The status of private military companies under international humanitarian law; towards a new convention

The public-private dichotomy of warfare is crumbling down as governments are voluntarily surrendering one of the essential and defining attributes of statehood: the state's monopoly on the legitimate use of force, leading to the privatization of war and conflict

Health-related quality of life and depression among participants in the Sjögren's International Collaborative Clinical Alliance registry.

ObjectiveTo examine health-related quality of life (HRQoL) and depression among participants in an international Sjögren's syndrome (SS) registry, comparing those with and without SS.MethodsCross-sectional study of participants in the Sjögren's International Collaborative Clinical Alliance (SICCA) registry. The 2016 American College of Rheumatology/European League Against Rheumatism SS classification criteria were used to determine disease status. HRQoL was assessed using the Short Form 12, version 2 Health Survey to derive scores for physical component summary (PCS) and mental component summary (MCS). Depression was assessed using the 9-Item Patient Health Questionnaire. Multivariate linear and logistic regression analyses were performed to identify predictors of HRQoL and depression while controlling for potential confounders.ResultsAmong 2401 SICCA participants who had symptoms of dry eyes and dry mouth, 1051 had SS (44%) and 1350 did not (56%). After controlling for confounders, when compared with non-SS participants, those with SS had better PCS (p<0.001, β=2.43, 95% CI 1.57 to 3.29), MCS (p=0.002, β=1.37, 95% CI 0.50 to 2.23) and lower adjusted odds of depression (p<0.001, OR 0.67, 95% CI 0.55 to 0.81). Other significant predictors of HRQoL and depression included employment, country of residence and use of medication with anticholinergic effect or for management of SS-related signs and symptoms.ConclusionOur results suggest that among symptomatic patients, having a diagnosis of SS may be associated with better emotional and psychological well-being compared with patients without a diagnosis. Having a definitive diagnosis of SS may encourage patients to obtain a better understanding of their disease and have coping mechanisms in place to better manage their symptoms

Caroline T. Daniels Correspondence

Entries include the typed transcripts of letters from the Maine State Library on the presentation of an inscribed book and concerning an article in the Portland Press Herald

Community as resource: crowdsourcing transcription of an historic newspaper.

Like many cultural heritage institutions, the Archives and Special Collections at the University of Louisville faces the dichotomy of material abundance and budgetary scarcity. Driven by the desire to make historical primary sources accessible online, this organization harnessed the power of the public to transcribe the Louisville Leader, an historic African American newspaper. The first sections of this article define crowdsourcing and describe how it was implemented at the University of Louisville, including the tools adopted and the process used. The latter sections outline the marketing strategy, the public response, and lessons learned from this ongoing project

Managing the merger of archives and special collections : setting our own agenda.

At the University of Louisville a merger of archives and special collections had been discussed for decades, but for a variety of reasons, always dismissed. There were practical reasons in favor of it, but there were some significant internal barriers that made it easier to keep things as they were. But in 2012 things changed. Heightened appreciation for the traditional and emerging roles of special collections in university libraries, institutional budget concerns, key retirements and gradual replacement of people resistant to change, and an inclusive approach to planning, all aligned to make the merger seem like a natural progression for the departments. After years of waiting, when we acted, we acted relatively quickly, creating the new unit in less than a year. Knowing our planning period was short, we also tried to put in place mechanisms and procedures for ironing out the kinks that we knew would crop up. Although we still are identifying and addressing those kinks, each member of our staff, our institutional colleagues, and, most importantly, our users, express confidence that the merger is a success. We believe that part of that success was driven by the level of control we, as a group, exerted over the planning and execution of the merger. Our change was internally driven, but we think our experience has value for departments who face a variety of motivations for coming together

Health professionals' perspectives on psychological distress and meeting patients' support needs in rheumatology care settings:A qualitative study

