Stepping on Board the Rule 11 Bandwagon

Prior to the 1983 amendments to Rule 11, there was some concern as to whether or not the Federal Rules had adequate provisions to insure the truthfulness of allegations in pleadings and motions. With the 1983 incorporation of an objective standard of reasonableness, subjective good faith was eliminated as a defense. Whether anticipated or not, the federal courts have now become flooded with litigation concerning the new Rule 11. Certain differences do exist among the circuits; however the differences are relatively minor, relating primarily to each circuit\u27s description of the conduct which violates the relevant standards and to the standard of review to be exerted by the appellate courts. There is uniformity in the application of the objective nature of the standard of reasonableness and a uniform recognition that deserved sanctions will be upheld and increased, if appropriate, for frivolous appeals. Additionally, the appellate courts have recognized areas where a district court may overstep its limits by relying too heavily on a hindsight analysis or by otherwise failing properly to apply the objective standard to the paper at the time it was filed. It uniformly appears as though the federal courts have not only been receptive to the new Rule 11, but they are all stepping on board the Rule 11 bandwagon to sanction frivolous filings

Investigating the structure of the autism-spectrum quotient using Mokken scaling

Traits similar to those shown in autism spectrum condition (ASC) are apparent in relatives of individuals with ASC, and in the general population without necessarily meeting diagnostic criteria for an ASC. We assess whether the Autism-Spectrum Quotient (AQ), a self-report measure, has hierarchical properties using Mokken scaling. Hierarchical scales allow the presence of a latent trait to be identified by discovering whether and how many specific items form an ordered array along it. Data were collected from 2 groups: (1) people with ASC (n = 449: 240 males, 209 females, M age 35.4 years, SD = 12.8) and (2) university students (n = 943: 465 males, 475 females, M age = 23.0 years, SD = 8.4). A single Mokken scale was obtained in the data from university students and 3 scales were obtained in the data from people with ASC. The scales all showed moderate Mokken scaling properties with the single scale obtained from university students showing weak invariant item ordering and 2 of the scales from people with ASC showing weak invariant item ordering. The AQ formed reliable Mokken scales. There was a large overlap between the scale from the university student sample and the sample with ASC, with the first scale, relating to social interaction, being almost identical. The present study confirms the utility of the AQ as a single instrument that can dimensionalize autistic traits in both university student and clinical samples of ASC, and confirms that items of the AQ are consistently ordered relative to one another

Clinical and financial consequences of setting up an asthma clinic at St. Luke’s Hospital

The effects of setting up an asthma clinic were assessed in an audit study. A comparison was made between the quality and quantity of medication used by patients before and after attending the asthma clinic. The number and severity of exacerbations during a six month period before and a six month period after attending were also assessed. The cost of treatment before and after was also calculated. In 14% of patients, occupational factors, drugs or underlying lung disease were significant contributors to asthma. The number of acute episodes of severe asthma were reduced from 98 to 47, with hospital admissions falling from 26 to 1. Pulmonary function (%FEV1) improved in the group as a whole with the number of patients having their best FEV above 80% improving from 44 to 71. In spite of the expense of high cost drugs and the running costs of the clinic there were substantial savings largely from the reduced number of hospital admissions. The calculated annual cost fell from Lm 22,769 to Lm 10,654.peer-reviewe

Intelligence and action agents: 185 years of state security

Tijdens de Tweede Wereldoorlog voelden talrijke Belgische burgers, mannen en vrouwen, van alle leeftijden en beroepsklassen, verontwaardigd door de bezetting van hun vaderland, zich geroepen om ‘iets’ te doen. Zij zouden uitgroeien tot een zeer bijzondere vorm van het Verzet. In totaal 18.716 erkende IAA – Inlichtingen en Actie Agenten, in 129 IAD – Inlichtingen en Actie Diensten, actief in het bezette België. Zij werden aangestuurd door de Veiligheid van de Staat in ballingschap te Londen, in samenwerking met de Britse diensten MI.6, MI.9 en SOE. Zij waren actief in: politieke, economische en militaire spionage; sabotage; psychologische oorlogsvoering; propaganda; ontsnappingslijnen; meteorologische inlichtingen; ondersteuning van gedwongen werkweigeraars; ... Minstens 4.000 van hen werden gearresteerd en 1.815 vermoord (neergeschoten, onthoofd, omgekomen in concentratiekampen ...). Dit boek brengt hun verhaal en geeft deze onbekende helden na 70 jaar een naam

Comorbidity and polypharmacy in chronic heart failure:a large cross-sectional study in primary care

Background: Comorbidity is common in heart failure, but previous prevalence estimates have been based on a limited number of conditions using mainly non-primary care data sources. Aim: To compare prevalence rates of comorbidity and polypharmacy in those with and without chronic heart failure due to left ventricular systolic dysfunction (LVSD). Design and setting: A cross-sectional study of 1.4 million patients in primary care in Scotland. Method: Data on the presence of LVSD, 31 other physical, and seven mental health comorbidities, and prescriptions were extracted from a database of 1 424 378 adults. Comorbidity prevalence was compared in patients with and without LVSD, standardised by age, sex, and deprivation. Pharmacology data were also compared between the two groups. Results: There were 17 285 patients (1.2%) who had a diagnosis of LVSD. Compared with standardised controls, the LVSD group had greater comorbidity, with the biggest difference found for seven or more conditions (odds ratio [OR] 4.10; 95% confidence interval (CI] = 3.90 to 4.32). Twenty-five physical conditions and six mental health conditions were significantly more prevalent in those with LVSD relative to standardised controls. Polypharmacy was higher in the LVSD group compared with controls, with the biggest difference found for ≥11 repeat prescriptions (OR 4.81; 95% CI = 4.60 to 5.04). However, these differences in polypharmacy were attenuated after controlling for the number of morbidities, indicating that much of the additional prescribing was accounted for by multimorbidity rather than LVSD per se. Conclusion: Extreme comorbidity and polypharmacy is significantly more common in patients with chronic heart failure due to LVSD. The efficient management of such complexity requires the integration of general and specialist expertise