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Tuberculous spondylitis - Historically known as “Pott’s Disease”

Pott (or Pott’s) disease was named after Percivall Pott, who wrote several lectures on the nature and treatment of this condition.

The name “tuberculous spondylitis” comes from the disease tuberculosis, and the Greek “spondylos”, meaning spine, and “-itis”, meaning swelling. This is actually a form of chronic osteomyelitis, generally found in the lower thoracic or upper lumbar spine of adults. It’s also one of the oldest chronic conditions for which we have archaeological evidence.

Before tuberculosis had effective treatment modalities, this was one of the most common bone afflictions in adults. There were often internal abscesses that the infection drained into, which, while generally not the primary concern, could rupture and cause peritonitis or generalized infection of the thoracic cavity.

As the condition advanced, the degeneration of the bone often caused spinal cord compression and so-called “Pott’s paralysis” - a form of paraplegia that was actually reversible if the pressure was taken off the spinal cord soon after it started. This was usually done by stiff metal or (later) plastic braces or medical corsets. Once the infection advanced to the point that paralysis was caused, it often caused a complete collapse of the affected vertebrae, and could result in thoracic kyphosis, or “hunchback”.

The images above show a mummified priest of Ammon, from the XXIst dynasty (1000 BCE) of Egypt, with the characteristic lateral protrusion of the spine (left image) that hasn’t yet advanced to a collapse of the spinal discs. There is also a large sac in the abdomen (right image) that was soft when mummification occurred, and which would have been the abscess where the infection drained. There was evidence that the priest lived for over a decade with this condition, and it was probably not what killed him in the end.

Studies in the Paleopathology of Egypt. Sir Marc Armand Ruffer, 1921.

Letter to the Editors: ‘Seeking Refuge: Central American Migration to Mexico, The US and Canada’

Dear editors,

I just finished reading Maria Cristina Garcia’s book ‘Seeking Refuge: Central American Migration to Mexico, The US and Canada’ (University of California Press, 2006). For someone like me who is involved in the current Central American crisis, but was not fully familiar with the history, this was a humbling read. It details the amazing work of advocates in the sanctuary movement, legal battles and the horrors at the border that we are seeing again today. And, it is especially helpful in that it details refugee and immigration policy not just in the US, but in Mexico and Canada. This book so much highlights the need for legal aid and the amazing work of legal advocates.

Galya Ruffer, J.D., Ph.D.

Director, International Studies Program

Director, Center for Forced Migration Studies

Northwestern University

Publications & Resources

‘[W]omen and young girls face what the UN’s independent expert on human rights in Somalia refers to as “double victimization” — first the rape or sexual assault itself, then failure of the authorities to provide effective justice or medical and social support’ – Somalia: Women fearing gender-based harm / violence. UK Home Office. February 2015.‘The report aims to provide information on the security situation in Afghanistan, which is relevant for international protection status determination (PSD; refugee status and subsidiary protection)’ – EASO Country of Origin Information Report. Afghanistan Security Situation. European Asylum Support Office. January 2015.

‘This volume presents a comprehensive study of the relevance of experts, as mediators of culture, who are called upon to corroborate, substantiate credibility, and serve as translators in the face of confusing legal standards that require proof of new forms and reasons for persecution around the globe’ – Adjudicating Refugee and Asylum Status. The Role of Witness, Expertise, and Testimony. Benjamin N. Lawrence and Galya Ruffer (Eds). Cambridge University Press. February 2015.

‘The viewpoint that the humanitarian crisis constituted a national security threat… became an optical filter that bent normal principles of justice and fairness into a tiny void where a cynical governmental response formed: the women and children, regardless of the particular facts in their particular lives, must be deported for political purposes. Indeed, the Administration’s decision to deport them was made before any of the women sent to Artesia had been interviewed’ – Ending Artesia. Stephen Manning. Innovation Law Lab. 2015.

‘The victims are typically aged between 13 and 17, sent back home after being detained by immigration authorities for entering the country without authorisation’ – Deported children face deadly new dangers on return to Honduras. UNHCR. 29 January 2015.

