Child-Custody Decisionmaking

The most famous article on child-custody law, and one of the most important in family law scholarship altogether, is Robert H. Mnookin\u27s Child Custody Adjudication: Judicial Functions in the Face of Indeterminacy, published in Law and Contemporary Problems in 1975. In that article, Professor Mnookin analyzed the best-interests-of-the-child standard, which by the 1970s had emerged as the dominant custody decision rule. Although the best-interests standard seemed on its face to be an uncomplicated and straightforward way to put the interests of children first in custody decisionmaking, Professor Mnookin explained its distinctive character and deficiencies as a legal rule. His two core themes were the indeterminacy of the best-interests standard and the differences between private custody disputes and those in which the state seeks to take custody of a child from a parent. The goal of this issue of Law and Contemporary Problems is to examine the impact of Professor Mnookin\u27s framework and insights and to analyze developments in legal and social-science research and in practice since his article imposed conceptual order on the field

Confirmation of six Be X-ray binaries in the Small Magellanic Cloud

The X-ray binary population of the Small Magellanic Cloud (SMC) contains a large number of massive X-ray binaries, and the recent survey of the SMC by XMM–Newton has resulted in almost 50 more tentative high-mass X-ray binary (HMXB) candidates. Using probability parameters from Haberl and Sturm together with the optical spectra and timing in this work, we confirm six new massive X-ray binaries in the SMC. We also report two very probable binary periods of 36.4 d in XMM 1859 and of 72.2 d in XMM 2300. These Be X-ray binaries are likely part of the general SMC population, which rarely undergoes an X-ray outburst.This paper is based on ESO data from 079.D−0371 and 088.D−0352. The AAT observations have been supported by the OPTICON project (observing proposals 2011A/014 and 2012/A015), which is funded by the European Commission under the Seventh Framework Programme (FP7). VAM acknowledges financial support from the National Research Foundation of South Africa (Grant 93405) and the World Universities Network. RD, AM and IN from the University of Alicante acknowledge support from the Spanish Government Ministerio de Economía y Competitividad under grant AYA2015-68012-C2-2-P (MINECO/FEDER). ESB acknowledges support from a Claude Leon Foundation fellowship and from the Marie Curie Actions of the European Commission (FP7-COFUND). The OGLE project has received funding from the National Science Centre, Poland, grant MAESTRO 2014/14/A/ST9/00121 to AU

Hypervirulent Clostridium difficile PCR-Ribotypes Exhibit Resistance to Widely Used Disinfectants

The increased prevalence of Clostridium difficile infection (CDI) has coincided with enhanced transmissibility and severity of disease, which is often linked to two distinct clonal lineages designated PCR-ribotype 027 and 017 responsible for CDI outbreaks in the USA, Europe and Asia. We assessed sporulation and susceptibility of three PCR-ribotypes; 012, 017 and 027 to four classes of disinfectants; chlorine releasing agents (CRAs), peroxygens, quaternary ammonium compounds (QAC) and biguanides. The 017 PCR-ribotype, showed the highest sporulation frequency under these test conditions. The oxidizing biocides and CRAs were the most efficacious in decontamination of C. difficile vegetative cells and spores, the efficacy of the CRAs were concentration dependent irrespective of PCR-ribotype. However, there were differences observed in the susceptibility of the PCR-ribotypes, independent of the concentrations tested for Virkon®, Newgenn®, Proceine 40® and Hibiscrub®. Whereas, for Steri7® and Biocleanse® the difference observed between the disinfectants were dependent on both PCR-ribotype and concentration. The oxidizing agent Perasafe® was consistently efficacious across all three PCR ribotypes at varying concentrations; with a consistent five Log10 reduction in spore titre. The PCR-ribotype and concentration dependent differences in the efficacy of the disinfectants in this study indicate that disinfectant choice is a factor for llimiting the survival and transmission of C. difficile spores in healthcare settings

Dexamethasone reduces emesis after major gastrointestinal surgery (DREAMS)

BACKGROUND: Postoperative nausea and vomiting is one of the most common complications affecting patients after surgery and causes significant morbidity and increased length of hospital stay. It is accepted that patients undergoing surgery on the bowel are at a higher risk. In the current era of minimally invasive colorectal surgery combined with enhanced recovery, reducing the incidence and severity of postoperative nausea and vomiting is particularly important. Dexamethasone is widely, but not universally used. It is known to improve appetite and gastric emptying, thus reduce vomiting. However, this benefit is not established in patients undergoing bowel surgery, and dexamethasone has possible side effects such as increased risk of wound infection and anastomotic leak that could adversely affect recovery. DESIGN: DREAMS is a phase III, double-blind, multicenter, randomized controlled trial with the primary objective of determining if preoperative dexamethasone reduces postoperative nausea and vomiting in patients undergoing elective gastrointestinal resections. DREAMS aims to randomize 1,350 patients over 2.5 years. Patients undergoing laparoscopic or open colorectal resections for malignant or benign pathology are randomized between 8 mg intravenous dexamethasone and control (no dexamethasone). All patients are given one additional antiemetic at the time of induction, prior to randomization. Both the patient and their surgeon are blinded as to the treatment arm. Secondary objectives of the DREAMS trial are to determine whether there are other measurable benefits during recovery from surgery with the use of dexamethasone, including quicker return to oral diet and reduced length of stay. Health-related quality of life, fatigue and risks of infections will be investigated. TRIAL REGISTRATION: ISRCTN2197362