Demonstrating Positive Obligations: Children's Rights and Peaceful Protest in International Law

Recently there has been a significant increase in the involvement of children and young people in protests across the globe. As a result of this increase, children have directly influenced political change but have also faced threats to their safety. This raises distinct children’s rights issues, and the trends identified necessitate both conceptualizing protest involvement from a children’s rights perspective, and critically examining the manner in which the law — at both a national and international level — has approached the involvement of children in such activities. This Article examines the positive obligations of States and argues that children should be recognized as a distinct, valid, and sometimes vulnerable group that has the right to protest and the right to be facilitated in doing so

Climate competence: Youth climate activism and its impact on international human rights law

Those who are under-18 are not often associated with the exercise of political rights. It is argued in this article however that youth-led climate activism is highlighting the extensive potential that children and young people have for political activism. Moreover, youth activists have come to be seen by many as uniquely competent on climate change. Youth activists have moved from the streets to the courts, utilising national and international human rights law mechanisms to further their cause. They are not the first to do so, and the extent of their impact is as yet unclear. Nevertheless, it is argued here that through applications such as Saachi (an application to the Committee on the Rights of the Child) and Duarte Agostinho (an application to the ECtHR) they are shifting the human-centric, highly procedural arena of international human rights law towards an approach which better encompasses person-environment connections

An exploration into the teaching of handwriting with first class pupils

This action research project was conducted in a co-educational, rural school with 30 first class pupils aged between 6 and 7 years. The research question was ‘How can I provide a more enriching experience for students when I am teaching handwriting?’ This area was chosen for research as I was concerned that I was using a didactic, teacher-led approach to teaching handwriting and this was not assisting the children with their handwriting skills. I was also not living out to my value of fairness by teaching in this way. The aim of the study was to find answers to the following questions: - What is the best way to teach this in the context of my own classroom? - How can I make handwriting more interesting for pupils in my classroom? - How to enhance my own understanding and knowledge of handwriting and the required skills in teaching this area Data for this study was collected using observations, children’s work samples, a reflective journal and conversations with critical friends. There were two cycles of action research, lasting four weeks each. The research took place between January and April 2019. The research cycles primarily focused on (1) environment (2) the introduction of fine and gross motor skills and (3) explicit handwriting instruction. The results of the research demonstrated the importance of allowing opportunities for creativity in the classroom. The importance of establishing a supportive environment was also highlighted, in addition to a child-centred approach using active methodologies to teach handwriting

Sexuality Education and International Standards: Insisting Upon Children’s Rights

The #MeToo movement has exposed the need for education about consent, power dynamics and positive relationships. International human rights instruments oblige states to provide sexuality education, and there have been some legal challenges to state provision of such education. Courts at regional and domestic levels have focused on the benefits to the state of sexuality education, holding it permissible if it is "objective" and if parents may educate privately to avoid it. It is argued in this article however that greater focus is required on sexuality education as primarily a child's human right, independent of state discretion and/or parental rights

A DOOR IN USE IN TALLINN APPEARED TO BE OVER 600 YEARS OLD

In a medieval tower in the Tallinn Old Town wall there is a woodeninternal door that was suspected of being rather old. The age of thedoor was determined using dendrochronology. It was possible tomeasure tree rings from the lower ends of the oak planks of the door.Matching the ring-width series with oak references from northernEurope revealed that the door was over 600 years old, and still inplace in medieval Bremen Tower in Tallinn, Estonia. The ring-widthseries of the door was most similar to oak chronology from theDaugava River. However, this does not mean that the door timbersoriginate from that region. At present, we do not possess Estonianoak chronologies extending back to that time. Thus, the provenanceof the oak for this door remains undecided. The dendrochronologicaldate of the door, AD 1394–1411, can be confirmed and can be narrowedby documentary evidence to AD 1400–1410

Comparison of the prognostic value of ECOG-PS, MGPS and BMI/WL: Implications for a clinically important framework in the assessment and treatment of advanced cancer

BACKGROUND AND AIMS:The systemic inflammatory response is associated with the loss of lean tissue, anorexia, weakness, fatigue and reduced survival in patients with advanced cancer and therefore is important in the definition of cancer cachexia. The aim of the present study was to carry out a direct comparison of the prognostic value of Eastern Cooperative Oncology Group Performance Status (ECOG-PS), modified Glasgow Prognostic Score (mGPS) and Body Mass Index/Weight Loss Grade (BMI/WL grade) in patients with advanced cancer. METHOD:All data were collected prospectively across 18 sites in the UK and Ireland. Patient's age, sex, ECOG-PS, mGPS and BMI/WL grade were recorded, as were details of underlying disease including metastases. Survival data were analysed using univariate and multivariate Cox regression. RESULTS:A total of 730 patients were assessed. The majority of patients were male (53%), over 65 years of age (56%), had an ECOG-PS>0/1 (56%), mGPS≥1 (56%), BMI≥25 (51%), <2.5% weight loss (57%) and had metastatic disease (86%). On multivariate cox regression analysis ECOG-PS (HR 1.61 95%CI 1.42-1.83, p < 0.001), mGPS (HR 1.53, 95%CI 1.39-1.69, p < 0.001) and BMI/WL grade (HR 1.41, 95%CI 1.25-1.60, p < 0.001) remained independently associated with overall survival. In patients with a BMI/WL grade 0/1 both ECOG and mGPS remained independently associated with overall survival. CONCLUSION:The ECOG/mGPS framework may form the basis of risk stratification of survival in patients with advanced cancer

