Urethral atrophy after artificial urinary sphincter placement:Is cuff downsizing effective?

Purpose: We reviewed the outcome of cuff downsizing with an artificial urinary sphincter for treating recurrent incontinence due to urethral atrophy.

Materials and Methods: We analyzed the records of 17 patients in a 7-year period in whom clinical, radiological and urodynamic evidence of urethral atrophy was treated with cuff downsizing. Cuff downsizing was accomplished by removing the existing cuff and replacing it with a 4 cm. cuff within the established false capsule. Incontinence and satisfaction parameters before and after the procedure were assessed by a validated questionnaire.

Results: Mean patient age was 70 years (range 62 to 79). Average time to urethral atrophy was 31 months (range 5 to 96) after primary sphincter implantation. Mean followup after downsizing was 22 months (range 1 to 64). Cuff downsizing caused a mean decrease of 3.9 to 0.5 pads daily. The number of severe leakage episodes decreased from a mean of 5.4 to 2.1 The mean SEAPI (stress leakage, emptying, anatomy, protection, inhibition) score decreased from 8.2 to 2.4. Patient satisfaction increased from 15% to 80% after cuff downsizing. In 1 patient an infected cuff required complete removal of the device.

Conclusions: Patient satisfaction and continence parameters improved after cuff downsizing. We believe that this technique is a simple and effective method of restoring continence after urethral atrophy.

Time for Reform? Refugees, Asylum-seekers and Protection Under International Human Rights Law

The aim is to explore the protection that international human rights law offers to refugees, asylum-seekers, and the forcibly displaced. The ambition of the global rights framework is to guarantee a defined range of rights to all human beings, and thus move the basis for normative entitlement from exclusive reliance on national membership to a common humanity. This comprehensive and international perspective remains formally tied to states - acting individually or collectively - in terms of creation and implementation. The norms must find an entry point into the empirical world, and there must be clarity on responsibilities for practical delivery. It should remain unsurprising that the expectations raised by the normative reach of the law are frequently dashed in the complex and difficult human world of instrumental politics, power, and conflict. The intention here is to outline the international human rights law context, and indicate the value and limitations for the protection of refugees and asylum-seekers. A question is then raised about possible reform.

The International Protection of Refugees and Asylum Seekers: the Role of Article 3 of the European Convention on Human Rights

This book presents a comprehensive assessment of regional responses to the crisis in the asylum/refugee system and critically examines how different regions tackle the problem. The chapters consider the fundamental challenges which undermine an effective asylum process as well as regional difficulties with the various circumstances surrounding asylum seekers. With contributions on Africa, Europe, Latin America, South Asia and the Middle East, and the Pacific, the collection strives to appreciate what informs each region’s approach to the asylum process and asks if there are issues common to every region and if regions can learn from one another. The book seeks an understanding of the existing legal regime for the protection of asylum seekers and how regional institutions such as human rights commissions and regional courts enforce and adjudicate the law.

Privacy Region Protection for H.264/AVC with Enhanced Scrambling Effect and a Low Bitrate Overhead

While video surveillance systems have become ubiquitous in our daily lives, they have introduced concerns over privacy invasion. Recent research to address these privacy issues includes a focus on privacy region protection, whereby existing video scrambling techniques are applied to specific regions of interest (ROI) in a video while the background is left unchanged. Most previous work in this area has only focussed on encrypting the sign bits of nonzero coefficients in the privacy region, which produces a relatively weak scrambling effect. In this paper, to enhance the scrambling effect for privacy protection, it is proposed to encrypt the intra prediction modes (IPM) in addition to the sign bits of nonzero coefficients (SNC) within the privacy region. A major issue with utilising encryption of IPM is that drift error is introduced outside the region of interest. Therefore, a re-encoding method, which is integrated with the encryption of IPM, is also proposed to remove drift error. Compared with a previous technique that uses encryption of IPM, the proposed re-encoding method offers savings in the bitrate overhead while completely removing the drift error. Experimental results and analysis based on H.264/AVC were carried out to verify the effectiveness of the proposed methods. In addition, a spiral binary mask mechanism is proposed that can reduce the bitrate overhead incurred by flagging the position of the privacy region. A definition of the syntax structure for the spiral binary mask is given. As a result of the proposed techniques, the privacy regions in a video sequence can be effectively protected by the enhanced scrambling effect with no drift error and a lower bitrate overhead.

