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It is estimated that in excess of 300 000 children are born each year with a severe inherited disorder of hemoglobin and that approximately 80% of these births occur in low- or middle-income countries. As these countries go through an epidemiologic transition, with a reduction in childhood and infant mortality due to improved public health measures, babies who would have previously died of these diseases before they were recognized are now surviving to present for diagnosis and treatment. Hence, they are presenting an increasing global health burden. Because of their uneven distribution in high-frequency populations, reflecting their complex population genetics, the true magnitude of this burden is still unknown. In many poor countries there are virtually no facilities for the diagnosis and management of these conditions, and even in richer countries there are limited data about their frequency, clinical course, or mortality. Without this information, it will be impossible to persuade governments about the increasing importance of these diseases. The situation will only be improved by concerted action on the part of the hematology community of the richer countries together with input from the major international health organizations and funding agencies.

Is the law of ownership a barrier to energy upgrades in apartment blocks? Co-owners in multi-owned properties face challenges in reaching agreement to implement energy efficiency measures that owners of single family residences do not encounter. At the European level, this difficulty is recognised in Article 19 of the 2012 Energy Efficiency Directive, by which governments are obliged to address barriers to improvements which arise in the specific context of multi-owner properties. Despite this, the position of apartment owners remains mostly invisible in the policy discourse. The small quantity of literature examining the difficulties of group decision making around energy efficiency in apartments has so far focused on mapping the issues. This paper begins the process of 'colouring in' the existing outlines by providing an in-depth delineation of the governance barriers to energy upgrades presented by the law of ownership and management in two European jurisdictions: England and Scotland. A doctrinal analysis is employed to ascertain the relevant legal issues and identify how property law constitutes a barrier to energy upgrades within the framework of existing behavioural models. A theoretical inquiry is then used to suggest that reconceptualising property law in the context of multi-owner properties to focus on collective responsibilities rather than individual rights may help to minimise this effect of the law. The paper concludes with recommendations for further research to identify the range of issues property law presents across EU member states. This data is needed to fully test the reconceptualisation hypothesis presented here.

AbstractConsanguineous marriages potentially play an important role in the transmission of β-thalassaemia in many communities. This study aimed to determine the rate and socio-demographic associations of consanguineous marriages and to assess the influence on the prevalence of β-thalassaemia in Sri Lanka. Three marriage registrars from each district of Sri Lanka were randomly selected to prospectively collect data on all couples who registered their marriage during a 6-month period starting 1st July 2009. Separately, the parents of patients with β-thalassaemia were interviewed to identify consanguinity. A total of 5255 marriages were recorded from 22 districts. The average age at marriage was 27.3 (±6.1) years for males and 24.1 (±5.7) years for females. A majority (71%) of marriages were 'love' marriages, except in the Moor community where 84% were 'arranged' marriages. Overall, the national consanguinity rate was 7.4%. It was significantly higher among ethnic Tamils (22.4%) compared with Sinhalese (3.8%) and Moors (3.2%) (p < 0.001). Consanguinity rates were also higher in 'arranged' as opposed to 'love' marriages (11.7% vs 5.6%, p < 0.001). In patients with β-thalassaemia, the overall consanguinity rate was 14.5%; it was highest among Tamils (44%) and lowest among Sinhalese (12%). Parental consanguinity among patients with β-thalassaemia was double the national average. Although consanguinity is not the major factor in the transmission of the disease in the country, emphasis should be given to this significant practice when conducting β-thalassaemia prevention and awareness campaigns, especially in high-prevalence communities.