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Background Since the World Health Organization recommended single low-dose (0.25 mg/kg) primaquine (PQ) in combination with artemisinin-based combination therapies (ACTs) in areas of low transmission or artemisinin-resistant Plasmodium falciparum, several single-site studies have been conducted to assess efficacy. Methods An individual patient meta-analysis to assess gametocytocidal and transmission-blocking efficacy of PQ in combination with different ACTs was conducted. Random effects logistic regression was used to quantify PQ effect on (1) gametocyte carriage in the first 2 weeks post treatment; and (2) the probability of infecting at least 1 mosquito or of a mosquito becoming infected. Results In 2574 participants from 14 studies, PQ reduced PCR-determined gametocyte carriage on days 7 and 14, most apparently in patients presenting with gametocytemia on day 0 (odds ratio [OR], 0.22; 95% confidence interval [CI], .17–.28 and OR, 0.12; 95% CI, .08–.16, respectively). Rate of decline in gametocyte carriage was faster when PQ was combined with artemether-lumefantrine (AL) compared to dihydroartemisinin-piperaquine (DP) (P = .010 for day 7). Addition of 0.25 mg/kg PQ was associated with near complete prevention of transmission to mosquitoes. Conclusions Transmission blocking is achieved with 0.25 mg/kg PQ. Gametocyte persistence and infectivity are lower when PQ is combined with AL compared to DP.

In 2016, the government of Canada announced reforms to the federal judicial appointment process aimed at increasing openness and transparency in the process. As part of those changes, all applicants for appointment to, or elevation within, the federal judiciary are required to submit responses to a new questionnaire. Applicants are asked to reflect upon the role of the judiciary in Canada’s legal system. One of the questions they are asked is: “Who is the audience for decisions rendered by the court(s) to which you are applying?” While the audience for a court’s decisions is not a new matter of academic and professional discussion, this recent change has brought judicial audience more squarely into the public eye. Nearly every successful applicant, of those whose responses are available, highlighted three key constituencies that should be addressed in every court decision: the parties, the public, and the legal profession.Justice David Watt’s short, staccato style introductions to decisions, authored since his elevation to the Court of Appeal for Ontario, have received attention. His introductions, which differ from the conventional style of legal judgments, have been the subject of legal blogs, mainstream media articles, and professional praise and criticism. Decisions that include intentional stylistic departures from conventional judicial writing are sometimes referred to as literary judgments. These so called literary judgments, including the ones written by Justice Watt, raise particular issues regarding the notion of judicial audience. Justice Watt’s departure from the conventional style of legal writing, particularly given the gruesome and tragic facts involved in many of the decisions he has written, raises numerous questions: Who is the audience for these literary judgments? Do judges write for a different readership when they issue decisions which depart significantly from the traditional style of legal writing? What are some of the attendant risks of delivering literary judgments to particular audiences? Do Justice Watt’s literary judgments speak appropriately and productively to the three constituencies for court decisions identified by judges themselves: the parties (understood broadly), the public, and the legal profession? Using Justice Watt’s decisions as a case study, this article considers the issue of judicial audience in the context of literary judgments. The article proceeds in three sections, each dedicated to an examination of Justice Watt’s literary decisions in relation to one of these three audiences., En 2016, le gouvernement du Canada a annoncé des réformes du processus de nomination judiciaire fédéral visant à accroître l’ouverture et la transparence du processus. Dans le cadre de ces changements, tous les candidats à une nomination ou à une promotion au sein de la magistrature fédérale sont tenus de répondre à un nouveau questionnaire. Les candidats sont invités à réfléchir sur le rôle du pouvoir judiciaire dans le système juridique canadien. L’une des questions qui leur est posée est la suivante : « Quelle est l’audience à laquelle s’adressent les décisions rendues par le ou les tribunaux auxquels vous postulez ? » Bien que l’audience des jugements ne soit pas un nouveau sujet de discussion académique et professionnelle, ce récent changement a permis de mieux faire connaître au public l’audience des tribunaux. Presque tous les candidats retenus, parmi ceux dont les réponses sont disponibles, ont mis en évidence trois groupes clés qui devraient être abordés dans chaque décision : les parties, le public et la profession juridique.Les introductions courtes et staccatos dans les décisions du juge David Watt, rédigées depuis son élévation à la Cour d’appel de l’Ontario, ont attiré de l’attention. Ses introductions, qui diffèrent du style conventionnel des décisions judiciaires, ont fait l’objet de blogs juridiques, d’articles de journaux et de louanges et critiques professionnelles. Les décisions qui comportent des écarts stylistiques intentionnels par rapport à la rédaction judiciaire conventionnelle sont parfois appelées des « jugements littéraires ». Ces jugements dits littéraires, y compris ceux rédigés par le juge Watt, soulèvent des questions particulières concernant la notion d’audience judiciaire. Le fait que le juge Watt s’écarte du style conventionnel de la rédaction juridique, notamment en raison des faits macabres et tragiques qui sont impliqués dans nombre des décisions qu’il a rédigées, soulève de nombreuses questions : Quelle est l’audience de ces jugements littéraires ? Les juges écrivent-ils pour un lectorat différent lorsqu’ils rendent des décisions qui s’écartent considérablement du style traditionnel de la rédaction juridique ? Quels sont les risques liés au fait de rendre des jugements littéraires pour des audiences particulières ? Les jugements littéraires du juge Watt s’adressent-ils de manière appropriée et productive aux trois groupes de lecteurs identifiés par les juges eux-mêmes : les parties (au sens large), le public et la profession juridique ? En utilisant les décisions du juge Watt comme une étude de cas, cet article examine la question de l’audience judiciaire dans le contexte des jugements littéraires. L’article se divise en trois sections, chacune consacrée à l’examen des décisions littéraires du juge Watt par rapport à l’une de ces trois audiences.

