The activation of the International Criminal Court's jurisdiction over the crime of aggression: International institutional law and dispute settlement perspectives

In 2017 the plenary organ of the ICC, the ASP, adopted Resolution ICC-ASP/16/Res.5, activating the Court's jurisdiction over the crime of aggression; and confirming an interpretation of the Rome Statute. While the characterization of this Resolution as either a subsequent agreement or subsequent practice under Article 31(3) VCLT is relevant to treaty interpretation of the Rome Statute, this article submits that this Resolution is clearly a Rule of the International Organization, taken by one of its organs. Resolution ICC-ASP/16/Res.5 may constitute a ‘relevant rule’ of interpretation with regard to the Rome Statute, thereby taking precedence over the general rules of interpretation in Articles 31 and 32 of the VCLT; particularly when the interpreter is an organ of the ICC. If a dispute arises with regard to the interpretation of the Rome Statute on the crime of aggression, a specialist regime at the ICC exists for the settlement of disputes

Aggression and state responsibility at the International Criminal Court

The definition of the crime of aggression in Article 8 bis of the Rome Statute of the International Criminal Court (Rome Statute) stipulates that a State act of aggression is a material element of the crime, suggesting an intrinsic link between individual criminal responsibility and State responsibility for aggression. This article argues that the Rome Statute provides a legal basis for the International Criminal Court (ICC) to determine State responsibility for aggression when considering the material elements of the crime of aggression, which has important practical and conceptual implications for the law of international responsibility. Although the content of State responsibility flows automatically from the breach of the obligation, it is argued that a finding of aggression pursuant to Article 8 bis of the Rome Statute may be considered as a form of satisfaction for the purposes of Article 37 of the 2001 ILC Articles on Responsibility of States for Internationally Wrongful Acts (2001 ILC Articles). Furthermore, the material element of the crime in Article 8 bis of the Rome Statute requires the act of aggression by its character, gravity, and scale to constitute a manifest violation of the Charter of the United Nations, in line with the nomenclature used within the 2001 ILC Articles regarding serious breaches of obligations arising from peremptory norms of general international law (jus cogens). The article considers the important role that the ICC may play in relation to serious breaches of the jus cogens obligation to refrain from an act of aggression

Translating best practice into real practice: methods, results and lessons from a project to translate an English sexual health survey into four Asian languages

Background: Migrants are underrepresented in population health surveys. Offering translated survey instruments has been shown to increase migrant representation. While ‘team translation’ represents current best practice, there are relatively few published examples describing how it has been implemented. The purpose of this paper is to document the process, results and lessons from a project to translate an English-language sexual health and blood-borne virus survey into Khmer, Karen, Vietnamese and Traditional Chinese. Methods: The approach to translation was based on the TRAPD (Translation, Review, Adjudication, Pretesting, and Documentation) model. The English-language survey was sent to two accredited, independent translators. At least one bilingual person was chosen to review and compare the translations and preferred translations were selected through consensus. Agreed translations were pretested with small samples of individuals fluent in the survey language and further revisions made. Results: Of the 51 survey questions, only nine resulted in identical independent translations in at least one language. Material differences between the translations related to: (1) the translation of technical terms and medical terminology (e.g. HIV); (2) variations in dialect; and (3) differences in cultural understandings of survey concepts (e.g. committed relationships). Conclusion: Survey translation is time-consuming and costly and, as a result, deviations from TRAPD ‘best practice’ occurred. It is not possible to determine whether closer adherence to TRAPD ‘best practice’ would have improved the quality of the resulting translations. However, our study does demonstrate that even adaptations of the TRAPD method can identify issues that may not have been apparent had non-team-based or single-round translation approaches been adopted. Given the dearth of clear empirical evidence about the most accurate and feasible method of undertaking translations, we encourage future researchers to follow our example of making translation data publicly available to enhance transparency and enable critical appraisal

Home Blood Pressure Telemonitoring Technology for Patients With Asymptomatic Elevated Blood Pressure Discharged From the Emergency Department: Pilot Study

