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This chapter uses a close reading of The Lancet medical journal, and its radical, charismatic editor Thomas Wakley, to delineate the ‘high-water mark’ of Romantic sensibility as an emotional regime. It explores the ways in which Wakley and The Lancet leveraged the emotional politics of contemporary melodrama to critique the alleged nepotism and corruption of the London surgical elites. More especially, it analyses their campaign to expose instances of surgical incompetence at the city’s leading teaching hospitals, demonstrating the ways in which this strategy weaponised the emotions of anger, pity, and sympathy, and considering its implications for the cultural norms of an inchoate profession and for the ultimate stability of the emotional regime of Romantic sensibility.
This chapter looks at the abuse and regulation of schools. It begins with a brief history of religion and education law before examining the Trojan Horse Affair which began in 2014 and reverberates today. An extraordinary volume of disinformation encrusts this series of events, which is here related via an outline of the salient facts as drawn from official reports and court cases, with minimal reference to newspaper articles and academic commentary. The related issues of illegal schools and unregulated madrassas are touched on. The theoretical discussion illustrates that liberal individualism views education as a means to emancipate the individual into secularism, while multiculturalism treats it as a means to preserve and perpetuate minority cultures. It concludes that these perspectives fail to take schools seriously as institutions whose primary purpose is to provide as many British children as possible with a good education. The pluralist response points to what the Trojan Horse Affair and education law are really about: ensuring that every school, regardless of classification, is properly regulated, well-governed and capable of rebuffing any threat to its good functioning.
Chapter 7, written by Ohad Nahum, describes entrenched dependence from the adult-child's perspective, and how therapeutic contact with them may foster the transition from dysfunctional to functional dependence.
The mitral valvar complex is difficult to visualise accurately in only two dimensions. Three-dimensional echocardiography gives new insight into the dynamic changes of intra-cardiac structures during the cardiac cycle. The aim of this study was to study the mitral annulus in systole and diastole in normal children using three-dimensional echocardiography, and to analyse the effect of regurgitation on annular function.
Materials and methods
Three-dimensional echocardiographic datasets, acquired in 11 consecutive subjects with mitral regurgitation, and 20 normal subjects, were analysed offline using simultaneous multiplanar review.
Results
The mitral valvar annular area decreased in diastole, and increased in systole, in both groups. The annulus in patients with mitral regurgitation is dilated compared to normal subjects, the systolic value for those with regurgitation having a mean of 6.79 plus or minus 2.55 centimetres2/metres2, and the diastolic value a mean of 5.01 plus or minus 1.78 centimetres2/metres2, as opposed to a systolic mean value of 5.28 centimetres2/metres2 plus or minus 1.68, p = 0.091, and diastolic mean value of 3.05 centimetres2/metres2 plus or minus 0.90, in normal subjects (p less than 0.0001). The proportional change in mitral valvar annular area from systole to diastole showed a trend towards being smaller in those with mitral regurgitation, although this did not reach significance (24.8% versus 41.13%, p equal to 0.249). Analysis of subgroups of patients with moderate or severe mitral regurgitation showed mitral excursion, expressed as percentage of left ventricular length, to be significantly less than in normal subjects, at 12.78 plus or minus 5.10% versus 15.84 plus or minus 4.23% (p equal to 0.012).
Conclusions
Mitral valvar annular area in children decreases in diastole, and increases in systole. In those with mitral regurgitation, the annulus is dilated and the dynamic annular function is depressed.
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