The time is right to open up care services more widely, and user feedback has an important part to play been supposed

Alison Hopkins explains the merits of a public online feedback system for social care. Through a feedback model that suits the care sector, one that responds to the characteristics of the service and its users, people will know what standards to expect, see when providers are failing to meet those standards, and feel more empowered to hold providers to account

Defining the Protected Groups in the Law of Genocide: Learning from the Experience of the International Criminal Tribunal for Rwanda

April 6, 2009, marked the fifteenth anniversary of the beginning of the Rwandan Genocide. In 1994, international outcry was not immediately forthcoming, but the commitment made by the United Nations Security Council for an international criminal tribunal to bring those who were responsible for the genocide to justice was an important statement condemning the actions of many Rwandans. The International Criminal Tribunal for Rwanda (“ICTR”) had many legal issues to face, but the most important, by far, was an exploration of the law of genocide at international law. The ICTR was the first international court to try an individual for genocide, and it has continued with an unprecedented number of genocide charges. Jean-Paul Sartre argued that “[genocide] itself is as old as humanity.” The international law that prohibits genocide, though, is only sixty-one years old. It took fifty of those years before an individual was found guilty under the relatively young international law. The contributions of the ICTR to developments in the law of genocide are unquestionably significant. And while judicial decisions are considered a subsidiary means for determining rules of international law, they are essential to any understanding the law’s application. Genocide has been described as “the crime of crimes.” “Attacks on groups defined on the basis of race, nationality, ethnicity and religion have been elevated [...] to the apex of human rights atrocities” through international law. This elevated status exists because of the special intent required for an individual to be responsible for the commission of genocide. The legal analysis of this “special intent” is one of the most important aspects of all ICTR jurisprudence. Concern arose early within the ICTR that the Tutsi of Rwanda did not constitute a “protected group” under the 1948 Genocide Convention. Determining what did constitute a “protected group” under the Convention became an ongoing concern for the Tribunal. Ultimately, the question to be answered is what is the appropriate way to define “protected groups” under the 1948 Genocide Convention, and how will this definition impact proceedings before the International Criminal Court (“ICC”). By analyzing the jurisprudence of the ICTR, the accompanying jurisprudence of the International Criminal Tribunal for the Former Yugoslavia (“ICTY”) and academic commentary, this article will explore the issue of protected groups. More specifically, the four terms used in the Convention will be analyzed, followed by a discussion on the use of an objective or subjective approach to defining genocide. Although ICTR case law tends not to be as well-reasoned as much of the ICTY case law, the former is still significant and may more accurately represent the ongoing debate regarding the precise and appropriate meaning of the terms found in the Convention. The world turned a blind eye to Rwanda in 1994. As Boutros Boutros-Ghali stated, “[f]or us, genocide was the gas chamber - what happened in Germany. We were not able to realize that with the machete you can create a genocide.” The experience in Rwanda and the jurisprudence of the ICTR will forever shape notions of genocide at international law and will hopefully protect groups like the Tutsi of Rwanda from such atrocities in the future

Use of compression therapy to treat lower limb wounds across Europe: a scoping review protocol

Introduction Poor lower wound care is an avoidable patient harm. Compression therapy is an effective way of treating non-ischaemic lower limbs wounds, but it is not always used appropriately. There are many guidelines which set out how compression therapy should be used, but there is dearth of evidence about how it is actually used at a population level across Europe. Aim The aim of this scoping review is to map the evidence published in English relating to the use of compression therapy to treat lower limb wounds across Europe. Methods This scoping review will be conducted in line with the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols and Scoping Reviews guidance. A search for relevant publications will be conducted on variety of databases and key websites in order to identify a comprehensive range of relevant literature. Peer reviewed empirical papers, theoretical papers and other publications in English relating to the use of compression therapy across Europe will be considered for inclusion. Ethics and dissemination Ethical and research governance for this scoping review is not required because we will only gather secondary data. Our results will be disseminated to the widest possible audience through an open access paper in a peer reviewed international journal, conference presentations and a plain English summary. The results of this scoping review will be used by a panel of Key Opinion Leaders from across Europe to develop a driver diagram to underpin subsequent lower limb wound care improvement efforts

Convenient Fictions: The Script of Lesbian Desire in the Post-Ellen Era: A New Zealand Perspective

