On Truth and Ideology in International Criminal Law

Uppsatsen undersöker de internationella tribunalernas uppfattning om, och beskrivning av, det förflutna. Texten rör sig kring begreppen fred och försoning, vilka kvalificeras i människorätts-principen ‘non-repetition’, eller ‘icke-upprepning’, av tidigare förbrytelser. Denna princip väcker frågan om huruvida internationella brottmålsförfaranden kan motverka framtida förbrytelser, genom den historieskrivning de bidrar till. Inledningsvis presenteras den allt mer omfattande ’rätten till sanning’, dess ursprung, utveckling och nutida innebörd. Därpå beskrivs hur det förflutna bearbetas vid de internationella tribunalerna, samt hur denna process påverkar karaktären av, och särdragen i, den rättsliga historieskrivning som därigenom tar form. I samband med denna beskrivning ifrågasätts påståendet att den ‘sanning’ om det förflutna som befästs vid tribunalerna bidrar till att motverka framtida grova förbrytelser. ’Rätten till sanning’, företrädesvis den kollektiva dimensionen av normen, används som en måttstock för denna analys. I det avslutande kapitlet belyses den ideologiska dimensionen av den internationella straffrättens historieförståelse. Det framhålls att ambitionen att hålla individer straffrättsligt ansvariga för vissa särskilt grova brott är ett politiskt projekt och skall förstås som sådant. Slutligen hävdas att den rättsliga historieskrivningens ideologiska särdrag bör exponeras, för att främja den internationella straffrättens preventiva effekt.The dissertation investigates the character of the historical narrative that is produced at the international tribunals. It revolves around the notions of peace and reconciliation, qualified in the human rights principle of non-repetition and the potential of international criminal law to contribute to these ends. It is held that the collective aspect of the right to truth provides a useful tool, with which the potential of the narrative in preventing future crime can be evaluated. Following an inquiry into the scope and character of the emerging ‘right to truth’, the construct of truth and history in international criminal trial is described. The dissertation then deploys the ’right to truth’ and the thereby provoked question of the relation between a certain account of the past and the promise of non-recurrence, to analyse the utility of the typical narrative produced at the international tribunals. In the final chapter the concept of ideology is utilised to understand the project of international criminal justice as intrinsically political. In the final concluding comment it is held that the emancipatory potential of the work of the international tribunals can be fully realised only when the political character of the judicial account of the past is admitted

Surgeon-Performed Ultrasound as Preoperative Localization Study in Patients with Primary Hyperparathyroidism

Background: Minimally invasive parathyroidectomy is the treatment of choice for single-gland primary hyperparathyroidism. However, the exact location of the abnormal gland has to be established. Sestamibi scintigraphy, computed tomography and ultrasound (US) are commonly used modalities. We describe our experience in a non-academic center with surgeon-performed US (S-US) of the neck as preoperative localization study in patients with primary hyperparathyroidism (PHPT). Methods: Patients with a biochemically proven diagnosis of PHPT and preoperative S-US were included. Data were recorded prospectively. Perioperative gland location was compared to the preoperative S-US to determine sensitivity, specificity and accuracy rates. Results: Two of the 50 patients who underwent S-US were not subjected to surgery. In 85% of the patients analyzed by S-US, the appropriate abnormal gland(s) were identified. In 11%, no gland was identified, but abnormal glands were found during surgery. Sensitivity of S-US in our hospital is 85%, with a positive predictive value of 97%. Conclusions: We achieved a satisfactory sensitivity rate. S-US provides anatomic information to the surgeon which enables a more detailed operation planning, and it is a valuable diagnostic modality for patients with PHPT in our opinion. We hope that our data encourage other centers to implement this technique as well. Copyrigh

Impact of concomitant thyroid pathology on preoperative workup for primary hyperparathyroidism

BACKGROUND: The former standard surgical treatment in patients with primary hyperparathyroidism (pHPT) has been bilateral cervical exploration. New localization techniques and the possibility of intraoperative measurement of intact parathormone (iPTH) permit a focused, minimally invasive parathyroidectomy (MIP). The introduction of MIP without complete neck exploration leads to the potential risk of missing thyroid pathology. The aim of the present study is to evaluate the value of MIP in respect to coexisting thyroid findings and their impact on preoperative workup for primary hyperparathyroidism. METHODS: This is a prospective study including 30 consecutive patients with pHPT (median age 65 years; 17 females, 13 males). In all patients preoperative localization was performed by ultrasonography and 99m Tc-MIBI scintigraphy- Intraoperative iPTH monitoring was routinely done. RESULTS: Ten patients (33%) had a concurrent thyroid finding requiring additional thyroid surgery, and two patients (7%) with negative localization results underwent bilateral neck exploration. Therefore, MIP was attempted in 18 (60%) patients. The conversion rate to a four gland exploration was 6% (1/18). The sensitivities of 99m Tc-MIBI scanning and ultrasonography were 83.3% and 76.6%, respectively. The respective accuracy rates were 83.3% and 76.6%. Of note, the combination of the two modalities did not improve the sensitivity and accuracy in our patient population. During a median follow-up of 40 months, none of the patients developed persistent or recurrent hypocalcaemia, resulting in a 100% cure rate. CONCLUSION: Coexisting thyroid pathology is relatively frequent in patients with pHPT in our region. Among patients having pHPT without any thyroid pathology, the adenoma localization is correct with either ultrasonography or 99m Tc-MIBI scintigraphy in the majority of cases. MIP with iPTH monitoring are highly successful in this group of patients and this operative technique should be the method of choice

