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Edited by
James Ip, Great Ormond Street Hospital for Children, London,Grant Stuart, Great Ormond Street Hospital for Children, London,Isabeau Walker, Great Ormond Street Hospital for Children, London,Ian James, Great Ormond Street Hospital for Children, London
Anaesthesia for paediatric urology may be for minor to major complex surgery. In this chapter, we discuss the anaesthetic management of a subspecialty that allows for a variety of general and regional anaesthetic techniques to be applied. Minor procedures include cystoscopy, resection of posterior urethral valves, circumcision, insertion of suprapubic (SP) lines, hypospadias repair and orchidopexy. We discuss techniques for major surgery, including pyeloplasty, ureteric re-implantation, nephrectomy, resection of Wilms tumour (nephroblastoma), bladder exstrophy and epispadias repair, bladder augmentation (ileocystoplasty) and formation of Mitrofanoff, as well as renal transplantation. Preoperatively, children undergoing cystoscopy and major urological and reconstructive surgery require a urine culture to guide antibiotic prophylaxis. Local ‘maximum surgical blood ordering schedules’ should be followed for guidance regarding cross-matching of blood for major procedures. Close communication with the surgeon and wider multidisciplinary team is necessary to identify the extent of surgery, positioning and appropriate vascular access for complex surgery and renal transplantation.
Edited by
James Ip, Great Ormond Street Hospital for Children, London,Grant Stuart, Great Ormond Street Hospital for Children, London,Isabeau Walker, Great Ormond Street Hospital for Children, London,Ian James, Great Ormond Street Hospital for Children, London
The League’s conference on the codification of international law opened in The Hague in 1930, vested with responsibility for producing (among other things) a treaty on territorial waters. Two major issues gave rise to disagreement: the breadth of territorial waters, with some states arguing for their extension according to local circumstances; and the contiguous zone, with some states claiming limited jurisdiction over customs, immigration, security and fishing zones. The British, as the self-proclaimed guarantors of the freedom of the seas, took a hard line against both ideas, holding out for three-mile territorial waters without a contiguous zone. They could not compel most other states to agree to this – a symptom of their decline as the leading maritime power – but neither could the other states compel the British to accept their positions. This impasse resulted in the committee’s failure to settle either issue, or to produce a treaty.
Edited by
James Ip, Great Ormond Street Hospital for Children, London,Grant Stuart, Great Ormond Street Hospital for Children, London,Isabeau Walker, Great Ormond Street Hospital for Children, London,Ian James, Great Ormond Street Hospital for Children, London
Anaesthesia for thoracic surgery in children poses a variety of challenges for the paediatric anaesthetist, who will encounter problems different from those faced in adult practice. It is a low-volume surgical speciality, thus predominantly confined to specialist paediatric centres with anaesthesia required for a heterogenous range of conditions. One-lung ventilation may often be required, and knowledge of the techniques used for the varying size of the paediatric airway is essential. The impact of patient positioning, surgical retraction of the lung and the underlying disease process poses further challenges to the paediatric anaesthetist. This chapter covers management of the most common paediatric specific disease processes, including congenital and acquired lung abnormalities, intrathoracic masses, intrapleural collections and pectus surgery with an emphasis on lung isolation techniques and perioperative analgesia, including regional anaesthesia.
Although a product of his time – the literary traditions of Pope, Addison, and Swift; the Toryism and churchmanship of the eighteenth century – Samuel Johnson also transcended it through his own gifts and forceful character. After a difficult early life, marked by melancholy, a troubled relationship with his family, and an early departure from Oxford University, Johnson began to find his way in the 1730s. He married Elizabeth Porter, moved to London, and began to make his mark through work at the Gentleman’s Magazine and works such as the Life of Savage. He achieved renown as an essayist and fame as the compiler of the Dictionary but also suffered from bereavement and continuing financial insecurity. After the award of a government pension in 1762, Johnson’s works have a more relaxed style, and his final major work, the Lives of the Poets, helped to establish this era as the Age of Johnson.
This chapter examines the legal and institutional framework on access and benefit sharing (ABS) in the Middle East and North Africa (MENA) region. It examines the drivers and dimensions of access and benefit sharing risks in the MENA region, gaps in existing legal frameworks on ABS in the region, and innovative approaches for addressing such gaps. The chapter delves into the challenges of ABS in the MENA region. The Nagoya Protocol’s principles of access to genetic resources and benefit sharing are highlighted, underscoring their significance in the MENA context. Given the fragile nature of global biodiversity, it is crucial to support and innovatively implement these existing regulations, ensuring an effective and efficient approach to ABS.
