bluuebunny/crossref_metadata_2025 huggingface dataset:
Norm Conflicts, International Humanitarian Law, and Human Rights Law
Authors: Milanović Marko
Published: October 2011

This chapter rejects this conclusion: the lex specialis maxim ‘must be abandoned as a sort of magical, two-word explanation of the relationship between international humanitarian law (IHL) and international human rights law (IHRL) as it confuses far more than it clarifies’. The discussion of the interaction of particular norms of IHL and IHRL that regulate specific situations advances the following argument: such interaction will frequently result in a norm conflict, for which there are numerous tools for either conflict resolution or avoidance; lex specialis is at best a fairly limited tool of norm conflict avoidance, which cannot be used to describe the relationship between human rights and humanitarian law as a whole; and there are situations in which all legitimate interpretive tools will fail us, where a norm conflict will be both unavoidable and irresolvable due to a fundamental incompatibility in the text, object and purpose, and values protected by the interacting norms, and where the only possible solution to the conflict will be a political one. The chapter identifies three such possible situations of irresolvable antinomy — targeted killings, preventive security detention, and positive obligations during occupation — and discusses them in the light of recent cases.
The Role of the European Court of Human Rights in Monitoring Compliance with Humanitarian Law in Armed Conflict
Authors: Gioia Andrea
Published: October 2011

This chapter focuses on the relationship between the European Convention on Human Rights (ECHR) and international humanitarian law (IHL). The first part of the chapter analyzes the relationship between the ECHR and IHL from a general point of view. Having determined that the ECHR continues to apply in times of armed conflict — both international and non-international — the discussion proceeds to examine the Convention's extraterritorial application, the relationship between the ECHR and IHL, and the competence of the European Court of Human Rights to take IHL into account when applying the Convention in situations amounting to armed conflict. The second part discusses the Court's case-law relating to situations of armed conflict in order to ascertain what role IHL has so far played in the Court's decisions: special reference is made to cases relating to the right to life, to the right to liberty, and to the protection of property. The possible explanations for the Court's marked reluctance to refer to IHL are discussed in this context, while pointing out that generally the Court has not so far adopted decisions squarely contradicting the applicable rules of IHL. The chapter concludes with an implicit plea for the Court to depart from its ‘ivory tower’ attitude towards IHL, so as to contribute to a convergence of the two legal regimes towards a more coherent as well as a more realistic regulation of conduct in armed conflicts in general and in non-international armed conflicts in particular.
Sir James Crichton-Browne
Authors: Oppenheim Janet
Published: October 2011

No Victorian or Edwardian alienist assumed the scientific and moral responsibilities of his work with greater confidence than did James Crichton-Browne. During the course of his career, he sampled nearly all of the professional opportunities open to British psychiatry in these decades, serving as resident medical officer at several public asylums, lecturing on mental disease at provincial medical schools, editing journals, inspecting the treatment of lunatics as a government official, and advising private patients as a fashionable psychiatric consultant. Browne's approach to mental illness revealed the uneasy coexistence of physiological and psychological interpretations that characterized the work of British psychiatrists throughout the 19th century. On the one hand, he espoused the physical model, unequivocally affirming the conviction that somatic conditions gave rise to the symptoms of mental derangement. On the other hand, Browne conceded real potency to moral means, even if their impact could only be perceived somatically.
Manly Nerves
Authors: Oppenheim Janet
Published: October 2011

The great problem with nervous breakdown was that it made a mockery of the distinctions on male sexuality, reducing its male victims to passivity, removing them from business activities and public affairs, rendering them utterly indecisive. In short, nervous exhaustion brought men perilously close to the feminine condition. The medical profession in these decades never attempted to deny the widespread incidence of nervous breakdown among men. It is utterly erroneous to assume that Victorian doctors perceived the male half of the human race as paragons of health and vigor, while assigning all forms of weakness to women. They could not have done so, even had they wanted to, for the evidence exposing male nervous vulnerability was too familiar to the Victorian public for pretense. The solution they achieved helped to confine stereotypes of masculinity from which men crippled by severe depression could have only derived cold comfort.
Framing the Margins
Authors: Wilson Ivy G.
Published: October 2011

This chapter illuminates how the compositional logic of American genre painting strategically organized zones in terms of centers and margins in various settings as different as parlors, fields, and post offices as a means to illustrate the forms of national belonging. In works by William Sidney Mount, Richard Caton Woodville, Eastman Johnson, and Winslow Homer, it analyzes the depiction of written notices, furniture, and attire as political devices that materialize space as a social domain. It pays particular attention to the ways that African American subjects are literalized as shadows in many of these paintings, tucked away into corners of parlors or hovering on the outskirts of scenes of entertainment, through an analytic of what it theorizes as “the social logic of spatial forms”.
The Patriot Opposition to Walpole
Authors: Gerrard Christine
Published: October 2011

