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This contribution is a comment on the ECJ’s judgment of 20th December 2020 in L and P, which is a follow-up on the Court’s earlier ruling in LM – Minister for Justice and Equality (Deficiencies in the system of justice). It covers the key findings of the Advocate General’s Opinion, the judgment of the Court of Justice and the following implications for the national courts within the Judicial cooperation in criminal matters. The analysis investigates the case-law from a constitutional as well as a national perspective, with its main focus on pivotal considerations for the national courts within the execution of a European Arrest Warrant issued by a Rule of Law-backsliding country. The theoretical horizontal dialogue established by the Court is scrutinised in an attempt to concretise the diverse steps of the national examination of the judiciary in the issuing Member State.

EnglishThe case note reviews two decisions rendered by the German Supreme Court. In those decisions, the Court held that the general liability of partners towards a partnership’s creditors, as generally recognized under Sections 128 and 171 German Commercial Code, shall not extend to liabilities established after the partnership has declared bankruptcy, unless the root cause („Rechtsgrundlage“) of those liabilities precedes the declaration of bankruptcy. The case note begs to differ. It takes the view that neither a textual nor a contextual, purposive or historical construction of the cited provisions justifies this ratio decidendi. Consequently, it is submitted that, in the future, these precedents should not be followed. DeutschZur Besprechung gelangen zwei Urteile, in denen der BGH implizit entschieden hat, dass die in §§ 128, 171 HGB angeordnete Ausenhaftung der Personengesellschafter infolge teleologischer Reduktion eine bedeutende Ausnahme erfahrt: Sie soll sich nicht auf solche Gesellschaftsschulden erstrecken, die erst wahrend des Insolvenzverfahrens der KG entstanden sind, sofern deren Rechtsgrundlage nicht bereits vor Verfahrenseroffnung begrundet war. Die vorliegende Rezension kritisert diese Rechtsfortbildung: §§ 128, 171 HGB lassen weder in diesem noch in anderen prominent diskutierten Fallen eine teleologische Reduktion zu.

Background: Since March 2020, our clinic has used remote self-sampling for asymptomatic HIV testing as a means of delivering COVID-secure care whilst symptomatic patients attend face to face. In 2014, BASHH/EAGA guidelines recommended re-screening for HIV at 8 weeks following events deemed high risk of transmission. The updated 2020 guidelines recommend a window period (WP) of 45 days to detect 99% of infections for fourth-generation serological HIV tests. We aimed to audit practice against the 2014 recommendations, implement the 2020 guidelines and re-assess HIV WP discussion outcomes. Method: Using a plan-do- study- act (PDSA) model, case notes of all patients tested for HIV in a face-to- face appointment between 01/08/20 and 15/08/20 were reviewed (cycle 1, audit standard 2014 guidelines). Data on eligibility for HIV re-screen, WP discussion and follow-up testing were extracted from our electronic patient record. Eligibility for a HIV re-screen at the end of the WP was defined as having a sexual risk within that time or a regular partner for less than the WP duration. An intervention to improve clinician knowledge of HIV testing guidelines was delivered via online group teaching, alongside updates to our website and patient information leaflets. Practice was re-audited against the 2020 guidelines between 31/10/20 and 14/11/20 (cycle 2). Results: Eligibility for end of WP screening was similar in both PDSA cycles (Table 1). Following the intervention, the proportion of cases where an appropriate WP discussion was documented increased, with a higher percentage having specific follow-up testing. Conclusion: Empowering patients to consider HIV re-screening at the end of the WP facilitates best use of available resources. Amidst multiple competing demands and evolving clinical practices designed to mitigate COVID-19 risk, finding time to deliver appropriate WP advice is difficult. Whilst there were improved HIV WP discussion outcomes following an intervention, further work is required so that national standards are fully met. (Table Presented).

This case note examines the judicial controls on emergency powers established by the Hong Kong Court of Final Appeal in Kwok Wing Hang v Chief Executive in Council [2020] HKCFA 42. It argues that, ...

