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A good practice carried to an extreme and worked in accordance with the letter of the law becomes a positive evil.
A military historian once remarked that the history of man is the history of war and the history of war is the history of man. History tells us that peace is not the norm despite mankind's efforts to achieve lasting peace. For much of history, conflict has been a barbaric clash of wills with the strong prevailing. In large measure, good rarely triumphed over evil. Though early attempts were made to extend some type of civility to the battlefield, use of law and regulation in protecting combatants is a modern phenomenon. Only in the past fifty years have we seen a comprehensive legal regime evolve that attempts to regulate conduct in conflict.
Despite the establishment of the laws of armed conflict in the past century, modern conflict involves actors who do not follow any international norms and who ignore basic humanitarian principles. The dirty wars of the twentyfirst century will mirror conflict not seen since the Dark Ages. Actors in these conflicts choose to use fear, terror, and suffering as a weapon of war, preying upon the most vulnerable members of society – mainly women and children.
The international community is not prepared to predict, prevent, and fight in these types of conflicts. Even though the development of law in this area has flourished and the jurisprudence from the various international tribunals has developed the ability to hold combatants who do not follow the rule of law on the battlefield accountable, conflict itself has moved backward in many parts of the world where the standard is “no quarter.” Kill or be killed is the new norm in this evolving century.
Along with this devolution in conflict, we see the world in extremes as the final visages of the fifty-year-long Cold War slide away into history. It can be argued that the twentieth century was almost a century-long conflict that historians have broken up into three wars: World War I, World War II, and the Cold War.
The Balkan Wars, the Rwanda genocide, and the crimes against humanity in Cambodia and Sierra Leone spurred the creation of international criminal tribunals to bring the perpetrators of unimaginable atrocities to justice. When Richard Goldstone, David Crane, Robert Petit, and Luis Moreno-Ocampo received the call - each set out on a unique quest to build an international criminal tribunal and launch its first prosecutions. Never before have the founding International Prosecutors told the behind-the-scenes stories of their historic journey. With no blueprint and little precedent, each was a path-breaker. This book contains the first-hand accounts of the challenges they faced, the obstacles they overcame, and the successes they achieved in obtaining justice for millions of victims.
An evidence-based emergency department (ED) atrial fibrillation and flutter (AFF) pathway was developed to improve care. The primary objective was to measure rates of new anticoagulation (AC) on ED discharge for AFF patients who were not AC correctly upon presentation.
This is a pre-post evaluation from April to December 2013 measuring the impact of our pathway on rates of new AC and other performance measures in patients with uncomplicated AFF solely managed by emergency physicians. A standardized chart review identified demographics, comorbidities, and ED treatments. The primary outcome was the rate of new AC. Secondary outcomes were ED length of stay (LOS), referrals to AFF clinic, ED revisit rates, and 30-day rates of return visits for congestive heart failure (CHF), stroke, major bleeding, and death.
ED AFF patients totalling 301 (129 pre-pathway [PRE]; 172 post-pathway [POST]) were included; baseline demographics were similar between groups. The rates of AC at ED presentation were 18.6% (PRE) and 19.7% (POST). The rates of new AC on ED discharge were 48.6 % PRE (95% confidence interval [CI] 42.1%-55.1%) and 70.2% POST (62.1%-78.3%) (20.6% [p<0.01; 15.1-26.3]). Median ED LOS decreased from 262 to 218 minutes (44 minutes [p<0.03; 36.2-51.8]). Thirty-day rates of ED revisits for CHF decreased from 13.2% to 2.3% (10.9%; p<0.01; 8.1%-13.7%), and rates of other measures were similar.
The evidence-based pathway led to an improvement in the rate of patients with new AC upon discharge, a reduction in ED LOS, and decreased revisit rates for CHF.