This book is a full-length study of the so-called Patriot opposition to Robert Walpole, which reached its height during the clamour for war against Spain at the turn of the 1730s. The book examines the inter-relationship between patriotism, politics, and poetry in the period 1724-1742. It investigates the growing Patriot opposition during the Walpolian oligarchy, and asks whether a broad credo united all of Walpole's political opponents, or whether there was a distinction between Whig and Tory Patriots. The role of Frederick Prince of Wales as the campaign's cultural and political figurehead is discussed, as are the poetry and drama of such authors as James Thomson, Alexander Pope, and the young Samuel Johnson, who were all drawn to the heady idealism of the young Boy Patriots. Thomson's Rule Britannia and Johnson's London exploit the appeal to British history so central to the emotive propaganda of the Patriot campaign. Drawing on the literature, prints, architecture, and statuary of the 1730s, the book also discusses two of the decade's most powerful romantic patriotic myths — Gothic liberty, and Elizabethan greatness — and reveals that in its nationalistic emphasis upon Nordic and Celtic traditions, the figure of the ancient British Druid, and native ‘bards’, Patriot literature anticipates the ‘Gothic’ strain emerging in the poetry of Gray, Collins, and the Wartons only a few years later.
Jacobites and Patriots: Johnson and Savage
Authors: Gerrard Christine
Published: October 2011

By 1742, Robert Walpole had gone, only to be replaced by ‘politics as usual’, a Whig party reshuffle which in time came to include previous Patriot Whigs who abandoned their commitment to broad-bottom principles in pursuit of government places. Some of the most scathing definitions of Patriots, patriotism, and Whigs are supplied by Samuel Johnson. Patriot Whiggery and Jacobitism deployed overlapping sets of images and metaphors, especially those of redemptive kingship. But Patriot Whigs were rarely Jacobites. Patriot Whigs were remarkably consistent with their support for the House of Hanover, even if that support focused on the heir to the throne rather than its present occupant. This is not to deny that a few figures involved in Patriot politics later dabbled with Jacobite intrigue. But the fundamental tenet cherished by most opposition Whigs — defence of the Protestant succession — was ultimately irreconcilable with Jacobitism. Johnson's unusual oscillation between Whig Patriot idealism and stubborn Jacobite resentment was also characteristic of Richard Savage, perhaps the dominant influence on the young Johnson during his first years in London.
Katherine Mansfield and Virginia Woolf
Authors: Smith Angela
Published: October 2011

Long after the death of Katherine Mansfield (1888–1923), Virginia Woolf (1882–1941) described being haunted by her in dreams. Through detailed comparative readings of their fiction, letters, and diaries, this book explores the intense affinity between the two writers. Their particular inflection of modernism is interpreted through their shared experience as ‘threshold people’, familiar with the liminal, for each of them a zone of transition and habitation. Writing at a time when the First World War and changing attitudes to empire problematized boundaries and definitions of foreignness, this book shows how the fiction of both Mansfield and Woolf is characterised by moments of disorienting suspension in which the perceiving consciousness sees the familiar made strange, and the domestic made menacing.
From Subjectivity to Objectivity
Authors: Hundert Edward M.
Published: October 2011

This chapter shows how experiences of an (‘external’) world of objects are part and parcel of any experiences united in a single consciousness. In order to understand how Kant manages this crucial move, it becomes vital to understand how he conceptualizes the ‘self’ which unites its experiences according to the necessary unity of consciousness. Therefore, most of this chapter discusses two closely related parts of Kant's theory. The first associates the self with the activity which unites our experiences in consciousness. The second distinguishes the sensory and the intellectual features of the self. In this text, Kant defines philosophy in a strict way as dealing only with the ‘a priori’. This definition of philosophy is accepted by many great thinkers, such as Bennett who writes that the psychological question of how children de facto acquire concepts is ‘not the philosopher's business’.
The Thoughtful Brain
Authors: Hundert Edward M.
Published: October 2011

In this chapter, there is reconsideration of Kant's approach as applied to the biological reality of the nervous system. The neuroscientist's view of the necessary conditions for self-conscious experience of an external world is quite different from the conditions Kant devised. In particular, Edelman's theory of ‘group selection and phasic re-entrant signalling’ requires such conditions as the selection of degenerate groups of neurons as well as sequential and parallel processing by (R of R) groups capable of recognizing not only ‘inputs’, but also each other. Furthermore, this chapter explores sensorimotor ‘intelligence’ and the limits of neuroscientific research, the participation of the world in thoughtful brains and the biologic basis of intersubjective knowledge. This chapter concludes that it is, in a very practical sense, biology which supports the coherence theory of knowledge.
The City of Scythopolis
Authors: BINNS JOHN
Published: October 2011

This chapter examines monastic history of Scythopolis, the capital of the province of Palestine II during the Byzantine period. In this city, monasticism had penetrated into the fabric of society and this city provides the best example of the nature of provincial urban society during this period. Scythopolis attracted the construction of monasteries because of its central position in the network of roads built by the Romans.
The Origins and Development of the System of Planning and Control
Authors: Thain Colin , Wright Maurice
Published: October 2011