BACKGROUND: Hypertension affects 1 in 5 Canadians and is the leading cause of morbidity and mortality globally. Hypertension control is declining due to multiple factors including lack of access to primary care. Consequently, patients with hypertension frequently visit the emergency department (ED) due to high blood pressure (BP). Telehealth for Emergency-Community Continuity of Care Connectivity via Home-Telemonitoring Blood Pressure is a pilot project that implements and evaluates a comprehensive home blood pressure telemonitoring (HBPT) and physician case management protocol designed as a postdischarge management strategy to support patients with asymptomatic elevated BP as they transition from the ED to home. OBJECTIVE: Our objective was to conduct a feasibility study of an HBPT program for patients with asymptomatic elevated BP discharged from the ED. METHODS: Patients discharged from an urban, tertiary care hospital ED with asymptomatic elevated BP were recruited in Vancouver, British Columbia, Canada, and provided with HBPT technology for 3 months of monitoring post discharge and referred to specialist hypertension clinics. Participants monitored their BP twice in the morning and evenings and tele-transmitted readings via Bluetooth Sensor each day using an app. A monitoring clinician received these data and monitored the patient\u27s condition daily and adjusted antihypertensive medications. Feasibility outcomes included eligibility, recruitment, adherence to monitoring, and retention rates. Secondary outcomes included proportion of those who were defined as having hypertension post-ED visits, changes in mean BP, overall BP control, medication adherence, changes to antihypertensive medications, quality of life, and end user experience at 3 months. RESULTS: A total of 46 multiethnic patients (mean age 63, SD 17 years, 69%, n=32 women) found to have severe hypertension (mean 191, SD 23/mean 100, SD 14 mm Hg) in the ED were recruited, initiated on HBPT with hypertension specialist physician referral and followed up for 3 months. Eligibility and recruitment rates were 40% (56/139) and 88% (49/56), respectively. The proportion of participants that completed ≥80% of home BP measurements at 1 and 3 months were 67% (31/46) and 41% (19/46), respectively. The proportion of individuals who achieved home systolic BP and diastolic BP control at 3 months was 71.4% (30/42) and 85.7% (36/42) respectively. Mean home systolic and diastolic BP improved by -13/-5 mm Hg after initiation of HBPT to the end of the study. Patients were prescribed 1 additional antihypertensive medication. No differences in medication adherence from enrollment to 3 months were noted. Most patients (76%, 25/33) were highly satisfied with the HBPT program and 76% (25/33) found digital health tools easy to use. CONCLUSIONS: HBPT intervention is a feasible postdischarge management strategy and can be beneficial in supporting patients with asymptomatic elevated BP from the ED. A randomized trial is underway to evaluate the efficacy of this intervention on BP control

Activation of Human Monocytes by Live Borrelia burgdorferi Generates TLR2-Dependent and -Independent Responses Which Include Induction of IFN-β

It is widely believed that innate immune responses to Borrelia burgdorferi (Bb) are primarily triggered by the spirochete's outer membrane lipoproteins signaling through cell surface TLR1/2. We recently challenged this notion by demonstrating that phagocytosis of live Bb by peripheral blood mononuclear cells (PBMCs) elicited greater production of proinflammatory cytokines than did equivalent bacterial lysates. Using whole genome microarrays, we show herein that, compared to lysates, live spirochetes elicited a more intense and much broader transcriptional response involving genes associated with diverse cellular processes; among these were IFN-β and a number of interferon-stimulated genes (ISGs), which are not known to result from TLR2 signaling. Using isolated monocytes, we demonstrated that cell activation signals elicited by live Bb result from cell surface interactions and uptake and degradation of organisms within phagosomes. As with PBCMs, live Bb induced markedly greater transcription and secretion of TNF-α, IL-6, IL-10 and IL-1β in monocytes than did lysates. Secreted IL-18, which, like IL-1β, also requires cleavage by activated caspase-1, was generated only in response to live Bb. Pro-inflammatory cytokine production by TLR2-deficient murine macrophages was only moderately diminished in response to live Bb but was drastically impaired against lysates; TLR2 deficiency had no significant effect on uptake and degradation of spirochetes. As with PBMCs, live Bb was a much more potent inducer of IFN-β and ISGs in isolated monocytes than were lysates or a synthetic TLR2 agonist. Collectively, our results indicate that the enhanced innate immune responses of monocytes following phagocytosis of live Bb have both TLR2-dependent and -independent components and that the latter induce transcription of type I IFNs and ISGs

Land-based sources of marine pollution and dumping at sea

It is now generally accepted that a rule of customary international law, as also reflected in Article 194(1) of the United Nations Convention on the Law of the Sea (UNCLOS), provides an obligation for States to take, in accordance with their capabilities, ‘all measures (...) that are necessary to prevent, reduce and control pollution of the marine environment from any source’. Indeed, the causes and anthropogenic factors giving rise to marine pollution are varied. However, its main sources can be broadly classified in two categories: land-based sources, which account for approximately 80 per cent of marine pollution, and dumping at sea, which accounts for a further 10 per cent. The present contribution aims to provide an overview of the international regulation, both global and regional, on these two sources of marine pollution