Little has been published about the ascending trajectory of lesbian characters in prime-time television texts. Rarer still are analyses of lesbian fictions on New Zealand television. This study offers a robust and critical interrogation of Sapphic expression found in the New Zealand television landscape. More specifically, this thesis analyses fictional lesbian representation found in New Zealand's prime-time, free-to-air television environment. It argues that television's script of lesbian desire is more about illusion than inclusion, and that lesbian representation is a misnomer, both qualitatively and quantitively. In order to assess the authenticity of television's lesbian fictions, I sampled the opinions of New Zealand's television audience through focus group and survey methodology, and analysed two primary sources of lesbian representation available between 2004-2006. Television and other media provide the social and cultural background - the milieu - against or within which their fictions, dramas and comedies are set. Even when media texts are clearly non- or anti realistic (fantasy films, for instance), they usually attempt to produce their narratives as consistent, familiar and in keeping with the cultural characteristics, values and proclivities of mainstream contemporary society. This is not realism so much as a set of arbitrary conventions that are read as, or stand for, reality and the real. In short, the media is a teller of stories and fairy tales; and since mainstream Western culture has naturalised homonormativity, television's fairy tales are almost exclusively tales of heterosexuality. Television, from this perspective, reinscribes and reinforces what Pierre Bourdieu refers to as the 'masculine order'. Television uses reality to frame messages of compulsory heterosexuality, and it rarely presents homonormative messages. Lesbian representation is, therefore, difficult for a heteronormative medium to render without effort. Homonormativity is, for lesbian audiences, a central part of the cultural background - the components of realism, if you like, within which representations of lesbians would 'play out' their stories in media texts. Television stories which ignore this imperative deny both the audience's ability to interpret for themselves the integrity of the representation, and their ability to acquire new knowledge of lesbians

Research into the Impact of School Leadership on Pupil Outcomes: Policy and Research Contexts

This paper extends the introduction to the authors’ study of successful school leadership and how it influences pupil outcomes begun in the Editorial introduction. Critical to an appreciation especially of the external validity of their results is an understanding of the policy context in which the English leaders in their study found themselves; this is a policy context dominated by concerns for external accountability and increases in the academic performance of pupils. In addition to describing this context, the paper summarises the conceptual and methodological framework that guided the early stage of their research and outlines their mixed-methods research design

Project C.O.R.E.: Coaching Opportunities with Real Experiences

Retention and graduation rates of VCU men of color (MOC) is significantly lower than white men and women of color. Due to demonstrated significant attrition occurring after the sophomore year, Project C.O.R.E. (Coaching Opportunities with Real Experiences) is proposed as a sophomore-focused program that builds upon an existing freshman course on professional development for MOC. While the first-year course introduces students to a VCU support network, Project C.O.R.E. aims to increase university retention by expanding the student support network to members of the local community. Students are paired with community coaches, predominantly VCU alumni, to enhance their career and life-skills development. This program provides continued community, guidance, and support to encourage MOC to continue on the path to graduation

Concurrent infection with the filarial helminth Litomosoides sigmodontis attenuates or worsens Influenza A virus pathogenesis in a stage-dependent manner

Filarial helminths infect approximately 120 million people worldwide initiating a type 2 immune response in the host. Influenza A viruses stimulate a virulent type 1 pro-inflammatory immune response that in some individuals can cause uncontrolled immunopathology and fatality. Although coinfection with filariasis and influenza is a common occurrence, the impact of filarial infection on respiratory viral infection is unknown. The aim of this study was to determine the impact of pre-existing filarial infection on concurrent infection with influenza A virus. A murine model of co-infection was established using the filarial helminth Litomosoides sigmodontis and the H1N1 (A/WSN/33) influenza A virus (IAV). Co-infection was performed at 3 different stages of L. sigmodontis infection (larval, juvenile adult, and patency), and the impact of co-infection was determined by IAV induced weight loss and clinical signs, quantification of viral titres, and helminth counts. Significant alterations of IAV pathogenesis, dependent upon stage of infection, was observed on co-infection with L. sigmodontis. Larval stage L. sigmodontis infection alleviated clinical signs of IAV co-infection, whilst more established juvenile adult infection also significantly delayed weight loss. Viral titres remained unaltered at either infection stage. In contrast, patent L. sigmdodontis infection led to a reversal of age-related resistance to IAV infection, significantly increasing weight loss and clinical signs of infection as well as increasing IAV titre. These data demonstrate that the progression of influenza infection can be ameliorated or worsened by pre-existing filarial infection, with the outcome dependent upon the stage of filarial infection

Caspase-1 cleavage of the TLR adaptor TRIF inhibits autophagy and β-interferon production during pseudomonas aeruginosa infection