BACKGROUND: Celiac disease (CD) is an immune-mediated systemic disorder elicited by the ingestion of gluten. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidelines published in 2012 suggested a no-biopsy pathway (NBP) for symptomatic children with IgA tissue transglutaminase (TGA-IgA) ≥10x upper limit of normal (ULN). Biopsy confirmation remained mandatory for other cases. OBJECTIVE: This retrospective case note study was aimed at evaluating the adherence to the ESPGHAN 2012 guidelines for diagnosing CD in our unit. METHODS: Forty-three cases with positive TGA-IgA were identified by a laboratory database search from January 2013 to December 2019. 6 of 43 patients were not referred for a confirmation of CD diagnosis. Data was collected on the diagnostic pathways followed, and appropriateness of adherence was compared with the existing ESPGHAN guidelines. RESULTS: A total of 37 cases were included with 35 children diagnosed with CD. 29/35 (83%) were diagnosed via the NBP;15/29 (52%) children did not meet all the criteria required for NBP, but were diagnosed and managed as having CD. 20/35 (57%) children were diagnosed with CD in adherence to the 2012 guidelines. CONCLUSION: The recommended diagnostic guidelines were frequently not implemented; adherence to the guidelines may improve following regular educational sessions. The revised 2020 ESPGHAN guidelines which exclude HLA-DQ2/DQ8 testing would address the issue of diagnosis for the 10/15 NBP cases (with TGA-IgA >10xULN) in our study who did not have HLA testing and were therefore non-adherent to the 2012 diagnostic guidelines. NBP, with the reduced need for endoscopy may be beneficial in resource limited settings. RESUMO CONTEXTO: A doença celíaca (DC) é uma doença sistêmica imuno-mediada provocada pela ingestão de glúten. As diretrizes da Sociedade Europeia de Gastroenterologia Pediátrica, Hepatologia e Nutrição (ESPGHAN) publicadas em 2012 sugeriram uma via sem biópsia (VSB) para crianças sintomáticas com transglutaminase de tecido IgA (TGA-IgA) ≥10x limite superior do normal (LSN). A confirmação da biópsia permaneceu obrigatória para outros casos. OBJETIVO: Este estudo retrospectivo de dados de caso teve como objetivo avaliar a adesão às diretrizes da ESPGHAN 2012 para o diagnóstico de DC em nossa unidade. MÉTODOS: Quarenta e três casos com TGA-IgA positivo foram identificados por uma pesquisa laboratorial de banco de dados de janeiro de 2013 a dezembro de 2019. Seis de 43 pacientes não foram encaminhados para confirmação do diagnóstico de DC. Os dados foram coletados nas vias diagnósticas seguidas, e a adequação da adesão foi comparada com as diretrizes ESPGHAN existentes. RESULTADOS: Foram incluídos 37 casos com 35 crianças diagnosticadas com DC. Foram diagnosticados 29 (83%) de 35 VSB; 15 (52%) de 29 crianças não atenderam a todos os critérios exigidos para a VSB, mas foram diagnosticadas e gerenciadas como tendo DC. Vinte (57%) em 35 foram diagnosticadas com DC em adesão às diretrizes de 2012. CONCLUSÃO: As diretrizes diagnósticas recomendadas não foram frequentemente implementadas; a adesão às diretrizes pode melhorar após sessões educativas regulares. As diretrizes revisadas ESPGHAN de 2020 que excluem os testes HLA-DQ2/DQ8 abordariam a questão do diagnóstico para 10 em 15 casos VSB (com TGA-IgA >10x LSN) em nosso estudo os quais não fizeram testes de HLA e, portanto, não aderiram às diretrizes de diagnóstico de 2012. A VSB, com a necessidade reduzida de endoscopia, pode ser benéfica em configurações limitadas de recursos.