Increasing evidence documents domestic violence and abuse (DVA) and domestic homicide of adults killed by a relative in non-intimate partner relationships. Most literature focuses on intimate partner violence and homicide, yet non-intimate partner homicides form a substantial but neglected minority of domestic homicides. This article addresses this gap by presenting an analysis from 66 domestic homicide reviews (DHRs) in England and Wales where the victim and perpetrator were related, such as parent and adult child. Intimate partner homicides are excluded. These 66 DHRs were a sub-sample drawn from a larger study examining 317 DHRs in England and Wales.The article contributes towards greater understanding of the prevalence, context and characteristics of adult family homicide (AFH). Analysis revealed five interlinked precursors to AFH: mental health and substance/alcohol misuse, criminal history, childhood trauma, economic factors and care dynamics. Findings indicate that, given their contact with both victims and perpetrators, criminal justice agencies, adult social care and health agencies, particularly mental health services, are ideally placed to identify important risk and contextual factors. Understanding of DVA needs to extend to include adult family violence. Risk assessments need to be cognisant of the complex dynamics of AFH and must consider social-structural and relational-contextual factors.Key messagesUnderstanding of domestic violence and abuse needs to include adult family violence.Risks and dynamics of adult family homicide are complex and must consider social-structural and relational-contextual factors.Criminal justice agencies, social care, substance misuse and mental health services provide opportunities for prevention.

BackgroundWe present baseline data on the first 50 participants recruited to the UK MS Pregnancy Register.MethodsData collected via questionnaires from consenting participants until 20th December 2021 were included.Results50 participants (all with relapsing remitting MS; mean age at diagnosis 28.0 years; mean age at recruitment 33.0 years) were included. Median EDSS was 2.5 (n=16). Gestation at recruitment ranged from 2 to 40 weeks. 78% had discussed their pregnancy in advance with their MS team. 90% of patients had ever taken DMT. Of the patients that stopped DMT (n=23), 16 reported stopping for pregnancy-related reasons. Of these, 39% stopped before pregnancy and 30% following conception. 15 women are continuing DMT during their current pregnancy, taking the following DMT: Glatiramer acetate (n=5), natalizumab (n=7), Peginterferon beta-1a (n=2), not recorded (n=1). In those with prior pregnancies, 61% (14/23) reported pregnancy loss with 1 case of a rare genetic condition in the baby. None of the prior pregnancy losses happened whilst on DMT. One participant reported previous PPH and foetal macrosomia and another reported previous pre-eclampsia.ConclusionsThese results show that a patient-facing pregnancy MS registry is feasible and can collect previous adverse pregnancy outcomes. Future results will inform clinicians and women about the safety of DMT and adjunctive medication during pregnancy and postpartum.

