Committing to Justice: The Case for Impact of Race and Culture Assessments in Sentencing African Canadian Offenders

Canadian judges have made notable, although too limited, strides to recognize the unique conditions of Black Canadians in sentencing processes and decisionmaking. The use of Impact of Race and Culture Assessments in sentencing people of African descent has gradually gained popularity since they were first introduced in R v “X.” These reports provide the court with the necessary information about the effect of systemic anti-Black racism on people of African descent and how the experience of racism has informed the circumstances of the offence, the offender, and how it might inform the offender’s experience of the carceral state. This paper lays out the legislative authority for considering systemic and background factors in sentencing African Canadian offenders; analyzes and classifies the relevant case law with a view to establishing a framework for sentencing African Canadian offenders and clarifying our thinking about how impact assessments may advance sentencing goals; and flags some of the outstanding issues that require further study. Les juges canadiens ont fait des progrès notables, bien que trop limités, pour reconnaître les conditions uniques des Canadiens noirs dans les processus de détermination de la peine et de prise de décision. L’utilisation des évaluations de l’impact de la race et de la culture dans la détermination de la peine des personnes d’origine africaine a progressivement gagné en popularité depuis qu’elles ont été introduites dans l’affaire R c. « X .» Ces rapports fournissent au tribunal les informations nécessaires sur l’effet du racisme anti-Noir systémique sur les personnes d’origine africaine et sur la manière dont l’expérience du racisme a influencé les circonstances de la perpétration de l’infraction, le délinquant, et comment elle pourrait influencer l’expérience de l’état carcéral du délinquant. Dans le présent article, nous présentons l’autorité législative permettant de prendre en compte des facteurs systémiques et contextuels dans la condamnation des délinquants afro-canadiens; nous analysons et classons la jurisprudence pertinente en vue d’établir un cadre pour la condamnation des délinquants afro-canadiens et de clarifier notre réflexion sur la manière dont les évaluations d’impact peuvent faire progresser les objectifs de condamnation; enfin, nous signalons certaines des questions en suspens qui nécessiteraient une étude plus approfondie

Integrating personalized medical test contents with XML and XSL-FO

Background: In 2004 the adoption of a modular curriculum at the medical faculty in Muenster led to the introduction of centralized examinations based on multiple-choice questions (MCQs). We report on how organizational challenges of realizing faculty-wide personalized tests were addressed by implementation of a specialized software module to automatically generate test sheets from individual test registrations and MCQ contents. Methods: Key steps of the presented method for preparing personalized test sheets are (1) the compilation of relevant item contents and graphical media from a relational database with database queries, (2) the creation of Extensible Markup Language (XML) intermediates, and (3) the transformation into paginated documents. Results: The software module by use of an open source print formatter consistently produced high-quality test sheets, while the blending of vectorized textual contents and pixel graphics resulted in efficient output file sizes. Concomitantly the module permitted an individual randomization of item sequences to prevent illicit collusion. Conclusions: The automatic generation of personalized MCQ test sheets is feasible using freely available open source software libraries, and can be efficiently deployed on a faculty-wide scale

Mapping Turnaround Times (TAT) to a Generic Timeline: A Systematic Review of TAT Definitions in Clinical Domains

Background: Assessing turnaround times can help to analyse workflows in hospital information systems. This paper presents a systematic review of literature concerning different turnaround time definitions. Our objectives were to collect relevant literature with respect to this kind of process times in hospitals and their respective domains. We then analysed the existing definitions and summarised them in an appropriate format. Methods: Our search strategy was based on Pubmed queries and manual reviews of the bibliographies of retrieved articles. Studies were included if precise definitions of turnaround times were available. A generic timeline was designed through a consensus process to provide an overview of these definitions. Results: More than 1000 articles were analysed and resulted in 122 papers. Of those, 162 turnaround time definitions in different clinical domains were identified. Starting and end points vary between these domains. To illustrate those turnaround time definitions, a generic timeline was constructed using preferred terms derived from the identified definitions. The consensus process resulted in the following 15 terms: admission, order, biopsy/examination, receipt of specimen in laboratory, procedure completion, interpretation, dictation, transcription, verification, report available, delivery, physician views report, treatment, discharge and discharge letter sent. Based on this analysis, several standard terms for turnaround time definitions are proposed. Conclusion: Using turnaround times to benchmark clinical workflows is still difficult, because even within the same clinical domain many different definitions exist. Mapping of turnaround time definitions to a generic timeline is feasible

