What Is an Unreasonable Search?

42 pagesPerhaps the greatest puzzle of the Fourth Amendment—and indeed in all American law more broadly—is its definition of reasonableness. The Fourth Amendment guarantees our right to be secure “against unreasonable searches and seizures” without clearly elaborating on what such searches and seizures are. The laconic construction of this clause could simultaneously suggest a lack of interest among the Framers in adding this particular right to the Constitution,2 and their abiding belief that the right is so fundamental as to be already universally known.3 We moderns, on the other hand, find the Fourth Amendment to be both intensely compelling and confounding

Editorial: South African Guidelines Excellence (SAGE): Efficient, effective and unbiased clinical practice guideline teams

No Abstrac

Australian Bat Lyssavirus: Observations of Natural and Experimental Infection in Bats

This conference abstract gives data and conclusions arising from targeted surveillance of wild bats for naturally occuring Australian bat lyssavirus (ABLV) infection and other central nervous system diseases. It also provides data and conclusions arising from experimental infection of 10 Greyheaded flying foxes (Pteropus poliocephalus)

ADRIC: Adverse Drug Reactions In Children - a programme of research using mixed methods

Aims To comprehensively investigate the incidence, nature and risk factors of adverse drug reactions (ADRs) in a hospital-based population of children, with rigorous assessment of causality, severity and avoidability, and to assess the consequent impact on children and families. We aimed to improve the assessment of ADRs by development of new tools to assess causality and avoidability, and to minimise the impact on families by developing better strategies for communication. Review methods Two prospective observational studies, each over 1 year, were conducted to assess ADRs in children associated with admission to hospital, and those occurring in children who were in hospital for longer than 48 hours. We conducted a comprehensive systematic review of ADRs in children. We used the findings from these studies to develop and validate tools to assess causality and avoidability of ADRs, and conducted interviews with parents and children who had experienced ADRs, using these findings to develop a leaflet for parents to inform a communication strategy about ADRs. Results The estimated incidence of ADRs detected in children on admission to hospital was 2.9% [95% confidence interval (CI) 2.5% to 3.3%]. Of the reactions, 22.1% (95% CI 17% to 28%) were either definitely or possibly avoidable. Prescriptions originating in the community accounted for 44 out of 249 (17.7%) of ADRs, the remainder originating from hospital. A total of 120 out of 249 (48.2%) reactions resulted from treatment for malignancies. Off-label and/or unlicensed (OLUL) medicines were more likely to be implicated in an ADR than authorised medicines [relative risk (RR) 1.67, 95% CI 1.38 to 2.02; p  48 hours, the overall incidence of definite and probable ADRs based on all admissions was 15.9% (95% CI 15.0 to 16.8). Opiate analgesic drugs and drugs used in general anaesthesia (GA) accounted for > 50% of all drugs implicated in ADRs. The odds ratio of an OLUL drug being implicated in an ADR compared with an authorised drug was 2.25 (95% CI 1.95 to 2.59; p < 0.001). Risk factors identified were exposure to a GA, age, oncology treatment and number of medicines. The systematic review estimated that the incidence rates for ADRs causing hospital admission ranged from 0.4% to 10.3% of all children [pooled estimate of 2.9% (95% CI 2.6% to 3.1%)] and from 0.6% to 16.8% of all children exposed to a drug during hospital stay. New tools to assess causality and avoidability of ADRs have been developed and validated. Many parents described being dissatisfied with clinician communication about ADRs, whereas parents of children with cancer emphasised confidence in clinician management of ADRs and the way clinicians communicated about medicines. The accounts of children and young people largely reflected parents’ accounts. Clinicians described using all of the features of communication that parents wanted to see, but made active decisions about when and what to communicate to families about suspected ADRs, which meant that communication may not always match families’ needs and expectations. We developed a leaflet to assist clinicians in communicating ADRs to parents. Conclusion The Adverse Drug Reactions In Children (ADRIC) programme has provided the most comprehensive assessment, to date, of the size and nature of ADRs in children presenting to, and cared for in, hospital, and the outputs that have resulted will improve the management and understanding of ADRs in children and adults within the NHS. Recommendations for future research: assess the values that parents and children place on the use of different medicines and the risks that they will find acceptable within these contexts; focusing on high-risk drugs identified in ADRIC, determine the optimum drug dose for children through the development of a gold standard practice for the extrapolation of adult drug doses, alongside targeted pharmacokinetic/pharmacodynamic studies; assess the research and clinical applications of the Liverpool Causality Assessment Tool and the Liverpool Avoidability Assessment Tool; evaluate, in more detail, morbidities associated with anaesthesia and surgery in children, including follow-up in the community and in the home setting and an assessment of the most appropriate treatment regimens to prevent pain, vomiting and other postoperative complications; further evaluate strategies for communication with families, children and young people about ADRs; and quantify ADRs in other settings, for example critical care and neonatology

Characterization by NMR of Reactants and Products of Hydrofluoroether Isomers, CF3(CF2)3OCH3 and (CF3)2C(F)CF2OCH3, Reacting with Isopropyl Alcohol

The 3M Company product Novec™ 71IPA DL, a mixture of methoxyperfluorobutane, methoxyperfluoroisobutane and 4.5 wt.% isopropyl alcohol, has been found to be very stable at ambient temperature, producing fluoride at the rate of ~1 ppm/year. Our earlier kinetic and theoretical studies have identified the reaction mechanism. This paper identifies the 1H and 19F NMR chemical shifts, multiplicities, and coupling constants of reactants and the major products that result from aging the mixture in sealed Pyrex NMR tubes for periods up to 1.8 years at temperatures from 26 °C to 102 °C. Chemical shifts and coupling constants of fluorine and hydrogen atoms on the hydrofluoroethers and isopropyl alcohol are traced through the reactions to their values in the products – esters, isopropylmethyl ether, and HF. These spectral positions, multiplicities, and coupling constants are presented in table format and as figures to clarify the transformations observed as the samples age

Assessing Landscape Functions with Broad-Scale Environmental Data: Insights Gained from a Prototype Development for Europe

We examine the advantages and disadvantages of a methodological framework designed to analyze the poorly understood relationships between the ecosystem properties of large portions of land, and their capacities (stocks) to provide goods and services (flows). These capacities (stocks) are referred to as landscape functions. The core of our assessment is a set of expert- and literature-driven binary links, expressing whether specific land uses or other environmental properties have a supportive or neutral role for given landscape functions. The binary links were applied to the environmental properties of 581 administrative units of Europe with widely differing environmental conditions and this resulted in a spatially explicit landscape function assessment. To check under what circumstances the binary links are able to replace complex interrelations, we compared the landscape function maps with independently generated continent-wide assessments (maps of ecosystem services or environmental parameters/indicators). This rigorous testing revealed that for 9 out of 15 functions the straightforward binary links work satisfactorily and generate plausible geographical patterns. This conclusion holds primarily for production functions. The sensitivity of the nine landscape functions to changes in land use was assessed with four land use scenarios (IPCC SRES). It was found that most European regions maintain their capacity to provide the selected services under any of the four scenarios, although in some cases at other locations within the region. At the proposed continental scale, the selected input parameters are thus valid proxies which can be used to assess the mid-term potential of landscapes to provide goods and service