The Ed O'Brien Street Law and Legal Literacy International Best Practices Conference, Durban, South Africa, April 2016

South Africa has been the home of a vibrant public legal education (PLE)　programme for many years. Indeed its Street Law initiative has been　described as one of the strategic responses to　and a　catalyst for change during the apartheid era. The focus on democracy and human rights for all　in the lead up to and following the 1994 election has aided the transition from the old regime to the new.　Ignorance of the law and legal process is of course a problem in many developing and developed countries and an　international conference was therefore　planned last year to bring the ever-expanding international legal literacy scene to Durban in order to identify and share best practice - an attempt to promote and support a better understanding of rights and responsibilities under the law.　The untimely death of the Street Law co-founder, Ed O'Brien, in July 2015　gave the event even greater poignancy. The conference was not only a global sharing of experience but also an important reminder of how this movement began and of Ed's (and others') role in that process

The Turn Team Initiative: A Hospital Acquired Pressure Injury (HAPI) Reduction Technique

https://digitalcommons.psjhealth.org/other_pubs/1125/thumbnail.jp

Teachers' Perspectives of Supporting Children with Trauma

Childhood trauma is impacting children and teachers across the nation. According to attachment theory, when children do not form secure attachments with parents, they will seek out attachments from other adults. Teachers are acting as secondary attachment figures. In this study, seven prekindergarten teachers participated in semi-structured interviews about their experiences supporting students with trauma and their relationships with these students. Prekindergarten teachers are supporting students by teaching self-regulation skills and emotional coping strategies. Teachers are also building relationships with students by learning about their interests and developing relationships with students’ support systems (i.e., parents, colleagues, and administration). Teachers are struggling with practicing self-care, but they reason that self-care is important. The results of this study imply that parents, teachers, and administration need to continue to work together to support students with trauma. Teachers can more adequately support students if they feel supported and practice self-care strategies

ORALNA PRIMJENA EPLERENONA U LIJEČENJU AKUTNE CENTRALNE SEROZNE KORIORETINOPATIJE (CSCR)

