Independent Judges and Independent Justice

Sherry discusses how judges have exercised their independence. She provides a brief historical overview of judges using their independence to implement their own view of justice

A Future Legal Coordinated Cadastre for Sweden?

This paper initially presents an introduction to the Swedish land administration system, particularly focusing on the parts of the Real Property Register that compose the cadastre. Here, a brief retrospect of the long tradition of land related registration follows by an account of the current components, functions and parties concerned. The second part of the paper then discusses a vision, expressed by the National Land Survey of Sweden, of implementing a legal coordinated cadastre. In short, that would mean making the boundary point coordinates, mirrored in the digital cadastral map, conclusive evidence of the location of boundaries. The aim of such a cadastre is to make possible more efficient and secure handlings with land within cadastral work, physical planning, infrastructure projects etc. Due to the present hierarchy of evidence, the “monuments before measurements” principle stated in the Land Code, a future reform of that kind would give rise to great challenges in respect of technical, economical and legal aspects. Some of these issues have become subject of a doctoral study at Lund University, Sweden. The aim of the study is to identify and analyse probable consequences of an implementation of a Swedish legal coordinated cadastre. The question of legislation and legal security, both in regard to the public sector and private interests, will be especially emphasised. The last part of this paper breifly presents this ongoing doctoral study

Death Holds No Fear: Overdose Risk Perceptions Among People Who Inject Drugs

Drug overdose is an important public health problem. Despite well-known risk factors and various preventive measures, the overdose mortality rate has increased substantially in several countries worldwide over the past decade. There is therefore a need to understand overdoses on the basis of how people who inject drugs (PWID) perceive and experience risk. Based on qualitative interviews with 80 PWID recruited from low-threshold settings in Norway, this study explores the complex lived experiences and perceptions of overdose. The qualitative approach is sensitive towards lived experiences and provides new understandings of overdoses. The analysis revealed three types of accounts concerning perceived overdose risk. First, interviewees described death as natural and not frightening, based on perceptions of death as universal, a part of their high-risk lifestyle and their previous overdose experiences. Second, they presented accounts of how they perceived others to be at greater risk of overdose than themselves, in respect of experience, skills and tolerance. Finally, interviewees described an indifference towards death, on a continuum between the wish to live and death as relief from various life challenges. This study illustrates how PWID inhabit drug-using environments which entail a high-risk lifestyle. Faced with these risks, the interviewees presented stories which may serve several functions, such as neutralizing feelings of risk and stigma and gaining a sense of agency and control. They also created symbolic boundaries in order to form positive perceptions of self, by distancing themselves from other stereotypical people who use drugs. The participants additionally expressed an indifference towards overdose death. This may entail that avoiding death, the main rationale of overdose interventions, is viewed with indifference by some PWID. This is important for understanding the complexity of overdose mortality and should be reflected in future harm-reduction initiatives

“Sex won’t make him yours, and a baby won’t make him stay” - normer och värderingar i amerikanska kampanjer mot tonårsgraviditeter.

Author: Kristin Karlsson Title: “Sex won't make him yours, and a baby won't make him stay” A study of norms and values in campaigns to prevent teenage pregnancy Supervisor: Maria Bangura Arvidsson The aim of this study was to examine what kind of norms and values programs to prevent teen pregnancy communicate to teenage girls regarding giving birth, sex, contraceptives, abortion and gender. The study was based on document analysis of homepages to two different kinds of programs to prevent teen pregnancy; It’s great to wait and Stay teen. It’s great to wait is an abstinence-only program while Stay teen is a comprehensive program. The analysis was made from a feministic perspective. On It’s great to wait’s homepage there was a clear message that teenagers should abstain from all kind of sexual activity until they get married and that sexual activity outside marriage is likely to have harmful psychological and physiological effects. On Stay teen’s homepage there was a message that teenagers have to make their own choice to either abstain from sex or be sexual active. At the same time abstinence was presented as the best of these choices, by focusing on the disadvantages of having sex and the advantages of abstaining. Both homepages communicated that giving birth as a teenage girl cause a lot of problem for the girl herself, her child and the society. While It’s great to wait portrayed the teenage mother as a victim that has to struggle trough life, Stay teen portrayed her as a “bad mother” who couldn’t take good care of her child. Keywords: Teenage pregnancy, United States, abstinence-only program, gende

Stereotactic body radiation therapy of lung tumours : clinical and dosimetric aspects