Cervical cancer (CC) has been identified as a leading cause of cancer-related death of women in Nigeria. Unfortunately, treatment for CC induces renal function injury due to nephrotoxicity of commonly used cytotoxic medications and radiotherapy. The aim of this study was to determine whether radiotherapy consistently impairs the renal function of cervical cancer patients after treatment as claimed by literature. The study was an ex post facto research, for retrospective evaluation of documented information on 220 cervical cancer patients treated in the Department of Radiotherapy, Usman Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria. The study covered a six-year period from January, 2010 to December, 2015. Data were obtained from the patients’ case notes using a semi-structured data extraction form. Independent t-test and chi-square statistics were used to obtain and interpret results from the analysis of the data. The study hypothesis one states that there would be both positive and negative effects of radiotherapy on the renal function of patients with cervical cancer. But no significant difference was found regarding the effect of radiotherapy on renal function of the patients with cervical cancer at χ2 (1, N=220) = .284, P = 288. Hypothesis two states that there was no statistically significant difference in the Glomerular Filtration Rate (GFR) of the patients, measured before and after treatment (t (219) = -0.66, P> 0.5). Extrapolating from the study results revealed that radiotherapy does not only cause renal function impairment, but also enhances renal function among patients with cervical cancer. The study however recommends that there should be a constant monitoring of the GFR for every patient with cervical cancer underdoing radiotherapy.

Otoacariasis is a parasitic otopathy reported in many parts of the world. This study presents the seasonal pattern, risk factors, and case notes on human otoacariasis in two climatically different districts: Anuradhapura and Kandy in the Dry and Wet/Intermediate zone of Sri Lanka, respectively. Ticks removed from the ear canal of patients were collected. Risk factors of otoacarisis were determined by a case/control follow-up study. Nymphal Dermacentor auratus (90.8%) was the main tick species associated otoacariasis. In the Kandy District, infestation was year-round, while in the Anuradhapura District, it was seasonal with a peak in December–February. Children

Objectives The objectives of this study were to ascertain factors significantly responsible for mortality from traumatic head injuries and prescribe measures necessary to circumvent such outcome. Methods A retrospective cohort study of all traumatic head injuries seen at our facility from October 2013 to September 2015 was done utilizing data from patient's case notes, ward registers, and casualty department. Extracted data were analyzed using descriptive statistics. Results A total of 221 patient records were analyzed with 161 men and 60 women. It was observed that although the younger age group (19–30 years) was the most frequently affected by traumatic head injuries (36.2%), the elderly (>60 years) were 4.6 times more likely to die from traumatic head injuries than any other age group. Also, those with severe head injuries were 58 times more likely to die than any other category of head injury, even though the commonest category of head injuries seen were mild head injuries (68.7%). Patients with traumatic head injury from road traffic accidents were 5.8 times more likely to die than any other cause. The sex of the patient and the length of hospital stay had no significant influence on mortality from traumatic head injuries. Conclusions The postresuscitation Glasgow Coma Scale score, age of the patient, and mechanism of head injuries are important determining factors of outcome in traumatic head injuries, with the Glasgow Coma Scale score being the single most important determining factor. Efforts should be made at preventing such causes, with prompt and aggressive care instituted for cases at risk of unfavorable outcome.

This case note examines the latest development on the police’s power to search the digital contents of an arrested person’s mobile phone without a warrant in Sham Wing Kan v Commissioner of Police [2020] HKCA 186; [2020] 2 HKLRD 529. Two issues will be discussed. First, the Court of Appeal’s approach to American and Canadian law in this area will be critically analysed. Second, the safeguards proposed by the Court for a police officer’s warrantless search of the digital contents on a mobile phone will be evaluated. It argues that the Court’s erroneous interpretation of foreign law on the police’s power to search the digital contents on a mobile phone has contributed to the inadequacy of the safeguards proposed by the Court vis-à-vis an arrestee’s privacy rights under the Hong Kong Basic Law and the Hong Kong Bill of Rights.

