Mitigating humanitarian crises during non-international armed conflicts:the role of human rights and ceasefire agreements

Situations of humanitarian crisis are often caused by armed conflicts. Given the prevalence of non-international armed conflicts today, ways of ameliorating these situations are at the forefront of concerns. The international humanitarian law rules governing non-international armed conflict remain much less developed than those for international armed conflicts. This is exacerbated by the lack of direct human rights obligations for non-state armed groups, which makes governing the behaviour of non-state parties to non-international armed conflicts (non-state armed groups) even more challenging. Although several initiatives have been taken to encourage non-state actors to mitigate situations of humanitarian crisis, the role of human rights law is in need of further clarification. The paper aims to assess what role human rights may have in improving humanitarian crises, suggesting one specific way: The paper will first discuss the international laws applicable to situations of non-international armed conflict, before critically analysing some of the initiatives that have already been taken to govern the behaviour of non-state armed groups. Part 3 will assess the possibility of using cease-fire agreements to impose specific human rights obligations on all parties to a non-international armed conflict. Finally, a conclusion will be drawn in Part 4 as to the role that human rights and ceasefire agreements could have during humanitarian crises

Technology policy under changing socioeconomic conditions

In the paper, it is argued that technology is a forceful change agent in society, at the level both of individual firms and of the society at large. At both levels, however, there is a definite need for 'management of change'. In this context, a balanced and integrated technology policy should contain three principal and interrelated elements determining innovative potential, namely technological opportunities, structure of the industrial sector, and size and structure of market demand. This view is illustrated by means of some examples from Japan and Sweden. It is concluded that the industrialized countries require a broader policy framework to accommodate these changes without undue tension.

Consequences of cervical pessary for subsequent pregnancy: follow-up of randomized clinical trial (ProTWIN)

Objective: To evaluate the effect of cervical pessary, as a strategy to prevent preterm birth (PTB), on the outcome of subsequent pregnancy and maternal quality of life 4 years after the index twin pregnancy. Methods: Between 2009 and 2012, the ProTWIN trial randomized women with a multiple pregnancy to pessary use vs standard care for the prevention of PTB. The trial showed no benefit in unselected women with a twin pregnancy, but showed a 60% reduction in poor perinatal outcomes in favor of the pessary group in the subgroup of women with a mid-trimester short cervix (cervical length < 38 mm). All women were invited to participate in a follow-up study 4 years after their participation in the ProTWIN trial. In this follow-up study, maternal quality of life was assessed using the EQ-5D-3L questionnaire and women were asked separate questions about subsequent pregnancies. Results were compared between women who were randomized to the pessary vs the control group in the ProTWIN trial by calculating relative risk (RR) and 95% CI. Subgroup analysis was performed for women with a mid-trimester short cervix (cervical length < 38 mm). Results: Of the 813 women included in the ProTWIN trial, 408 (50.2%) participated in this follow-up study, comprising 228 randomized to the pessary group and 180 to the control group in the original trial. The median interval between participation in the ProTWIN trial and participation in this follow-up study was 4.1 (interquartile range (IQR), 3.9–7.1) years. Ninety-eight (24.0%) participants tried to conceive after their participation in the ProTWIN trial. Of those, 22 (22.4%) women did not have a subsequent pregnancy (no difference between pessary and control groups), seven (7.1%) women had at least one miscarriage but no live birth, and 67 (68.4%) women had at least one live birth (35 in the pessary vs 32 in the control group; RR, 0.93 (95% CI, 0.8–1.07)). In two women, the pregnancy outcome was unknown. Preterm delivery (< 37 weeks of gestation) of the first live birth occurred in three women in the pessary vs one woman in the control group (all singleton; RR, 2.57 (95% CI, 0.28–23.44)). No differences were found between the pessary and control groups in the subgroup of women with mid-trimester short cervix, but the numbers analyzed were small. The median health state index score was 0.95 (IQR, 0.82–0.95), with no difference between the pessary and control groups. Conclusion: Our findings suggest that there are no long-term effects of pessary use on the outcome of subsequent pregnancies and maternal quality of life. Data on obstetric outcome were limited due to the small numbers