The prognosis for people with lung cancer may be worsened by delays in seeking medical help following the onset of symptoms. Previous research has highlighted that patients’ experiences of stigma and blame may contribute to these delays. This short report focuses on stigma as a barrier to diagnosis of lung cancer, from patient and general practitioner (GP) perspectives. Semi-structured interviews were conducted with people diagnosed with lung cancer (n=20) and with GPs (n=10) in New South Wales, Australia. Participants’ experiences of blame and stigma, GPs preconceptions of lung cancer risk and the impact of anti-smoking messaging were explored. Participants reported experiencing stigma owing to a diagnosis of lung cancer. For some, the anticipation of stigma resulted in delays in seeking diagnosis and hence treatment. The sense of blame associated with a lung cancer diagnosis was also reflected in GP interviews. Successful tobacco control activities have increased societal awareness of lung cancer as smoking related and potentially contributed to the participants’ experiences of stigma. Removing blame associated with smoking is central to reducing delays in diagnosis of lung cancer.
Older African Americans tend to perform poorly in comparison with older Whites on episodic memory tests. Observed group differences may reflect some combination of biological differences, measurement bias, and other confounding factors that differ across groups. Cognitive reserve refers to the hypothesis that factors, such as years of education, cognitive activity, and socioeconomic status, promote brain resilience in the face of pathological threats to brain integrity in late life. Educational quality, measured by reading test performance, has been postulated as an important aspect of cognitive reserve. Previous studies have not concurrently evaluated test bias and other explanations for observed differences between older African Americans and Whites. We combined data from two studies to address this question. We analyzed data from 273 African American and 720 White older adults. We assessed DIF using an item response theory/ordinal logistic regression approach. DIF and factors associated with cognitive reserve did not explain the relationship between race, and age- and sex-adjusted episodic memory test performance. However, reading level did explain this relationship. The results reinforce the importance of considering education quality, as measured by reading level, when assessing cognition among diverse older adults. (JINS, 2011, 17, 625–638)
International criminal law is about politics. It is a naïve Chief Prosecutor who plans for and executes his prosecution plan (if he or she has one) without keeping in mind the bright red thread of politics that permeates the entire existence of a tribunal or court. Conceived due to a political event and a creature of political compromise, politics is in the DNA of all of the justice mechanisms that make up the modern era of international criminal justice.
Today, the climate is once again politically charged as the international community begins to adjust its thinking about how to solve diplomatically, in an acceptable manner, the indictment of the sitting President of the Sudan, Omar al-Bashir. The clarion calls by various States and organizations for peace first, maybe justice later, with a mounting pressure to defer the arrest warrant for a year, are familiar. These threats, comments, and histrionics are the very same as when I unsealed the indictment of then-President Charles Taylor of Liberia in June 2003. At the end of the day, his indictment brought a more sustainable peace for the people of Liberia, and Bashir's indictment will do the same for the people of the Sudan. It will be interesting to watch how this political process plays out.
This paper will use as a case study the development, planning, and execution of a political event that ultimately set into motion the prosecution of the various warring factions of Sierra Leone in the 1990s.
Since the creation of the Joint Committee on Powder Diffraction Standards (JCPDS) over sixty years ago, the Powder Diffraction File (PDF) has been the key source of standard powder diffraction data for identification and analysis of materials of all types, from natural minerals and high-tech ceramics to metals and alloys and pharmaceuticals. Although this editorially reviewed database has been the mainstay for diffraction pattern reference for the x-ray powder diffraction community, recent developments provide information and tools for electron diffraction. In recent years, the International Centre for Diffraction Data (ICDD, formerly JCPDS) has transformed the flat-file format of the PDF to a more flexible relational database (RDB) format. The PDF has been greatly expanded to include calculated patterns from multiple collaborating databases, including the Inorganic Crystal Structure Database (FIZ Karlsruhe, Germany), the Linus Pauling File (MPDS, Vitznau, Switzerland), and the Cambridge Structural Database (CCDC, Cambridge, United Kingdom). A significant portion of its entries include atomic coordinates and a specific database dedicated to organic phases exists. All new entries for the ICDD databases undergo over 100 quality checks before inclusion, and a quality mark is assigned for each entry that passes.