Background Early mobilization following joint arthroplasty surgery has been shown to be beneficial for patients, but it is unclear whether it is associated with a shorter length of stay (LOS) for both hip and knee arthroplasty (KA) patients. Methods We undertook a retrospective observational study, reviewing the case notes of 386 patients admitted to an enhanced recovery programme for total hip (THA) or total/unicompartmental KA. We evaluated the influence of early mobilization on LOS, adjusting for possible confounders, stratifying by surgery type. Results THA patients first mobilized within 12 h of returning to the acute orthopaedic ward following surgery had a significantly shorter mean LOS (mean = 3.6, standard deviation = 1.1) than THA patients who first mobilized 12 or more hours (mean = 4.1, standard deviation = 1.2), P = 0.004. There was no statistical significant difference in the mean LOS between the KA patients mobilized earlier or later. Conclusion Early mobilization as part of an enhanced recovery programme was associated with decreased LOS for patients having THA; however, this was not the case for KA patients.

Understanding the frequency of bacteraemia of dental origin that is implicated in severe infective endocarditis (IE) will further our understanding of the disease's pathoaetiology and help us take steps to reduce its prevalence. A total of 78 patients from the Royal Papworth Hospital, Cambridge, who had valve surgery due to IE (as confirmed by the Modified Duke Criteria) were included. Case notes were retrospectively reviewed for microorganisms that were implicated in the bacteraemia and IE. Associated factors were also recorded to determine whether they were different if a dental or non-dental pathogen was inoculated. A dental pathogen was implicated in 24 of the patients with IE; 20 had non-dental pathogens, and 30 were culture negative. This was not deemed statistically significant (p=0.54). Of the associated factors, only smoking was statistically significant with a greater proportion of non-smokers having bacteraemia of dental origin (p=0.03). No other associated factor was appreciably different based on the aetiology of the microorganism. Our results indicate that dental pathogens are not more likely to cause severe IE. We therefore advocate the stance adopted by the current national guidance on the judicious prescription of antibiotic prophylaxis for IE with regard to dental procedures.

Objective To describe the diagnostic features of intracranial dural arteriovenous fistulae (DAVF) presenting with cervical cord or brainstem swelling. Methods Retrospective case note and neuroimaging review of patients with angiographically confirmed DAVF diagnosed during January 2015–June 2020 at a tertiary neuroscience centre (Walton Centre NHS Foundation Trust, Liverpool, UK). Results Six intracranial DAVF causing cervical cord or brainstem oedema (all males aged 60–69 years) and 27 spinal DAVF (88% thoracolumbar) were detected over a 5.5-year period. Significantly more patients with intracranial DAVF received steroids for presumed inflammatory myelitis than those with spinal DAVF (5/6 vs 1/27, p = 0.0001, Fisher’s exact test). Several factors misled the treating clinicians: atypical rostral location of cord oedema (6/6); acute clinical deterioration (4/6); absence (3/6) or failure to recognise (3/6) subtle dilated perimedullary veins on MRI; intramedullary gadolinium enhancement (2/6); and elevated CSF protein (4/5). Acute deterioration followed steroid treatment in 4/5 patients. The following features may suggest DAVF rather than myelitis: older male patients (6/6), symptomatic progression over 4 or more weeks (6/6) and acellular CSF (5/5). Conclusion Intracranial DAVF are uncommon but often misdiagnosed and treated as myelitis, which can cause life-threatening deterioration. Neurologists must recognise suggestive features and consider angiography, especially in older male patients. Dilated perimedullary veins are an important clue to underlying DAVF, but may be invisible or easily missed on routine MRI sequences.

Vision level varies within the population of children born with visual impairment (VI). Children with profound visual impairment (PVI – with light awareness at best) are more developmentally vulnerable than peers born with typical sight or those with severe visual impairment (SVI – basic form vision). Many children with VI are dependent on their hand skills to support their development. However, the impact of vision level on the development of hand use is poorly understood. The aim of the study was to describe the associations between vision level and early hand use in children between 6 and 36 months of age with SVI and PVI. A historical case note review, including video footage of 19 children with SVI ([Formula: see text] = 19 months) and 12 children with PVI ([Formula: see text] = 16 months), was completed. Hand use was observed while the children completed the Reynell-Zinkin Scales. Observations were recorded using a data collection tool designed for the study. The tool included a checklist of developmentally appropriate hand skills expected to emerge in the first 3 years of life. The observer marked each skill as present, absent or emerging in the video clips. Children with SVI used 80.2% (95% confidence interval [CI] = [75.0, 87.5]) of the hand skills under observation. Those with PVI used 57.1% (95% CI = [46.4, 67.9]) of these skills. Vision level and hand use were positively correlated: rs = .564 (95% CI = [.263, .765]), p

