Fatal injuries to car occupants: analysis of health and population data

Although this report was commissioned by the Department for Transport (DfT), the findings and recommendations are those of the authors and do not necessarily represent the views of the DfT. While the DfT has made every effort to ensure the information in this document is accurate, DfT does not guarantee the accuracy, completeness or usefulness of that information; and it cannot accept liability for any loss or damages of any kind resulting from reliance on the information or guidance this document contains

The Dodd-Frank Wall Street Reform Act\u27s Turn to International Law

The development of a harmonized system for resolving the failures of large, international financial institutions is considered by academics and policy-makers to be critical to reducing systemic risk and reducing the probability that the insolvency of a major bank will lead to a global economic collapse. Reaching agreement on how to develop this harmonized system for financial institutions with significant transnational assets and liabilities has proved elusive thus far. Commentators in favor of a more international and less parochial approach to resolving bank failures can point to a number of extremely high-profile events that demonstrate the manifest unfairness of resolving bank failures on an individual basis. The bankruptcies of Lehman Brothers and the Bank of Credit and Commerce International (BCCI) are two of many such examples

Against Political Theory in Constitutional Interpretation

Judges and academics have long relied on the work of a small number of Enlightenment political theorists—particularly Locke, Montesquieu, and Blackstone—to discern meaning from vague and ambiguous constitutional provisions. This Essay cautions that Enlightenment political theory should rarely, if ever, be cited as an authoritative source of constitutional meaning. There are three principal problems with constitutional interpretation based on eighteenth-century political theory. First, Enlightenment thinkers developed distinct and incompatible theories about how to structure a republican form of government. That makes it difficult to decide which among the conflicting theories should possess constitutional significance. Second, the Framers did not write the Constitution in the image of the philosophy of Montesquieu, Locke, or Blackstone. Instead, they developed a new form of government to meet what they perceived to be the needs of a nascent republic. And third, the Constitution itself departs from the dominant strands of Enlightenment political theory in crucial respects. For example, while some Enlightenment theorists advocated for precisely divided federal powers, the Framers favored a system of procedural checks, not formal separation. Thus, while Enlightenment works can be normatively persuasive or act as a guide to historical meaning, they should be treated as presumptively irrelevant in constitutional interpretation. Unless the party who would invoke an Enlightenment political theorist can produce evidence of consensus or common ground about that theory from an episode of American constitutional debate, the theorist’s prescriptions are no more probative than any other work of normative political theory

Effectiveness of a targeted telephone-based case management service on activity in an Emergency Department in the UK: a pragmatic difference-in-differences evaluation.

BACKGROUND: This study evaluates the effectiveness of a targeted telephone-based case management service that aimed to reduce ED attendance amongst frequent attenders, known to disproportionately contribute to demand. Evidence on the effectiveness of these services varies. METHODS: A 24-month controlled before-and-after study, following 808 patients (128 cases and 680 controls (41 were non-compliant)) who were offered the service in the first four months of operation within a UK ED department. Patients stratified as high-risk of reattending ED within 6 months by a predictive model were manually screened. Those positively reviewed were offered a non-clinical, nurse-led, telephone-based health coaching, consisting of care planning, coordination and goal setting for up to 9 months. Service effectiveness was estimated using a difference-in-differences (DiD) analysis. Incident rate of ED and Minor Injury Unit (MIU) attendances and average length of stay in intervention recipients and controls over 12 months after receiving their service offer following ED attendance were compared, adjusting for the prior 12-month period, sex and age, to give an incidence rate ratio (IRR). RESULTS: Intervention recipients were more likely to be female (63.3% versus 55.4%), younger (mean of 69 years versus 76 years), and have higher levels of ED activity (except for MIU) than controls. Mean rates fell between periods for all outcomes (except for MIU attendance). The Intention-to-Treat analysis indicated non-statistically significant effect of the intervention in reducing all outcomes, except for MIU attendances, with IRRs: ED attendances, 0.856 (95% CI: 0.631, 1.160); ED admissions, 0.871 (95% CI: 0.628, 1.208); length of stay for emergency and elective admissions: 0.844 (95% CI: 0.619, 1.151) and 0.781 (95% CI: 0.420, 1.454). MIU attendance increased with an IRR: 2.638 (95% CI: 1.041, 6.680). CONCLUSIONS: Telephone-based health coaching appears to be effective in reducing ED attendances and admissions, with shorter lengths of stay, in intervention recipients over controls. Future studies need to capture outcomes beyond acute activity, and better understand how services like this provide added value

