Palaeozoic Welsh depositional basin and those of the palaeo-shelf in the stratotype Wenlock and Ludlow areas of Shropshire. Chitinozoans seem affected by the phenomena that caused the late Wenlock ‘Mulde extinction’ in graptolites but, with the final disappearance of 9 species and re-appearance of 11 species following an interval of overall low diversity, they seem to have suffered less severely than their macro-zooplanktonic contemporaries.
Dual-Polarization Radar and Twitter were analyzed to determine the impact on injuries sustained by the Hattiesburg EF-4 tornado.
Tracking data provided from the Dual-Pol radar systems in National Weather Service Jackson were reviewed. Twitter data from four local Twitter handles were obtained. The change in tweets and followers for the day of the storm were compared to historical averages. A Student t-test was utilized in determining statistical significance (p<0.05). Medical records from two local emergency departments were reviewed for patients treated up to 24 hours after the tornado. An Injury Severity Score (ISS) was calculated for trauma records related to the tornado.
Radar detection of the tornado gave approximately 30 minutes of advanced warning time. Statistical significance in follower growth was seen in all four Twitter handles. Out of 50 patients, the average ISS was 3.9 with a range of 1 to 29. There were zero fatalities.
An ISS average of 3.9 was significantly less than two previous tornadoes of similar strength that occurred prior to increased usage of Dual-pol radar and Twitter as a means for communicating severe weather information. Early detection from Dual-pol radar improved warning time. Tweets informed citizens to seek appropriate shelter. (Disaster Med Public Health Preparedness. 2013;7:585-592)
The ‘ethnic density hypothesis' is a proposition that members of ethnic minority groups may have better mental health when they live in areas with higher proportions of people of the same ethnicity. Investigations into this hypothesis have resulted in a complex and sometimes disparate literature.
To systematically identify relevant studies, summarise their findings and discuss potential explanations of the associations found between ethnic density and mental disorders.
A narrative review of studies published up to January 2011, identified through a systematic search strategy. Studies included have a defined ethnic minority sample; some measure of ethnic density defined at a geographical scale smaller than a nation or a US state; and a measure ascertaining mental health or disorder.
A total of 34 papers from 29 data-sets were identified. Protective associations between ethnic density and diagnosis of mental disorders were most consistent in older US ecological studies of admission rates. Among more recent multilevel studies, there was some evidence of ethnic density being protective against depression and anxiety for African American people and Hispanic adults in the USA. However, Hispanic, Asian–American and Canadian ‘visible minority’ adolescents have higher levels of depression at higher ethnic densities. Studies in the UK showed mixed results, with evidence for protective associations most consistent for psychoses.
The most consistent associations with ethnic density are found for psychoses. Ethnic density may also protect against other mental disorders, but presently, as most studies of ethnic density have limited statistical power, and given the heterogeneity of their study designs, our conclusions can only be tentative.
Two broad interpretations currently prevail in the literature on developing country participation in the GATT. The first suggests that developing countries spent most of their time in the GATT negotiating to be relieved of various commitments, focusing on the pursuit of industrialization through import substitution and/or free-riding on the commitments made by their industrial counterparts. The second interpretation suggests that developing countries spent the majority of their time in the GATT either as ‘quiet bystanders’ lacking the expertise or political representation to participate fully, or else attempting to redress biases in the institution's design. The problem with both of these interpretations is that while each has merit neither offers a sufficiently rounded account of developing country participation. Our purpose in this paper is to offer an alternative account of developing country participation that shows more accurately the extent and variation of that participation. We argue that throughout the development of the GATT developing countries were active participants that consistently sought to have an impact on the nature and direction of the multilateral trading system. We also argue that while the energy of developing countries was often directed towards negotiating more favourable treatment for themselves, this was a result more of the asymmetrical manner in which the GATT was deployed and a consequence of their relative underdevelopment than of a desire to free-ride on the favourable trading conditions created by the concession exchanging activities of others.
