Letteratura scientifica selezionata sul tema "Lambda Legal"

In the fall of 1989, the queer community became embroiled in a fierce debate over whether to press for marriage rights. Two attorneys from Lambda Legal, a leading gay and lesbian rights organization, set out the competing considerations in the pages of Out/Look, a community magazine. Tom Stoddard, the then-executive director, argued that the movement should prioritize marriage rights because that strategy provided the surest path to equality. Paula Ettelbrick, Lambda's Legal Director, disagreed. She conceded that marriage provided “the ultimate form of acceptance” and “an insider status of the most powerful kind.” That fact, however, was the problem. Gays and lesbians, she argued, should not be focused on assimilating to the mainstream, but rather should pursue justice for those who were different.

In the digital age, where data integrity is essential, the management of legal data requires innovative solutions. SecureLaw is a new project that combines the immutable power of blockchain, the flexibility of Cloud. The agility of the Cloud, Express.js, React.js, Node .js suite. This integration forms the backbone of the transformation of data protection laws, providing unparalleled security, transparency and easy access. Highlights of this project: SecureLaw is instrumental in redefining information law in India. Traditional systems often face security breaches and lack of transparency, undermining the integrity of the legal process. SecureLaw solves these problems by integrating blockchain technology, which provides immutable data that ensures legal documents are not tampered with and ensure their authenticity. The introduction of smart contracts automates the process, controls permissions and makes data immutable, thus increasing efficiency and reducing errors. Leveraging Cloud services such as S3 for storage, API gateways for seamless communications, Lambda for serverless computing, and DynamoDB for scalable databases provides a powerful, scalable, and cost-effective infrastructure. Scalability is important to accommodate legal system growth, and Cloud’s Dynamic Services provide a solution. The AERN group (AWS, Express.js, React.js, Node.js) strengthens the foundation of the project. Express.js is a simple and easy backend framework that seamlessly integrates for efficient data processing and processing. React.js is a front-end library with many features that make it user responsive and intuitive. Node.js is known for its performance that enables dynamic recovery and makes data fast and recoverable. SecureLaw's user centric approach includes managing access to personal and legal personal details. Personal auditors, regional directors, directors (DGs), judges, etc. It deals with many user roles, personal control panels, and access rights. This change promotes cooperation, transparency and communication in the legal system. Features of a self-explanatory legal system encourage people to understand the legal process, fostering transparency, trust, and collaborative knowledge. Keywords: Blockchain, Application Programming Interface (API), Cloud , Express.js, React.js, Node.js

The paper considers the problem of building of the transformable object-relation mapping. It is shown that an essential part of the task is to get the conversion of data objects doing their representation adjusted for the corresponding data model. It is offered to receive the de- cision by a semantic method in case of which the formal models of object system and relational system are considered and their interpre- tations are set. The transformation mappings are considered as a kind of mappings saving interpretations of the given form. Creation of model of converting of data objects on the basis of applicative computing systems is offered what allows to build models of both object, and relational systems dipping in applicative structures with the given means of expression, in particular, to use a lambda-algebra or a lambda model. On this basis the models can be received allow compositions of means of converting and also determination and check of global restrictions for the changes of data determined by the given set of methods of converting. Achievement of flexibility requires use parameterization of the considered construction, i.e. support of dependence of a set of available methods of interpretation on parameters as which semantic characteristics of processed data appear. The prototypes of constructions of models have been used for informational legal supporting of implementation of the best available technology (or just BAT) in practice in Russia.

O percevejo marrom (Euschistus heros) é considerado a principal espécie praga da soja no Brasil, com ampla distribuição geográfica predominando nas regiões Centro-Oeste e norte do Paraná. Além disso, esta praga apresenta tolerância aos inseticidas químicos utilizados para o seu controle. Deste modo, o objetivo desse trabalho foi avaliar o tempo letal e o período residual de inseticidas em ninfas e adultos do percevejo-marrom. Foram utilizados os inseticidas lambda-cialotrina + tiametoxam, imidacloprido, imidacloprido + bifentrina, bifentrina e acefato, e em sequência submetidos as ninfas e os adultos de percevejo marrom a alimentação foram submetidos aos inseticidas acima para determinação do tempo letal e período residual dos produtos. Os inseticidas Imidacloprido + Bifentrina e Lambda-cialotrina + Tiametoxam são mais eficientes para o controle de ninfas e adultos de E. heros por apresentarem menor tempo letal e maior período residual.

