Analysing the justice needs of Rwandan female victim-survivors of conflict-related sexual violence and their experiences with the gacaca courts

Judith Rafferty analysed the justice needs of Rwandan women who were raped during the 1994 genocide. She found that the women had multiple justice needs and many, but not all, were addressed by Rwandan community courts. Her findings can help design justice processes that consider the needs of rape survivors

Enhancing the student experience through the creation and use of authentic and accessible conflict scenarios

Authentic conflict scenarios are an essential basis for learning activities and assessment tasks in the conflict management and resolution field. Authentic scenarios allow students to apply theories and skills to realistic situations, enhancing their learning experiences and workforce readiness. However, finding suitable conflict scenarios for use in teaching and learning is challenging due to a) Confidentiality: limiting the types of conflicts that can be used; b) Evolving resources: conflicts already in the public eye are often complex and continue to evolve which requires a great deal of effort by educators to update content, restricts the diversity of resources available, and makes it difficult to impartially present all aspects of a conflict in an engaging way; and c) Lack of engaging resources: fictitious scenarios are often presented in written text only, failing to provide interactive and engaging resources. In 2016, the James Cook University (JCU) Conflict Management and Resolution (CMR) Program, with the support of a Student Services and Amenities Fee (SSAF) grant, created an authentic and digitally accessible conflict scenario designed to address these challenges and deliver improved learning experiences for postgraduate conflict management and resolution students and educators. This article discusses the value of authentic scenarios to improve postgraduate student experiences and career outcomes in the dispute resolution field, the approach taken by the JCU CMR Program to develop the scenario and presents findings from preliminary feedback from students' and educators' experience using the conflict scenario in postgraduate course work

Phenological overlap of interacting species in a changing climate: an assessment of available approaches

Abstract Concern regarding the biological effects of climate change has led to a recent surge in research to understand the consequences of phenological change for species interactions. This rapidly expanding research program is centered on three lines of inquiry: (1) how the phenological overlap of interacting species is changing, (2) why the phenological overlap of interacting species is changing, and (3) how the phenological overlap of interacting species will change under future climate scenarios. We synthesize the widely disparate approaches currently being used to investigate these questions: (1) interpretation of longterm phenological data, (2) field observations, (3) experimental manipulations, (4) simulations and nonmechanistic models, and (5) mechanistic models. We present a conceptual framework for selecting approaches that are best matched to the question of interest. We weigh the merits and limitations of each approach, survey the recent literature from diverse systems to quantify their use, and characterize the types of interactions being studied by each of them. We highlight the value of combining approaches and the importance of longterm data for establishing a baseline of phenological synchrony. Future work that scales up from pairwise species interactions to communities and ecosystems, emphasizing the use of predictive approaches, will be particularly valuable for reaching a broader understanding of the complex effects of climate change on the phenological overlap of interacting species. It will also be important to study a broader range of interactions: to date, most of the research on climateinduced phenological shifts has focused on terrestrial pairwise resourceconsumer interactions, especially those between plants and insects

Reduced ovarian reserve relates to monocyte activation and subclinical coronary atherosclerotic plaque in women with HIV

Objective: To investigate differences in subclinical coronary atherosclerotic plaque and markers of immune activation among HIV-infected and non-HIV-infected women categorized by degree of ovarian reserve and menopause status. Design: Cross-sectional evaluation. Methods: Seventy-four women (49 HIV-infected, 25 non-HIV-infected) without known cardiovascular disease (CVD) were classified as premenopausal, premenopausal with reduced ovarian reserve, or postmenopausal based on menstrual history and anti-Mü llerian hormone (AMH) levels. Participants underwent contrast-enhanced coronary computed tomography angiography and immune phenotyping. Comparisons in coronary atherosclerotic plaque burden and immune markers were made between the HIV-infected and non-HIV-infected women overall and within the HIV-infected and non-HIV-infected women by reproductive classification group. Results: Among the overall group of HIV-infected women, the women with reduced ovarian reserve (undetectable AMH) had a higher prevalence of coronary atherosclerotic plaque (52 versus 6%, P ¼ 0.0007) and noncalcified plaque (48 versus 6%, P ¼ 0.002), as well as higher levels of log sCD163 (P ¼ 0.0004) and log MCP-1 (P ¼ 0.006), compared with the premenopausal women with measurable AMH. Furthermore, reduced ovarian reserve in the HIV-infected group related to noncalcified plaque, controlling for traditional CVD risk factors (P ¼ 0.04) and sCD163 (P ¼ 0.03). Conclusion: HIV-infected women with reduced ovarian reserve have increased subclinical coronary atherosclerotic plaque compared with premenopausal women in whom AMH is measurable. This relationship holds when controlling for CVD risk factors (including age) and immune activation. Our findings demonstrate that reduced ovarian reserve may contribute to CVD burden in HIV-infected women and support a comprehensive assessment of CVD risk prior to completion of menopause in this population