An Algorithm Informed by the Parathyroid Hormone Level Reduces Hypocalcemic Complications of Thyroidectomy

Ó The Author(s) 2010. This article is published with open access at Springerlink.com Background Measurement of the parathyroid hormone (PTH) level following total thyroidectomy (TTx) may allow prediction of postoperative hypocalcemia. We present an algorithmic method of managing hypocalcemia preemptively, based on the PTH level 1 h after operation. Materials and methods We examined 423 consecutive patients undergoing TTx at a single institution. A subset of patients were managed using an algorithm involving routine postoperative oral calcium administration and the early addition of oral calcitriol in patients with a low 1-h postoperative PTH level. Algorithm patients were compared to a concurrent, conventionally managed group. Outcomes measured included serum calcium levels, symptoms of hypocalcemia, postoperative complications, and receipt of intravenous (IV) calcium. Results The algorithm was applied in 135 patients, and 288 patients were managed conventionally. Critically low calcium levels (total calcium \7.5 mg/dl [1.88 mmol/l] or ionized calcium \0.94 mmol/l) were less common in algorithm patients (10.6 % vs. 25.3%; p \ 0.005). Much of this difference was attributable to the protective impact of the algorithm on patients undergoing TTx for cancer, 30% of whom developed critically low calcium levels when managed conventionally. Among patients requiring IV calcium, algorithm patients received fewer doses (1.29 vs

Limitations of Tc99m-MIBI-SPECT Imaging Scans in Persistent Primary Hyperparathyroidism

In primary hyperparathyroidism (PHPT) the predictive value of technetium 99m sestamibi single emission computed tomography (Tc99m-MIBI-SPECT) for localizing pathological parathyroid glands before a first parathyroidectomy (PTx) is 83-100%. Data are scarce in patients undergoing reoperative parathyroidectomy for persistent hyperparathyroidism. The aim of the present study was to determine the value of Tc99m-MIBI-SPECT in localizing residual hyperactive parathyroid tissue in patients with persistent primary hyperparathyroidism (PHPT) after initial excision of one or more pathological glands. We retrospectively evaluated the localizing accuracy of Tc99m-MIBI-SPECT scans in 19 consecutive patients with persistent PHPT who had a scan before reoperative parathyroidectomy. We used as controls 23 patients with sporadic PHPT who had a scan before initial surgery. In patients with persistent PHPT, Tc99m-MIBI-SPECT accurately localized a pathological parathyroid gland in 33% of cases before reoperative parathyroidectomy, compared to 61% before first PTx for sporadic PHPT. The Tc99m-MIBI-SPECT scan accurately localized intra-thyroidal glands in 2 of 7 cases and a mediastinal gland in 1 of 3 cases either before initial or reoperative parathyroidectomy. Our data suggest that the accuracy of Tc99m-MIBI-SPECT in localizing residual hyperactive glands is significantly lower before reoperative parathyroidectomy for persistent PHPT than before initial surgery for sporadic PHPT. These findings should be taken in consideration in the preoperative workup of patients with persistent primary hyperparathyroidis

Studentbloggens i sitt sammanhang – En studie av tio studentbloggar, deras tema och utformning på tre olika universitet

Titel: Studentbloggens i sitt sammanhang – En studie av tio studentbloggar, deras tema och utformning på tre olika universitet Författare: Lisa Bergenfelz Uppdragsgivare: Institutionen för journalistik, medier och kommunikation vid Göteborgs Universitet (JMG) Kurs: Examensarbete i medie- och kommunikationsvetenskap. Institutionen för journalistik, medier och kommunikation, Göteborgs universitet Termin: Vårterminen 2012 Handledare: Ulrika Andersson Sidantal/Antal ord: 44 sidor/15 487 ord inklusive källförteckning samt bilagor. Syfte: Syftet med studien är att göra en genomlysning av olika former av studentbloggar som återfinns på universitet i Sverige för att skapa förståelse hur det fungerar då ett personligt medium används inom en organisatorisk kontext. Metod: Kvalitativ innehållsanalys av studentbloggar med hjälp av Ethnographic Content Analysis (ECA). Material: Tio utvalda studentbloggar ifrån Linköpings Universitet, Karlstad Universitet och Uppsala Universitet. Huvudresultat: Arbetet med studentbloggar skilde sig åt mellan de tre universiteten. De hade olika former av avtal med studenterna som bloggade, publiceringsplattform skilde sig åt och presentationen av studentbloggen på hemsidan varierade. Detta påverkade studentbloggens sammanhang och hur anknuten studentbloggen var till universitetet. Detta påverkade vilket tema som bloggen behandlade. De studentbloggar som hade en närmare anknytning till universitetet behandlade i större grad universitetsrelaterade ämnen i sina bloggar än de studentbloggar som hade en svagare anknytning till sitt universitet. Detta påvisar att bloggen är beroende av dess sammanhang. Däremot visade det sig även att det fanns en likhet i hur de tio studentbloggarna utformades på de tre universiteten. Studentbloggarna användande sig av olika tekniska funktioner på liknande vis. Det kom till uttryck i en liknande hantering av bilder och länkar i blogginlägg och liknande användning av kategorier, arkiv och länkar i marginalen på bloggen. Resultaten visar på att studentbloggens tema och utformning påverkas av sin anknytning till universitetet men även av hur studenten är bunden av rollen som bloggare vilket tar sig i uttryck i anpassningen efter en gemensam bloggpraktik hos studentbloggarna. Tillsammans påverkar detta hur studentbloggen utformas