A window beneath the skin: how computed tomography assessment of body composition can assist in the identification of hidden wasting conditions in oncology that profoundly impact outcomes?

Advancements in image-based technologies and body composition research over the past decade has led to increased understanding of the importance of muscle abnormalities, such as low muscle mass (sarcopenia), and more recently low muscle attenuation (MA), as important prognostic indicators of unfavourable outcomes in patients with cancer. Muscle abnormalities can be highly prevalent in patients with cancer (ranging between 10 and 90 %), depending on the cohort under investigation and diagnostic criteria used. Importantly, both low muscle mass and low MA have been associated with poorer tolerance to chemotherapy, increased risk of post-operative infectious and non-infectious complications, increased length of hospital stay and poorer survival in patients with cancer. Studies have shown that systemic antineoplastic treatment can exacerbate losses in muscle mass and MA, with reported loss of skeletal muscle between 3 and 5 % per 100 d, which are increased exponentially with progressive disease and proximity to death. At present, no effective medical intervention to improve muscle mass and MA exists. Most research to date has focused on treating muscle depletion as part of the cachexia syndrome using nutritional, exercise and pharmacological interventions; however, these single-agent therapies have not provided promising results. Rehabilitation care to modify body composition, either increasing muscle mass and/or MA should be conducted, and its respective impact on oncology outcomes explored. Although the optimal timing and treatment strategy for preventing or delaying the development of muscle abnormalities are yet to be determined, multimodal interventions initiated early in the disease trajectory appear to hold the most promise

Computed tomography diagnosed cachexia and sarcopenia in 725 oncology patients: is nutritional screening capturing hidden malnutrition?

Background: Nutrition screening on admission to hospital is mandated in many countries, but to date, there is no consensus on which tool is optimal in the oncology setting. Wasting conditions such as cancer cachexia (CC) and sarcopenia are common in cancer patients and negatively impact on outcomes; however, they are often masked by excessive adiposity. This study aimed to inform the application of screening in cancer populations by investigating whether commonly used nutritional screening tools are adequately capturing nutritionally vulnerable patients, including those with abnormal body composition phenotypes (CC, sarcopenia, and myosteatosis). Methods: A prospective study of ambulatory oncology outpatients presenting for chemotherapy was performed. A detailed survey incorporating clinical, nutritional, biochemical, and quality of life data was administered. Participants were screened for malnutrition using the Malnutrition Universal Screening Tool (MUST), Malnutrition Screening Tool (MST), and the Nutritional Risk Index (NRI). Computed tomography (CT) assessment of body composition was performed to diagnose CC, sarcopenia, and myosteatosis according to consensus criteria. Results: A total of 725 patients (60% male, median age 64 years) with solid tumours participated (45% metastatic disease). The majority were overweight/obese (57%). However, 67% were losing weight, and CT analysis revealed CC in 42%, sarcopenia in 41%, and myosteatosis in 46%. Among patients with CT-identified CC, the MUST, MST, and NRI tools categorized 27%, 35%, and 7% of them as ‘low nutritional risk’, respectively. The percentage of patients with CT-identified sarcopenia and myosteatosis that were categorised as ‘low nutritional risk’ by MUST, MST and NRI were 55%, 61%, and 14% and 52%, 50%, and 11%, respectively. Among these tools, the NRI was most sensitive, with scores <97.5 detecting 85.8%, 88.6%, and 92.9% of sarcopenia, myosteatosis, and CC cases, respectively. Using multivariate Cox proportional hazards models, NRI score < 97.5 predicted greater mortality risk (hazard ratio 1.8, confidence interval: 1.2–2.8, P = 0.007). Conclusions: High numbers of nutritionally vulnerable patients, with demonstrated abnormal body composition phenotypes on CT analysis, were misclassified by MUST and MST. Caution should be exercised when categorizing the nutritional risk of oncology patients using these tools. NRI detected the majority of abnormal body composition phenotypes and independently predicted survival. Of the tools examined, the NRI yielded the most valuable information from screening and demonstrated usefulness as an initial nutritional risk grading system in ambulatory oncology patients