Access to interpreting services in England: secondary analysis of national data

Background: Overcoming language barriers to health care is a global challenge. There is great linguistic diversity in the major cities in the UK with more than 300 languages, excluding dialects, spoken by children in London alone. However, there is dearth of data on the number of non-English speakers for planning effective interpreting services. The aim was to estimate the number of people requiring language support amongst the minority ethnic communities in England. Methods: Secondary analysis of national representative sample of subjects recruited to the Health Surveys for England 1999 and 2004. Results: 298,432 individuals from the four main minority ethnic communities (Indian, Pakistani, Bangladeshi and Chinese) who may be unable to communicate effectively with a health professional. This represents 2,520,885 general practice consultations per year where interpreting services might be required. Conclusion: Effective interpreting services are required to improve access and health outcomes of non-English speakers and thereby facilitate a reduction in health inequalities

Twelve Key Questions on Self-Defense against Non-State Actors

This article examines the most pertinent questions relating to the applicability of the right of self-defense to attacks conducted by non-State armed groups (NSAGs) acting independently of State control from the territory of one or more States against the territory of another State. These questions are approached from the perspective of legality (does the right of self-defense apply to attacks not mounted by or under the control of a State) and modality (assuming the applicability of self-defense to such attacks; how do the principles of necessity, proportionality and immediacy affect its application)? Starting with an assessment of the place of self-defense in international law at the time the U.N. Charter was adopted, it proceeds with an examination of State practice before and after the 9/11 attacks. The 9/11 attacks triggered not only increased reliance upon self-defense in relation to attacks by NSAGs, but also an ongoing debate to which this article is intended as a constructive contribution. After concluding that there is substantial and increasing, albeit not universal support for the applicability of self-defense to attacks by NSAGs, the modality of its application is discussed. In that context, the principle of necessity in the context of self-defense is presented as being of paramount importance in answering the question of under which circumstances self-defense against NSAGs can be exercised on the territory of another State and how such action relates to the rights of the State where the NSAG is located and conducting operations from

Anticipatory Self-Defense in the Cyber Context

This chapter explores the application of the law relating to anticipatory self-defence to attacks in the cyber domain

Optimal Time Utility Based Scheduling Policy Design for Cyber-Physical Systems

Classical scheduling abstractions such as deadlines and priorities do not readily capture the complex timing semantics found in many real-time cyber-physical systems. Time utility functions provide a necessarily richer description of timing semantics, but designing utility-aware scheduling policies using them is an open research problem. In particular, optimal utility accrual scheduling design is needed for real-time cyber-physical domains. In this paper we design optimal utility accrual scheduling policies for cyber-physical systems with periodic, non-preemptable tasks that run with stochastic duration. These policies are derived by solving a Markov Decision Process formulation of the scheduling problem. We use this formulation to demonstrate that our technique improves on existing heuristic utility accrual scheduling policies

Scheduling Design with Unknown Execution Time Distributions or Modes

Open soft real-time systems, such as mobile robots, experience unpredictable interactions with their environments and yet must respond both adaptively and with reasonable temporal predictability. Because of the uncertainty inherent in such interactions, many of the assumptions of the real-time scheduling techniques traditionally used to ensure predictable timing of system actions do not hold in those environments. In previous work we have developed novel techniques for scheduling policy design where up-front knowledge of execution time distributions can be used to produce both compact representations of resource utilization state spaces and efficient optimal scheduling policies over those state spaces. This paper makes two main contributions beyond our previous work, to the state of the art in scheduling open soft real-time systems: (1) it shows how to relax the assumption that the entire distribution of execution times is known up front, to allow online learning of an execution time distribution during system run-time; and (2) it shows how to relax the assumption that the execution time of a system action can be characterized by a single distribution, to accommodate different execution time distributions for an action being taken in one of multiple modes. Each of these contributions allows a wider range of system actions to be scheduled adaptively and with temporal predictability, which increases the applicability of our approach to even more general classes of open soft real-time systems

Particularized protection: UNSC mandates and the protection of civilians in armed conflict

The protection of civilians at risk in armed conflict has, since the late 1990s, become institutionalized at the United Nations (UN), gaining acceptance as a normative rationale for UN peacekeeping. However, the bulk of civilians in need of protection in armed conflict are unlikely to attain it. The article develops an argument on ‘particularized protection’ - particularized in that UN Security Council (SC) mandates are formulated and adjusted over time to direct mission protection to specific subsets of civilian populations, that is, those relevant to the UN itself, the host state, other states, NGOs and the media, leaving most local civilians receiving little effective protection. Particularized protection, we argue, is a result of the institutional dynamics involving actors producing mandates - the UNSC - and those providing protection - peacekeeping missions - whereby mandates are specified to direct mission protection to selected, particularized groups. We demonstrate these dynamics in two cases, Côte d’Ivoire and Somalia

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Scalable Scheduling Policy Design for Open Soft Real-Time Systems

Open soft real-time systems, such as mobile robots, must respond adaptively to varying operating conditions, while balancing the need to perform multiple mission specific tasks against the requirement that those tasks complete in a timely manner. Setting and enforcing a utilization target for shared resources is a key mechanism for achieving this behavior. However, because of the uncertainty and non-preemptability of some tasks, key assumptions of classical scheduling approaches do not hold. In previous work we presented foundational methods for generating task scheduling policies to enforce proportional resource utilization for open soft real-time systems with these properties. However, these methods scale exponentially in the number of tasks, limiting their practical applicability. In this paper, we present a novel parameterized scheduling policy that scales our technique to a much wider range of systems. These policies can represent geometric features of the scheduling policies produced by our earlier methods, but only require a number of parameters that is quadratic in the number of tasks. We provide empirical evidence that the best of these policies are competitive with exact solution methods in small problems, and significantly outperform heuristic methods in larger ones

Multiple novel prostate cancer susceptibility signals identified by fine-mapping of known risk loci among Europeans

Genome-wide association studies (GWAS) have identified numerous common prostate cancer (PrCa) susceptibility loci. We have fine-mapped 64 GWAS regions known at the conclusion of the iCOGS study using large-scale genotyping and imputation in 25 723 PrCa cases and 26 274 controls of European ancestry. We detected evidence for multiple independent signals at 16 regions, 12 of which contained additional newly identified significant associations. A single signal comprising a spectrum of correlated variation was observed at 39 regions; 35 of which are now described by a novel more significantly associated lead SNP, while the originally reported variant remained as the lead SNP only in 4 regions. We also confirmed two association signals in Europeans that had been previously reported only in East-Asian GWAS. Based on statistical evidence and linkage disequilibrium (LD) structure, we have curated and narrowed down the list of the most likely candidate causal variants for each region. Functional annotation using data from ENCODE filtered for PrCa cell lines and eQTL analysis demonstrated significant enrichment for overlap with bio-features within this set. By incorporating the novel risk variants identified here alongside the refined data for existing association signals, we estimate that these loci now explain ∼38.9% of the familial relative risk of PrCa, an 8.9% improvement over the previously reported GWAS tag SNPs. This suggests that a significant fraction of the heritability of PrCa may have been hidden during the discovery phase of GWAS, in particular due to the presence of multiple independent signals within the same regio