The Public Expenditure Survey Committee (PESC) system originated in the 1950s and its development is traced in this chapter emphasising the system's context in the planning and controlling of public expenditure in Britain. This is referenced through the publication of the Plowden Report in 1961 and also includes an introduction to the proposed cash planning in 1982. This chapter argues that the process was a gradual one and the new planning and control system's principles were rooted in the official Treasury's response to changing government objectives in the 1950s. The gradual development of PESC was abruptly halted in the middle of 1970s as the need to cut expenditure and restore control coincided with the Keynesian principle's crumble. After the planning of how PESC was to be done and implemented, monitoring and cash control were then the dominant characteristics of the process.
The Treasury and FMI
Authors: Thain Colin , Wright Maurice
Published: October 2011

During the 1980s and 1990s, the planning and control of expenditure was conducted within the context of major changes in the Civil Service structure and organisation. A programme to reduce the size and scope of the public sector to make the remaining services more efficient and effective was an important part of the Conservative Party's manifesto at the 1979 general election. More significant was the Financial Management Initiative (FMI) launched in 1982, and the implementation of ‘Next Steps’ which led to the creation of Executive Agencies. The implementation of both has had, and will continue to have, profound effects upon the relations between the Treasury and the spending departments, and is the issue which runs through all the remaining chapters of this book: central control and departmental autonomy. This chapter looks at the involvement of the Treasury and other central departments in the design and implementation of FMI leading up to ‘Next Steps’.
The Structure and Organization of the Treasury
Authors: Thain Colin , Wright Maurice
Published: October 2011

It was only since 1947 that the British Treasury has been formally responsible for economic policy coordination as its main functions were on raising of revenue through its subordinate departments of Inland Revenue and Customs and controlling public expenditure. This chapter includes a thorough definition of the Treasury's role in planning and controlling public expenditure as set in its annual Department Report as well as a tally of ministerial responsibilities and duration of service. The Treasury possesses an advantage over other departments in the sense of perspective as the organisation is uniquely placed to see the ‘bigger picture’ of expenditure functions. Expenditure Controllers are professional administrators and their skills and qualifications are outlined in this chapter with an overview on how they deal with changes in the system of planning and controlling public expenditure.
The Whitehall Expenditure Policy Network
Authors: Thain Colin , Wright Maurice
Published: October 2011

The Treasury and the spending departments have a dynamic relationship and this is explored in this chapter as it looks into the concepts of policy community and policy network that can be used to identify and characterize the principal players and their roles, and to explain the behavioural and policy ‘rules of the game’ regulating the relationships of spending departments and Treasury. Exchange of information is crucial and the communication channels to which decisions between officials are conveyed are examined. This is important especially in determining the robustness of a department's financial management and the reliability and quality of people running the organization. Credibility is established through information delivered in a two-way process in which Expenditure Controllers must be able to bring what is promised on a proposal and equally the Finance Division or Policy Division must also be reliable.
Determining the Priorities of Public Spending
Authors: Thain Colin , Wright Maurice
Published: October 2011

From 1976 until the introduction of the New Control Total in 1992, the priorities of total public expenditure were determined by various officials and departments. It is argued in this chapter that the budget was set not in line with prospective revenue but more as a result of considerations concerned with broad macroeconomic strategy as well as the result of pressures for additional resources from spending ministers. Determining the total expenditure and the process of allocating costs were changed in 1992 when the New Control Total was introduced and throughout the transition of the processes and their effects, priority cases were given emphasis. Cross-departmental comparisons were made and the significance of priority in government is briefly discussed.
The Public Expenditure Survey
Authors: Thain Colin , Wright Maurice
Published: October 2011

The processes of planning and controlling public expenditure have evolved by the late 1980s and 1990s up to the decision to introduce the Unified Budget and the New Control Total in 1992. This chapter explains the changes made through the timeline of public expenditure control. Previous practices include the introduction of cash limits in 1976 until volume planning was abandoned and cash planning was introduced in 1982 and became the turning point for the Public Expenditure Survey (PES). The annual Medium Term Financial Strategy was also one of the past measures as well as the centrally determined pay factors which were abolished, separating programme and running costs expenditure and the impact of fiscal crises in 1992 which verified the differences of the PES from those in the 1970s. These changes are yet to be seen if they have a lasting effect on the decision-making process as the state of the PES in the 1990s is assessed in this chapter including the immediate effects of changes in 1992.
Departmental ‘Winners’ and ‘Losers’
Authors: Thain Colin , Wright Maurice
Published: October 2011

The most significant output of the Public Expenditure Survey (PES) system is the aggregate total of public expenditure planned for the coming financial year. This is measured in terms of the government's short- and long-term public spending objectives, in the context of its broader politico-economic objectives, and is attributable to the government collectively and to the Treasury as the instrument of its policy. The intermediate outputs of the system of interest are the departmental allocations published formerly in the November Autumn Statement, and from 1993 the Unified Budget. The PES allocations cannot be read as a scorecard of who has won and lost in the process of bidding and negotiating with the Treasury and Cabinet Expenditure Committee. There are problems of definition, measurement, and interpretation.
Controlling Public Expenditure More Effectively?
Authors: Thain Colin , Wright Maurice
Published: October 2011