BackgroundThe UK MS Register (UKMSR) has been capturing longitudinal clinical and patient reported outcomes (PROs) since 2011. As the UK population ‘locked-down’ in March 2020 it became important that clinicians could record hospitalised MS patients due to COVID-19 and record outcome. The UKMSR provided an electronic case return form, designed collaboratively by the community.AimImpacts of disability, age and treatment on mortality in pwMS with COVID-19MethodLinear modelling and standardised hypothesis testing were performed on an outcome of died or not, impact of disability (EDSS), disease modifying therapies and age.ResultsN=132 PCR confirmed COVID-19 patients submitted, 14 missing EDSS, leaving n=118. Female n=80, n relapsing =74, n progressive = 44, mean age 49.2. Median EDSS = 5.0. Linear regression for age was found to be most significant for outcome (p=0.002). Univariate analysis found that the outcome was not independent of EDSS (ChiSq p=0.0008), DMT (ChiSq p=0.006) and MSType (ChiSq p=0.0006). In the multivariate model only, age remained significant.ConclusionsOnly age remained as a marker of poor outcome multivariate analysis. No MS Specific characteristics were found to be significant. We would encourage continued data collection from UK neurology centres to increase the utility of this data.r.m.middleton@swansea.ac.uk73

The focus of this article is on the judicial application of Canada’s sexual assault doctrine in the context of the so called ‘rough sex defence’. Canadian criminal courts have seen an increased prevalence of legal narratives about S/M in recent years. In particular, courts are increasingly confronted with individuals who defend themselves against allegations of sexual assault by claiming that the impugned acts constituted consensual S/M or ‘rough sex’. The analysis is aimed at illustrating the way in which courts may fail to properly apply legal doctrine because of a problematic approach to the S/M context in which allegations arose., Le présent article porte sur l’application judiciaire de la doctrine canadienne en matière d’agression sexuelle dans le contexte de la défense dite des « pratiques sexuelles brutales ». Au cours des dernières années, les tribunaux pénaux canadiens ont constaté une prévalence accrue des exposés des faits mentionnant des pratiques de sadomasochisme. En particulier, les tribunaux sont de plus en plus confrontés à des personnes se défendant contre des allégations d’agression sexuelle en affirmant que les actes reprochés constituaient du sadomasochisme ou des « pratiques sexuelles brutales » consensuels. L’analyse vise à illustrer la manière dont les tribunaux peuvent omettre d’appliquer correctement la doctrine juridique en raison d’une approche problématique à l’égard du contexte du sadomasochisme duquel les allégations découlent.

In order of first author surname

This literature review appraises how the justice system of the United Kingdom deals with child on child sexual abuse allegations. It is crucial to consider the impact of minor sexual abuse within the community. Sensationalized reporting of sex crimes demonizes offenders and unintentionally hides some perpetrators by not representing children can cause harm. Cases where children demonstrate sexual agency are confusing and uncomfortable to appropriate blame. A freedom of information request to the Metropolitan Police uncovered 5,500 minor sex abuse allegations in England and Wales between 2011 and 2014, includ- ing, 4,000 physical assaults and 600 rape allegations. Officials caution these figures only represent a small proportion of known sexual abuse cases but the full extent of the problem is yet to be seen. Children are being exposed to explicit imagery far beyond their developmental age causing a blurring of the lines between normal sexual curiosity, harmful behavior, sexual deviance, and abuse. Evidence suggests societal failings and technological advances have created vulnerabilities from which new and dangerous sexual norms have evolved. Therefore, this paper reviews the justice, welfare, and restorative justice frame- works to explore the efficacy of the justice system in dealing with child on child sexual abuse in the UK.

