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The treaty creating the African Court of Justice and Human and Peoples' Rights, if and when it comes into force, contains innovative elements that have potentially significant implications for current substantive and procedural approaches to regional and international dispute settlements. Bringing together leading authorities in international criminal law, human rights and transitional justice, this volume provides the first comprehensive analysis of the 'Malabo Protocol' while situating it within the wider fields of international law and international relations. The book, edited by Professors Jalloh, Clarke and Nmehielle, offers scholarly, empirical, critically engaged and practical analyses of some of its most challenging provisions. Breaking new ground on the African Court, but also treating old concepts in a novel and relevant way, The African Court of Justice and Human and Peoples' Rights in Context is for anyone interested in international law, including international criminal law and international human rights law. This title is also available as Open Access on Cambridge Core.
To identify risk factors for surgical site infections (SSIs) after spine operations.
Case-control study of SSIs among patients undergoing spine operations.
An academic health center.
We studied patients undergoing spinal fusions or laminectomies at the University of Iowa Hospitals and Clinics from January 1, 2007, through June 30, 2009. We included patients who acquired SSIs meeting the National Healthcare Safety Network definition. We randomly selected controls among patients who had spine operations during the study period and did not meet the SSI definition.
In total, 54 patients acquired SSIs after 2,309 spine operations (2.3 per 100 procedures). SSIs were identified a median of 20 days after spinal fusions and 17 days after laminectomies; 90.7% were identified after discharge and 72.2% were deep incisional or organ-space infections. Staphylococcus aureus caused 53.7% of SSIs. Of patients with SSIs, 64.9% (fusion) and 70.6% (laminectomy) were readmitted and 59.5% (fusion) and 64.7% (laminectomy) underwent reoperation. By multivariable analysis, increased body mass index, Surgical Department A, fusion of 4–8 vertebrae, and operation at a thoracic or lumbar/sacral level were significant risk factors for SSIs after spinal fusions. Lack of private insurance and hypertension were significant risk factors for SSIs after laminectomies. Surgeons from Department A were more likely to use nafcillin or vancomycin for perioperative prophylaxis and to do more multilevel fusions than surgeons from Department B.
SSIs after spine operations significantly increase utilization of healthcare resources. Possible remediable risk factors include obesity, hypertension, and perioperative antimicrobial prophylaxis.
Reaction among conservatives to Pope Francis' Evangelii Gaudium has most often been negative. Ross Douthat, however, in his 2013 New York Times op-ed, has offered a more nuanced critique. Our four Roundtable authors respond to Douthat's implied invitation to a discussion by responding from the viewpoint of Catholic social thought.