Through the 1990s, pressures for more public spending continued unabated, and governments continued to attempt to restrain the growth of the aggregate, and to decide upon the allocation of mereasingly scarce resources. Yet there are constitutional and practical limits to the exercise of tight Treasury control. This chapter discusses how the processes of making and carrying out expenditure policy might be changed to enhance the effectiveness of that control. The structure and organization of the Treasury, as well as the techniques of budgeting which it employs, are examined. The chapter also considers whether the collective responsibility of the Cabinet could be made more effective, in the light of the changes introduced in 1992. It concludes by focusing on the circumstances in which a paradigm shift might occur.
Lessons of the Golden Age: An Overview
Authors: Marglin Stephen A.
Published: October 2011

This chapter provides an overview of the historical and theoretical arguments of the book. It differentiates causes and triggers. It notes that conventional wisdom dates the end of the ‘golden age’ by the first oil shock, OPEC I in 1973. The second oil shock, OPEC II in 1979, is conventionally argued to have ushered in the current phase of neoliberalism, monetarism, and the return to the market. However, this book's argument explains that OPEC I and II are not fundamental causes but triggers which set off forces that had deep roots in the internal economies of the industrial countries and in the relationships among them and between them and the Third World. It discusses the relationship between the underlying reasons why different periods of postwar capitalism ended (‘causes’) and the events that sparked off these ends (‘triggers’).
Information Technology and Economic Growth: Introduction and Conclusions
Authors: POHJOLA MATTI
Published: October 2011

While there are large discrepancies between the average incomes of the world's poorest countries in contrast with the world's richest countries, such evidences point out that there are significant differences in human welfare and in the quality of life experienced by people who come from these different countries. In terms of both the poverty of basic choices and opportunities and that of incomes, about one third of the people in various developing countries are experiencing a great deal of poverty. Considering the importance of both human and physical capital, and other such economic factors, developing and developed countries alike have expressed interest in turning to modern information technology (IT) for improved economic growth. The information revolution is said to be brought about by the decline in information processing prices, the developments in network computing, and the merge of computing technologies with communication, and such will hopefully give rise to an economy with knowledge-based services.
The Problem of Public Order and the Knights
Authors: Kaeuper Richard W.
Published: October 2011

This chapter focuses on the role of knights in public order. It presents the misadventure of Balain which depicts the problem of public order. This story is all the more powerful for being a part of a major structural contrast built into this widely read cycle of romances. The contrast is embodied in two knights who possess undoubted and praised prowess, but the results of their knighthood could scarcely be more different. The source of Balain's misery and misfortune is set opposite Galahad, bringer of joy and release. The Unfortunate Knight stands on one side, the Good Knight on the other.
English Kingship, Chivalry and Literature
Authors: Kaeuper Richard W.
Published: October 2011

This chapter discusses the case of chivalry and English kingship, emphasizing their differences. It investigates the particularities of English political and social circumstances. Legal records show that the knightly violence so widespread in chivalric literature was practised in everyday life, with serious consequences for public order.
Social Dominance of Knights
Authors: Kaeuper Richard W.
Published: October 2011

This chapter argues that the fundamental bond of prowess and honour is strengthened by an assertion of high status. The commendation given to chivalry can be understood without recognizing its bonds with these crucially important social issues. Assertion of a right to social dominance gives another important component to the fusion that made chivalry and gave it such power in medieval society. Over time, knights rose in status and even the nobility decided to wear the chivalric mantle.
Knights, Ladies, and Love
Authors: Kaeuper Richard W.
Published: October 2011

This chapter argues that the fundamental bond of prowess and honour is strengthened by a troubled link with love and gendered relations. The eulogies sung to chivalry — and the worries more prudently expressed — can scarcely be understood without recognizing its bonds to these crucially important social issues. It shows that chivalry formed the frame for the important issue of gendered relations. It documents the variety of medieval views on this subject to show that chivalric literature is a literature of criticism and reform, as much as a mirror to society. It establishes the link between love and gendered relations. Lastly, it discovers the continuing concern over the issue of violence as it relates to chivalry.
Solutions to the Puzzle Cases
Authors: Gallois André
Published: October 2011

This chapter examines possible solutions to the identity puzzle called the ship of Theseus. It explains the intuition developed for the puzzle which considers the ship assembled from a collection of planks as ORIGINAL, the ship constructed from the planks removed from the ORIGINAL as REASSEMBLY, and the progressive replacement of the ORIGINAL's planks as the REPLACEMENT. It suggests that the multiple location view cannot be possible because while it is compatible with the main intuition, it violates Leibniz's Law. The chapter evaluates the applicability of the occasional identity thesis to this puzzle case.
Identity Strict and Loose
Authors: Gallois André
Published: October 2011

