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The European Union policy and normative framework in addressing climate mobility
No full textClimate change is altering the character of human mobility in myriad ways: migration is taking more complex forms, altering traditional ones that are based on more linear and clearly distinguishable causal narratives. [1]Responses to climate migration have been fragmented and fraught to date, owing partly to the contentious nature of climate change and migration and partly to the multivarious stakeholders, interests and jurisdictions involved. [2] Consequently, and precisely because of the wide range of mobility outcomes, the distinction between certain protection norms or frameworks is excessively rigid and outdated. What is required is a two-pronged legal and policy approach that seeks to minimise forced displacement while facilitating, where necessary, migration as an adaptation strategy to ensure that all those affected by climate change receive appropriate support. Adequate protection of climate migrants [3] with sound planning for and management of climate mobility has become critical for human security. What is required, therefore, is a more holistic approach with more concerted efforts and greater international responsibility-sharing to support host communities develop effective localised practices world-wide. Countries concerned need to better ensure that climate change adaptation measures, both incremental and transformational, address climate-driven human mobility.[1] E. Pan, ‘Reimagining the Climate Migration Paradigm: Bridging Conceptual Barriers to Climate Migration Responses’ (2020) 50 Environmental Law 4: 1173, 1175.[2] Ibid. at 1176.[3] In the interest of conciseness, the use of the notion “climate migrant” is here used in broad terms. The lack of a solid empirical foundation for the causal link between climate change and migration explains the absence of a clear definition of “climate migrant” and existing disagreements among academics and policy-makers as to a notion that can comprehensively capture the complexity of this type of human mobility. The debate is centred around two main and opposing schools of thought, namely maximalism and minimalism. The former conceives of the link between environmental change and migration as causative and direct. As such it predicts large scale human mobility as a necessary outcome of large-scale changes in the environment. The latter emphasizes the multifactorial conditions that determine migratory movements and thus question the assumption of a direct causal link between environmental change and migration; see further J. Morrissey, ‘Rethinking the 'debate on environmental refugees': from “maximalists and minimalists” to “proponents and critics”’ (2012) 19 Journal of Political Ecology 1: 36-49. doi: https://doi.org/10.2458/v19i1.21712; G. Sciaccaluga, International Law and the Protection of “Climate Refugees” (Springer 2020), pp. 39-56; for a detailed account of the plethora of notions and terms adopted over time, see F. Rosignoli, Environmental Justice for Climate Refugees (Routledge 2022), pp. 1-31.</p
Michelangelo, Giordano Bruno, Galileo, and their Poetry as Ekphrastic Frenzy
No full textA research-level monograph which explores the little-known poetry of Michelangelo the
artist, Giordano Bruno the philosopher, and Galileo the scientist, exposing how their verse
engaged with groundbreaking concepts that challenged an era at the crossroads between the
Reformation and the Scientific Revolution.</p
Bloodstream infections and Blood-Brain barrier Permeability: An observational cohort study
No full textBackgroundSepsis associated encephalopathy is a poorly understood yet common complication of sepsis. Immune challenge and animal models implicate blood–brain barrier (BBB) dysfunction and microglial activation in the hippocampus as key drivers of pathology. In this exploratory study, we used bloodstream infections (BSI) as a model of severe infection to investigate the relationship between changes in cognition with plasma biomarkers of brain injury, BBB permeability and microglial activation quantified using advanced neuroimaging.MethodsIn this longitudinal exploratory study we recruited patients hospitalised with BSI as well as age matched controls. Cognition was assessed at the bedside and at convalesce using a CANTAB battery. MRI scanning was performed as soon as practicable after hospital discharge. Hippocampal and thalamic BBB permeability was assessed using dynamic enhanced contrast MRI (DCE-MRI). Microglial morphometry was assessed using diffusion-weighted magnetic resonance spectroscopy (DW-MRS) of the left thalamus. Plasma glial fibrillary acidic protein (GFAP) and neurofilament light protein (NFL) were quantified using Single molecule array (SiMoA) technology.Results21 patients with BSI and 16 age matched controls were enrolled (median [IQR] 64.3 [51.1–68.5] years). Patients with BSI had poorer cognitive function, particularly attention (RVP A-prime z-score −1.08 [95% CI −1.75, −0.61], p ConclusionsOur findings suggest that BSI are associated with acute, inflammation-mediated brain injury. However, cognitive dysfunction, particularly in the domain of attention, is temporary and not associated with changes in BBB permeability or microglial activation at convalescence. Given persistent mood dysfunction and elevated biomarkers of neuronal injury longitudinal study is warranted to determine long-term sequelae BSI and other severe infections.</p
Jurisdiction in International Law
No full textThis chapter explores the law of jurisdiction under international law as relevant to the specific context of Pakistan. It explores the legal concepts of legislative and enforcement jurisdiction under international law and correspondingly, provides a detailed mapping of the relevant international customary law principles, international treaties, to which Pakistan is a state party, and domestic legislation within Pakistani federal law in relation to both civil and criminal matters.</p
[Letter] How is heated tobacco product use described by people who use them daily?
