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The effects of renewable energy transitions on energy costs and economic growth have led to cost concerns and a prioritisation of economic issues during the economic crisis. Bulgaria, the EU's poorest state has nevertheless already achieved its 2020 renewable energy targets. This achievement seems to challenge the widely held assumption that poorer countries struggle to meet environmental objectives. This paper analyses the drivers and implications of Bulgaria's renewables expansion in order to test general expectations on influential factors shaping renewable energy transitions in the context of poor states. The analysis employs the energy justice framework to identify the justice, equity and fairness implications of Bulgaria's renewable energy for its energy system. Despite the clear justice implications raised by changing energy systems, there are limited pieces analysing the relationship between renewable energy transitions and energy justice. The analysis shows that whilst Bulgaria was able to reach its renewables targets, the mismanaged, opaque and corrupted policy framework undermines the longterm viability of its energy transition. The analysis confirms the importance of long term strategies, effective policies and a supportive macroeconomic context for renewable energy transitions, and highlights the negative implications of renewables to achieve greater energy justice if these factors are omitted.

Prior to the 2015 Paris Conference of the Parties (COP), every state was requested to submit a pledge of their own design. To date, there has been a lack of large-n studies that provide a broad picture of these pledges. We employ Discourse Network Analysis to examine critically the climate pledges of all 162 actors at the Paris COP. Our research offers four main contributions. First, we provide data regarding the mitigation and adaptation components of every national pledge. Second, we identify six types of mitigation targets, and visually cluster every state according to these formats. Third, we argue that the pledges of the Umbrella Group of non-EU developed states, and of the group of oil exporting countries, showed greater internal similarity than the group comprising Brazil, China, India and South Africa. Finally, we critique the method as a means of analysing the new global climate governance context and argue that the method offers an innovative and unique means of understanding this complex policy landscape, when applied in a specific and focused manner.

The European Union (EU) faces a double crisis: both economic and environmental, which has brought into stark relief the question of whether climate change mitigation and economic growth are mutually exclusive. Is saving the environment a ‘luxury’ reserved for wealthy countries, with less affluent countries being too poor to be green? We seek to address this important and timely question using fuzzy-set Qualitative Comparative Analysis (fsQCA) to analyse the causal relationship between economic growth and stability, and the expansion of renewable electricity shares among the European Union's (EU) 28 member states during the recent economic recession (2008–2013). Our paper, analyses the recent economic and financial crisis and its effects on sustainability transitions, and establishes a new indicator for progress in renewable electricity transitions in the context of Europe's 2020 targets. It therefore extends the ‘sustainability as a luxury’ debate to include renewable energy. The analysis reveals an ambivalent picture of the role of wealth in renewable energy transitions (RET) in Europe. Indeed, driven by the EU's common renewable energy targets, the findings suggest that RETs are promoted both because, and in spite of the means.

Introduction Social determinants of health play an important role in explaining poor health outcomes across many chronic disease states. The impact of the social gradient in the setting of an inherited heart disease, hypertrophic cardiomyopathy (HCM), has not been investigated. This study sought to profile the socioeconomic status of patients attending a specialized multidisciplinary clinic and to determine the impact on clinical factors, psychosocial wellbeing and adherence to medical advice. Methods Patients with HCM and at-risk relatives attending a specialized multidisciplinary clinic in Sydney Australia between 2011 and 2013 were included. Clinical, socioeconomic, geographic remoteness and adherence data were available. A broader clinic and registry-based group completed a survey including psychological wellbeing, health-related quality of life, Morisky Medication Adherence Scale and individual-level socioeconomic information. Results Over a 3-year period, 486 patients were seen in the specialized clinic. There was an over-representation of patients from socioeconomically advantaged and the least geographically remote areas. Socioeconomic disadvantage was associated with comorbidities, poor psychological wellbeing and health-related quality of life, lower understanding of HCM and more complex clinical management issues such as NYHA class, atrial fibrillation and left ventricular outflow tract obstruction. Approximately 10% of patients were non-adherent to medical advice, and poor medication adherence was seen in 30% of HCM patients with associated factors being younger age, minority ethnicity, anxiety and poor mental quality of life. Conclusions Of all the patients attending a specialized cardiac genetic clinic, there is an overrepresentation of patients from very advantaged and major metropolitan areas and suggests that those most in need of a multidisciplinary approach to care are not accessing it.

Background: The yield of positive sarcomere mutations in hypertrophic cardiomyopathy (HCM) is increased in probands with a family history of disease, younger age and asymmetric septal morphology, suggesting different clinical subgroups of disease occur. We hypothesized probands with no family

Background—Multiple likely pathogenic/pathogenic (LP/P; ≥2) variants in patients with hypertrophic cardiomyopathy were described 10 years ago with a prevalence of 5%. We sought to re-examine the si...

Familial long QT syndrome (LQTS) is the most common primary arrhythmogenic disorder. The clinical diagnosis of LQTS can be difficult, and genotype plays a vital role in early disease identification.Wesought toassess factors that impacton communication of genetic results, uptake and access to testing. Participants were recruited from the Australian Genetic Heart Disease (AGHD) Registry and the Genetic Heart Disease Clinic, RPA Hospital Sydney. Sociodemographic, clinical, genetic and family history data was obtained via the AGHD Registry. A survey including the Hospital Anxiety and Depression Scale (HADS), Intolerance of Uncertainty Scale (IOU) and a number of short and open-ended questions about communication was sent to participants. Fifty-eight participants have so far been approached with 45 (78%) surveys returned. Of thosewith a genetic result, 91% self reported all first degree relatives were informed. Probands reported ‘feeling obligated’ (78%) and that ‘knowledge results could help relatives’ (84%), played a large role in the decision to share. Ninety percent reported thinking a result would ‘help relatives make healthcare decisions’ made sharing easier. Probands with a pathogenic result were less likely to be satisfied with their understanding of LQTS (78% versus 30%, p = 0.037). Other factors such as family history of sudden cardiac death and sociodemographic characteristics showed interesting trends, but small sample size has limited the power of these analyses. Data collection is ongoing. Preliminary results suggest communication of genetic results is good in Australian LQTS families, and this research may help to inform pre and post-test genetic counselling.

Summary Hypnotic suggestion on four occasions at weekly intervals failed to give any objective improvement, either immediate or delayed, in a series of 25 children of between 8 and 15 years of age, with chronic asthma.