This article analyses the phenomenon of rising powers from a historical materialist perspective. It (1) elaborates the key concepts of historical structures of world order, state-society complexes and transnational class formation, and (2) applies them to Brazil, Russia, India, China and other so-called 'rising powers' to account for the nature and extent of the challenge they pose to the existing institutions of global governance. A double argument is advanced: first, the integration of rising powers into the historical structure of global capitalism has reduced traditional sources of great power conflict, and made rising powers heavily dependent on the existing institutional framework established by the liberal West. This facilitates their integration into the existing governance order. However, within the limits of the existing order, two factors lend a heartland-contender cleavage to the politics of global governance: the rising powers' relatively more statist, less market-driven forms of state, and their subsequent failure to be integrated into emergent transnational capitalist class structures. Consequently, it is not the global governance order itself, but its most liberal features, that are contested by rising powers. The result is that, in contrast to realist pessimism and liberal optimism, the rise of new powers is leading to a hybrid governance order that is both transnationally integrated and less liberal.

Premature activation of the hypothalamic-pituitary-gonadal (HPG) axis manifests as gonadotropin-dependent precocious puberty. The mechanisms behind HPG activation are complex and a clear etiology for early activation is often not elucidated. Though collectively uncommon, the neoplastic and developmental causes of gonadotropin-dependent precocious puberty are very important to consider, as a delay in diagnosis may lead to adverse patient outcomes. The intent of the current paper is to review the neoplastic and developmental causes of gonadotropin-dependent precocious puberty. We discuss the common CNS lesions and human chorionic gonadotropin-secreting tumors that cause sexual precocity, review the relationship between therapeutic radiation and gonadotropin-dependent precocious puberty, and finally, provide an overview of the therapies available for height preservation in this unique patient population.

No abstract

The objective of this study was to evaluate the impact of short stature on generic health-related quality of life (HRQOL) and cognitive functioning in pediatric patients. Eighty-nine youth, 48 who were initially seen with short stature (SS group) and 41 with a history of short stature being treated with growth hormone (GHT group) and one of their legal guardians participated in the study. HRQOL and cognitive functioning were assessed using the PedsQL™ 4.0 Generic Core Scales and PedsQL™ Cognitive Functioning Scale. Comparisons were made between the study groups and with a previously obtained matched healthy sample. For the GHT group, height Z score was found to be a positive predictor of overall HRQOL while duration of GHT was found to be a predictor of physical functioning. For the SS group, the difference between midparental height Z score and height Z score was found to be a negative predictor of overall HRQOL and cognitive functioning. Comparison with the healthy sample demonstrated significant negative impact on HRQOL for child self-report and on HRQOL and cognitive functioning for parent proxy-report in both study groups. The GHT group had a significantly higher child self-reported Physical Functioning score than the SS group (effect size (ES) = 0.52, p < 0.05). In conclusion, the GHT group had slightly better HRQOL scores than the SS group, but the difference was not statistically significant. Both groups had significantly lower HRQOL and cognitive functioning scores than healthy sample. Predictors of HRQOL and cognitive functioning found in this study lend support to the use of the PedsQL™ 4.0 Generic Score Scales and PedsQL™ Cognitive Functioning Scale in routine assessment of children with short stature in order to identify children at increased risk for impaired HRQOL and cognitive functioning.