This chapter evaluates three possible solutions to the problems presented by the five identity puzzle cases previously described. It explains the applicability of the view about arbitrary undetached parts and the illusion of strict identity to the ship of Theseus puzzle. This chapter suggests that philosopher Roderick Chrisholm's account of diachronic identity and the flexible designation view satisfied the desideratum laid out at the outset and provided the solution to all the puzzle cases. This is because both views reject an assumption whose truth is required to generate any of the puzzles about diachronic identity.
Building the New Nationalism
Authors: Stears Marc
Published: October 2011

Educated and well-informed Britons and Americans radically changed the way they thought about the nature of their society as a series of philosophical, sociological, and psychological movements from idealism to Darwinism and from Fabianism to pragmatism stretched out during the 20th century. This chapter analyses the conceptual debate on liberty based on the structure of theorists. First, the chapter examines the theorists' immediate response to the conceptual agenda of their predecessors. Through this examination Herbert Croly, Walter Lippmann, and Walter Weyl are shown first to have adopted and then significantly radicalised the conceptual understandings their idealist, Darwinist, and pragmatist predecessors in the United States had outlined. Secondly, the chapter considers the distinctly political uses to which this conceptual approach was put, exploring the ways in which conceptual agenda and political programme were closely related together. It then presents a new interpretation of the theoretical structure and the practical scope of the ideological movement that was known as the ‘new nationalism’.
Conclusion
Authors: Stears Marc
Published: October 2011

Between 1909 and 1925, the American nationalist progressives and British socialist pluralists outlined two sharply distinct political philosophies: one apparently state-centred, the other fiercely anti-statist. The nationalist progressives, it appeared, wished to construct an entirely new central state machine in the United States, one capable of overcoming the obstacles of localism and sectionalism and imposing a nationwide political agenda and social identity across several States. The socialist pluralists, on the other hand, seemed fiercely to reject the state-centred programmes of their contemporaries. They celebrated diversity, social difference, and group autonomy, and argued for a radical decentralization of authority in all aspects of social, economic, and political life. And yet, despite these stark differences, the ideological evolution of these two groups also appeared intricately intertwined. Indeed, not only did the groups' leaders involve themselves in a continual dialogue, they also identified individual programmes of concrete reform that could be shared between them.
Midsummer Eve in Sweden: a natural fluid challenge in patients with heart failure
Authors: Gudmundsson Kristjan , Lyngå Patrik , Karlsson Helena , Rosenqvist Mårten , Braunschweig Frieder
Published: October 2011

Aims

Volume overload exacerbations in patients with chronic heart failure (HF) are associated with a dismal prognosis and are often triggered by dietary incompliance. We aimed to describe the effects of dietary changes on measures of fluid retention in HF patients.

Methods and results

Thirty‐one HF patients with an implantable defibrillator (age 64 ± 11 years, ejection fraction 25 ± 12%, median NT‐proBNP 2090 ng/L, resynchronization therapy: n= 25) were followed by daily body weight (BW) (telemonitoring) and intrathoracic impedance (by the implanted device) around Swedish Midsummer 2009, a holiday traditionally celebrated with meals including salty fish dishes and ample intake of fluids. Midsummer Eve celebrations caused a distinct and rapid increase in BW and a decrease in impedance indicating increased fluid retention. Compared with baseline values, peak BW increased by 1225 g [interquartile range (IQR) 475–2013 g)] which was accompanied by a decrease in impedance (3 Ω; IQR −5.2 to −1.2) and a clear deflection on the impedance‐based fluid detection algorithm (OptiVol) that crossed the preset fluid‐alert threshold six times following Midsummer. Body weight and impedance values were normalized after a period of 20 and 8 days, respectively. A clustering of minor clinical events following Midsummer suggests a possible adverse impact of dietary incompliance. However, none of the patients were hospitalized for HF.

Conclusions

Dietary incompliance, e.g. on the occasion of a ceremonial meal, may lead to marked disturbances in the fluid balance of patients with HF reflected by increased BW and decreased intrathoracic impedance. These findings underline the importance of maintaining stable volume conditions in HF patients.
Assessing people with long-standing pain
Authors: Souter Andrew
Published: October 2011

Assessing patients properly is a crucial first step in medicine. Faced with someone who has had long-term pain, the first response is to do anything to avoid being pulled into a long and difficult conversation. Often these patients will already be very familiar and perhaps it is felt that nothing new will emerge, or no progress will be made. However, a simple assessment in the form of history and examination will point the way to appropriate management. Firstly there are treatments that can be provided in primary care; and secondly, because of waiting lists in all parts of the health service, the best referral is one that goes to the right specialist who has the necessary information on first seeing the patient.
Injections, invasive treatments and the ‘whole patient’ view
Authors: Lee John
Published: October 2011

This chapter discusses the care of a patient who is being managed in a disjointed fashion. It describes a complex patient with a standard back pain problem where a failure of effective communication leads to an unhappy customer and a disgruntled and bewildered family. It draws on this experience to show how teams like the pain service can occasionally work to improve collaboration and communication. It also describes the medical treatments that pain clinics may offer.
What should I feel like after treatment at the pain clinic?
Authors: Dolin Simon , Ward Lucy
Published: October 2011