Background: Pakistan is a resource limited country with one of the highest neonatal mortality rate (NMR) in the world. Kangaroo Mother Care (KMC) helps in reducing the mortality and improving the care of preterm babies. The objective of this study was to identify the benefits of KMC in hospitalized newborns in terms of better weight gain and early discharge from hospital. Subjects and methods: A retrospective case-control study was conducted in the Neonatal Department of Services Hospital from 01.02.2019 to 31.01.2020. A total of 144 case notes, who met inclusion criteria were included. Subjects were divided in 2 Groups of 77 each. Group 1 did not receive KMC and Group 2 received KMC (partial or complete). Admission weight, gestational age at birth, duration of hospital stay and the average weight gain was noted for subjects in both groups. SPSS version 23 was used to analyze data. Independent samples t-test was applied. A p-value of ˂0.05 is taken as significant. Results: Mean weight gain in Group 1 was 5.521 g/kg/day (±6.664), whereas in Group 2 was 15.635 g/kg/day (±9.268). Mean hospital stay in Group 1 was 12.558 days (±10.856) and in Group 2 it was 8.208 days (±6.473). Weight gain and duration of hospital stay was significantly better in KMC Group with a p-value ˂0.05. This benefit was observed both for partial and complete KMC. Conclusion: KMC (partial or complete) leads to better weight gain and reduces the duration of hospital stay.

This is a case note on R v Lanning and Camille [2021] EWCA Crim 450. It considers the concept of ‘overwhelming supervening acts’ (OSA) and its relationship to the ‘fundamental difference rule’ (FDR).

In O’Neill v Holland, the Court of Appeal was asked to clarify what qualified as ‘detriment’ for the purposes of establishing a common intention constructive trust. Although the case provides some clarity on ‘lost gains’, it did not resolve the main question of whether it is possible for a Claimant to rely on the detriment of another.

Background: Teenage pregnancy constitutes a high-risk pregnancy due to possible physical, psychological, socio-economic and increased obstetric risks associated with it. These risks though equally present in the older pregnant women are probably less when compared with teenagers. Thus perinatal outcome of pregnancies in these groups of patients varies. Objective: To compare the socio-demographic characteristics, pattern of pregnancy complications and perinatal outcome of pregnancy among primigravid teenagers and older primigravid women. Method: A comparative study was carried out among 58 primigravid teenagers and equal numbers of adult primigravidae at Federal Teaching Hospital, Ido Ekiti, Nigeria over five year period between January 2008 and December, 2012. Their socio-demographic characteristics, booking status, pregnancy complications, estimated gestational age at delivery, mode of delivery, post-partum morbidities, neonatal birth weight and perinatal mortalities were obtained from their case notes. Results: Deliveries by teenagers accounted for 2.48% of all deliveries during the period under review. Teenage age was significantly associated with unmarried status (P in both groups (P > 0.05). Conclusion: Pregnancy and deliveries in teenagers are high risk. Therefore, sex education as well as access to reproductive health information and care will help reduce the occurrence of unwanted pregnancies and their lasting impact on teenagers, their families, and the society.

