Current developments: Public international law I. Conflicts of criminal jurisdiction

The expansion of claims of extended territorial and extraterritorial criminal legislative jurisdiction and the increasing facility with which States are able to obtain custody over defendants by way of more effective extradition arrangements is leading to a new problem in transnational criminal law. The result of these developments is that more than one State may have legitimate jurisdiction to legislate for the same conduct and the courts of more than one State may be entitled to exercise judicial jurisdiction over those persons charged with crimes arising from that conduct. For prosecutors, the problem may present itself as one of prosecutorial efficiency—how may the case be proceeded with expeditiously, in particular, in which jurisdiction is a conviction most likely to be secured? Considerations such as the availability of witnesses or the admissibility of evidence may influence the prospects of conviction and prospective punishments may be a factor when deciding in which system prosecutors prefer the case to go ahead. Defendants have different perspectives. In many cases involving extradition to face a charge based on an exercise of extended jurisdiction, the defendant will be removed from the place where he lives and works to another State. There may be adverse consequences for him compared to facing a trial where he is usually located. Criminal proceedings abroad will be in an unfamiliar legal system; bail may be harder to obtain because of a perceived greater danger of flight; the impossibility to continue working during the period in which the trial is being prepared may impose financial hardship; defendants will be removed from their families and social networks for considerable periods

No Californian Left Behind: Clean and Affordable Transportation Options for All Through Vehicle Replacement

As California focuses in on new, high-tech, best-in-class transportation strategies, it risks leaving behind an important subset of households and communities who could most benefit from the transition to a cleaner, cheaper, and more sustainable transportation future. Hundreds of thousands of low-income Californians, particularly those in rural parts of the state, live with some of the worst air pollution in the U.S. They also often drive relatively old, inefficient, unsafe, and highly polluting vehicles, and struggle to cover the costs of their basic transportation needs. For these Californians, getting into a relatively more efficient vehicle is more realistic than getting into a new electric vehicle, which is expensive, or onto public transit, which is often ineffective in serving rural and non-urban households.The state has recognized this problem and attempted to address it by focusing on vehicle repair and retirement programs. However, by merely repairing and retiring vehicles and not replacing them with cleaner, more efficient ones, existing programs do not maximize long-term air benefits or lessen the financial burden these inefficient vehicles currently place on low-income Californians. To help address this issue, Senate Bill 459, signed by Governor Brown in September 2013, directs the California Air Resources Board (ARB) to rewrite the guidelines of California's Enhanced Fleet Modernization Program (EFMP). This program has been in place since 2010, and is designed to allow residents who own the highest-emitting vehicles in the state to retire and/or replace them.In this report, we discuss the contribution made by these highly polluting vehicles to the state's air quality problems; we also discuss the serious drag that driving these vehicles can have on household budgets. After outlining these problems, we discuss the state's current policies aimed at promoting vehicle retirement and replacement and offer some recommendations for improving those programs.California is already a leader in advanced and high-tech transportation and transit solutions. It is time we also became a leader in pragmatic solutions for a population that is sometimes left behind in these discussions: non-urban, low-income, car-dependent households. Bringing solutions to these communities will have a huge impact on our current air quality and family budgets; it will also widen the circle of Californians who play an active part in moving this state toward a cleaner, less oil-dependent future

Let’s stop feeding the risk monster: towards a social model of ‘child protection’

This article explores how the child protection system currently operates in England. It analyses how policy and practice has developed, and articulates the need for an alternative approach. It draws from the social model as applied in the fields of disability and mental health, to begin to sketch out more hopeful and progressive possibilities for children, families and communities. The social model specifically draws attention to the economic, environmental and cultural barriers faced by people with differing levels of (dis)ability, but has not been used to think about ‘child protection’, an area of work in England that is dominated by a focus on risk and risk aversion. This area has paid limited attention to the barriers to ensuring children and young people are cared for safely within families and communities, and the social determinants of much of the harms they experience have not been recognised because of the focus on individualised risk factors

Integrating self-management support for knee injuries into routine clinical practice: TRAK intervention design and delivery

Background TRAK is a web-based intervention that provides knee patients with health information, personalised exercise plans and remote clinical support. The aim of this study was to fully define TRAK intervention content, setting and context and develop the training through an implementation study in a physiotherapy out-patient service. Methods A mixed methods study. Phase 1 was a qualitative interview study, whereby fifteen physiotherapists used TRAK for 1 month with a patient of their choice. Interviews explored patient and physiotherapist views of TRAK intervention and training requirements. In Phase 2 seventy-four patients were recruited, all received conventional physiotherapy, a subset of 48 patients used TRAK in addition to conventional Physiotherapy. Aspects of feasibility measured included: uptake and usage of TRAK. Results Patients and physiotherapists reported that TRAK was easy to use and highlighted the therapeutic benefit of the exercise videos and personalised exercise plans to remind them of their exercises and the correct technique. Patients reported needing to use TRAK with the guidance of their treating physiotherapist initially. Physiotherapists highlighted appointment time constraints and lack of familiarity with TRAK as factors limiting engagement. In Phase 2, 67% patients accessed TRAK outside of the clinical environment. A total of 91% of patients were given a personalised exercise plan, but these were only updated in 34% of cases. Conclusion A comprehensive training package for patients and clinicians has been defined. The refined TRAK intervention is reported using the ‘Template for Intervention Description and Replication in preparation for a definitive randomised control trial