Objectives: Mineralocorticoid receptor (MR) are located in neuroretina and excessive glucocorticoid-dependent choroid activation in choroidal vessels is believed to play a large role in CSCR pathogenesis. The aim of this study was to examine eplerenone (Inspra, Pfizer), a MR antagonist as a potential treatment modality for acute CSCR. Materials and methods: A prospective cohort was carried out on patients diagnosed with acute CSCR receiving oral eplerenone. Spectral domain optical coherence tomography (SD-OCT) imaging was performed, including manual measurements of subretinal fluid (SRF) diameter and height at baseline and subsequent follow-up exams. The primary outcome measure of the study, was the best corrected visual acuity (BCVA) following eplerenone administration. Secondary outcome measures comprised, SRF diameter and height, cube volume (CV), cube average thickness (CAT) and central subfield thickness (CST). Results: 15 eyes of 15 patients diagnosed with acute CSCR, treated for a total of 28 days, with 50 mg/d of oral eplerenone. At study completion, statistically significant decreases from the baseline were observed in, SRF diameter (P<0.01), SRF height (P=0.001), CV(P<0.01), CAT (P=0.01) and CST (P<0.01). Complete resolution of SRF was seen in 8 out of 15 (53.3%) eyes, with further 5 eyes (33.3%) showing a marked improvement, but failing to achieve full resolution after treatment. 1 eye demonstrated no treatment effect and 1 eye worsened following treatment. The BCVA was 0.9 0.1 (P=0.001) after 28 days, compared to baseline BCVA 0.8 0.1. Conclusion: Following eplerenone treatment for acute CSCR, an accelerated improvement of SRF resolution, in comparison to the natural disease course, and a statistically significant difference in BCVA was noted. The results of this study are in line with previous studies that eplerenone is effective mode of treatment for CSCR. However, as this study is the first of its kind to test the effectiveness of eplerenone in the acute setting of CSCR much more high-quality evidence, in the form of larger prospective RCT’s are necessary to better elucidate the effectiveness of eplerenone in acute CSCR treatment.Ciljevi: Receptori za mineralokortikoide (MR) se nalaze u mrežnici i žilnici te se smatra da prenaglašena aktivacija žilničkih krvnih žila ovisna o djelovanju glukokortikoida igra značajnu ulogu u patogenezi CSCRa. Cilj ove studije je bio ispitati učinkovitost eplerenona (Inspra, Pfizer) u liječenju akutnog CSCRa. Materijali i metode: Ovo je bila prospektivna kohortna studija koja se provela na ispitanicima sa akutnom CSCR, a koji su bili liječeni oralnom primjenom eplerenona. Prilikom uključenja u studiju i svih daljnjih kontrolnih pregleda rađena je optička koherentna tomografija te mjerenje visine i dijametra subretinalne tekućine. Primarna mjera ishoda je bila promjena vidne oštrine nakon liječenja eplerenonom. Sekundarne mjere ishoda su bile: dijametar i visina subretinalne tekućine, CV (engl. Cube volume), CAT (engl. Cube average thickness) i CST (engl. Central subfield thickness). Rezultati: U studiju je bilo uključeno 15 očiju od 15 bolesnika sa akutnom CSCR, koji su bili liječeni kroz 28 dana dnevnom dozom od 50 mg eplerenona. Na kraju studije nađen je statistički značajan pad dijametra subretinalne tekućine (P<0,01), visine subretinalne tekućine (P=0,001), CV (P<0,01), CAT (P=0,001), CST (P<0,01) i u odnosu na početne vrijednosti. Potpuno povlačenje SRF je nađeno u 8 od 15 očiju (53,3%), a u daljnjih 5 očiju (33,3%) zabilježeno je značajno poboljšanje, no bez potpunog oporavka nakon terapije. U jednom oku nije zabilježen nikakav efekt terapije i u još jednom oku je bilo zabilježeno pogoršanje nakon liječenja. U usporedbi sa početnom vidnom oštrinom od 0,8 ± 0,1, 28 dana nakon terapije vidna oštrina je iznosila 0,9 ± 0,1 (P=0,001). Zaključak: U usporedbi s prirodnim tijekom bolesti, nakon liječenja akutne CSCR eplerenonom zabilježeno je ubrzano povlačenje subretinalne tekućine, te je također nađena statistički značajna razlika u vidnoj oštrini. Rezultati ove studije se slažu s nalazom prethodnih studija koje kažu da je eplerenon učinkovita terapija za liječenje CSCR. No kako je ovo prva studija koja je ispitivala učinkovitost eplerenona u liječenju akutne forme CSCR, postoji potreba za većom količinom visokovrijednih dokaza dobivenih u randomiziranim kontroliranim studijama kako bi se bolje razjasnila djelotvornost eplerenona u liječenju akutnog CSCR

The LawWorks Law School Pro Bono and Clinic Survey 2014

A survey of UK law schools use of clinical legal education and pro bono services

The Potential of Medical Abortion to Reduce Maternal Mortality in Africa: What Benefits for Tanzania and Ethiopia?

BACKGROUND: Unsafe abortion is estimated to account for 13% of maternal mortality globally. Medical abortion is a safe alternative. METHODS: By estimating mortality risks for unsafe and medical abortion and childbirth for Tanzania and Ethiopia, we modelled changes in maternal mortality that are achievable if unsafe abortion were replaced by medical abortion. We selected Ethiopia and Tanzania because of their high maternal mortality ratios (MMRatios) and contrasting situations regarding health care provision and abortion legislation. We focused on misoprostol-only regimens due to the drug's low cost and accessibility. We included the impact of medical abortion on women who would otherwise choose unsafe abortion and on women with unwanted/mistimed pregnancies who would otherwise carry to term. RESULTS: Thousands of lives could be saved each year in each country by implementing medical abortion using misoprostol (2122 in Tanzania and 2551 in Ethiopia assuming coverage equals family planning services levels: 56% for Tanzania, 31% for Ethiopia). Changes in MMRatios would be less pronounced because the intervention would also affect national birth rates. CONCLUSIONS: This is the first analysis of impact of medical abortion provision which takes into account additional potential users other than those currently using unsafe abortion. Thousands of women's lives could be saved, but this may not be reflected in as substantial changes in MMRatios because of medical abortion's demographic impact. Therefore policy makers must be aware of the inability of some traditional measures of maternal mortality to detect the real benefits offered by such an intervention