Introduction: Recent studies suggest that incidence of multiple myeloma (MM) is increasing in Asian countries. Prevalence is also expected to rise due to ageing populations and advances in treatment. Therapeutic options continue to expand as new, targeted agents enter the market. However, despite advances in therapy and supportive care, MM remains incurable. Most patients receive care outside the setting of clinical trials. Therefore, the generation of Real-World Evidence (RWE) on practice, including long-term monitoring and evaluation of current and future treatment strategies, is important in informing optimal therapies for MM and enable benchmarking to improve outcomes, quality of life (QoL), and cost-effectiveness of care for patients. Some country-specific data are available in Asia, but few at regional level. We established the Asia-Pacific (APAC) Myeloma and Related Diseases Registry (MRDR) in 2018, as a regional collaboration and sister registry to the Australian and New Zealand MRDR (ACTRN12618000659202). The aims are collection of a standardised APAC dataset for analysis and benchmarking. Key opinion leaders from the participating countries were invited to form the steering committee to provide local clinical context and oversight of the registry. Early in the process, ethics committees and legal counsel were consulted to assist with challenges presented by the diversity in data privacy and ethical regulations across the APAC region. Participating hospitals are responsible for obtaining local ethics approval, patient recruitment, and data collection. Participants provide written informed consent before data collection. Methods: The APAC MRDR prospectively collects observational data on patient characteristics, diagnosis, medical history, treatment (including supportive therapies), and outcomes (overall and progression-free survival, and QoL using the EQ-5D-5L) on newly diagnosed MM (NDMM), plasma cell leukaemia, plasmacytoma, and MGUS patients via a secure, country-specific web-based database. Whilst the core dataset is standardised across countries to ensure comparability, regional differences such as units of measurements and local privacy laws were accommodated in the design of each country's database. Participants are reviewed 4-monthly for a minimum of 2 years. Longer-term outcomes will be collected through linkage with local cancer and death registries. Six-monthly hospital reports, providing de-identified, risk-adjusted outcome data at hospital- and country-level, will be provided to contributing hospitals. Preliminary APAC MRDR data from October 2018 to June 2019 were analysed. Results: Eleven hospitals now have Institutional Review Board approval to participate and patient recruitment has commenced at 6 hospitals in Korea and Singapore. Sites in Taiwan, Hong Kong, China, and Malaysia are in progress. To date, 182 patients have been enrolled and data collection on these patients is in progress. At the time of analysis, 85% (96/113) were NDMM. Median age was 66 years (IQR: 59-73) and 54% were male. Median EQ5D VAS Health State score at diagnosis was 70 (IQR: 50-80; self-report: 100=best health imaginable, 0=the worst). Comorbidities were present in 47%. Proportion of patients with main paraprotein type IgG: 64%, IgA: 17%, light chain only Kappa: 13%, light chain only Lambda: 6%. Median number of days from diagnosis to chemotherapy was 9.5 (IQR: 3-15). The top two most frequently used first-line regimens for NDMM patients in Korea and Singapore were: Korea: 1. bortezomib/thalidomide/dexamethasone (VTd: 39%), 2. lenalidomide/dexamethasone (Rd: 27%), and Singapore: 1. VTd: 41%, 2. bortezomib/cyclophosphamide/dexamethasone (VCD): 25%. Overall response rate to first-line chemotherapy (≥PR) was 86% (44/51). Conclusion: The APAC MRDR database is expanding and, as data mature and feedback is provided to participating sites, will provide RWE that will contribute to our understanding on current myeloma treatment strategies and patient outcomes in the Asia-Pacific region. Future plans include expansion to additional sites and countries, and linkage with local cancer and death registries. The registry can also serve as a regional resource by providing infrastructure and identifying eligible participants for clinical trials and other research. Disclosures Aoki: Janssen Asia-Pacific: Research Funding. Moore:Takeda: Research Funding; Gilead: Research Funding. Wood:Bristol-Myers Squibb: Research Funding; Novartis: Research Funding; Alexion: Research Funding; Roche: Research Funding; Takeda: Research Funding; Gilead: Research Funding; Janssen-Cilag: Research Funding; Amgen: Research Funding; CSL Behring: Research Funding; Sanofi: Research Funding; Celgene: Research Funding; Abbvie: Research Funding. McQuilten:Gilead Sciences: Research Funding; CSL Biotherapies: Research Funding; Celgene: Research Funding; AbbVie: Research Funding; Takeda Pharmaceuticals: Research Funding; Janssen-Cilag: Research Funding. Spencer:Takeda: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Haemalogix: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Janssen Oncology: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; AbbVie: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Amgen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Specialised Therapeutics Australia: Consultancy, Honoraria; Sanofi: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Secura Bio: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Servier: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees.