Applying the recovery approach to the interface between mental health and child protection services

There are a range of theoretical approaches which may inform the interface between child protection and adult mental health services. These theoretical perspectives tend to be focused on either child protection or mental health with no agreed integrating framework. The interface continues to be identified, in research, case management reviews and inquiry reports, as complex and problematic. This paper proposes that more positive, integrated approaches to service user engagement, risk assessment and management may lead to better outcomes in working with families experiencing parental mental health problems and child protection concerns. It is proposed that the recovery approach, increasingly used in mental health services, can inform the processes of engagement, assessment and intervention at the mental health and child protection interface. The article provides a critical overview of the recovery approach and compares it with approaches typifying interventions in child protection work to date. Relevant research and inquiries are also examined as a context for how to more effectively respond to cases where there are issues around parental mental health problems and child protection. The article concludes with case material to illustrate the potential application of the recovery approach to the interface between mental health and child protection services.

Interpretation of Section 17 Employment Protection Act in the light of ECJ case law and under consideration of the cases pending before the Federal Labour Court

This article analyses the relevance of the ECJ ruling in Junk for German labour law.

Pro-active protection against racialist discrimination in employment law - lessons from South Africa?

This study investigates the potential of the prohibition of indirect race discrimination to be used for law reform, and to uncover discriminatory practices. It reflects on the history and contents of the concept, and focuses in particular on its application in the Republic of South Africa

Decision making in child protection: An international comparative study on maltreatment substantiation, risk assessment and interventions recommendations, and the role of professionals’ child welfare attitudes

Child welfare professionals regularly make crucial decisions that have a significant impact on children and their families. The present study presents the Judgments and Decision Processes in Context model (JUDPIC) and uses it to examine the relationships between three indepndent domains: case characteristic (mother’s wish with regard to removal), practitioner characteristic (child welfare attitudes), and protective system context (four countries: Israel, the Netherlands, Northern Ireland and Spain); and three dependent factors: substantiation of maltreatment, risk assessment, and intervention recommendation.
The sample consisted of 828 practitioners from four countries. Participants were presented with a vignette of a case of alleged child maltreatment and were asked to determine whether maltreatment was substantiated, assess risk and recommend an intervention using structured instruments. Participants’ child welfare attitudes were assessed.
The case characteristic of mother’s wish with regard to removal had no impact on judgments and decisions. In contrast, practitioners’ child welfare attitudes were associated with substantiation, risk assessments and recommendations. There were significant country differences on most measures.
The findings support most of the predictions derived from the JUDPIC model. The significant differences between practitioners from different countries underscore the importance of context in child protection decision making. Training should enhance practitioners’ awareness of the impact that their attitudes and the context in which they are embedded have on their judgments and decisions.

Glycine betaine-mediated protection of peas (Pisum sativum L.) during blanching and frozen storage

We used glycine betaine (5–20% w/v) for blanching green peas (100°C, 60 s), and their subsequent freezing and storage (–20°C, 90 days). Blanching after the addition of glycine betaine at ≥10% (w/v) followed by a 90 day storage period which resulted in the most desirable outcome: higher vitamin C levels, a superior green color, enhanced organoleptic quality and texture, and improved retention of peroxidase and lipoxygenase activity relative to control peas (no glycine betaine added). Microscopic characterizations of control and treated peas revealed that glycine betaine acts as a cryoprotectant which maintains cellular integrity. Glycine betaine (10% w/v) could be used commercially for production of frozen peas with better quality attributes.

Refugees and Human Rights: The Future of International Protection in the UK

The global refugee crisis is raising profound questions for the future of international protection. This article, based on a talk given as part of Refugee Week 2015, offers reflections on the current debate. The need to internationalise the conversation is underlined. Although no one state can resolve the problems of the world, it is precisely in the response to the plight of the forcibly displaced that commitments to human rights and refugee protection are tested in practical terms. This article argues that the UK’s approach remains inadequate and problematic.

Exploring inequities in child welfare and child protection services: Explaining the ‘inverse intervention law’

Attempts to record, understand and respond to variations in child welfare and protection reporting, service patterns and outcomes are international, numerous and longstanding. Reframing such variations as an issue of inequity between children and between families opens the way to a new approach to explaining the profound difference in intervention rates between and within countries and administrative districts. Recent accounts of variation have frequently been based on the idea that there is a binary division between bias and risk (or need). Here we propose seeing supply (bias) and demand (risk) factors as two aspects of a single system, both framed, in part, by social structures. A recent finding from a study of intervention rates in England, the 'inverse intervention law', is used to illustrate the complex ways in which a range of factors interact to produce intervention rates. In turn, this analysis raises profound moral, policy, practice and research questions about current child welfare and child protection services.