Patients who have been to the pain clinic may run into trouble as a consequence of the treatments provided. They may be unhappy about seeking advice from the pain clinic if they feel worse after the treatment, or they may contact their GP surgery first. This chapter will discuss the management of a patient with lower back pain (LBP) and the possible complications that a GP may be asked for help with.
Working across boundaries in pain medicine
Authors: Towell Trudy
Published: October 2011

This chapter explores some of the issues which patients, their carers, GPs, hospital doctors, nurses and pain teams experience particularly when confronted with a challenging case. The findings of a critical study that examined the communication patterns between GPs and nurses providing palliative care in Australia highlighted difficulties patients’ families face due to constant reassessments, the need to communicate information between different professionals and to update professionals on medication changes. The report identified that the patient often only received a few days’ discharge medications, requiring the need to contact the GP. The GPs were often unaware that their patient was home and collaborative networking time was very limited for all professionals. Two case studies highlight the need for unambiguous decision making concerning patient management and interdisciplinary relationships.
Dementia disorders: an overview
Authors: Zahn Roland , Burns Alistair
Published: October 2011

• Dementia is a clinical syndrome which comprises three domains: cognitive impairments, behavioural symptoms and impairments of activities of daily living

• Dementia may be caused by a wide range of brain disorders and systemic conditions. Alzheimer’s disease (AD) is the most frequent cause of dementia...
Diagnosing Alzheimer’s disease in clinical practice
Authors: Waldemar Gunhild
Published: October 2011

• In the current clinical criteria, the diagnosis of Alzheimer’s disease (AD) is a clinical diagnosis based on characteristic symptoms and signs, and the exclusion of other causes.

• AD must be differentiated from cognitive impairment due to depression, metabolic conditions, substance abuse, and other neurodegenerative or vascular brain diseases...
Diagnostic disclosure of Alzheimer’s disease
Authors: Derouesné Christian , Selmès Jacques
Published: October 2011

• There is a large consensus that disclosing the diagnosis of Alzheimer’s disease to patients is appropriate

• The main issue is therefore but when, what and how to tell

• Sharing the diagnosis requires time and should be influenced by factors such as how much the patient is able to understand...
Managing behavioural and psychological symptoms in Alzheimer’s disease
Authors: Robert Philippe , Leone Elsa , Amieva Hélène
Published: October 2011

• The behavioural and psychological symptoms of dementia (BPSD) form an important part of the clinical picture of Alzheimer’s disease (AD)

• Anti-dementia agents may facilitate behavioural management of AD and may decrease the use of psychotropic agents

• Management should preferentially be non-pharmacological Medication is to be prescribed only after assessment of the individual risk/benefit ratio. The prescription should be for a limited period and frequently re-assessed...
Editorial
Authors: Meade Tom
Published: October 2011

The contributions in Volume 57 of the Royal Society’s
Biographical Memoirs
once again demonstrate a remarkable breadth of scientific and personal achievement. It seems invidious to pick out just a few of the people all of whose scientific accomplishments were of the highest order, but brief details about a few illustrate the scope of their work and lives.
Synthetic Antisense Oligodeoxynucleotides to Transiently Suppress Different Nucleus- and Chloroplast-Encoded Proteins of Higher Plant Chloroplasts
Authors: Dinç Emine , Tóth Szilvia Z. , Schansker Gert , Ayaydin Ferhan , Kovács László , Dudits Dénes , Garab Győző , Bottka Sándor
Published: October 2011

Selective inhibition of gene expression by antisense oligodeoxynucleotides (ODNs) is widely applied in gene function analyses; however, experiments with ODNs in plants are scarce. In this work, we extend the use of ODNs in different plant species, optimizing the uptake, stability, and efficiency of ODNs with a combination of molecular biological and biophysical techniques to transiently inhibit the gene expression of different chloroplast proteins. We targeted the nucleus-encoded phytoene desaturase (pds) gene, encoding a key enzyme in carotenoid biosynthesis, the chlorophyll a/b-binding (cab) protein genes, and the chloroplast-encoded psbA gene, encoding the D1 protein. For pds and psbA, the in vivo stability of ODNs was increased by phosphorothioate modifications. After infiltration of ODNs into juvenile tobacco (Nicotiana benthamiana) leaves, we detected a 25% to 35% reduction in mRNA level and an approximately 5% decrease in both carotenoid content and the variable fluorescence of photosystem II. In detached etiolated wheat (Triticum aestivum) leaves, after 8 h of greening, the mRNA level, carotenoid content, and variable fluorescence were inhibited up to 75%, 25%, and 20%, respectively. Regarding cab, ODN treatments of etiolated wheat leaves resulted in an up to 59% decrease in the amount of chlorophyll b, a 41% decrease of the maximum chlorophyll fluorescence intensity, the cab mRNA level was reduced to 66%, and the protein level was suppressed up to 85% compared with the control. The psbA mRNA and protein levels in Arabidopsis (Arabidopsis thaliana) leaves were inhibited by up to 85% and 72%, respectively. To exploit the potential of ODNs for photosynthetic genes, we propose molecular design combined with fast, noninvasive techniques to test their functional effects.
Cucumber mosaic virus: viral genes as virulence determinants
Authors: MOCHIZUKI TOMOFUMI , OHKI SATOSHI T.
Published: October 2011