BackgroundPatients with inflammatory rheumatic diseases (IRDs) face challenges including pain, fatigue and disease flares. Evidence suggests their levels of anxiety and depression are higher compared to the general population. Rheumatology teams report psychologically distressed patients have additional support needs and require more clinical time. Little is currently known about models of support and their integration into care pathways.AimTo understand rheumatology health professionals' perspectives on patients' psychological distress and ways to meet support needs.MethodsThe study used a qualitative design, with data collected in telephone semi-structured interviews. Inductive thematic analysis was used to analyse the data.ResultsFifteen interviews were conducted. Two main themes with sub-themes represent the data: Theme 1: ‘No one shoe fits all’—the many manifestations of distress in patients (sub-themes: recognising distress, dealing with distress, dealing with life events alongside an IRD) and Theme 2: ‘If rheumatology could be interwoven with psychological principles’—the need to attend to the psychological impact of IRDs, alongside the physical impact (sub-themes: priority given to physical health, working together to help patients in distress, how should patient distress be measured?, the need for extra time and resources).ConclusionDistress can be obvious or hidden, cause issues for patients and health professionals and lead to poor engagement with care provision. Health professionals described the powerful link between physical and mental distress. This study suggests psychological support provision should be embedded within the rheumatology team and that patients' emotional wellbeing should be given equal priority to their physical wellbeing

Altered drug susceptibility during host adaptation of a <i>Plasmodium falciparum</i> strain in a non-human primate model

Infections with Plasmodium falciparum, the most pathogenic of the Plasmodium species affecting man, have been reduced in part due to artemisinin-based combination therapies. However, artemisinin resistant parasites have recently emerged in South-East Asia. Novel intervention strategies are therefore urgently needed to maintain the current momentum for control and elimination of this disease. In the present study we characterize the phenotypic and genetic properties of the multi drug resistant (MDR) P. falciparum Thai C2A parasite strain in the non-human Aotus primate model, and across multiple passages. Aotus infections with C2A failed to clear upon oral artesunate and mefloquine treatment alone or in combination, and ex vivo drug assays demonstrated reduction in drug susceptibility profiles in later Aotus passages. Further analysis revealed mutations in the pfcrt and pfdhfr loci and increased parasite multiplication rate (PMR) across passages, despite elevated pfmdr1 copy number. Altogether our experiments suggest alterations in parasite population structure and increased fitness during Aotus adaptation. We also present data of early treatment failures with an oral artemisinin combination therapy in a pre-artemisinin resistant P. falciparum Thai isolate in this animal model

Caprock integrity and public perception studies of carbon storage in depleted hydrocarbon reservoirs

Capture and subsurface storage of CO2 is widely viewed as being a necessary component of any strategy to minimise and control the continued increase in average global temperatures. Existing oil and gas reservoirs can be re-used for carbon storage, providing a substantial fraction of the vast amounts of subsurface storage space that will be required for the implementation of carbon storage at an industrial scale. Carbon capture and storage (CCS) in depleted reservoirs aims to ensure subsurface containment, both to satisfy safety considerations, and to provide confidence that the containment will continue over the necessary timescales. Other technical issues that need to be addressed include the risk of unintended subsurface events, such as induced seismicity. Minimisation of these risks is key to building confidence in CCS technology, both in relation to financing/liability, and the development and maintenance of public acceptance. These factors may be of particular importance with regard to CCS projects involving depleted hydrocarbon reservoirs, where the mechanical effects of production activities must also be considered. Given the importance of caprock behaviour in this context, several previously published geomechanical caprock studies of depleted hydrocarbon reservoirs are identified and reviewed, comprising experimental and numerical studies of fourteen CCS pilot sites in depleted hydrocarbon reservoirs, in seven countries (Algeria, Australia, Finland, France, Germany, Netherlands, Norway, UK). Particular emphasis is placed on the amount and types of data collected, the mathematical methods and codes used to conduct geomechanical analysis, and the relationship between geomechanical aspects and public perception. Sound geomechanical assessment, acting to help minimise operational and financial/liability risks, and the careful recognition of the impact of public perception are two key factors that can contribute to the development of a successful CCS project in a depleted hydrocarbon reservoir