Inter-war interactions in the development of the protection of civilians: a historical perspective

According to the dominant narrative in international humanitarian law, the 1949 Geneva Convention on Civilians is part of the discipline’s humanitarian progress, driven by the International Committee of the Red Cross, in response to atrocities committed during World War II. This paper argues that historical research enables a more nuanced historical account which challenges when, how and by whom the protection of civilians was developed. It demonstrates that the Convention’s protection regime was shaped by the efforts of a variety of non-state actors during the inter-war years. In particular, it focuses on attempts by the International Committee of the Red Cross, International Law Association and International Committee of Military Medicine and Pharmacy to advance the law independently and in cooperation in relation to ‘enemy civilians’ and safety zones after World War I. However, it suggests that these actors were to some extent inhibited by conceptual limitations and self-restraint, which ultimately led to some of the weaknesses in the protection regime under the 1949 ‘Civilian Convention’. The paper thus reveals the struggle over the conceptualisation of individuals who are today considered civilians in the inter-war years which is embedded in the text of the adopted treaty.</p

Characteristics and primary care experiences of people who self-report as autistic: a probability sample survey of adults registered with primary care services in England

ObjectivesLittle is known about adults who self-report as autistic. This study aimed to profile the demographic characteristics, long-term health conditions and primary care experiences of adults who self-report as autistic (including those with and without a formal diagnosis).Design/settingA nationally representative cross-sectional survey of adults registered with National Health Service (NHS) General Practitioner (GP) surgeries in England.Participants623 157 survey respondents aged 16 and over, including 4481 who self-report as autistic.OutcomesWeighted descriptive statistics, with 95% CIs. Logistic regression modelling adjusted for age, gender, ethnicity and area-level deprivation compared those who self-report as autistic with the rest of the population.ResultsA total of 4481 of the 623 157 survey participants included in the analysis self-reported autism, yielding a weighted proportion estimate of 1.41% (95% CI 1.35% to 1.46%). Adults self-reporting as autistic were more likely to be younger, male or non-binary, to identify as a gender different from their sex at birth, have a non-heterosexual sexual identity, be of white or mixed or multiple ethnic groups, non-religious, without caring responsibilities, unemployed, live in more deprived areas and not smoke. All chronic conditions covered were more prevalent among adults self-reporting as autistic, including learning disability, mental health conditions, neurological conditions, dementia, blindness or partial sight and deafness or hearing loss. Adults self-reporting as autistic were also less likely to report a positive experience of making an appointment (adjusted OR (aOR) 0.90, 95% CI 0.82 to 0.98) and navigating GP practice websites (aOR 0.78, 95% CI 0.70 to 0.87) and more likely to report seeking advice from a friend or family member prior to making an appointment (aOR 1.25, 95% CI 1.14 to 1.38) and having a preferred GP (aOR 2.25, 95% CI 2.06 to 2.46). They were less likely to report that their needs were met (aOR 0.73, 95% CI 0.65 to 0.83).ConclusionsAdults self-reporting as autistic have a distinctive sociodemographic profile and heightened rates of long-term conditions. They report challenges in both accessing primary care and having their needs met when they do. These findings should inform future care initiatives designed to meet the needs of this group.</p

Pharmacological management of fragile X syndrome: a systematic review and narrative summary of the current evidence

Introduction: Fragile X syndrome (FXS) is the most common inherited cause of Intellectual Disability. There is a broad phenotype that includes deficits in cognition and behavioral changes, alongside physical characteristics. Phenotype depends upon the level of mutation in the FMR1 (fragile X messenger ribonucleoprotein 1) gene. The molecular understanding of the impact of the FMR1 gene mutation provides an opportunity to target treatment not only at symptoms but also on a molecular level. Methods: We conducted a systematic review to provide an up-to-date narrative summary of the current evidence for pharmacological treatment in FXS. The review was restricted to randomized, blinded, placebo-controlled trials. Results: The outcomes from these studies are discussed and the level of evidence assessed against validated criteria. The initial search identified 2377 articles, of which 16 were included in the final analysis. Conclusion: Based on this review to date there is limited data to support any specific pharmacological treatments, although the data for cannabinoids are encouraging in those with FXS and in future developments in gene therapy may provide the answer to the search for precision medicine. Treatment must be person-centered and consider the combination of medical, genetic, cognitive, and emotional challenges.</p