Introduction/Background Cervical cancer is one of the most commonly occurring female cancers with increasing incidence worldwide. The mainstay of treatment for locally advanced cervical cancer is primary chemoradiotherapy. Pre-operative imaging alongside laparoscopic extraperitoneal para-aortic node dissection (LEPAND) has been used in order to best target this treatment. This study looked at all the women in the Belfast Trust over the last 9 years who had this investigation done as part of their pre-treatment workup and their outcomes. Methodology Retrospective data was collected for all those who had LEPAND for locally advanced cervical cancer from January 2010 to December 2018. These women all had pre-operative imaging that suggested positive pelvic lymph nodes but negative para-aortic nodes therefore deeming them suitable for the surgery. Results Sixty women were identified in this group with an age range from 23–69 and median age of 39. 93.3% had stage 2b cervical cancer, the remainder were 1b2 or 3b. 17% had adenocarcinoma of the cervix and 83% had squamous cell carcinoma. 70% of the women had primary LEPAND surgery before chemoradiotherapy with the remainder having their primary treatment before surgery. 5% (3/60) had positive para-aortic nodes on histopathology although 100% appeared node negative on MRI or PET imaging. None of those with positive nodes had recurrences but 66% died within 2 years. 15% of the study population died with 90% of these in the two years after diagnosis. 67% of these women had primary LEPAND followed by chemoradiotherapy with the others proceeding straight to primary treatment. The median survival for this group is 5 years. Conclusion 5% of the group had positive para-aortic lymph nodes on histopathological examination. This was despite imaging stating that they were node negative.LEPAND surgery prevented undertreatment in these women by re-targeting their radiotherapy. Disclosure Nothing to disclose.

Objectives Cervical cancer is one of the most commonly occurring female cancers with increasing incidence. The mainstay of treatment for locally advanced disease is primary chemoradiotherapy. Pre-operative imaging in combination with laparoscopic extraperitoneal para-aortic node dissection (LEPAND) has been used to best target this treatment. This study looked at all women in the Belfast Trust over the last 9 years who had this investigation as part of their pre-treatment workup. Methods Retrospective data was collected for all those who had LEPAND for locally advanced cervical cancer from January 2010 to December 2018. All women had pre-operative imaging that suggested positive pelvic nodes but negative para-aortic nodes. Results Sixty women were identified in this group ageing 23–69 with median age 39. 93.3% had stage 2b cervical cancer, the remainder were 1b2 or 3b. 17% had adenocarcinoma of the cervix and 83% had squamous cell carcinoma. The median survival overall is 5 years. 70% of women had primary LEPAND surgery before chemoradiotherapy with the remainder having primary treatment before surgery. 15% of the study population died, 90% of which died within two years of diagnosis. 67% of these women had primary LEPAND followed by chemoradiotherapy with the others proceeding straight to primary treatment prior to surgery. 5% (3/60) had positive para-aortic nodes on histopathology although 100% appeared node negative on MRI/PET imaging. None with positive nodes had recurrences but 66% died within 2 years. Conclusions Despite having negative nodes on imaging 5% had positive para-aortic lymph nodes on histopathology. LEPAND surgery prevented undertreatment in these women.

Who speaks and with what authority, who is believed, what evidence is introduced, and how it is presented are all informed not only by the substantive law and the rules of evidence but also by the rituals of the trial. It is from this legal process as a whole that a judge or jury determines the (legal) ‘truth’ about a woman’s allegation of rape. A sexual assault complainant’s capacity to be believed in court, to share in the production of meaning about an incidence of what she alleges was unwanted sexual contact, requires her to play a part in certain rituals of the trial. Many of these rituals are hierarchical, requiring complainants to perform subordinate roles that mirror the gender-, race-, and socio-economic status-based societal hierarchies in which the problem of sexual violence is rooted. Relying on the work of Robert Cover and interdisciplinary work on ritual for its conceptual framework, this article pursues two objectives. First, it attempts to depict, through the use of trial transcripts, the brutality of the process faced by sexual assault complainants. Second, it exposes some of the institutionalized practices, as manifested through courtroom rituals, that contribute to the inhospitable conditions faced by those who participate in the criminal justice response to sexualized violence.