The general aim of this thesis was to increase the knowledge regarding some clinical and methodological aspects, relevant in view of toxicity as well as tumour control, in stereotactic body radiation therapy (SBRT) of lung tumours. In the first two studies, reirradiation and radiation-induced atelectasis were studied. In the following two studies, estimations of doses delivered to the tumour, considering geometrical uncertainties, were performed. Considering the very high biological tumour doses delivered in SBRT, knowledge of the risk of high grade toxicity is of utmost importance for its clinical use. In the first study, reirradiation with SBRT of lung tumours after previous SBRT in the same region was retrospectively evaluated in 29 patients with 32 tumours with regard to toxicity, local control and survival. Larger tumour volumes and central location were correlated to more severe toxicity, and larger tumour volumes were also correlated to worse local control. Three of the patients with centrally located lung tumours died due to bleeding, while no grade-5 toxicity was observed for patients with peripherally located tumours. The one- and three-year survival from time of reirradiation was estimated to 59% and 23%, respectively. It was concluded that reirradiation with SBRT in a location previously treated with SBRT was feasible with low rates of toxicity for patient with peripheral lung tumours, while caution should be taken for patients with central lung tumours due to the risk of increased severe toxicity. In the second study a possible dose-response relationship for radiation-induced atelectasis and bronchial doses after SBRT close to the main, lobar or segmental bronchi was evaluated. Out of the 74 patients, 18 (24%) developed radiation-induced atelectasis at a median time of 8 month after radiotherapy. A significant dose-response relationship was found between the high-dose bronchial volume and the incidence of atelectasis. The median of the minimum dose to 0.1 cm3 of the bronchi receiving the highest dose (D0.1cm3) was 210 Gy3 (EQD2, using α/β=3 Gy) for patients with atelectasis, and 105 Gy3 for patients without. The estimated incidence of atelectasis at 1, 2 and 3 years was 3%, 8% and 13%, respectively, at a bronchial D0.1cm3 of 100 Gy3, 10%, 21% and 31% at 150 Gy3, and 25%, 42% and 53%, respectively, at a dose of 200 Gy3. Of decisive importance for the clinical use of SBRT is the balance between the risk of toxicity and the gain expected by control of the treated tumour. As a surrogate, to quantitatively foresee the latter, dose to the tumour is used. As planned and delivered dose may differ more in SBRT as compared to conventional radiotherapy, knowledge of delivered dose is highly important for SBRT. Study three and four were focused on the issue of delivered tumour dose in SBRT. Study three aimed to evaluate the accuracy of a dose-shift approximation used for estimating delivered clinical target volume (CTV) doses, given the geometrical uncertainties pertinent to SBRT. For a set of 10 representative patients with lung tumours, the static dose matrix was shifted according to clinically representative setup errors and a breathing trace scaled with different breathing amplitudes. The dose-shift approximation was compared to the more accurate beam-shift method with recalculation of dose at every geometrical position. Averaged over the patients, the disagreement between the methods for minimum CTV dose (D98%) was approximately 4% (root-mean-square) for setup shifts up to 10 mm, and for setup shifts up to 5 mm the disagreement was approximately 2%. It was concluded that for estimation of delivered dose for a particular patient it is advisable to use the beam-shift method for increased accuracy, while averaged over a group of patients the dose-shift approximation has an acceptable error. In study four, the delivered CTV dose was estimated for a cohort of patients treated with SBRT, taking clinical data of breathing motions and setup errors into account. Two different volumetric soft-tissue image-guidance techniques were compared; pre-treatment verification computed tomography (CT) (IG1) and online verification with cone-beam CT (CBCT) (IG2). Treatment plans for 50 consecutively treated patients, with 69 lung tumours, were retrospectively simulated. The dose-shift approximation was used with the static dose distribution shifted according to a breathing trace scaled with patient-specific amplitudes. Applied were also systematic and random setup errors (for IG1) and matching errors (for IG2), sampled from normal distributions. Each simulation was repeated 500 times for each tumour. For each tumour, 500 different dose-volume histograms were obtained, and from those a tumour-specific dose coverage histogram was calculated. For all tumours, a population-averaged dose coverage histogram was calculated as the mean of the tumourspecific dose coverage histograms. The result showed that prescribed dose, to the periphery of the planning target volume, was delivered to 98% of the CTV with a population coverage probability within 86-96% (range between worst and best case setup assumptions, realistic assumptions: 90%) using IG1, and 97-99% (realistic assumptions: 99%) using IG2. Looking at 90% of the simulations with highest dose to 98% of the CTV (tumour coverage probability), at least the prescribed dose was delivered to 67% of the tumours with IG1 using realistic assumptions of setup errors, and to 99% of the tumours with IG2. In conclusion, the minimum dose delivered to the CTV increased with the use of online CBCT image-guidance, compared to the pre-treatment verification CT

Green Public Procurement for Accelerating the Transition towards Sustainable Freight Transport

Requests for emission reduction in the freight transport sector will be more intense in the coming years. One possible strategy to reduce emissions from freight transport is through utilising zero emission vehicles, which requires substantial investments both by transporters and by authorities. This paper examines how green public procurement (GPP) can be used to push the market in an environmentally sustainable direction. For this purpose, interviews with both public authorities and freight service providers are conducted. The results show that GPP is considered a useful tool for public authorities to both boost the uptake of zero emission vehicles and to share the investment costs with freight service providers. However, our study shows that there are differences between small and large municipalities. Moreover, to succeed with GPP, public authorities must prioritise such tasks in their daily routines through political decisions and strategies. Additionally, barriers related to financial possibilities are crucial to handle, as public support schemes are important to reduce costs for all involved stakeholders. Altogether, our paper shows that with the right tools and willingness among both public and private stakeholders, GPP can contribute to the use of more environmentally friendly solutions in the freight transport sector.publishedVersio