Desmosomal glycoproteins 2 and 3 (dg2 and 3) or desmocollins have been implicated in desmosome adhesion. We have obtained a 5.0-kb-long clone for dg3 from a bovine nasal epidermal lambda gt11 cDNA library. Sequence analysis of this clone reveals an open reading frame of 2,517 bases encoding a polypeptide of 839 amino acids. The sequence consists of a signal peptide of 28 amino acids, a precursor sequence of 104 amino acids, and a mature protein of 707 amino acids. The latter has the characteristics of a transmembrane glycoprotein with an extracellular domain of 550 amino acids and a cytoplasmic domain of 122 amino acids. The sequence of a partial clone from the same library shows that dg2 has an alternative COOH terminus that is extended by 54 amino acids. Genomic DNA sequence data show that this arises by splicing out of a 46-bp exon that encodes the COOH-terminal 11 amino acids of dg3 and contains an in-frame stop codon. The extracellular domain of dg3 shows 39.4% protein sequence identity with bovine N-cadherin and 28.4% identity with the other major desmosomal glycoprotein, dg1, or desmoglein. The cytoplasmic domain of dg3 and the partial cytoplasmic domain of dg2 show 23 and 24% identity with bovine N-cadherin, respectively. The results support our previous model for the transmembrane organization of dg2 and 3 (Parrish, E.P., J.E. Marston, D.L. Mattey, H.R. Measures, R. Venning, and D.R. Garrod. 1990. J. Cell Sci. 96:239-248; Holton, J.L., T.P. Kenny, P.K. Legan, J.E. Collins, J.N. Keen, R. Sharma, and D.R. Garrod. 1990. J. Cell Sci. 97:239-246). They suggest that these glycoproteins are specialized for calcium-dependent adhesion in their extracellular domains and, cytoplasmically, for the molecular interactions involved in desmosome plaque formation. Moreover this represents the first example of alternative splicing within the cadherin family of cell adhesion molecules.

Determination of sex from the skeletal remains is of medico legal importance for establishing the identity of an individual. The determination of deceased sex is first step in skeletal analysis since estimation of age at death, race,and stature depends on sex of the deceased. Total 100 adult dry skull were of unknown sex available in the Department of Anatomy Santosh medical college and hospital,Gaziabad and Government Institute of Medical Sciences,Greater Noida, were studied. Distance between bregma and lambda were obtained and presence of any sutural bone was observed in bregma. The results were compared with the present literature. Still there is a demand for further research to validate the distance from bregma to lambda for anthropometric use for particular race and various other surgical procedures.

Plasma cell granulomas (PCGs) or inflammatory pseudotumors are non-neoplastic lesions that consist of predominantly antibody-producing plasma cells and innate immune cells such as neutrophils, macrophages, and eosinophils. Unlike in multiple myeloma, the plasma cells are polyclonal and proliferate in a fibroblast-rich stromal background. These lesions are predominantly reported in the lungs; however, they may involve other organs too. Very few cases are reported regarding the presence of PCG in the oral cavity and a confirmatory diagnosis is crucial for further management. A critical and careful examination from a pathological point of view is obviously necessary to rule out other plasma cell neoplasms. We present here two cases of intra-oral PCGs; one in the gingiva & another within the jaw; both showing a polyclonal staining pattern in immunohistochemistry confirming a diagnosis of plasma cell granuloma. Keywords: Inflammatory pseudotumor, Plasma cell granuloma, Plasma cells, Polyclonal plasma cells, Lambda and kappa chain