The role of multisystemic resilience in fostering critical agency: UK adolescents during the COVID-19 Pandemic

Critical agency (CA) refers to an individual’s feeling of power in relation to social inequalities. Research has demonstrated that high CA is associated with positive adolescent outcomes, however, less is known about what supports are important for its development. Moreover, a large majority of the literature is based on studies from the US and various countries in Africa; although the UK is saturated with inequalities there is little research within a UK context. In this paper we examine (a) the validity of using an existing measure of CA with a sample of UK adolescents and (b) the extent to which resilience supports account for variance in CA. Our analysis identified two distinct factors of CA: justice-oriented and community-oriented. High CA in both factors was explained by resilience supports associated with peer relationships (p </p

Reducing the blocking effect in the airport slot allocation problem with seasonal flexibility

Capacity limitations, combined with increased air-traffic, continue to drive the need for better resource management at airports. At congested airports, the allocation of resources for flights to take-off and land is governed through the use of slots. Slots are allocated twice a year according to the Worldwide Airport Slot Guidelines (WASG). A principle of WASG is to allocate slots to a request at the same time and day of the week over a given period, to maintain regularity in a schedule. Adhering to this principle can result in blocking, where requests are displaced to an alternative time period due to lack of available capacity. This paper addresses blocking by allowing a request to be allocated to slightly different times on different operating days. We present a novel integer linear programming (ILP) model and develop a two-stage framework, incorporating the Late Acceptance Hill Climbing metaheuristic, to increase flexibility across a complete scheduling season to mitigate the effect of blocking on three real-world congested airport instances. Results show that exact methods are not tractable for larger problems, as they are unable to find a solution in reasonable computational time, resulting in the need for heuristic methods to solve such problems in practice. Schedules created using the proposed framework are directly compared to an existing state-of-the-art model which aims to mitigate the effect of blocking through seasonal segmentation. The proposed approach is demonstrated to be able to reduce the effect of blocking, reduce the total number of displaced requests, and the maximum displacement within slot schedules when compared with non-flexible schedules.</p

Interprofessional learning to integrate care: organic strategic and systemic responses for change

In the first of three articles, we scanned global and national sources to help understand the concept and scope of integrated care. New policy directives seek closer working relationships between health and social care systems and practitioners to tackle modern challenges relating to the ageing population, poverty, disadvantage, and mental health. We identified that the practitioner workforce has not been fully considered or prepared for large shifts in working practices, often bringing new practitioners’ roles to address local needs in newly managed interprofessional working systems for integrated care. In this second article, we consider the major themes identified by our review of integrated care policy to explore their implications for interprofessional learning, drawing on developmental pathways for interprofessional education from organic to strategic and systemic responses, to ask in what ways we will need to prepare our learners for these new ways of delivering integrated care.</p

The Effect of Evidential Impact on Perceptual Probabilistic Judgments

In a series of three behavioral experiments, we found a systematic distortion of probability judgments concerning elementary visual stimuli. Participants were briefly shown a set of figures that had two features (e.g., a geometric shape and a color) with two possible values each (e.g., triangle or circle and black or white). A figure was then drawn, and participants were informed about the value of one of its features (e.g., that the figure was a “circle”) and had to predict the value of the other feature (e.g., whether the figure was “black” or “white”). We repeated this procedure for various sets of figures and, by varying the statistical association between features in the sets, we manipulated the probability of a feature given the evidence of another (e.g., the posterior probability of hypothesis “black” given the evidence “circle”) as well as the support provided by a feature to another (e.g., the impact, or confirmation, of evidence “circle” on the hypothesis “black”). Results indicated that participants’ judgments were deeply affected by impact, although they only should have depended on the probability distributions over the features, and that the dissociation between evidential impact and posterior probability increased the number of errors. The implications of these findings for lower and higher level cognitive models are discussed.</p