Bacterial infection can trigger autophagy and inflammasome activation, but the effects of inflammasome activation on autophagy are unknown. We examined this in the context of Pseudomonas aeruginosa macrophage infection, which triggers NLRC4 inflammasome activation. P. aeruginosa induced autophagy via TLR4 and its adaptor TRIF. NLRC4 and caspase-1 activation following infection attenuated autophagy. Caspase-1 directly cleaved TRIF to diminish TRIF-mediated signaling, resulting in inhibition of autophagy and in reduced type I interferon production. Expression of a caspase-1 resistant TRIF mutant enhanced autophagy and type I interferon production following infection. Preventing TRIF cleavage by caspase-1 in an in vivo model of P. aeruginosa infection resulted in enhanced bacterial autophagy, attenuated IL-1β production, and increased bacterial clearance. Additionally, TRIF cleavage by caspase-1 diminished NLRP3 inflammasome activation. Thus, caspase-1 mediated TRIF cleavage is a key event in controlling autophagy, type I interferon production, and inflammasome activation with important functional consequences

Breakfast Dietary Patterns among Mexican Children Are Related to Total-Day Diet Quality

Background: Mexico has experienced shifts in food availability and consumption patterns over the past few decades from traditional diets to those containing more high-energy density foods, resulting in the development of unhealthful dietary patterns among children and adults. However, to our knowledge it is not known whether breakfast consumption patterns contribute to the overall daily diet of Mexican children.Objective: We examined total-day diet among breakfast consumers compared with breakfast skippers, identified and investigated breakfast dietary patterns in relation to energy and nutrient intakes at breakfast and across the day, and examined these patterns in relation to sociodemographic characteristics.Methods: With the use of nationally representative dietary data (one 24-h recall) from the 2012 Mexican National Health and Nutrition Survey, 3760 children aged 4-13 y were categorized into mutually exclusive breakfast patterns with the use of cluster analysis. The association between breakfast patterns and breakfast skippers with dietary intake at breakfast and for the total day was investigated with the use of multivariate linear regression.Results: Most children (83%) consumed breakfast. Six breakfast dietary patterns were identified (milk and sweetened breads, tortillas and beans, sweetened beverages, sandwiches and quesadillas, eggs, and cereal and milk) and reflected both traditional and more Westernized dietary patterns. Sugar-sweetened beverages were consumed across all patterns. Compared with all breakfast dietary patterns, breakfast skippers had the lowest intake of several nutrients of public health concern. Nutrients to limit that were high at breakfast tended to be high for the total day and vice versa for nutrients to encourage.Conclusions: There was not a single pattern that complied perfectly with the Mexican School Breakfast Guidelines, but changes such as increasing dietary fiber by encouraging more whole grains, fruits, vegetables, and beans and reducing sodium and sugar-sweetened beverages could support compliance with these targets and improve overall diet quality

The Spatial Clustering of ROSAT All-Sky Survey AGNs II. Halo Occupation Distribution Modeling of the Cross Correlation Function

This is the second paper of a series that reports on our investigation of the clustering properties of AGNs in the ROSAT All-Sky Survey (RASS) through cross-correlation functions (CCFs) with Sloan Digital Sky Survey (SDSS) galaxies. In this paper, we apply the Halo Occupation Distribution (HOD) model to the CCFs between the RASS Broad-line AGNs with SDSS Luminous Red Galaxies (LRGs) in the redshift range 0.16<z<0.36 that was calculated in paper I. In our HOD modeling approach, we use the known HOD of LRGs and constrain the HOD of the AGNs by a model fit to the CCF. For the first time, we are able to go beyond quoting merely a `typical' AGN host halo mass, M_h, and model the full distribution function of AGN host dark matter halos. In addition, we are able to determine the large-scale bias and the mean M_h more accurately. We explore the behavior of three simple HOD models. Our first model (Model A) is a truncated power-law HOD model in which all AGNs are satellites. With this model, we find an upper limit to the slope (\alpha) of the AGN HOD that is far below unity. The other two models have a central component, which has a step function form, where the HOD is constant above a minimum mass, without (Model B) or with (Model C) an upper mass cutoff, in addition to the truncated power-law satellite component, similar to the HOD that is found for galaxies. In these two models we find the upper limits of \alpha < 0.95 and \alpha < 0.84 for Model B and C respectively. Our analysis suggests that the satellite AGN occupation increases slower than, or may even decrease with, M_h, in contrast to the satellite's HODs of luminosity-threshold samples of galaxies, which, in contrast, grow approximately as \propto M_h^\alpha with \alpha\approx 1. These results are consistent with observations that the AGN fraction in groups and clusters decreases with richness.Comment: 15 pages, 9 figures. ApJ in pres