Abstract Background To help ensure that children and families get the right support and services at the right time, strong and stable relationships between various child service organizations are vital. Moreover, strong and stable relationships and a key network position for gatekeepers are important preconditions for interprofessional collaboration, the timely and appropriate referral of clients, and improved health outcomes. Gatekeepers are organizations that have specific legal authorizations regarding client referral. However, it is largely unclear how strong relations in child service networks are structured, whether the gatekeepers have strong and stable relationships, and what the critical relations in the overall structure are. The aim of this study is to explore these preconditions for integrated care by examining the internal structure and dynamics of strong relations. Methods A comparative case study approach and social network analysis of three inter-organizational networks consisting of 65 to 135 organizations within the Dutch child service system. Multiple network measures (number of active organizations, isolates, relations, average degree centrality, Lambda sets) were used to examine the strong relation structure and dynamics of the networks. Ucinet was used to analyze the data, with use of the statistical test: Quadratic Assignment Procedure. Visone was used to visualize the graphs of the networks. Results This study shows that more than 80% of the organizations in the networks have strong relations. A striking finding is the extremely high number of strong relations that gatekeepers need to maintain. Moreover, the results show that the most important gatekeepers have key positions, and their strong relations are relatively stable. By contrast, considering the whole network, we also found a considerable measure of instability in strong relationships, which means that child service networks must cope with major internal dynamics. Conclusions Our study addressed crucial preconditions for integrated care. The extremely high number of strong relations that particularly gatekeepers need to build and maintain, in combination with the considerable instability of strong relations considering the whole network, is a serious point of concern that need to be managed, in order to enable child service networks to improve internal coordination and integration of service delivery.

