•We developed two models for assessing physical torture.•The two models – a semi-quantitative and a quantitative – supplement each other.•Expert peer reviewing of allegations of torture make the ...final conclusions robust.•Criteria of classification of data facilitates achievement of joint peer conclusions.•There should be criteria of how to merge physical and psychological conclusions.
No means exists to classify the overall credibility of physical torture allegations, which relies on qualitative forensic medical criteria.
To develop procedures for processing physical data from torture allegations in order to achieve robust credibility assessments. To assess inter-observer variation in semi-quantitative evaluations. To analyse the importance of physical aspects for the overall assessment of allegations of torture. To assess the correlation between a quantitative description of physical aspects of torture and the appraisal of credibility based on the semi-quantitative model.
We developed a semi-quantitative model to assess credibility of physical torture allegations and a model to describe allegations quantitatively. Information about physical aspects of ill-treatment in 202 extensive reports made by psychologists (part of a Basque Country Governmental project) was appraised individually and jointly by the two authors in the semi-quantitative model. Inter-observer variation was appraised. The assessed credibility based on physical details was compared with the psychologists’ overall assessments and with the quantitative scoring of physical data.
The inter-observer agreement was substantial with kappa values of 0.64–0.77. Peer-reviewing revealed an error; using the defined criteria in the models facilitated achievement of common opinions. Comparison of credibility assessments found by different means suggests that physical data may be given a low priority in the overall assessment of torture allegations. There was a strong correlation (r=0,86, p<0.001) between the semi-quantitative credibility assessment and the quantitative scoring of physical aspects of torture, reinforcing the validity of both means.
Peer-reviewing of physical aspects of torture based on a qualitative /semi-quantitative /quantitative multi-step analysis leads to robust assessments of credibility. A procedure is needed on how to merge the credibility assessments of the psychological and the physical data into an overall conclusion. We suggest that the highest level of the two evaluations should constitute the overall credibility assessment.
The examinations were done years after the detentions, they were not focused on physical details and the data we used was retrieved retrospectively.
Contribution to the 30th Anniversary of the Torture Journal by Dr. Hans Draminsky Petersen. The author describes his more than 30-years’ of experience in conducting monitoring visits to detention ...centres in different countries with an analytical perspective on the elements that perpetuate torture.
Knowledge about how marginalised citizens use urban spaces is hard to access and apply in urban planning and policy. Based on current debates around “smart cities” and “smart governance,” the City of ...Odense, in Denmark, has tested the integration of “smart engagement” by means of GPS-tracking techniques into the municipality’s cross-sectoral strategy for an “inclusive city.” In a period of austerity, cities have the incentive to optimise public services. Hence, GPS-tracking data was produced by 64 marginalised citizens, resulting in a data inventory covering three weeks of spatial behaviour. First, this article shows how these GPS-tracking data were processed into maps without revealing person-sensitive spatial patterns. Secondly, the article explores whether such maps and the GPS-tracking techniques that underpin them are considered valid, relevant, and applicable to urban planning from the perspectives of marginalised citizens, their representatives, and municipal planners and professionals respectively. The GPS project showed shortcomings as regards the quality of the data inventory and the representativity of the mapped behaviour, which made them inapplicable for optimising dedicated public service. However, the article also finds that the GPS-based maps succeeded in being non-person sensitive and in providing a valuable platform for citizen-centric dialogues with marginalised citizens with the potential for raising awareness and increasing knowledge about this citizen group’s living conditions and urban lives. An important derived effect of the project is that it has ensured ongoing cross-sectoral collaboration among a range of professional stakeholders, imperative for ensuring creating greater equity in urban planning.
It is not for the documenting medical experts (Shir, 2019), but for the court to decide whether the level of pain and suffering inflicted reaches the threshold of torture while disregarding ...ill-treatment, i.e., the court upholds the prerogative to apply its own interpretation of the definition of torture, no matter existing medical evidence and disregarding the Istanbul Protocol. The criteria used to determine the level of FT's pain and suffering does not appear in the ruling. The ruling states that the burden of proof that the "means" were not reasonable constituting torture falls upon the petitioner (para 36). In the light of the above (1, a-h) this is in practice impossible for the petitioner to establish. This aligns with Shir's statement that no ISA interrogator has been indicted in 1200 torture complaints.