A mixed-methods exploration of regular consumers’ experiences of plant-based meat alternatives (PBMA) in Singapore and the United Kingdom

Research on plant-based meat alternatives (PBMA) often focuses on its initial acceptance among new consumers with limited investigation into consumers who regularly incorporate PBMA in their diets. This study used a mixed methods approach to investigate PBMA consumption patterns, including motivations and barriers to sustained consumption, among 404 regular consumers (defined as PBMA consumption of at least once a week) in Singapore and the UK (SG: n=228; UK: n=176; 57.9 % women; 69.8 % aged 21–40 years old). Quantitative results showed similar PBMA consumption between Singapore and the UK (p=.498) but motives and barriers to sustained consumption and their consumer characteristics (i.e., food choice motives, food neophobia) were significantly different (p<.001). UK consumers showed greater agreement with motivational statements and were more sustainability-driven while Singapore consumers showed greater agreement with barrier statements and valued the impact of food on their body more. Product-related motives (β=0.22, p<.001) and accessibility barriers (β=0.15, p=.024) predicted overall PBMA consumption in both countries. Qualitative results suggest that whilst UK and Singapore consumers were satisfied with PBMA, they wanted higher nutritional quality, greater accessibility to affordable options and a wider variety. Further improvements in these areas could encourage repeated purchases and support the long-term adoption of PBMA.</p

Warming of northern peatlands increases the global temperature overshoot challenge

Meeting the Paris Agreement's temperature goals requires limiting future carbon emissions, yet current policies make temporarily overshooting the 1.5°C target likely. The potential climate feedback from destabilizing peatlands, storing large amounts of carbon, remains poorly quantified. Using the reduced-complexity Earth System Model OSCAR with an integrated peat carbon module, we found that across various overshoot pathways that temporarily exceed 1.5°C–2.5°C, northern peatlands exhibit net positive feedback, amplifying the overshoot challenge. Warming increases peatlands’ net carbon uptake, but this is largely offset by higher methane emissions. We estimated that for each 1°C increase in peak warming, the positive feedback from peatlands decreases the remaining carbon budget by 37 GtCO2 (22–48 GtCO2). If the 1.5°C temperature target is exceeded, peatlands would increase carbon removal requirement by about 40 GtCO2 (16–60 GtCO2) (8.6%). Our findings highlight the importance of properly accounting for northern peatlands for estimating climate feedbacks, especially under overshoot scenarios.</p

Non-stationary modes of suction and an external free-stream for the boundary-layer flow over a rotating disk

This study is dedicated to examining how traveling modes influence the flow of a boundary layer over a rotating disk in an axial fluid system under suction. It is understood that non-stationary modes become evident in the boundary layer of a rotating disk characterized by highly polished and exceptionally smooth surfaces. Our primary focus is on an asymptotic analytical method we used to solve the governing equations and output the waveangle and wavenumber of the system. Then, it is followed by comparing data from asymptotic and numerical analyses concerning types I and II. We further examine how variations in traveling mode frequencies impact the critical Reynolds number for type I instabilities in axial flow scenarios with suction applied to the rotating disk. Additionally, an energy balance analysis is performed to evaluate the influence of traveling mode frequencies on type I instabilities. Our findings reveal that increasing the frequency destabilizes the viscous wall type II modes while the inviscid cross-flow type I modes become more stable. This study enhances our understanding of the effects of axial flow direction and strength, as well as suction, on stability in fixed axial flow conditions.</p