The prevalence of advanced dementia (AD) is expected to increase dramatically over the next few decades. Patients with AD suffer from recurrent episodic illnesses that frequently result in transfers to acute care hospitals. The default pathway followed by some emergency physicians, internists and intensivists who see those patients is to prioritize disease-directed therapies over attention to the larger picture of AD. While this strategy is desired by many families, some families prefer a different approach. This essay examines the reason why there can be a failure to focus on the over-arching issue of AD and offers suggestions for improvement. Gaps in information and physician workload are important factors, but we argue that until physicians who see patients in emergency departments learn to pause first and ask “Why are we doing this?” they will revert to their comfort zone of ordering tests and therapies that may be unwanted. A separate emergency palliative care pathway may be one solution. Shifting the focus back to the larger picture of AD and away from the physiologic disturbance of the moment may alter the trajectory of care in ways that truly respect the wishes of some patients and their families. On s’attend à ce que la prévalence de la démence avancée (DA) augmente de façon extrêmement importante au cours des prochaines décennies. Or, il arrive que des patients atteints de DA soient aux prises avec des maladies épisodiques récurrentes qui entraînent fréquemment un transfert dans un hôpital de soins actifs. La voie suivie par défaut par certains urgentologues, internistes et intensivistes qui reçoivent ces patients consiste à donner la priorité à l’application de traitements axés sur la maladie plutôt qu’à aborder le problème plus large de la DA. Cette stratégie satisfait bien des familles, mais certaines préfèrent une autre approche. Cet article examine pourquoi on semble vouloir éviter de s’attarder au problème récurrent de la DA et offre des suggestions d’amélioration. Des lacunes en matière d’information ainsi que la charge de travail des médecins sont sûrement des facteurs importants qui mènent à cette situation. Toutefois, nous soutenons que tant que les médecins qui voient ces patients au service des urgences ne prendront pas le temps de s’arrêter et de se questionner sur leur choix d’actions, ils se limiteront à se retirer dans leur zone de confort qui consiste à prescrire des tests et des traitements qui risquent d’être inopportuns. Une voie distincte en matière de soins palliatifs d’urgence peut s’avérer être une solution. En déplaçant l’accent mis sur les troubles physiologiques du moment pour le mettre sur le problème plus large de la DA, la trajectoire des soins pourrait être modifiée de façon à mieux respecter les désirs de certains patients et de leur famille.An 84-year-old bed-bound man with severe Alzheimer’s dementia presents to the emergency department with pneumonia, accompanied by his 3 daughters. He has been hospitalized 4 times in the past 2 years for antibiotic-associated Clostridium difficile diarrhea. Antibiotics and intravenous fluids were started by the first physicians who saw him. An internist was consulted to take over his care.In 2016, 564,000 Canadians were living with dementia. Each year 25,000 new cases of dementia are diagnosed, and it is expected that by 2030 there will be close to 1 million Canadians who have dementia.1 People with advanced dementia (AD) suffer with cognitive deficits and are unable to communicate, ambulate and have incontinence. They are at high risk for imminent death,2,3 an under-recognized fact even among health care professionals.4 In contrast to patients with terminal cancer and end stage heart disease, most patients with AD do not die from devastating acute events (like bowel obstruction, or heart failure) that result from the progression of their primary disease. Instead, they die from recurrent episodic illnesses that can be treated with relatively simple therapeutic responses (like intravenous fluids or antibiotics). 3 These include pneumonias, urinary tract and skin infections, influenza, problems with eating (including aspiration) and dehydration. It is not surprising that in the United States that 19% of nursing home residents with cognitive impairment experience at least one transfer to a hospital in the last 120 days of life.5When these patients arrive in the emergency department (ED), the default pathway is to prioritize disease-directed therapies (e.g., intravenous fluid and antibiotics) over attention to the larger picture of AD. The physiologic disturbances receive intense focus and the AD is seemingly forgotten. These patients often suffer from treatable symptoms, including pain and shortness of breath.3 In some (but not all) cases, patients may receive care they don’t really want, families may be afraid to express their true wishes, and health care professionals may deliver care they suspect is unnecessary, or even harmful. This essay examines the reasons why this phenomenon occurs and offers suggestions for improvement by encouraging acute care clinicians to pause and ask themselves, “Why are we doing this?” and by engage family members in focused goals of care discussions that include outcomes of aggressive disease-directed treatments and palliative approaches.There are many reasons why the physicians who treat these patients in acute care hospitals (primarily emergency physicians, internists/hospitalists and intensivists) prioritize life-sustaining therapies over relief of burdensome symptoms as the default strategy. Information gaps affect the process of care. These physicians likely assume that a transfer to an acute care facility indicates the (sometimes mistaken) desire for life-sustaining interventions by the patient’s relatives. Transfer decisions are a human endeavour, and thus are subject to error6 especially when personnel worry about blame. While nearly half of all transfers from nursing homes to the ED are for cardiovascular and respiratory problems, 7 key factors influencing decisions to transfer as reported by family physicians include medico-legal concerns, family pressure, the capability of nursing home staff and the physician’s workload.8Even in Ontario, where nursing home residents are legally required to have annually updated instructions about whether transfer to acute care hospitals is indicated, the process only works as well as the nature of the counselling and discussion (which is often perfunctory) that takes place before the patients or their legal substitutes sign that document. In the United States, it is unclear how and whether the rapid uptake of Physician Orders for Life-Sustaining Treatment in nursing homes has affected end-of-life care in AD.9 From an economic and medico-legal perspective, there is no incentive for nursing homes or their staff to manage the acutely ill nursing home patient themselves, and every incentive to transfer care to an ED even when “no transfer” instructions are clearly recorded. The physician who meets the patient for the first time in the ED often lacks familiarity with the patient’s clinical course and his or her family, which coupled with a lack of communication