Executive Summary:International Clinical Practice Guidelines for Pediatric Ventilator Liberation, A Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network Document

Rationale: Pediatric-specific ventilator liberation guidelines are lacking despite the many studies exploring elements of extubation readiness testing. The lack of clinical practice guidelines has led to significant and unnecessary variation in methods used to assess pediatric patients’ readiness for extubation. Methods: Twenty-six international experts comprised a multiprofessional panel to establish pediatrics-specific ventilator liberation clinical practice guidelines, focusing on acutely hospitalized children receiving invasive mechanical ventilation for more than 24 hours. Eleven key questions were identified and first prioritized using the Modified Convergence of Opinion on Recommendations and Evidence. A systematic review was conducted for questions that did not meet an a priori threshold of &gt;80% agreement, with Grading of Recommendations, Assessment, Development, and Evaluation methodologies applied to develop the guidelines. The panel evaluated the evidence and drafted and voted on the recommendations. Measurements and Main Results: Three questions related to systematic screening using an extubation readiness testing bundle and a spontaneous breathing trial as part of the bundle met Modified Convergence of Opinion on Recommendations criteria of &gt;80% agreement. For the remaining eight questions, five systematic reviews yielded 12 recommendations related to the methods and duration of spontaneous breathing trials, measures of respiratory muscle strength, assessment of risk of postextubation upper airway obstruction and its prevention, use of postextubation noninvasive respiratory support, and sedation. Most recommendations were conditional and based on low to very low certainty of evidence. Conclusions: This clinical practice guideline provides a conceptual framework with evidence-based recommendations for best practices related to pediatric ventilator liberation.</p

Executive Summary: International Clinical Practice Guidelines for Pediatric Ventilator Liberation, A PALISI Network Document

RATIONALE: Pediatric specific ventilator liberation guidelines are lacking despite the many studies exploring elements of extubation readiness testing. The lack of clinical practice guidelines has led to significant and unnecessary variation in methods used to assess pediatric patients' readiness for extubation. METHODS: Twenty-six international experts comprised a multi-professional panel to establish pediatric specific ventilator liberation clinical practice guidelines, focusing on acutely hospitalized children receiving invasive mechanical ventilation for more than 24 hours. Eleven key questions were identified and first prioritized using the Modified Convergence of Opinion on Recommendations and Evidence. Systematic review was conducted for questions which did not meet an a-priori threshold of ≥80% agreement, with Grading of Recommendations, Assessment, Development, and Evaluation methodologies applied to develop the guidelines. The panel evaluated the evidence, drafted, and voted on the recommendations. MEASUREMENTS AND MAIN RESULTS: Three questions related to systematic screening, using an extubation readiness testing bundle and use of a spontaneous breathing trial as part of the bundle met Modified Convergence of Opinion on Recommendations criteria of ≥80% agreement. For the remaining 8 questions, 5 systematic reviews yielded 12 recommendations related to the methods and duration of spontaneous breathing trials; measures of respiratory muscle strength; assessment of risk of post-extubation upper airway obstruction and its prevention; use of post-extubation non-invasive respiratory support; and sedation. Most recommendations were conditional and based on low to very low certainty of evidence. CONCLUSION: This clinical practice guideline provides a conceptual framework with evidence-based recommendations for best practices related to pediatric ventilator liberation.The project was funded by Eunice Kennedy Shriver National Institute of Child Health (NICHD) and Human Development National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH) (R13HD102137), in addition to funds from department of pediatrics at Indiana University School of Medicine, Indianapolis, Indiana