IL-4 induces cAMP and cGMP in human monocytic cells

Human monocytes, preincubated with IFN-γ respond to IL-4 by a cGMP increase through activation of an inducible NO synthase. Here, IL-4 was found to induce an accumulation of cGMP (1 – 3 min) and cAMP (20 – 25 min) in unstimulated monocytes. This was impaired with NOS inhibitors, but also with EGTA and calcium/calmodulin inhibitors. These results suggest that: (1) IL-4 may stimulate different NOS isoforms in resting and IFN-γ activated monocytes, and (2) cAMP accumulation may be partially dependent on the NO pathway. By RT-PCR, a type III constitutive NOS mRNA was detected in U937 monocytic cells. IL-4 also increased the [Ca2+]i in these cells. Different NOS may thus be expressed in monocytic cells depending on their differentiation and the signals they receive

C3–C4 composition and prior carbon dioxide treatment regulate the response of grassland carbon and water fluxes to carbon dioxide

During May, July and October 2000, we measured the effects of temporarily increasing or decreasing CO2 concentration by 150–200 μmol mol−1 on daytime net ecosystem CO2 exchange (NEE) and water flux (evapotranspiration, ET) of C3–C4 grassland in central Texas, USA that had been exposed for three growing seasons to a CO2 gradient from 200 to 560 μmol mol−1. Grassland grown at subambient CO2 (\u3c 365 μmol mol−1) was exposed for 2 days to an elevated CO2 gradient (\u3e 365 μmol mol−1). Grassland grown at elevated CO2 was exposed for 2 days to a subambient gradient. Our objective was to determine whether growth CO2 affected the amount by which grassland NEE and ET responded to CO2 switching (sensitivity to CO2)

Peroxisome proliferator-activated receptor delta limits the expansion of pathogenic Th cells during central nervous system autoimmunity.

Peroxisome proliferator-activated receptors (PPARs; PPAR-alpha, PPAR-delta, and PPAR-gamma) comprise a family of nuclear receptors that sense fatty acid levels and translate this information into altered gene transcription. Previously, it was reported that treatment of mice with a synthetic ligand activator of PPAR-delta, GW0742, ameliorates experimental autoimmune encephalomyelitis (EAE), indicating a possible role for this nuclear receptor in the control of central nervous system (CNS) autoimmune inflammation. We show that mice deficient in PPAR-delta (PPAR-delta(-/-)) develop a severe inflammatory response during EAE characterized by a striking accumulation of IFN-gamma(+)IL-17A(-) and IFN-gamma(+)IL-17A(+) CD4(+) cells in the spinal cord. The preferential expansion of these T helper subsets in the CNS of PPAR-delta(-/-) mice occurred as a result of a constellation of immune system aberrations that included higher CD4(+) cell proliferation, cytokine production, and T-bet expression and enhanced expression of IL-12 family cytokines by myeloid cells. We also show that the effect of PPAR-delta in inhibiting the production of IFN-gamma and IL-12 family cytokines is ligand dependent and is observed in both mouse and human immune cells. Collectively, these findings suggest that PPAR-delta serves as an important molecular brake for the control of autoimmune inflammation

HIS-based Kaplan-Meier plots - a single source approach for documenting and reusing routine survival information

<p>Abstract</p> <p>Background</p> <p>Survival or outcome information is important for clinical routine as well as for clinical research and should be collected completely, timely and precisely. This information is relevant for multiple usages including quality control, clinical trials, observational studies and epidemiological registries. However, the local hospital information system (HIS) does not support this documentation and therefore this data has to generated by paper based or spreadsheet methods which can result in redundantly documented data. Therefore we investigated, whether integrating the follow-up documentation of different departments in the HIS and reusing it for survival analysis can enable the physician to obtain survival curves in a timely manner and to avoid redundant documentation.</p> <p>Methods</p> <p>We analysed the current follow-up process of oncological patients in two departments (urology, haematology) with respect to different documentation forms. We developed a concept for comprehensive survival documentation based on a generic data model and implemented a follow-up form within the HIS of the University Hospital Muenster which is suitable for a secondary use of these data. We designed a query to extract the relevant data from the HIS and implemented Kaplan-Meier plots based on these data. To re-use this data sufficient data quality is needed. We measured completeness of forms with respect to all tumour cases in the clinic and completeness of documented items per form as incomplete information can bias results of the survival analysis.</p> <p>Results</p> <p>Based on the form analysis we discovered differences and concordances between both departments. We identified 52 attributes from which 13 were common (e.g. procedures and diagnosis dates) and were used for the generic data model. The electronic follow-up form was integrated in the clinical workflow. Survival data was also retrospectively entered in order to perform survival and quality analyses on a comprehensive data set. Physicians are now able to generate timely Kaplan-Meier plots on current data. We analysed 1029 follow-up forms of 965 patients with survival information between 1992 and 2010. Completeness of forms was 60.2%, completeness of items ranges between 94.3% and 98.5%. Median overall survival time was 16.4 years; median event-free survival time was 7.7 years.</p> <p>Conclusion</p> <p>It is feasible to integrate survival information into routine HIS documentation such that Kaplan-Meier plots can be generated directly and in a timely manner.</p