Background: Small bowel obstruction (SBO) is a common surgical emergency usually treated via standard laparotomy. But with the advancement of laparoscopic surgical skills, more surgeons are undertaking laparoscopic approach as well to treat uncomplicated SBO. We aimed to compare outcomes following laparoscopic vs. open surgical techniques in a district general hospital. Methods: A retrospective review of case notes of patients who underwent operative surgical treatment for SBO between January 2012 and July 2018 was carried out. Mann-Whitney U test was used for nominal data and Chi-square test for categorical data analysis. Results: A total of 99 surgical procedures were carried out for SBO during this period at our district general hospital with 31 laparoscopic and 68 open procedures. Fifteen out of 31 were completed laparoscopically (totally laparoscopic approach (TLA)), while 16/31 were converted to open procedure (laparoscopic-assisted group (LAG)) to complete the operation. Median age for open group was 69 years (26 - 91 years) vs. 71 years (23 - 94 years) for laparoscopic group. Median length of stay was 10 vs. 6.5 days for single band adhesions treated laparoscopically (P = 0.02). Median Charlson comorbidity index was 6 vs. 5 (TLA). Eight out of 31 in laparoscopic group had complications, whereas 27/68 in open group (P = 0.26). The 30-day mortality was 5/68 for open vs. none for laparoscopy group. The 1-year follow-up for all patients confirmed 7/68 in open vs. 1/31 laparoscopic group mortalities. Conclusion: Laparoscopic surgical approach for SBO seems to have statistically significant lower small bowel resection rate and length of stay in this hospital when compared to laparotomy in selected patients. J Curr Surg. 2021;11(1):1-7 doi: https://doi.org/10.14740/jcs430

On May 5, 2021 Facebook Oversight Board, a global body created by the company to act as an independent appeals mechanism for Facebook's content moderation, issued its highly awaited decision concerning the "indefinite suspension" of former US President Donald Trump's account. The suspension was originally imposed by Facebook between January 6 and 7, 2021 for Trump's posts related to the attacks on Capitol Hill in Washington, DC. This case note shows the Oversight Board's almost exclusive reliance on international human rights standards in deciding the case. It sees it as a positive development. Additionally, the author argues that the decision also highlights Facebook's struggle and potential lack of willingness to develop a unified approach to its treatment of political leaders and the company's reluctance to grapple with the way its business model has potentially contributed to violent events, including the attacks on the Capitol Hill on January 6, 2021.

Evidence indicates that autism spectrum disorder (ASD) is underidentified in populations with psychosis, but that clinical presentations of comorbid ASD and psychosis (ASD-P) and specific treatment needs that may relate to this group are not well understood. In fact, recent studies of ASD in first-episode psychosis suggest that there may be a specific clinical presentation of ASD-P. In response, the Cambridgeshire and Peterborough Early Intervention in Psychosis (EIP) service in the UK implemented and evaluated a 3-step ASD screening and diagnostic protocol, using the Autism Spectrum Disorder in Adults Screening Questionnaire (ASDASQ), case note review, and the Autism Diagnostic Observation Schedule (ADOS-2) and the Childhood Autism Spectrum Test (CAST). As a quality improvement project, the evaluation aimed to (1) establish the prevalence of patients with ASD-P, (2) describe characteristics of the clinical presentation of ASD-P and compare them to those of patients suffering from psychosis but no ASD, and (3) determine any differences in treatment between psychosis patients with and without ASD. Notably, at least 9% of the EIP service caseload met the criteria for a diagnosis of ASD-P, with half identified via the implementation of this protocol. The patients with ASD-P had specific clinical presentations and treatment needs that differed from those of patients with psychosis but no ASD. Thus, the findings from this study supported existing evidence concerning the underdetection of ASD in EIP populations. Our findings also added to emerging evidence for a clinical presentation of ASD-P with specific treatment needs. Our protocol has now been established as routine practice, and its implementation has improved the detection and treatment of patients with ASD-P within our EIP service.

In Peninsula Securities, the Supreme Court held that a restrictive covenant, granted in a lease to an anchor tenant of a shopping centre not to allow any retail unit in the centre to be leased to competing shops, does not engage the doctrine of restraint of trade. The question of its enforceability therefore hinges on whether the relevant covenant breaches competition law, and specifically whether it is anti-competitive by object or effect. This relatively straightforward conclusion of the Supreme Court in Peninsula Securities masks over 50 years of conflicting judgments and uncertainty in the area. Prior to Peninsula Securities, the majority decision of the House of Lords in Esso Petroleum v Harper's Garage gave rise to a ‘battle of the tests’: the majority opined that the doctrine of restraint of trade would only be engaged if the covenantor contracts to give up a freedom they already had (what has come to be known as the ‘pre-existing freedom test’; Lord Wilberforce, dissenting, formulated what came to be known as the ‘trading society test’ which is basically a rule of reason test. In Peninsula Securities, the Supreme Court clearly sided with the latter, but in reality neither test is likely to be considered in future challenges to an anchor tenancy restrictive covenant – the key question is whether it is anti-competitive, something which only the relevant facts of the case will determine.