Published data on antiinflammatory and immunomodulatory effects of statins suggest they may reduce mortality risks associated with an unchecked immune response to selected infections, including ...influenza and COPD. We assessed whether statin users had reduced mortality risks from these conditions.
We conducted a matched cohort study (n = 76,232) and two separate case-control studies (397 influenza and 207 COPD deaths) to evaluate whether statin therapy is associated with increased or decreased mortality risk and survival time using health-care encounter data for members of health maintenance organizations. For the cohort study, baseline illness risks from all causes prior to initiation of statin therapy were used to statistically adjust for the occurrence of outcomes after initiation of treatment.
For moderate-dose (≥ 4 mg/d) statin users, this cohort study found statistically significant reduced odds ratios (ORs) of influenza/pneumonia death (OR, 0.60; 95% confidence interval CI, 0.44 to 0.81) and COPD death (OR, 0.17; 95% CI, 0.07 to 0.42) and similarly reduced survival hazard ratios. Findings were confirmed with the case-control studies. Confounding factors not considered may explain some of the effects observed.
This study found a dramatically reduced risk of COPD death and a significantly reduced risks of influenza death among moderate-dose statin users.
Patients with chronic obstructive pulmonary disease (COPD) frequently have albuminuria (indicative of renal endothelial cell injury) associated with hypoxemia.
To determine whether (1) cigarette ...smoke (CS)-induced pulmonary and renal endothelial cell injury explains the association between albuminuria and COPD, (2) CS-induced albuminuria is linked to increases in the oxidative stress-advanced glycation end products (AGEs) receptor for AGEs (RAGE) pathway, and (3) enalapril (which has antioxidant properties) limits the progression of pulmonary and renal injury by reducing activation of the AGEs-RAGE pathway in endothelial cells in both organs.
In 26 patients with COPD, 24 ever-smokers without COPD, 32 nonsmokers who underwent a renal biopsy or nephrectomy, and in CS-exposed mice, we assessed pathologic and ultrastructural renal lesions, and measured urinary albumin/creatinine ratios, tissue oxidative stress levels, and AGEs and RAGE levels in pulmonary and renal endothelial cells. The efficacy of enalapril on pulmonary and renal lesions was assessed in CS-exposed mice.
Patients with COPD and/or CS-exposed mice had chronic renal injury, increased urinary albumin/creatinine ratios, and increased tissue oxidative stress and AGEs-RAGE levels in pulmonary and renal endothelial cells. Treating mice with enalapril attenuated CS-induced increases in urinary albumin/creatinine ratios, tissue oxidative stress levels, endothelial cell AGEs and RAGE levels, pulmonary and renal cell apoptosis, and the progression of chronic renal and pulmonary lesions.
Patients with COPD and/or CS-exposed mice have pulmonary and renal endothelial cell injury linked to increased endothelial cell AGEs and RAGE levels. Albuminuria could identify patients with COPD in whom angiotensin-converting enzyme inhibitor therapy improves renal and lung function by reducing endothelial injury.
Objective Cigarette smoking is the most important risk factor for COPD in the United States. Host factors that influence the rapid rate of FEV1 decline in smokers and how decline rate influences risk ...for developing COPD are unknown. The aim of this study was to characterize the rate of FEV1 decline in ever smokers, compare the risk of incident COPD between those with rapid decline and others, and determine the effect of selected drugs on rapid decline. Methods A total of 1,170 eligible ever smokers from the longitudinal Lovelace Smokers Cohort with repeat spirometry tests over a minimum follow-up period of 3 years (mean follow-up, 5.9 years) were examined, including 809 ever smokers without a spirometric abnormality at baseline. Longitudinal absolute decline in postbronchodilator FEV1 from the slope of the spirometric values over all examinations was annualized and classified as rapid (≥ 30 mL/y), normal (0-29.9 mL/y), or no (> 0 mL/y) decline. Logistic regression and Kaplan-Meier survival curves were used for the analysis. Results Approximately 32% of ever smokers exhibited rapid decline. Among ever smokers without a baseline spirometric abnormality, rapid decline was associated with an increased risk for incident COPD (OR, 1.88; P = .003). The use of angiotensin-converting enzyme (ACE) inhibitors at baseline examination was protective against rapid decline, particularly among those with comorbid cardiovascular disease, hypertension, or diabetes (ORs 0.48, 0.48, and 0.12, respectively; P ≤ .02 for all analyses). Conclusions Ever smokers with a rapid decline in FEV1 are at higher risk for COPD. Use of ACE inhibitors by smokers may protect against this rapid decline and the progression to COPD.