BackgroundDespite the potential public health gains of enabling access to patient-level data on emerging infections, the launch of a centralised, international platform to deliver on this has not been achieved to date. Barriers include: concerns over retention of national data ownership; patient privacy; appropriate consent; loss of academic recognition; criticism or exploitation of the data generators; perceived data misuse; and the challenges of sharing benefits with communities where data is generated.MethodsTo determine the best approach to these issues in the context of Ebola, we have assembled a collaboration of partners including governments of Ebola-affected countries, non-government organisations, academic institutions, funders and public health authorities to form the Steering Committee of the Ebola Data Platform. Following stakeholder consultation, research and debate, the committee has developed a governance framework to enable access to emerging infections data, beginning with the data from the West African Ebola outbreak.ResultsPromoting fair and equitable sharing of benefits that arise from the use of data is a key element of the framework. Strategies to secure this principle include integration of platform data management activities with the national health institutions in Ebola-affected countries and collaboration with research communities in these countries to determine research priorities and plan analyses. Public health benefit in affected countries is further supported via training and strengthening of research capacity and infrastructure.ConclusionDeveloping a governance framework centered on the principle of equity has focused activities of the Ebola Data Platform on the affected health and research communities where they can have the most impact on patient outcomes, public health preparedness and future outbreak response.

In delineating the legal boundaries of capacity to consent to sexual touching, law makers and jurists must grapple with tensions between sexual liberty, morality, sexual minority equality interests, and public safety. Legal rules that stipulate that an individual cannot consent in advance to unconscious sexual activity, or that an individual under a certain age or with a particular intellectual capacity cannot consent to sexual touching have an impact on sexual liberty and should be justified. In this sense, defining legal capacity to consent to sex throws into relief the tensions between sexual liberty and the protection of sexual integrity. This is true across jurisdictions, regardless of the substantive definition of consent adopted by a particular legal system. This paper argues that establishing these limits based on normative assessments about specific sexual acts poses too great a threat to the liberty interests of women and sexual minorities. A better approach is to accept that in sex, as is probably true of all complex human interactions, an accurate application of the definitional turns on the particular. Context is everything. No sexual act, including one that objectifies, is inherently harmful. The paper offers an alternative approach by suggesting that laws defining capacity to consent should be justified on the basis of assessments of risk rather than moral assessments about sex. This stands to circumscribe law’s limits on sexual liberty in ways that are better for women and sexual minorities. What this approach does not resolve is the paradox presented by the reality that although sex is inherently contextual, criminal laws prohibiting violations of sexual integrity should not be applied contextually. The paper explores how a recent legal ruling in Canada denying the capacity to provide advance consent to unconscious sex reveals this paradox. The discussion concludes by asserting that the failure of law to exclude morally inculpable unconscious sex between ongoing sexual partners reveals the limits of law and in doing so suggests the need to reevaluate the law’s conception of the relationship between sexual liberty and sexual integrity.

L'Université Trinity Western (l'UTW), une école chrétienne privée en Colombie-Britannique, pourrait devenir la première faculté de droit chrétienne du Canada. Trinity Western pratique la discrimination fondée sur l'orientation sexuelle tant dans sa politique d'embauche que dans sa politique d'admission. On a aussi constaté qu'elle entrave la liberté académique. Les établissements dont les politiques discriminatoires vont à l'encontre des valeurs juridiques fondamentales ne sont pas compétents pour procurer une formation juridique. La Fédération des ordres professionnels de juristes du Canada, l'organisme national qui coordonne les 14 ordres professionnels du Canada, ne devrait pas approuver des programmes d’établissements qui ont des politiques discriminatoires. La décision de ne pas approuver la demande de l'UTW résisterait à une contestation judiciaire de celle-ci. Le contexte juridique dans lequel une décision de la Fédération ferait l'objet d'un examen judiciaire a changé depuis que la Cour suprême du Canada a tranché en faveur de Trinity Western dans l'arrêt Université Trinity Western c B.C. College of Teachers. La décision de la Fédération serait examinée selon la norme de la décision raisonnable plutôt que de la décision correcte. Considérant la mission, le mandat et les exigences académiques actuelles de la Fédération, une décision de rejeter la demande de l'UTW serait confirmée par les tribunaux parce qu'elle est raisonnable. L'UTW devrait être libre de faire de la recherche et de l'enseignement conformément à ses engagements religieux. L'UTW ne devrait cependant pas être autorisée à imposer au public un programme fondé sur la religion qui ne peut pas être en mesure de fournir une formation juridique conforme à ce que les organismes de réglementation de la profession juridique au Canada ont reconnu comme nécessaire pour protéger le public.