Taxonomic relationships: Cucumber mosaic virus (CMV) is the type species of the genus Cucumovirus in the family Bromoviridae, which also encompasses the Peanut stunt virus (PSV) and the Tomato aspermy virus (TAV). Nucleotide sequence similarity among these three cucumoviruses is 60%–65%. CMV strains are divided into three subgroups, IA, IB and II, based on the sequence of the 5′ untranslated region of the genomic RNA 3. Overall nucleotide sequence similarity among CMV strains is approximately 70%–98%.

Geographical distribution, host range and symptomatology: CMV is distributed worldwide, primarily in temperate to tropical climate zones. CMV infects more than 1200 species of 100 plant families, including monocot and dicot plants. Symptoms caused by CMV infection vary with the host species and/or CMV strain, and include mosaic, stunt, chlorosis, dwarfing, leaf malformation and systemic necrosis. CMV disease is spread primarily by aphid transmission in a nonpersistent manner.

Physical properties: In tobacco sap, the thermal inactivation point of the viral infectivity is approximately 70 °C (10 min), the dilution end‐point is approximately 10−4 and viral infectivity is lost after a few days of exposure to 20 °C. Viral infectivity can be retained in freeze‐dried tissues and in the form of virions purified using 5 mm sodium borate, 0.5 mm ethylenediaminetetraacetic acid and 50% glycerol (pH 9.0) at −20 °C. CMV particles are isometric, approximately 28–30 nm in diameter and are composed of 180 capsid subunits arranged in pentamer–hexamer clusters with T= 3 symmetry. The sedimentation coefficient (s20,w) is c. 98 S and the particle weight is (5.8–6.7) × 106 Da. The virions contain 18% RNA. The RNA–protein interactions that stabilize the CMV virions are readily disrupted by sodium dodecylsulphate or neutral chloride salts.

Genomic properties: The genomic RNAs are single‐stranded messenger sense RNAs with 5′ cap and 3′ tRNA‐like structures containing at least five open reading frames. The viral RNA consists of three genomic RNAs, RNA 1 (c. 3.3 kb), RNA 2 (c. 3.0 kb) and RNA 3 (c. 2.2 kb), and two subgenomic RNAs, RNA 4 (c. 1.0 kb) and RNA 4A (c. 0.7 kb). The 3′ untranslated regions are conserved across all viral RNAs. CMV is often accompanied by satellite, noncoding, small, linear RNA that is nonhomologous to the helper CMV.

Useful websites: http://www.dpvweb.net/dpv/showdpv.php?dpvno=400 (general information); http://www.rcsb.org/pdb/explore/explore.do?pdbId=1f15 (structure).
A controversial consensus – comment on article by Broderick et al
Authors: van der Meer J. W. M. , Lloyd A. R.
Published: October 2011

This article comments on: Myalgic encephalomyelitis: International Consensus Criteria
Jurassic to Palaeogene tectono‐magmatic evolution of northern Chile and adjacent Bolivia from detrital zircon U‐Pb geochronology and heavy mineral provenance
Authors: Wotzlaw Jörn F. , Decou Audrey , von Eynatten Hilmar , Wörner Gerhard , Frei Dirk
Published: October 2011

Terra Nova, 23, 399–406, 2011

Heavy mineral provenance data presented in this article reinforce evidence for significant late Palaeogene deformation and relief formation along the western margin of the Central Andean Plateau. Late Eocene–Oligocene onset of molasse‐type sedimentation records initial range uplift. Strikingly different basement sources of sediments deposited to the east and west of the Late Palaeogene range indicate that initial relief development was governed by a bivergent thrust system. Significantly higher sediment accumulation rates to the east of the range compared to the west suggest that the generated relief acted already as an effective orographic barrier at that time. Higher precipitation and denudation along the eastern slope facilitated deeper erosion of the trust belt.
Indigenous beliefs about biomedical and bush medicine treatment efficacy for indigenous cancer patients: a review of the literature
Authors: van Schaik K. D. , Thompson S. C.
Published: October 2011

Background:  Australia's Indigenous people suffer from higher cancer mortality than non‐Indigenous Australians, a discrepancy partly caused by differences in beliefs about treatment efficacy between Indigenous patients and their non‐Indigenous healthcare providers. This paper critically reviews the literature associated with Indigenous beliefs about cancer treatment, both ‘bush medicine’ and biomedical, in order to provide recommendations to healthcare providers about accommodating Indigenous beliefs when treating cancer.

Methods:  A search was undertaken of peer‐reviewed journal papers using electronic databases and citation snowballing. Papers were selected for inclusion based upon relevance to themes that addressed the research questions.