INTRODUCTION Continuity of midwifery carer improves outcomes, but there is significant variation in how such schemes are implemented and evaluated cross-culturally. The Angus home birth scheme in Scotland incorporates continuity of carer throughout pregnancy, labor, birth, and the postnatal period. METHODS Manual maternity case note review to evaluate the 80% continuity of carer and 3% planned home birth rate targets. RESULTS Of 1466 women booking for maternity care, 69 joined the scheme. Forty-four had a planned home birth (3% overall), of whom seven were originally deemed ineligible. Of the 44, eight (18%) also achieved 80% continuity of carer with the primary midwife; by including a home birth team colleague, the continuity rate rose to 73%. Women whose care achieved home birth and continuity targets had lower deprivation scores. Eligibility issues, women's changing circumstances, and data recording lapses were complicating issues. CONCLUSIONS Targets must be both feasible and meaningful and should be complemented by assessing a broad range of outcomes while viewing the scheme holistically. By expanding eligibility criteria, the home birth rate target was met; including input from a home birth team colleague in the calculation meant the continuity target was nearly met. With dedicated and competent staff, adequate resource and political support, and when considered in the round, the scheme's viability within local services was confirmed. Other generalizable learning points included the need to standardize definitions and data recording methods. Comparability across schemes helps grow the evidence base so that the links between processes and outcomes can be identified.

Background and Objectives: Large-scale prospective case series of tapentadol abuse or dependence in India is not available. Hence, we aimed to study the prevalence and profile of tapentadol users in a treatment-seeking population. Materials and Methods: The study had prospective and retrospective arms. We collected 8-month prospective data by face-to-face interviews (n = 70) and 8-year retrospective data from case notes (n = 26) with either tapentadol misuse/abuse or dependence in patients attending a de-addiction center. Results: The prevalence of tapentadol abuse or dependence was 25% among the pharmaceutical opioid users. Concurrent use of other opioids was seen in >80% of participants of both the arms. Major sources of tapentadol were chemists (without a prescription) (53%) and doctors (prescriptions) (40%). Patients in the tapentadol dependence group had a significantly higher dose, duration, and pharmaceutical opioid use. Conclusion: India needs awareness promotion, training, availability restriction, and provision of treatment for tapentadol abuse or dependence.

Over five years after the Islamic State (IS) terrorist group launched its genocidal attack against the Yazidi ethno-religious minority community in Sinjar, Northern Iraq, calls for 'justice' remain largely unanswered. While hundreds of IS members have been tried and convicted of their group affiliation, few have faced charges for crimes committed against the Yazidis. However, in March 2020, Ashwaq Haji Hamid Talo – a 20-year-old Yazidi woman – took the stand of a Baghdad courtroom and played a driving role in the prosecution and conviction of her attacker. Through examination of her case in the context of wider political and procedural concerns for trying IS members, this article highlights both the opportunities and challenges for individual victims and the wider Yazidi community to secure meaningful 'justice'.

Children provided with general anaesthesia for dental extractions at East Surrey Hospital were audited to determine the percentage of children who were prescribed adequate pain management in accordance with guidance published by the Association of Paediatric Anaesthetists of Great Britain and Ireland. Three audit cycles were completed. Data were collected retrospectively through case note review. The results from the first cycle showed that only 47% of children were prescribed with a recommended analgesic regimen. Implementation of change included the development of a protocol for analgesic delivery, which was disseminated to the anaesthetic and dental teams. Full compliance with the audit standards was then demonstrated in the second and third cycles. This audit demonstrates the importance of multidisciplinary collaboration in order to provide high standards of care for children undergoing dental extractions under general anaesthesia. The protocol developed could be applied to other surgical day case procedures for children to improve the patient experience.