This chapter starts by providing historical perspective on the evolution of the Polish regulatory framework for the protection of utility models. Interestingly, the draft IPL takes us to legislative solutions already tested in the past. One might even say nihil novi sub sole (there is nothing new under the sun). The chapter presents data about the functioning of the regime currently in force. This is followed by a more general discussion, drawing on experience from other jurisdictions, of how various aspects of the regulatory framework might affect the ability of the system to promote innovation. Then, the current legislative framework is presented against the backdrop of the solutions proposed in the draft IPL.
Edited by
James Ip, Great Ormond Street Hospital for Children, London,Grant Stuart, Great Ormond Street Hospital for Children, London,Isabeau Walker, Great Ormond Street Hospital for Children, London,Ian James, Great Ormond Street Hospital for Children, London
The extensive thermodynamic variables of a fluid are introduced as the internal energy, volume, and number of molecules. The entropy is defined and also shown to be extensive. Taking the total derivative of the internal energy produces the first law of thermodynamics and defines the intensive parameters of temperature, pressure, and chemical potential. Changing variables from extensive variables to intensive variables is accomplished with the Legendre transform and defines alternative energies such as the Helmholtz free energy, enthalpy, and Gibbs free energy. Thermodynamic equilibrium requires that each element of a system have the same temperature, pressure, and chemical potential. For equilibrium to be stable, the material properties of each element must satisfy certain derived constraints. First-order phase transition are treated for a single-species system. Multispecies systems are treated and a widely used expression for how the chemical potentials of each species depend on the concentration of the species is derived. Chemical reactions are treated as is osmosis. The thermodynamics of solid systems is addressed along with mineral solubility in liquid solutions.
This chapter explores how Estonia became Europe’s top performer on PISA, without that being the goal. It unpacks social and education policies and practices and interventions that have helped build a high-equity high-performing education system. These include policies and initiatives fostering equity, inclusion, learner autonomy, teacher and school principal professionalism, autonomy and responsibility. Stakeholder engagement has led to longstanding cross-party agreements on the purpose of education. Thanks to investments into evidence- and results-based planning those agreements have been generative-productive. Eighteen months of paid job-protected parental leave encourages early responsive parenting. High levels of investment into preschool education help give children a good start in life. There are national curricula, but schools reinterpret those, creating their own curricula. Stakeholders and government took bold decisions such as the digitalisation of education at a point when the idea seemed utopian. They invested in free school meals, support for students in difficulty and voluntary formative assessment systems. No less important was a shift to favouring school self-evaluation over external inspections. In addition, the system generates substantial easily accessible and user-friendly data, including perceptions of well-being, autonomy and connectedness, not just examination results. This builds internal and external accountability and contributes to stakeholder collective efficacy.
Chapter 5 focuses on four different aspects of economic and social inequality. There were historical differences in level of economic development across provinces and there is persistence. The Bombay Presidency was one of the richest parts of colonial India. Maharashtra and Gujarat today are among the richest provinces in India. The poorer regions in colonial India, such as the United Provinces and the Central Provinces rank among the poorer regions today. Income inequality was high in the 1930s and 1940s. The first decades after independence saw a decline in inequality following the policies of public sector led development. Since the economic reforms of 1980, income inequality has increased, but it is not as high as in the colonial period. There is continuity in caste inequality in many dimensions, but also changes. Upper castes were heather and more literate in colonial India. Today lower castes have better access to education and jobs due policies of affirmative action, big differences remain. Finally, one aspect of gender inequality that is specific to India is sons preference. The regional variation in male biased sex ratio continues today.
Australia’s botanical diversity has shaped its literature of the environment. Through a selection of novels, short stories, and poetry, this overview focuses on the literary depiction of native species such as the coolabah, paperbark, and wattle. Structured chronologically, the discussion begins with Indigenous Australian narratives of plants, arguably the world’s oldest literary representations of botanical life. In the narratives of Aboriginal and Torres Strait Islander people, plants are wellsprings of material and spiritual sustenance. Between British settlement and Federation, non-Indigenous narratives of Australian flora begin to appear. In these decades, literature negotiates the strangeness of antipodean plants in comparison to familiar European species. In post-Federation literature, the relationship between flora and nation becomes more pronounced. During this period, writers increasingly foreground the clearance of forests in the post-colonial state. Contemporary literature reveals an expanded understanding of plant ecologies and conservation realities. The work of Judith Wright and Oodgeroo Noonuccal during these years establishes a precedent for later literary activism. The Anthropocene literature of recent decades confronts humanity’s escalating impacts on plants especially in Australian regions. Literary works critique climate disturbance, habitat degradation, urban development, and related exigencies that continue to imperil the future of plants in Australia.