Introducing a gender-sensitive approach to pre-trial assessment and probation: Evaluation of an innovation in Kenya

This paper evaluates a pioneering project to introduce a gender-sensitive approach to working with women completing probation and community service orders in Kenya. The intervention consisted of context-specific research with women throughout Kenya, leading to adaptations to existing probation tools, followed by pilot implementation of a gender-sensitive approach. The evaluation explores the relevance, effectiveness and sustainability of the intervention and presents opinions of implementing probation officers and sector experts. Findings suggest that the project genuinely broke new ground in terms of research on gender-sensitivity and quality of pre-trial reporting for women. Close adherence to the UN Bangkok Rules means the model and lessons are applicable both domestically and globally

Disruptive approaches for subtitling in immersive environments

The Immersive Accessibility Project (ImAc) explores how accessibility services can be integrated with 360o video as well as new methods for enabling universal access to immersive content. ImAc is focused on inclusivity and addresses the needs of all users, including those with sensory or learning disabilities, of all ages and considers language and user preferences. The project focuses on moving away from the constraints of existing technologies and explores new methods for creating a personal experience for each consumer. It is not good enough to simply retrofit subtitles into immersive content: this paper attempts to disrupt the industry with new and often controversial methods. This paper provides an overview of the ImAc project and proposes guiding methods for subtitling in immersive environments. We discuss the current state-of-the-art for subtitling in immersive environments and the rendering of subtitles in the user interface within the ImAc project. We then discuss new experimental rendering modes that have been implemented including a responsive subtitle approach, which dynamically re-blocks subtitles to fit the available space and explore alternative rendering techniques where the subtitles are attached to the scene

Public health emergencies: a new peacekeeping mission? Insights from UNMIL’s role in the Liberia Ebola outbreak

The UN Security Council meeting on 18 September 2014 represented a major turning-point in the international response to the Ebola outbreak then underway in West Africa. However, in the light of widespread criticism over the tardiness of the international response, it can be argued that the UN, and particularly the Security Council, failed to make best use of a potential resource it already had on the ground in Liberia: the United Nations Mission in Liberia (UNMIL). This article examines whether UNMIL could have done more to contribute to the emergency response and attempts to draw some lessons from this experience for potential peacekeeper involvement in future public health emergencies. UNMIL could have done more than it did within the terms of its mandate, although it may well have been hampered by factors such as its own capacities, the views of Troop Contributing Countries and the approach taken by the Liberian government. This case can inform broader discussions over the provision of medical and other forms of humanitarian assistance by peacekeeping missions, such as the danger of politicising humanitarian aid and peacekeepers doing more harm than good. Finally, we warn that a reliance on peacekeepers to deliver health services during ‘normal’ times could foster a dangerous culture of dependency, hampering emergency responses if the need arises

Using smart pumps to help deliver universal access to safe and affordable drinking water

It is estimated that broken water pumps impact 62 million people in sub-Saharan Africa. Over the last 20 years, broken handpumps have represented US$1·2–1·5 billion of lost investment in this region, with 30–40% of rural water systems failing prematurely. While the contributory factors are complex and multi-faceted, the authors consider that improved post-construction monitoring strategies for remote water projects, which rely on smart pumps to monitor operational performance in place of physical site visits, may address some of these problems and help reduce the heavy time and resource demands on stakeholders associated with traditional monitoring strategies. As such, smart pumps could play a significant role in improving project monitoring and might subsequently help deliver universal access to safe and affordable drinking water by 2030, which constitutes one of the key targets of United Nations sustainable development goal 6 and is embedded in some national constitutions

High stakes and low bars: How international recognition shapes the conduct of civil wars

When rebel groups engage incumbent governments in war for control of the state, questions of international recognition arise. International recognition determines which combatants can draw on state assets, receive overt military aid, and borrow as sovereigns—all of which can have profound consequences for the military balance during civil war. How do third-party states and international organizations determine whom to treat as a state's official government during civil war? Data from the sixty-one center-seeking wars initiated from 1945 to 2014 indicate that military victory is not a prerequisite for recognition. Instead, states generally rely on a simple test: control of the capital city. Seizing the capital does not foreshadow military victory. Civil wars often continue for many years after rebels take control and receive recognition. While geopolitical and economic motives outweigh the capital control test in a small number of important cases, combatants appear to anticipate that holding the capital will be sufficient for recognition. This expectation generates perverse incentives. In effect, the international community rewards combatants for capturing or holding, by any means necessary, an area with high concentrations of critical infrastructure and civilians. In the majority of cases where rebels contest the capital, more than half of its infrastructure is damaged or the majority of civilians are displaced (or both), likely fueling long-term state weakness