In indecency cases, Canadian courts historically employed a model of sexual morality based on the community’s standard of tolerance. However, the Supreme Court of Canada’s recent jurisprudence addressing the role of morality in the criminal law relies upon, in order to protect, the fundamental values enshrined in the Canadian constitution. This article analyzes the Court’s decisions in R. v. Labaye and R. v. Kouri and demonstrates that these cases represent a shift in the relationship between law and sexuality. The author illuminates the possibility of a new approach by the Court to the regulation of sex. Such an approach allows for the legal recognition of pleasure behind, beyond, or outside of legal claims regarding identity, antisubordination, relationship equality, and conventional privacy rights. A new theoretical approach to the legal regulation of sexuality recognizes the importance and benefit of challenging mainstream beliefs about sexuality and subverting certain dominant sexual norms. Such an approach is firmly grounded in the principles of liberalism that Labaye reflects., En matière d’indécence, les cours canadiennes ont historiquement utilisé un modèle de moralité sexuelle se basant sur la norme de tolérance de la société. Cependant, la jurisprudence récente de la Cour suprême du Canada s’appuie sur les valeurs fondamentales garanties par la Constitution canadienne, afin de les protéger. Cet article analyse les jugements de la Cour dans R. c. Labaye et R. c. Kouri et démontre que ces affaires représentent une mutation du lien entre le droit et la sexualité. L’auteure expose la possibilité d’une nouvelle approche de la Cour quant à la régulation des relations sexuelles. Une telle approche permettrait la reconnaissance judiciaire du plaisir au-delà et hors des revendications touchant l’identité, l’anti-subordination, l’égalité des relations et le droit à la vie privée. Une nouvelle approche théorique à la régulation de la sexualité reconnaît l’importance et les bénéfices de défier les croyances majoritaires concernant la sexualité et de subvertir certains normes dominantes en matière de sexualité. Une telle approche est fortement basée sur les principes de libéralisme qui transparaissent dans Labaye.

The doctrine of stare decisis has long been considered foundational to our judicial system. The concept operates in two manners: (1) to bind lower courts to the previous decisions of higher courts, which is known as vertical precedent; and (2) horizontal precedent — the practice of a court adhering to its own prior decisions. This article examines the adherence to horizontal precedent by appellate courts and, in particular, how appellate judges that have substantially disagreed with the majority through a concurring judgment should treat this concurrence in a subsequent case in which the majority’s legal rule has become a horizontal precedent. The discussion focuses primarily on Chief Justice McLachlin’s adherence to the majority’s decision in R. v. Cuerrier in her unanimous decision in R. v. Mabior, even though she wrote a concurring opinion in Cuerrier strongly disagreeing with the majority’s decision. This article argues that if precedent must prevail, Chief Justice McLachlin should have followed her own personal stare decisis rather than horizontal precedent.

After introducing a promising school violence prevention program, Students Against Violence Everywhere (S.A.V.E.), this article describes a process for program staff to use in preparing for program evaluations. It suggests ten evaluation questions to use as guidelines to prepare essential information about the program to be evaluated. The rest of the article describes the program information prepared by S.A.V.E. staff to inform evaluators about S.A.V.E., their purposes in seeking evaluation, the questions they wanted an evaluation to answer, their descriptions of the evaluation's challenges, and their suggestions for the evaluation design. Language: en

Online advertising has become a primary source of information about legal services. This trend towards web-based marketing of legal services poses new challenges to the regulation of the legal profession. Challenges which, to date, have not been fully met. It also creates a new source of data for researchers studying aspects of the legal profession such as legal ethics, lawyers’ perspectives and strategies, and legal discourse. The objective of this study is to examine the most prominent websites in Canada that advertise legal representation for individuals accused of sexual offences. The study of these websites yielded two types of observations regarding the commercial expression engaged in by this subset of the criminal defence bar. The first pertains to the parameters of ethical advertising by criminal defence lawyers who practice sexual assault law. A significant subset of lawyers who advertise legal representation services to individuals accused of sexual offences engage in commercial expression that may be inconsistent with the limits and guidelines specified in their professional codes of conduct. The study produced a second observation. Examination of these websites offers a window into the narratives about sexual assault that some defence lawyers construct for their clients or the public, and perhaps also the perspectives about sexual assault held by some defence lawyers themselves.