“When the history of congenital heart disease comes to be written, Brown will be given a high and honourable place along with Farre, Peacock, Fallot, Théremin, Vierordt, and Maude Abbott, as one whose labours have contributed vitally to the subject.”1
Little is known about the implications of left ventricular noncompaction in children with additional congenital cardiac malformations. With this in mind, we conducted a retrospective review of every left ventricular angiogram performed in a single tertiary referral centre for paediatric cardiology, in Melbourne, Australia, between 1994 and 2000 in children with congenital heart disease, looking specifically for patients with angiographic evidence of noncompaction of the left ventricle. The outcome of patients identified as having noncompaction was compared with that of patients from the same population, stratified by their primary congenital cardiac malformation.
Of 1515 children undergoing left ventricular angiography, 31, with 13 being male, were found to have angiographic evidence of left ventricular noncompaction, giving a prevalence of 2% (95% CI: 1.3%–2.8%). Of 69 (22%) children with a functionally single left ventricle, 15 fulfilled the criterions for noncompaction, compared to 16 of 1446 (1.1%) children with a balanced ventricular arrangement (p is less than 0.0001). The presence of noncompaction and a functionally single left ventricle were each associated with a doubling of mortality, the effect being cumulative. Of surviving patients with left ventricular noncompaction, 19% (4%–34%) have left ventricular dysfunction at their latest follow-up. We suggest that the important late sequels of noncompaction justify careful scrutiny for this entity in children with congenital cardiac disease.
Congenital cardiac malformations which include isomerism of the atrial appendages are amongst the most challenging of problems for diagnosis and also for medical and surgical management. The nomenclature for pathological description is controversial, but difficulties can be overcome by the use of a segmental approach. Such an approach sets out the morphology and the topology of the chambers of the heart, together with the types and modes of the atrioventricular, ventriculo-arterial, and venous connections. We have applied this method to a study of 35 hearts known to have isomerism of the atrial appendages. We have already published accounts of 27 of these cases, but these were reviewed for this study in the light of our increased awareness of the implications of isomerism, and 8 new cases were added. After examining, or re-examining, the morphology of every heart in detail, we grouped them together according to their ventricular topology and modes of atrioventricular connection. Then we studied the course of the specialised conduction system, by the use of the light microscope, first in each individual case, and then together in their groups. We conclude that the pathways for atrioventricular conduction in hearts with isomerism of the atrial appendages are conditioned both by ventricular topology, and by the atrioventricular connections. Based on our experience, we have been able to establish guidelines that direct the clinician to the likely location of the conduction tissues.
Congenitally corrected transposition is a complex cardiac lesion that is often associated with ventricular septal defect, obstruction of the outflow tract of the morphologically left ventricle, and abnormalities of the morphologically tricuspid valve.1,2 Nomenclature for this lesion has been variable and confusing.1 In this review, we define, and hopefully clarify this terminology. The lesion is a combination of discordant union of the atrial chambers with the ventricles, and the ventricles with the arterial trunks.1,2 In rare circumstances, discordant atrioventricular connections can be associated with concordant ventriculo-arterial connections. This malformation has been called “isolated ventricular inversion”. The term is less than precise, and the descriptive approach using the phrase “discordant atrioventricular connections with concordant ventriculo-arterial connections” is preferred, as discussed below.
Microsatellite primers are often developed in one species and used to assess neutral variability in related species. Such analyses may be confounded by ascertainment bias (i.e. a decline in amplification success and allelic variability with increasing genetic distance from the source of the microsatellites). In addition, other factors, such as the size of the microsatellite, whether it consists of perfect or interrupted tandem repeats, and whether it is autosomal or X-linked, can affect variation. To test the relative importance of these factors on microsatellite variation, we examine patterns of amplification and allelic diversity in 52 microsatellite loci amplified from five individuals in each of six populations of Cyrtodiopsis stalk-eyed flies that range from 2·2% to 11·2% mitochondrial DNA sequence divergence from the population used for microsatellite development. We find that amplification success and most measures of allelic diversity declined with genetic distance from the source population, in some cases an order of magnitude faster than in birds or mammals. The median and range of the repeat array length did not decline with genetic distance. In addition, for loci on the X chromosome, we find evidence of lower observed heterozygosity compared with loci on autosomes. The differences in variability between X-linked and autosomal loci are not adequately explained by differences in effective population sizes of the chromosomes. We suggest, instead, that periodic selection events associated with X-chromosome meiotic drive, which is present in many of these populations, reduces X-linked variation.