No full textHeated tobacco products (HTPs) heat tobacco, usually in the form of a stick of compacted, reconstituted tobacco rather than burning it, to produce an aerosol that contains nicotine and other tobacco constituents. In countries where these products are marketed, prevalence has increased, most notably Japan.1 HTPs deliver lower levels of toxicants than conventional cigarette smoke2 and are promoted as harm-reduced alternatives to smoking. It is unclear how HTP users describe the act of inhaling the aerosol generated. One qualitative study among adult HTP users found considerable confusion as to what term was appropriate,3 and although the term ‘smoking’ was commonly used, they resisted being labelled as ‘smokers’.</p
CATwin-IDS: context-aware intrusion detection system for both in-vehicle and external-vehicle networks via digital twin
No full textNo description supplied</p
Accuracy of final-year paramedic students' ECG interpretation and referrals for transient loss of consciousness, per the NICE CG109 guidelines
No full textINTRODUCTION: Paramedics in the UK independently assess patients with transient loss of consciousness (TLOC) in community settings. The UK's National Institute for Health and Care Excellence publish guidance on assessment of TLOC (NICE CG109), recommending ECG interpretation to identify red-flag abnormalities that warrant referral. This study assessed whether final-year university paramedic students meet these recommendations uniformly across different ECG patterns. MAIN HYPOTHESIS: Participants will identify Brugada Syndrome (a required but difficult to recognize ECG pattern) with a lower success rate than Ventricular Tachycardia (an easily recognizable pattern). METHODS: An online study tested third-year paramedic students' ECG interpretation skills and referral decisions across 18 UK higher educational institutions. Students' subjective confidence ratings were also measured. RESULTS: Participants identified ventricular tachycardia (94.7%) and STEMI (89.4%) well but struggled with Brugada sign (51.5%), ventricular hypertrophy (43.9%), and Wolff-Parkinson-White (40.9%). While most abnormalities were referred despite misidentification, some high-risk patterns were not recognized and, more concerningly, often not referred. Lower self-reported confidence in an ECGs interpretation was associated with a higher likelihood of referring normal traces. CONCLUSION: A mismatch exists between final year paramedic students' ECG interpretation ability and the NICE CG109 expectations. While participants generally took a cautious approach, failure to refer some critical ECG abnormalities raises concerns. Educational programs and CG109 should align better to ensure paramedics reliably recognize and act on important ECG findings.</p
Cutting through the clutter: cleaning the lens on work-related wellbeing concepts
No full textWork-related wellbeing research is increasingly constrained by conceptual and terminological clutter. Labels such as worker wellbeing, employee wellness, wellbeing at work, occupational health, quality of working life, and other terms are often treated as synonyms, defined at different levels of abstraction, or operationalised through proxies, limiting cumulative theory and cross-study comparability. This conceptual, semantically-focused, critical paper demonstrates the ways in which legacy terminology, interdisciplinary language gaps, issues with the overarching concept of wellbeing and category errors contributed to the current conceptual and definitional disarray. It then proposes a conceptual map to help resolve this state of affairs. The framework distinguishes overall wellbeing from work-related wellbeing, separates life-domain labels from wellbeing components, clarifies population segmentations, and offers unified set of definitions to these wellbeing constructs. This conceptual work is intended to improve construct selection, specification, and measurement in both research and applied settings. This paper concludes with a future agenda.</p
Integration and scale-up of a primary healthcare-based chronic wound care package for persons affected by Skin-Neglected Tropical Diseases and other conditions in Ethiopia: a protocol for an implementation research study
No full textBackground The profound impact of wounds on the quality of life of those affected is often underestimated. Chronic wounds impose substantial burdens on individuals and communities in terms of disability, mental distress, stigma, and economic productivity losses. To effectively address these challenges, an integrated and comprehensive approach to primary healthcare-based chronic wound care prevention and management is essential. This implementation research study aims to assess the integration and scale-up of a comprehensive package of primary healthcare-based wound care and psychosocial support for persons affected by chronic wounds caused by NTDs and other conditions in selected districts in Ethiopia. Methods The study will be implemented in Central Ethiopia in three stages, utilizing a mixed-methods approach to co-develop a comprehensive care package and progressively implement the care package building on learnings from successive stages of implementation. Stage 1 will encompass the co-development of a holistic wound care package and strategies for its integration into routine primary health services. Stage 2 will involve a pilot study in one sub-district, to establish the care package’s adoption, feasibility, acceptability, fidelity, potential effectiveness, readiness for scale-up, and costs. Stage 3 will involve the scale-up of the wound care package and its evaluation in several districts. Discussion This implementation research study on integration and scale up of chronic wound care within primary health services will substantially improve access to care and support for affected persons in Ethiopia. Knowledge products from this study will be disseminated using a variety of channels, including publications in scientific journals, conference presentations, policy briefs, and workshops. Persons affected by chronic wounds, healthcare providers and program planners will benefit from this study.</p