Trinity Western University has a Community Covenant that only permits sexual minorities to attend at considerable personal cost to their dignity and sense of self-worth. All student and staff applicants to TWU are required to sign this covenant pledging not to engage in same sex intimacy. On April 11, 2014, the Law Society of British Columbia accredited TWU’s law degree program despite the university’s formal policy of exclusion on the basis of sexual orientation. Later that month, the Law Society of Upper Canada and the Nova Scotia Barristers’ Society refused to approve that same program because of concerns regarding the institution’s discriminatory admissions policy. Law societies in some other provinces have yet to make a decision on accreditation. The purpose of this article is to offer a reply to the arguments advanced by proponents of granting law society accreditation to TWU’s proposed program.The paper rejects six of the central claims that proponents of approval have advanced. First it responds to the claim that TWU does not actually discriminate against the LGBTQ community. Second it speaks to the assertion that the Community Covenant represents a voluntary choice not to engage in same sex sexual intimacy. Third it rejects the contention that TWU welcomes gay and lesbian students. Fourth it challenges the distinction TWU supporters draw between a code of conduct that prohibits same sex intimacy and a policy that excludes gays and lesbians. Fifth it rejects the proposition, broadly accepted by the Benchers of the Law Society of BC, that the Supreme Court of Canada’s decision in BCCT is dispositive of the issue faced by law societies today. Sixth, it rejects the claim that opposition to public accreditation of TWU can be equated with opposition to a Christian worldview or the desirability of a faith-based university. The final section of the paper argues that the decisions of the LSUC and the NSBS were reasonable and will be respected by reviewing courts.

The Supreme Court’s recent decision in Vancouver Transportation is problematic for two reasons. First, the majority adopts an analytical framework for determining whether a claim triggers the positive rights Dunmore/Baier analysis, which means that policies restricting expressive rights based on groups rather than content could be less likely to fall within the scope of section 2(b). A better approach would be to characterize section 2(b) cases based on the nature of the claim rather than the nature of the restriction and to apply the positive rights Dunmore/Baier criteria only where the claim is for an audience with the government or access to government funding. Second, the Court’s section 1 analysis provides sparse and problematic guidance for addressing the now opened can of worms that is sure to arise from the government sale of private advertising in a legal context that draws the censorship line above controversial content but below offensive content.

Introduction The use of restrictive practices has significant adverse effects on the individual, care providers and organisations. This review will describe how, why, for whom, and in what circumstances approaches used by healthcare organisations work to prevent and reduce the use of restrictive practices on adults with learning disabilities. Methods and analysis Evidence from the literature will be synthesised using a realist review approach - an interpretative, theory-driven approach to understand how complex healthcare approaches work in reducing the use of restrictive practices in these settings. In step 1, existing theories will be located to explore what approaches work by consulting with key topic experts, holding consultation workshops with healthcare professionals, academics, and experts by experience, and performing an informal search to help develop an initial programme theory. A systematic search will be performed in the second step in electronic databases. Further searches will be performed iteratively to test particular subcomponents of the initial programme theory, which will also include the use of the CLUSTER approach. Evidence judged as relevant and rigorous will be used to test the initial programme theory. In step three, data will be extracted and coded inductively and deductively. The final step will involve using a realist logic of analysis to refine the initial programme theory in light of evidence. This will then provide a basis to describe and explain what key approaches work, why, how and in what circumstances in preventing and reducing the use of restrictive practices in adults with learning disabilities in healthcare settings. Results Findings will be used to provide recommendations for practice and policymaking. Registration In accordance with the guidelines, this realist review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 4th December 2019 (CRD42019158432).