Against Political Theory in Constitutional Interpretation

Judges and academics have long relied on the work of a small number of Enlightenment political theorists-—particularly Locke, Montesquieu, and Blackstone—-to discern meaning from vague and ambiguous constitutional provisions. This Essay cautions that Enlightenment political theory should rarely, if ever, be cited as an authoritative source of constitutional meaning. There are three principal problems with constitutional interpretation based on eighteenth-century political theory. First, Enlightenment thinkers developed distinct and incompatible theories about how to structure a republican form of government. That makes it difficult to decide which among the conflicting theories should possess constitutional significance. Second, the Framers did not write the Constitution in the image of the philosophy of Montesquieu, Locke, or Blackstone. Instead, they developed a new form of government to meet what they perceived to be the needs of a nascent republic. And third, the Constitution itself departs from the dominant strands of Enlightenment political theory in crucial respects. For example, while some Enlightenment theorists advocated for precisely divided federal powers, the Framers favored a system of procedural checks, not formal separation. Thus, while Enlightenment works can be normatively persuasive or act as a guide to historical meaning, they should be treated as presumptively irrelevant in constitutional interpretation. Unless the party who would invoke an Enlightenment political theorist can produce evidence of consensus or common ground about that theory from an episode of American constitutional debate, the theorist’s prescriptions are no more probative than any other work of normative political theory

Evaluating a person-centred chronic pain service using indices of reliable and clinically significant change

Background: Psychological interventions for chronic pain often require substantial individualisation, which can undermine links with the research evidence on which treatment is based. To ensure patients receive effective therapy, evaluation is needed. This paper demonstrates the use of individual level change indices, which may be more appropriate for assessing effectiveness of person-centred treatment than traditional group-level statistics. Aims: To evaluate the efficacy of a psychological chronic pain service at individual level and to recommend improvements for future service evaluation. Method: Indices of reliable and clinically significant change were used to assess outcomes on the HADS, CORE-10 andPSEQ. Results: Fifty-six out of 83 patients had usable outcome data. On the most widely administered outcome measure, the CORE-10, n=15 met reliable change and n=22 met clinically significant change criteria. Eighteen showed no reliable change. Only one person deteriorated. Conclusions: The person-centred treatment provided by this service was effective and achieved outcomes similar to published data from a structured group programme. However, missing data reduced the reliability of these conclusions andled to reduced usefulness of the evaluation for service planning. Recommendations for future evaluation are made

syn-Dispiro­[1,3-dioxolane-2,17′-penta­cyclo­[12.2.1.16,9.02,13.05,10]octa­decane-18′,2′′-[1,3]dioxolane]-7′,15′-diene

The title compound, C22H28O4, is composed of a central octa­decane ring and two spiro­[bicyclo­[2.2.1]hept[2]ene-7,2′-[1,3]dioxolane] units. This polycycle has pseudo twofold symmetry and the central cyclo­octane ring has a distorted boat configuration

Lithostratigraphy of the Mesoproterozoic Twakputs Gneiss

The Twakputs Gneiss is a garnetiferous, K-feldspar megacrystic, biotite granite-granodiorite orthogneiss. It represents a major unit in the Kakamas Domain of the Mesoproterozoic Namaqua-Natal Metamorphic Province extending about 250 km between Riemvasmaak in South Africa and Grünau in southern Namibia. The Twakputs Gneiss occurs as foliation-parallel, sheet-like bodies tightly infolded together with granulite-facies paragneisses into which it intrudes along with a variety of other pre-tectonic granite and leucogranite orthogneisses. These rocks were subsequently intruded by late-tectonic garnet-leucogranites, granites and charnockites. The Twakputs Gneiss is a distinctive unit characterised by large ovoid to elongate megacrysts of twinned perthitic K-feldspar, set in a coarse-grained matrix of garnet, biotite, quartz and feldspar. It contains a penetrative foliation defined by the alignment of K-feldspars and streaks of biotite that developed during the main phase D2 of the Namaqua Orogeny (~1.2 to 1.1 Ga). The foliation and an accompanying elongation lineation are more intensely developed along lithological contacts, especially at the margins of the mega-scale F3 domes and basins that refold the regional fabrics. U-Pb zircon dating of the Twakputs Gneiss has yielded concordia ages of between ~1192 and 1208 Ma. Wholerock geochemistry shows consistent major, trace and REE elemental trends, and thus reflect chemical variability from a single fractionating magma. The Twakputs Gneiss has a granitic to granodiorite composition and is strongly peraluminous. The geochemistry and the ubiquitous presence of garnet and pelitic xenoliths indicate an S-type granite protolith. The Twakputs Gneiss is the most voluminous and widespread member of the Eendoorn Suite which comprises seven textural variants of garnetiferous, K-feldspar-megacrystic granitoid orthogneiss of the same age