‘Recent history has witnessed numerous humanitarian crises in which noncitizens have been among those most seriously affected. With more people than at any other point in history residing outside of their country of origin, the presence of new and sustained eruptions of violence and conflict, and the frequency and intensity of disasters predicted to increase, noncitizens will continue to be caught in countries experiencing crises’ – On the Margins: Noncitizens Caught in Countries Experiencing Violence, Conflict and Disaster. Sanjula Weerasinghe, Abbie Taylor et al. Journal on Migration and Human Security. 2015.

‘In order to address the deficiencies in the Greek asylum system, some of which were highlighted in the M.S.S. judgment, Greece has been implementing a complex reform of its asylum system, based on the Greek Action Plan for Migration Management and Asylum developed by the Greek authorities and supported by a number of actors, including the European Commission (EC), the European Asylum Support Office (EASO) and the United Nations High Commissioner for Refugees (UNHCR)’ – Greece as a Country of Asylum. UNHCR Observations on the Current Situation of Asylum in Greece. UNHCR. December 2014.

‘Inconsistent approaches in determining an asylum seeker’s complicity in smuggling undermine refugee protection for sea-borne asylum seekers’ – Smuggled migrant or migrant smuggler: Erosion of sea-borne asylum seekers’ access to refugee protection in Canada. Chelsea Bin Han. Refugee Studies Centre (RSC) Working Paper Series. February 2015.

‘This research constitutes a significant pooling of knowledge on the law and practice on alternatives to detention in 6 EU Member States (Austria, Belgium, Lithuania, Slovenia, Sweden and the United Kingdom). In addition, it includes legal research on the scope of Member States’ obligations to implement alternatives to immigration detention under international, European (i.e., Council of Europe) and EU law’ – Alternatives to Immigration and Asylum Detention in the EU: Time for Implementation. Philippe De Bruycker (ed.). Odysseus Network. January 2015.

‘A summary of the current minimum international legal standards on the right to legal aid, from the European Convention on Human Rights and the case law of the European Court of Human Rights, supported by principles and standards from the International Covenant on Civil and Political Rights, the UN Human Rights Committee, the UN Principles and Guidelines on Access to Legal Aid in Criminal Justice Systems, and other European and UN bodies’ – European and International Standards on the Right to Legal Aid. Open Society Justice Initiative. December 2014.

‘This complex and multi-faceted human dilemma […] will only be solved when conditions in children’s countries of origin do not force them or their parents to migrate, when increased options exist for children and families to migrate through regular channels, and when policies at the regional, national, and local levels adhere to rights-based principles with the best interests of the child as a core standard and guaranteed access to international protection’ – Childhood and Migration in Central and North America: Causes, Policies, Practices and Challenges. Lisa Frydman, Karen Musalo, and Pablo Ceriani Cernadas (Eds.). Center for Gender & Refugee Studies, University of California Hastings College of the Law and the Migration and Asylum Program, Center for Justice and Human Rights, National University of Lanús, Argentina. February 2015.

‘The Tabit atrocities demonstrate the continuing and urgent need for a professional and independent force that can help protect civilian populations in Darfur from attack. It also underscores the reality that the current UNAMID force has been hamstrung in its performance and in the implementation of its core mandate’ – Mass Rape in Darfur: Sudanese Army Attacks Against Civilians in Tabit. Human Rights Watch. 11 February 2015.

‘Caseworkers must not stereotype the behaviour or characteristics of lesbian, gay or bisexual persons’ – Asylum Policy Instruction: Sexual Identity Issues in the Asylum Claim. UK Home Office. 11 February 2015.

‘Section 8 of the Asylum and Immigration (Treatment of Claimants, etc.) Act 2004 requires decision-makers to take into account the claimant’s conduct when applying the benefit of the doubt to unsubstantiated material facts. It is essential to provide the claimant with an opportunity to explain the reasons for such behaviour’ – Asylum Policy Instruction: Assessing Credibility and Refugee Status. UK Home Office. January 2015.