Operational Definitions related to Pediatric Ventilator Liberation

BACKGROUND: Common, operational definitions are crucial to assess interventions and outcomes related to pediatric mechanical ventilation. These definitions can reduce unnecessary variability amongst research and quality improvement efforts, to ensure findings are generalizable and can be pooled to establish best practices. RESEARCH QUESTION: Can we establish operational definitions for key elements related to pediatric ventilator liberation using a combination of detailed literature review and consensus-based approaches? STUDY DESIGN AND METHODS: A panel of 26 international experts in pediatric ventilator liberation, two methodologists and two librarians conducted systematic reviews on eight topic areas related to pediatric ventilator liberation. Through a series of virtual meetings, we established draft definitions which were voted upon using an anonymous web-based process. Definitions were revised by incorporating extracted data gathered during the systematic review and discussed in another consensus meeting. A second round of voting was conducted to confirm the final definitions. RESULTS: In eight topic areas identified by the experts, 16 preliminary definitions were established. Based on initial discussion and the first round of voting, modifications were suggested for 11 of the 16 definitions. There was significant variability in how these items were defined in the literature reviewed. The final round of voting achieved ≥80% agreement for all 16 definitions in the following areas: what constitutes respiratory support (invasive mechanical ventilation and non-invasive respiratory support), liberation and failed attempts to liberate from invasive mechanical ventilation, liberation from respiratory support, duration of non-invasive respiratory support, total duration of invasive mechanical ventilation, spontaneous breathing trials, extubation readiness testing, 28-ventilator free days, and planned vs rescue use of post-extubation non-invasive respiratory support. INTERPRETATION: We propose these consensus-based definitions for elements of pediatric ventilator liberation, informed by evidence, be used for future quality improvement initiatives and research studies to improve generalizability, and facilitate comparison.The project was funded by Eunice Kennedy Shriver National Institute of Child Health (NICHD) and Human Development National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH) (R13HD102137), in addition to funds from the Department of Pediatrics at Indiana University School of Medicine, Indianapolis, Indiana

“I did not want to look him in the eyes”– Analysing Process-related Justice Needs of Rwandan Victim-survivors of Genocidal Sexual Violence and their Experiences with the Gacaca Courts

This presentation discusses the findings of research that investigates the needs of female victim-survivors of conflict-related sexual violence and explores their experiences with transitional justice processes. The research focuses on the needs and experiences of Rwandan female victim-survivors who suffered sexual violence during the genocide against the Tutsi in 1994 and who raised their case at one of Rwanda’s local gacaca courts. The gacaca court system was established in 2001 by the Rwandan government to deal with genocide-related crimes with the intent to reveal the truth, end the ‘culture of impunity’ and promote both justice and reconciliation. The research was informed by phenomenological and feminist methodologies, utilised a qualitative approach and is based on semi-structured interviews with 23 Rwandan victim-survivors, conducted by the presenter in 2015/2016 with the assistance of a Kinyarwanda speaker. The interviews focused on investigating the women’s motivations to participate in gacaca and their experiences with the process. The analysis of the interviews revealed a comprehensive set of justice needs of the interviewees, which are distinguished as process-related and outcome-related justice needs. This presentation will focus on the interviewees’ process-related justice needs, which include “an enabling environment” (comprising both supportive procedures and supportive treatment by authorities involved in a justice process), opportunities for participation, as well as information and support regarding their cases. The research findings allow for the identification of several characteristics and procedures of justice initiatives to support victim-survivors to participate in justice processes in other settings. This presentation will discuss the interviewees’ process-related justice needs, how these were considered at the gacaca courts, as well as implications of the research for the design of future justice processes

"I Wanted Them to Be Punished or at Least Ask Us for Forgiveness”: Justice Interests of Female Victim-Survivors of Conflict-Related Sexual Violence and Their Experiences with Gacaca

Survivors of human rights abuses need to experience a sense of justice to support their individual recovery. Women who have experienced conflict-related sexual violence have specific justice interests that are distinct from those of survivors of other abuses. This article focuses on justice interests of Rwandan women who experienced sexual violence during the genocide in Rwanda and who had their cases tried in gacaca community courts between 2008 and 2012. The article discusses two justice interests that emerged during interviews with 23 Rwandan women about their gacaca experience. These interests include the punishment of perpetrators and perpetrators taking responsibility for their actions and the harm caused. Punishment was important to most women for several reasons, including retribution, safety, validation and vindication. Perpetrators taking responsibility by confessing, apologizing or asking for forgiveness was also important to many women and appeared to be an alternative way of experiencing validation and vindication