training for these circumstances, inhibits addressing goals of care directly.10Physician workload is also an important factor. In a busy ED, an empathetic conversation that elucidates patients’ goals of care, educates families about the outcomes of care11 and offers the option of prioritizing attention to symptoms takes time and requires a higher cognitive load than ordering tests, intravenous fluids and antibiotics. In addition, the process of acute care, once initiated, may be a contributing factor. Family members see that life-prolonging therapies can be given, making it more difficult for them to decide to forgo disease-directed therapies once started without being overwhelmed by a sense of guilt. Finally, precise prognostication in a patient with AD is fraught with hazards.12 All of these factors play a role, but overall, until the physicians who see patients in the ED acquire the expertise to routinely address goals of care, and experience the rewards and sense of professional fulfillment that can be derived from sparing patients unwanted invasive care, the opportunity to prioritize comfort may not be offered. Those physicians will revert to their comfort zone of checking the electrolytes, obtaining a chest x-ray and urine culture which then results in a discussion that starts by asking families questions like, “Do you want us to treat the hypernatremia?” When phrased that way, few family members (even those who are physicians) are prepared to say “No.”While assessing goals of care for patients with AD may currently be viewed as impractical in the busy ED, perhaps the right models have not been proposed. Complexity has not deterred the rapid response in EDs for patients with acute strokes and ST-elevation myocardial infarctions. One solution may be to develop a separate “emergency palliative care pathway” where the primary task is prioritizing relief of burdensome symptoms and eliciting true preferences.13 thus avoiding stressful lengthy stays in the chaotic ED where patients with AD are often of low priority. Interventions aimed upstream from the ED may include increasing resources for training of nursing home staff along with the provision of decision aids to assist caregivers in the clarification of goals of care prior to transfer to the ED.14Some patients with AD and their families may prefer prioritizing comfort above all else but may not be offered the chance to make that choice. In a survey of elderly hospitalized Canadians, 70% reported wanting to focus on providing comfort rather than life-prolonging treatment, yet 54% of these patients are admitted to intensive care units at the end of life. 15 Even if this circumstance occurs in a minority of the dementia patients who are sent to EDs, the substantial rise in the number of people with dementia means that it will occur much more commonly in the future. In these cases, emergency physicians and the consultants that they approach for help can play a critical role if they push the pause button before beginning empiric disease-directed therapies, and simply ask patients’ families, “What is your understanding of your loved one’s prognosis?” and, “ What are you hoping for?” On the one hand, these conversations take time. On the other, they can be efficient, focus on these simple questions, and describe outcomes of care including potential discomforts associated with treatments. By shifting the focus back to the larger picture of AD and away from the physiologic disturbance of the moment, they may alter the trajectory of care, ultimately reducing the burden to patients and their families. We can facilitate patients’ wishes and honour the truly vital role that family members play as members of the health care team.Returning to the case, after a 7-minute discussion of the goals and options for care, led by the internist, the patient’s daughters were unable to decide upon the best course of treatment. A phone call to his wife was made, and she indicated that comfort measures were “what he would want.” After initiating oxygen and subcutaneous morphine for relief of pain and dyspnea in the ED, the patient was transferred to the ward with palliative care physicians. He received comfort-directed care and died peacefully 4 days later surrounded by his family. Competing InterestsNone declared AcknowledgementsWe thank S. Ryan Greysen MD, Gurpreet Dhaliwal (both of University of California San Francisco), Lewis A. Lipsitz MD (Harvard), Howard Ovens MD and Barry J. Goldlist MD (both of University of Toronto) for comments on an earlier draft.References1. Alzheimer Society of Canada. Report summary Prevalence and monetary costs of dementia in Canada (2016): a report by the Alzheimer Society of Canada. Health promotion and chronic disease prevention in Canada: research, policy and practice. October 2016:231–32.2. Morrison RS, Siu AL. Survival in end-stage dementia following acute illness. JAMA 2000;284(1):47–52.3. Mitchell SL, Teno JM, Kiely DK, et al. The clinical course of AD. N Engl J Med 2009;361(16):1529–38. doi:10.1056/NEJMoa0902234.4. Chang A, Walter LC. Recognizing dementia as a terminal illness in nursing home residents: Comment on "Survival and comfort after treatment of pneumonia in AD." Arch Intern Med 2010;170(13):1107–1109. doi:10.1001/archinternmed.2010.166.5. Gozalo P, Teno JM, Mitchell SL, et al. End-of-life transitions among nursing home residents with cognitive issues. N Engl J Med 2011;365(13):1212–21. doi:10.1056/NEJMsa1100347.6. Stephens CE, Newcomer R, Blegen M, Miller B, Harrington C. Emergency department use by nursing home residents: effect of severity of cognitive impairment. Gerontologist 2012;52(3):383–93. doi:10.1093/geront/gnr109.7. Jensen PM, Fraser F, Shankardass K, Epstein R, Khera J. Are long-term care residents referred appropriately to hospital emergency departments? Can Fam Physician 2009;55(5):500–505.8. McDermott C, Coppin R, Little P, Leydon G. Hospital admissions from nursing homes: a qualitative study of GP decision making. Br J Gen Pract 2012;62(601):e538–e545. doi:10.3399/bjgp12X653589.9. Halpern SD. Toward evidence-based end-of-life care. N Engl J Med 2015;373(21):2001-2003. doi:10.1056/NEJMp1509664.10. Lamba S, Nagurka R, Zielinski A, Scott SR. Palliative care provision in the emergency department: barriers reported by emergency physicians. J Palliat Med 2013;16(2):143–47. doi:10.1089/jpm.2012.0402.11. Givens JL, Jones RN, Shaffer ML, et al. Survival and comfort after treatment of pneumonia in AD. Arch Intern Med 2010;170(13):1102–107. doi:10.1001/archinternmed.2010.181.12. Mitchell SL, Miller SC, Teno JM, et al. Prediction of 6-month survival of nursing home residents with advanced dementia using ADEPT vs hospice eligibility guidelines. JAMA 2010;304(17):1929–35. doi:10.1001/jama.2010.1572.13. Grudzen CR, Stone SC, Morrison RS. The palliative care model for emergency department patients with advanced illness. J Palliat Med 2011;14(8):945–50. doi:10.1089/jpm.2011.0011.14. Hanson LC, Zimmerman S, Song M-K, et al. Effect of the goals of care intervention for AD. JAMA Intern Med 2017;177(1):24–28. doi:10.1001/jamainternmed.2016.7031.15. Fowler R, Hammer M. End-of-life care in Canada. Clin Invest Med 2013;36(3):E127–E132.

