Sudden infant death syndrome (SIDS)--standardised investigations and classification: recommendations

Sudden infant death syndrome (SIDS) still accounts for considerable numbers of unexpected infant deaths in many countries. While numerous theories have been advanced to explain these events, it is increasingly clear that this group of infant deaths results from the complex interaction of a variety of heritable and idiosyncratic endogenous factors interacting with exogenous factors. This has been elegantly summarised in the "three hit" or "triple risk" model. Contradictions and lack of consistencies in the literature have arisen from diverse autopsy approaches, variable applications of diagnostic criteria and inconsistent use of definitions. An approach to sudden infant death is outlined with discussion of appropriate tissue sampling, ancillary investigations and the use of controls in research projects. Standardisation of infant death investigations with the application of uniform definitions and protocols will ensure optimal investigation of individual cases and enable international comparisons of trends.     

Britain and the Working Time Regulations

It is now over a year since the Working Time Regulations entered force in Britain on 1 October 1998, during a period when the government also introduced the minimum wage. But whereas that piece of legislation appears to have faded away into the background of British industrial relations, the Working Time Regulations continue to remain a central topic. Based on a survey of British companies and organisations, this article reviews the implementation of the legislation and examines the scope of coverage. It finds that the failure of the Labour government to consult the social partners – employer and employee representatives – resulted in business being unprepared for the Regulations. The article also notes that the manner in which this legislation was introduced has meant that many of the employees who were working excessive hours continue to do so.     

Work Roles,Domestic Roles,and Marital Quality: Perceptions of Fairness Among Dual-Earner Couples

Previous studies on the role of spouses' perceptions of fairness within marriage have typically dealt with the effects of those within the realm of the division of household labor. Using data from the 1993 National Survey of Families and Households, this study posits that the predominance of dual-earner couples necessitates the consideration of perceptions of fairness in both spouses' paid labor and domestic roles. Issues of fairness are shown to significantly affect husbands' and wives' evaluations of marital quality, yet these effects are limited to a noncomparative form (e.g., wives' evaluations of marital quality are not substantially affected by husbands' perceptions of unfairness). Implications of these findings for contemporary couples are discussed.     

Giving the reasonable patient a voice: information disclosure and the relevance of empirical evidence

In England the standard of risk disclosure required of doctors to avoid liability in negligence is governed by the Bolam test. The test is determined by what would be accepted as reasonable by the responsible doctor. Although able to lay down an independent standard, the courts have usually been guided by the medical expert's evidence. The judge's duty to scrutinise expert evidence was reaffirmed by the recent House of Lords ruling in Bolitho v City and Hackney HA. In Pearce v United Bristol Healthcare NHS Trust, Lord Woolf MR confirmed that this also applied to risk disclosure. Brazier & Miola argue that Pearce effectively introduces the prudent patient standard into English law. This paper examines that claim and considers whether it is justified by the Pearce judgment. The implications of Pearce are explored and, given the appeal to the concept of a material risk, I discuss the relevance of empirical research to determining the standard of disclosure. Finally, a small piece of empirical work is presented as an illustration of the pros and cons of such an approach and as a possible springboard for future research.     

Identity,dignity and development as trajectory: Bihar as a model for democratic progress in Nepal? Part II. Nepal’s promise

Part I of this article traced the experience of India’s Bihar state as it shifted in the last decade of the twentieth century from a region dominated by landowning upper castes and plagued by entrenched poverty to one led by newly emergent middle castes. In a two-step process, these groups first attained a significant dignity and self-respect and then it became possible in the 2000s to turn to economic growth and improvement in living standards. Part II makes a case that Nepal, long suffering under conditions similar to those hobbling Bihar until recently, might follow a similar two-stage path of dignity and then development.     

Reviews

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