‘This report presents country of origin information (COI) on Zimbabwe up to 27th November 2014 on issues of relevance in refugee status determination for Zimbabwean nationals’ – Zimbabwe Country Report. Asylum Research Consultancy. January 2015.

´Human Rights Watch is not aware of a single instance in which officials prosecuted a perpetrator of an attack against a journalist or media outlet since 2011’ – War on the Media: Journalists under Attack in Libya. Human Rights Watch. February 2015.

‘[J]ust as allowing migrants to drown in the Mediterranean is unconscionable, and leaving Jordan, Lebanon and Kenya (and to a lesser extent Italy) to absorb the outflows is unfair (as well as unworkable in the long term), so failing to offer training and education to those who could benefit from it is short-sighted’ – Europe’s refugee crisis is an economic opportunity lost. Charlotte Harford. Financial Times. 12 February 2015.

‘A lawyer told Human Rights Watch in December that interrogators subjected Shehata, who once led Egypt’s negotiations with the International Monetary Fund, and his brother to electrocution and other mistreatment to force Shehata to confess to weapons possession and other charges related to violence’ – Egypt: Investigate Professor’s Allegations of Torture. Human Rights Watch. 3 February 2015.

‘The same presiding judge who handed down a life sentence against Ahmed Douma today yesterday handed down 183 death sentences in a separate mass trial’ – Egypt: Hundreds of life sentences handed down in mass trial ‘farcical.’ Amnesty International. 4 February 2015.

‘Numerous conclusions of UNHCR’s Executive Committee, of which Australia is a founding member, have attested to the overriding importance of the non-refoulement principle irrespective of the geographic location of the asylum-seeker or refugee’ – UNHCR Legal Position: Despite court ruling on Sri Lankans detained at sea, Australia bound by international obligations. UNHCR. 4 February 2015.

‘[A]ny doubt on the age of an applicant will necessarily persist after a radiological examination, which automatically triggers an in dubio pro reo rule in EU law, according to which the applicant has to be treated as a child’ – Junk Science? Four Arguments Against the Radiological Age Assessment of Unaccompanied Minors Seeking Asylum. Gregor Noll. Lund University, Faculty of Law. January 2015.

‘[T]he Upper Tribunal, when considering whether a same sex orientated male who may be at risk of harm from his family could be expected to relocate, held that “India is a country of 1.2 billion people and we have not been drawn to any evidence that there is a central registration system in place which would enable the police to check the whereabouts of inhabitants in their own state, let alone in any of the other states or unions within the country”’ – India: Background information, including actors of protection, and internal relocation. UK Home Office. February 2015.

‘In the first half of 2014, 34 percent of children in detention were assessed as having mental health disorders at levels of seriousness that were comparable with children receiving outpatient mental health services in Australia. Less than two percent of children in the Australian population were receiving outpatient mental health services in 2014’ – The Forgotten Children: National Inquiry into Children in Immigration Detention. Australian Human Rights Commission. December 2014.

Meet Ruffer! Or…Ruff 2? He’s so new he doesn’t have a name yet…all we know is he has a high pitched voice, is nice, and related to Ruff. He has no idea what he’s in for…or maybe ‘we’ don’t know what’s coming.

INVESTMENT COMMENTARY FOR APRIL 2014

Comments

  • I added LON:FSV to my SIPP because it has performed less good than my other investments over a year and its NAV was around -10%. The top 10 holdings looked fine.
  • I added LON:FSV and First State Worldwide Sustainability (WS) to my ISA. The alternative to WS was more Infrastructure but I presume at some point WS will close and its nice to have some in my portfolio.
  • The Stan Druckenmiller interview is well worth watching - . Is it me or has oil been going up rapidly recently.

Allocations

33% Ruffer European O & C Acc

19% First State Global EM Sustainability Acc

17% First State Asia Pacific Sust Acc

13% Fidelity EMEA Onshore Acc

 7% First State Global Listed Infrastructure

 9% Fidelity Special Values PLC

 2% First State Worldwide Sustainability Acc