What do we know about the urban impoverished areas of the world and the living environment of its inhabitants? How did the urban poor cope with their surroundings? How did they interpret and adopt ...urban space in order to fight against their position at the periphery of society? This volume takes up these questions and investigates how far approaches of cultural sciences can contribute to overcome the 'exoticization of the ghetto' (Loïc Wacquant) and instead to look at the heterogeneity and individuality behind the facades. It opens new perspectives for the research of poverty and inequalities that do not stop at collective categories.
ADAM8 (a disintegrin and metalloproteinase domain-8) is expressed by leukocytes and epithelial cells in health, but its contribution to the pathogenesis of chronic obstructive pulmonary disease ...(COPD) is unknown.
To determine whether the expression of ADAM8 is increased in the lungs of patients with COPD and cigarette smoke (CS)-exposed mice, and whether ADAM8 promotes the development of COPD.
ADAM8 levels were measured in lung, sputum, plasma, and/or BAL fluid samples from patients with COPD, smokers, and nonsmokers, and wild-type (WT) mice exposed to CS versus air. COPD-like lung pathologies were compared in CS-exposed WT versus Adam8
mice.
ADAM8 immunostaining was reduced in macrophages, and alveolar and bronchial epithelial cells in the lungs of patients with COPD versus control subjects, and CS- versus air-exposed WT mice. ADAM8 levels were similar in plasma, sputum, and BAL fluid samples from patients with COPD and control subjects. CS-exposed Adam8
mice had greater airspace enlargement and airway mucus cell metaplasia than WT mice, but similar small airway fibrosis. CS-exposed Adam8
mice had higher lung macrophage counts, oxidative stress levels, and alveolar septal cell death rates, but lower alveolar septal cell proliferation rates and soluble epidermal growth factor receptor BAL fluid levels than WT mice. Adam8 deficiency increased lung inflammation by reducing CS-induced activation of the intrinsic apoptosis pathway in macrophages. Human ADAM8 proteolytically shed the epidermal growth factor receptor from bronchial epithelial cells to reduce mucin expression in vitro. Adam8 bone marrow chimera studies revealed that Adam8 deficiency in leukocytes and lung parenchymal cells contributed to the exaggerated COPD-like disease in Adam8
mice.
Adam8 deficiency increases CS-induced lung inflammation, emphysema, and airway mucus cell metaplasia. Strategies that increase or prolong ADAM8's expression in the lung may have therapeutic efficacy in COPD.
Abstract
Objective
To compare the effect of a conventional to an intensive blood pressure monitoring regimen on blood pressure in hypertensive patients in the general practice setting.
Design
...Randomized controlled parallel group trial with 12-month follow-up.
Setting
One hundred and ten general practices in all regions of Denmark.
Participants
One thousand forty-eight patients with essential hypertension.
Intervention
Conventional blood pressure monitoring (‘usual group’) continued usual ad hoc blood pressure monitoring by office blood pressure measurements, while intensive blood pressure monitoring (‘intensive group’) supplemented this with frequent home blood pressure monitoring and 24-hour ambulatory blood pressure monitoring.
Primary outcome measures
Mean day- and night-time systolic and diastolic 24-hour ambulatory blood pressure.
Secondary outcome measures
Change in systolic and diastolic office blood pressure and change in cardiovascular risk profile.
Results
Of the patients, 515 (49%) were allocated to the usual group, and 533 (51%) to the intensive group. The reductions in day- and night-time 24-hour ambulatory blood pressure were similar (usual group: 4.6 ± 13.5/2.8 ± 82 mmHg; intensive group: 5.6 ± 13.0/3.5 ± 8.2 mmHg; P = 0.27/P = 0.20). Cardiovascular risk scores were reduced in both groups at follow-up, but more so in the intensive than in the usual group (P = 0.02).
Conclusion
An intensive blood pressure monitoring strategy led to a similar blood pressure reduction to conventional monitoring. However, the intensive strategy appeared to improve patients’ cardiovascular risk profile through other effects than a reduction of blood pressure.
Trial registration
Clinical Trials NCT00244660.
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