Rereading the Universal Declaration of Human Rights: plurality and contestation, not consensus

In this paper I examine the drafting of the Universal Declaration of Human Rights. My analysis counters conventional narratives of consensus and imposition that characterize the development of the UN human rights regime. The central argument is that within the founding text of the contemporary human rights movement there is an ambiguous account of rights, which exceeds easy categorization of international rights as universal moral principles or merely an ideological imposition by liberal powers. Acknowledging this ambiguous history, I argue, opens the way to an understanding of human rights as an ongoing politics, a contestation over the terms of legitimate political authority and the meaning of “humanity” as a political identity

Holding and restraining children for clinical procedures within an acute care setting: an ethical consideration of the evidence

This critical reflection on the ethical concerns of current practice is underpinned by a systematic synthesis of current evidence focusing on why and how children are held or restrained for clinical procedures within acute care and the experiences of those present when a child is held against their wishes. Empirical evidence from a range of clinical settings internationally demonstrates that frequently children are held for procedures to be completed; younger children and those requiring procedures perceived as urgent are more likely to be held. Parents and health professionals express how holding children for procedures can cause feelings of moral distress expressed as uncertainty, guilt and upset and that this act breaches the trusting and protective relationship established with children. Despite this, children’s rights and alternatives to holding are not always respected or explored. Children’s experiences and perceptions are absent from current literature. Children and young people have a moral right to have their voice and protests heard and respected and for these to inform judgements of their best interests and the actions of health professionals. Without robust evidence, debate and recognition that children are frequently held against their wishes in clinical practice for procedures which may not be urgent, children’s rights will continue to be compromised

PrEP as a feature in the optimal landscape of combination HIV prevention in sub-Saharan Africa

INTRODUCTION: The new WHO guidelines recommend offering pre-exposure prophylaxis (PrEP) to people who are at substantial risk of HIV infection. However, where PrEP should be prioritised, and for which population groups, remains an open question. The HIV landscape in sub-Saharan Africa features limited prevention resources, multiple options for achieving cost saving, and epidemic heterogeneity. This paper examines what role PrEP should play in optimal prevention in this complex and dynamic landscape. METHODS: We use a model that was previously developed to capture subnational HIV transmission in sub-Saharan Africa. With this model, we can consider how prevention funds could be distributed across and within countries throughout sub-Saharan Africa to enable optimal HIV prevention (that is, avert the greatest number of infections for the lowest cost). Here, we focus on PrEP to elucidate where, and to whom, it would optimally be offered in portfolios of interventions (alongside voluntary medical male circumcision, treatment as prevention, and behaviour change communication). Over a range of continental expenditure levels, we use our model to explore prevention patterns that incorporate PrEP, exclude PrEP, or implement PrEP according to a fixed incidence threshold. RESULTS: At low-to-moderate levels of total prevention expenditure, we find that the optimal intervention portfolios would include PrEP in only a few regions and primarily for female sex workers (FSW). Prioritisation of PrEP would expand with increasing total expenditure, such that the optimal prevention portfolios would offer PrEP in more subnational regions and increasingly for men who have sex with men (MSM) and the lower incidence general population. The marginal benefit of including PrEP among the available interventions increases with overall expenditure by up to 14% (relative to excluding PrEP). The minimum baseline incidence for the optimal offer of PrEP declines for all population groups as expenditure increases. We find that using a fixed incidence benchmark to guide PrEP decisions would incur considerable losses in impact (up to 7%) compared with an approach that uses PrEP more flexibly in light of prevailing budget conditions. CONCLUSIONS: Our findings suggest that, for an optimal distribution of prevention resources, choices of whether to implement PrEP in subnational regions should depend on the scope for impact of other possible interventions, local incidence in population groups, and total resources available. If prevention funding were to become restricted in the future, it may be suboptimal to use PrEP according to a fixed incidence benchmark, and other prevention modalities may be more cost-effective. In contrast, expansions in funding could permit PrEP to be used to its full potential in epidemiologically driven prevention portfolios and thereby enable a more cost-effective HIV response across Africa