This chapter explores both sides of the country's deep-seated class conflict, which revealed itself in a public debate about constitutional democracy between the highest levels of the judiciary and the leaders of Germany's powerful labor unions. Legal theorists often emphasize the importance of reaching consensus on moral principles for the stability of a constitutional system. In Germany, that consensus did not exist. The political representatives whom Germans elected after the Great War to draft a constitution could agree that the new German state should be a republic as opposed to a monarchy. However, they could not find common ground regarding as foundational a question as the authority of the three branches of government and their proper relationship to one another. Most important, minds diverged on whether the state should embrace parliamentary supremacy: the idea that the legislative branch, not the judicial or executive, should enjoy final authority in national decision making.

This chapter looks at the volatile debate about the future of German youth and the ability of the schools to turn them away from nationalism and toward a vision of international understanding. After the resignation of Heinrich Brüning in May 1932, a battle over the future of national education exposed a dangerous ideological rift running through Germany. Although conflicts over constitutive issues such as the separation of legal powers and political economy had been fierce in the preceding years, German journalists began writing about the actual possibility of “civil war” in the summer of 1932. It was the precise point at which a new national government, led by chancellor Franz von Papen, began laying plans for a radical centralization of educational policy. It was the first time since Germany's political unification sixty years earlier that the national regime in Berlin took administration of schools and curriculum away from the individual states and began centralizing decision making in the capital.

This chapter addresses the question of cultural identity and cultural minorities, particularly the state's proper relationship to the values associated with Christianity and Judaism—the two main religions represented among the nation's population. As a precondition of entry to the League of Nations, the governments of new states in central and eastern Europe with a regional history of ethnic strife were required to negotiate treaties guaranteeing specific rights for people who did not identify as the national majority and thus faced a danger of discrimination. The League Council's commission on minorities had not, however, required the German government to sign any special protection treaty regarding Jews. Leaders of the central Jewish organizations in Germany had never sought a legal minority status. On the contrary, they claimed to be an integral part of the German cultural community, a religious faith group just like Protestants or Catholics whose members were inseparable from and contributed actively to German culture as Jews.