Exploring the socioethical dilemmas in the use of a global health archive

A global health archive consisting of podoconiosis tissue slides and blocks (which was collected and imported into the UK before the introduction of the Human Tissue Act), was donated to Brighton & Sussex Medical School in 2014. There is little guidance on the socioethical and legal issues surrounding the retrospective use of archived or ‘abandoned’ tissue samples, which poses a number of questions relating to the ethical standing of the archive. There is a great deal of interpretation in the guidelines that are currently in existence, however modern ethical principles cannot be applied as it is not feasible to either reconsent or retrospectively seek approval. Our research team believed that it was unethical to leave the archive in storage, as this option favours neither researcher nor subjects. Permission was obtained from the Human Tissue Authority and a local ethics board for the tissues to be utilised in on-going research on podoconiosis aetiology. There is a delicate balance between the benefits gained by society relating to the development and progress of scientific research and the risks to the donor regarding the reuse of their tissues. Clearer guidelines should be made available to ensure that researchers are able to re-use tissue archives in contemporary research

Promoting independence, health and well-being for older people: a feasibility study of computer-aided health and social risk appraisal system in primary care

Background - With population ageing, research is needed into new low-cost, scalable methods of effective promotion of health and wellbeing for older people. We aimed to assess feasibility, reach and costs of implementing a new tailored computer-aided health and social risk appraisal system in primary care. Methods - Design: Feasibility study. Setting: Five General Practices in London (Ealing) and Hertfordshire, United Kingdom (UK) Participants: Random sample of patients aged 65 + years. Intervention: The Multi-dimensional Risk Appraisal for Older people (MRA-O) system includes: 1) Postal questionnaire including health, lifestyle, social and environmental domains; 2) Software system generating a personalised feedback report with advice on health and wellbeing; 3) Follow-up of people with new concerning or complex needs by GPs or practice nurses. Evaluation: Feasibility of implementation; participant wellbeing, functional ability and quality of life; social needs, health risks, potential lifestyle changes; and costs of implementation. Results - Response rates to initial postal invitations were low (526/1550, 34%). Of these, 454/526 (86%) completed MRA-O assessments. Compared to local UK Census data on older people, participants were younger, more were owner-occupiers and fewer were from ethnic minority groups than expected. A range of problems was identified by participants, including pain in last week (269/438, 61.4%), low physical activity (173/453, 38.2%), sedentary lifestyle (174/447, 38.3%), falls (117/439, 26.7%), incontinence (111/441 25.2%), impaired vision 116/451 (25.7%), impaired hearing (145/431, 33.6%), depressed mood (71/451, 15.7%), impaired memory (44/444 9.9%), social isolation (46/449, 10.2%) and loneliness (31/442, 7.0%). Self-rated health was good/excellent in 312/437 (71.4%), and quality of life and well-being were slightly above age-specific population norms. Implementation costs were low. Practices reviewed medical records of 143/454 (31.5%) of participants as a consequence of their responses, and actively followed up 110/454 (24.2%) of their patients. Conclusions - A computer-aided risk appraisal system was feasible for General Practices to implement, yields useful information about health and social problems, and identifies individual needs. Participation rates were however low, particularly for the oldest old, the poorest, and ethnic minority groups, and this type of intervention may increase inequalities in access. Widespread implementation of this approach would require work to address potential inequalities

Neuroblastoma arginase activity creates an immunosuppressive microenvironment that impairs autologous and engineered immunity

Neuroblastoma is the most common extra cranial solid tumour of childhood, and survival remains poor for patients with advanced disease. Novel immune therapies are currently in development, but clinical outcomes have not matched preclinical results. Here, we describe key mechanisms in which neuroblastoma inhibits the immune response. We show that murine and human neuroblastoma tumour cells suppress T cell proliferation, through increased arginase activity. Arginase II is the predominant isoform expressed and creates an arginine deplete local and systemic microenvironment. Neuroblastoma arginase activity results in inhibition of myeloid cell activation and suppression of bone marrow CD34+ progenitor proliferation. Finally we demonstrate that the arginase activity of neuroblastoma impairs NY-ESO-1 specific TCR and GD2-specific CAR engineered T cell proliferation and cytotoxicity. High arginase II expression correlates with poor survival for neuroblastoma patients. The results support the hypothesis that neuroblastoma creates an arginase-dependent immunosuppressive microenvironment in both the tumour and blood that leads to impaired immune surveillance and sub-optimal efficacy of immunotherapeutic approaches

Temporary Spaces: Leveraging ArchivesSpace Container Management Functionality to Develop New Circulation Workflows

Presentation demonstrates how archivists at James Madison University are leveraging ArchivesSpace container management and location functionality to support emerging workflows for the storage and transport of collections among temporary storage and access spaces during a recently begun three year renovation and expansion project of JMU\u27s Carrier Library