Results:  Literature suggests that Indigenous beliefs about treatment efficacy for cancer involve five themes: (i) concerns about the toxicity of treatment; (ii) disconnect with the physician; (iii) fears about absence from home during treatment; (iv) different beliefs about disease aetiology; (v) biomedical cancer treatments failing to address holistic health.

Conclusions:  Although some information is known about Indigenous Australian healing beliefs and practices associated with cancer treatment, few studies have addressed ways in which Indigenous and biomedical approaches to cancer treatment might be integrated. Some recent work has examined the role of belief in cancer treatment, specifically bush medicine, but more research is required.
Influenza‐associated bacterial pathogens in patients with 2009 influenza A (H1N1) infection: impact of community‐associated methicillin‐resistant Staphylococcus aureus in Queensland, Australia
Authors: Hayashi Y. , Vaska V. L. , Baba H. , Nimmo G. R. , Davis L. , Paterson D. L.
Published: October 2011

Background:  Secondary bacterial pneumonia due to community onset methicillin‐resistant Staphylococcus aureus (MRSA) has become a highly publicised cause of influenza‐associated death. There is a risk that case reports of fatal outcomes with post‐influenza MRSA pneumonia may unduly influence antibiotic prescribing.

Aims:  The aim of this study was to demonstrate the incidence of community‐onset MRSA pneumonia in 2009 H1N1 influenza patients.

Methods:  The microbiology records of patients positive for influenza A (H1N1) in 2009 were reviewed for positive blood or respiratory tract cultures and urinary pneumococcal antigen results within a Queensland database. Patients with such positive results within 48 h of hospital admission and a positive H1N1 influenza result in the prior 6 weeks were included.

Results:  In 2009, 4491 laboratory‐confirmed pandemic influenza A (H1N1) infections were detected. Fifty patients (1.1% of the H1N1 cohort) who were hospitalised with H1N1 and who had a bacterial respiratory tract pathogen were identified. Streptococcus pneumoniae (16 patients; 32%), Staphylococcus aureus (13 patients; 26%) and Haemophilus influenzae (9 patients; 18%) were the most commonly cultured organisms. Of the cohort of 4491 patients, MRSA was detected in only two patients, both of whom were admitted to intensive care units and survived after prolonged admissions.

Conclusions:  Influenza‐associated community‐onset MRSA pneumonia was infrequently identified in the 2009 H1N1 season in Queensland, despite community‐onset MRSA skin and soft tissue infections being very common. Although post‐influenza MRSA pneumonia is of great concern, its influence on empiric‐prescribing guidelines should take into account its incidence relative to other secondary bacterial pathogens.
Side effects of intradetrusor botulinum toxin injections on ejaculation and fertility in men with spinal cord injury: preliminary findings
Authors: Caremel Romain , Courtois Frédérique , Charvier Kathleen , Ruffion Alain , Journel Nicolas Morel
Published: October 2011

Study Type – Therapy (case series)

Level of Evidence 4

What's known on the subject? and What does the study add?

The beneficial effect of intradetrusor botulinum toxin (BT) injections on hyperactive bladders in individuals with spinal cord injury is known from the literature, but its potential effect on ejaculation and fertility through diffusion is not. As BT injection paralyses the bladder muscle, it may also paralyse the muscular envelopes of the adjacent reproductive organs and lead to potential negative side effects, which have not been studied yet. This study provides preliminary data on the potential negative side effects of BT injections on semen volume and retrograde ejaculation, as well as some potential beneficial effects on semen quality.

OBJECTIVE

To investigate the effect of botulinum neurotoxin A on ejaculation potential and fertility. Intradetrusor injection of botulinum neurotoxin A is most commonly used nowadays to treat overactive bladder in patients with spinal cord injury (SCI).

PATIENTS AND METHODS

Retrospective analyses were carried out of 11 patients with complete lesions from C5 to T6 who had received botulinum (BT) injections for their overactive bladder and who had undergone ejaculation tests before and after BT treatment.

RESULTS

BT treatment was found effective in improving bladder function in up to 85% of the cases.

While no patients maintained natural ejaculation following their SCI, BT treatment was found to increase the incidence of retrograde ejaculation (vibrostimulation) in 46% of cases and to diminish semen volume in 77% of cases, from an average of 1.8 mL to 1 mL.

Semen quality was slightly improved following BT treatment, sperm mobility increased in 67% of cases, sperm vitality in 50% and semen culture improved in 43%.

CONCLUSIONS

BT treatment has beneficial and detrimental effects on ejaculation function. The detrimental effects involve retrograde ejaculation and reduced semen volume, which are explained by the spread of toxin to the bladder neck, reducing its tonus, and to the smooth muscle sexual accessory organs, reducing the strength of their contraction.

The beneficial effects are explained by the reduced contamination of the semen by urinary infection, which may improve spermatogenesis and subsequent semen quality.

The results are discussed in terms of their clinical implications and advice to patients.