This chapter considers how the view of dangerous, preternatural females of the stria/lamia type underwent significant evolution over the first millennium. In classical antiquity and the first centuries of the early Middle Ages, they and the goddess Diana were forces to be reckoned with. By the mid-eighth century, legal documents call into question the very existence of the stria and lamia, and Charlemagne's sweeping programmatic capitularies do not refer to them at all. Tenth-century penitentials strip Diana of the power that “misguided” women had ascribed to her. In the worldview of the elite, the insidious, malevolent, and dominating females had become silly but troublesome fictions. The aim here reached further than prohibiting deluded women from trafficking with demons; the writers of the time also sought to debunk myths enshrouding symbols of female magical power.

Essential Cases: Public Law provides a bridge between course textbooks and key case judgments. This case document summarizes the facts and decision in R (on the application of Nicklinson) v Ministry of Justice [2014] UKSC 38, Supreme Court. The case concerned assisted dying, specifically whether s. 2 of the Suicide Act 1961 was incompatible with the Human Rights Act 1998 (Nicklinson and Lambs’ cases), and whether the prosecution guidance on assisting someone to commit suicide issued by the Director of Public Prosecutions was sufficiently clear (Martin’s case). However, the primary focus of this case note is on the justices’ discussion of the respective competences of Parliament and the courts to resolve the legal issues in this area. The document also includes supporting commentary from author Thomas Webb.

Essential Cases: Public Law provides a bridge between course textbooks and key case judgments. This case document summarizes the facts and decision in R (on the application of Nicklinson) v Ministry of Justice [2014] UKSC 38, UK Supreme Court. The case concerned assisted dying, specifically whether s. 2 of the Suicide Act 1961 was incompatible with the Human Rights Act 1998 (Nicklinson and Lambs’ cases), and whether the prosecution guidance on assisting someone to commit suicide issued by the Director of Public Prosecutions was sufficiently clear (Martin’s case). However, the primary focus of this case note is on the justices’ discussion of the respective competences of Parliament and the courts to resolve the legal issues in this area. The document also includes supporting commentary from author Thomas Webb.

Essential Cases: Public Law provides a bridge between course textbooks and key case judgments. This case document summarizes the facts and decision in R (on the application of Nicklinson) v Ministry of Justice [2014] UKSC 38, Supreme Court. The case concerned assisted dying, specifically whether s. 2 of the Suicide Act 1961 was incompatible with the Human Rights Act 1998 (Nicklinson and Lambs’ cases), and whether the prosecution guidance on assisting someone to commit suicide issued by the Director of Public Prosecutions was sufficiently clear (Martin’s case). However, the primary focus of this case note is on the justices’ discussion of the respective competences of Parliament and the courts to resolve the legal issues in this area. The document also includes supporting commentary and questions from author Thomas Webb.

Essential Cases: Public Law provides a bridge between course textbooks and key case judgments. This case document summarizes the facts and decision in R (on the application of Nicklinson) v Ministry of Justice [2014] UKSC 38, Supreme Court. The case concerned assisted dying, specifically whether s. 2 of the Suicide Act 1961 was incompatible with the Human Rights Act 1998 (Nicklinson and Lambs’ cases), and whether the prosecution guidance on assisting someone to commit suicide issued by the Director of Public Prosecutions was sufficiently clear (Martin’s case). However, the primary focus of this case note is on the justices’ discussion of the respective competences of Parliament and the courts to resolve the legal issues in this area. The document also includes supporting commentary and questions from author Thomas Webb.

Abstract This chapter traces key points in the evolution of relations between Indigenous peoples, the state, and the mining industry in Chile. These include the growing legal recognition of Indigenous rights, but also continued limitations of these because of a sustained pursuit by the state of neo-liberal economic reform. Two case studies follow which allow detailed analysis of different facets of relations between the state, the mining industry, and Indigenous peoples in contemporary Chile. The first focuses on Pascua Lama, and considers why and how Diaguita peoples and their allies were able to stop a major multinational company from developing what would have become one of the world’s largest gold mines. The second traces engagement of Atacameño peoples with the copper and lithium industries in northern Chile, including through a detailed analysis of an agreement negotiated in 2016 between Rockwood, a wholly owned subsidiary of Albemarle Corporation, one of the world’s largest lithium producer, and 18 Atacameño communities. In combination, the case studies also allow further examination of Indigenous strategies of engagement and resistance.