Efficient RkNN Retrieval with Arbitrary Non-Metric Similarity Measures

A RkNN query returns all objects whose nearest k neighbors
contain the query object. In this paper, we consider RkNN
query processing in the case where the distances between
attribute values are not necessarily metric. Dissimilarities
between objects could then be a monotonic aggregate of dissimilarities
between their values, such aggregation functions
being specified at query time. We outline real world cases
that motivate RkNN processing in such scenarios. We consider
the AL-Tree index and its applicability in RkNN query
processing. We develop an approach that exploits the group
level reasoning enabled by the AL-Tree in RkNN processing.
We evaluate our approach against a Naive approach
that performs sequential scans on contiguous data and an
improved block-based approach that we provide. We use
real-world datasets and synthetic data with varying characteristics
for our experiments. This extensive empirical
evaluation shows that our approach is better than existing
methods in terms of computational and disk access costs,
leading to significantly better response times.

Can traditional harvesting methods for cockles be accommodated in a Special Area of Conservation?

The European Natura 2000 project attempts to balance conservation and exploitation by permitting activities that do not affect the conservation status of designated sites. Given the scale of Natura 2000, guidelines are needed to facilitate the drafting of simple site management plans. This need is particularly acute for traditional harvesting methods for which there is usually strong local opposition to the imposition of controls. These issues were examined in Strangford Lough, a special area of conservation where cockles have traditionally been harvested by hand-raking. Raking was found not to affect the ability of cockles to rebury. There were significant reductions in Zostera biomass when raking was carried out within eelgrass beds (a 90% reduction in biomass available to winter migrant birds from summer raking). Traditional harvesting methods could therefore be accepted in Strangford as long as Zostera beds are avoided. A relatively low intensity of harvesting activity in Strangford Lough probably reflects low cockle densities (average 91.8 m(-2)), with the most economically valuable individuals at some distance from points of access to the shore. An economically feasible management plan could sanction traditional harvesting and result in the implementation of more resource-intensive management only if increases in cockle stocks and market prices stimulate large increases in harvesting activity.

Access to medical records for research purposes:Varying perceptions across research ethics boards

Introduction: Variation across research ethics boards (REBs) in conditions placed on access to medical records for research purposes raises concerns around negative impacts on research quality and on human subject protection, including privacy. Aim: To study variation in REB consent requirements for retrospective chart review and who may have access to the medical record for data abstraction. Methods: Thirty 90-min face-to-face interviews were conducted with REB chairs and administrators affiliated with faculties of medicine in Canadian universities, using structured questions around a case study with open-ended responses. Interviews were recorded, transcribed and coded manually. Results: Fourteen sites (47%) required individual patient consent for the study to proceed as proposed. Three (10%) indicated that their response would depend on how potentially identifying variables would be managed. Eleven sites (38%) did not require consent. Two (7%) suggested a notification and opt-out process. Most stated that consent would be required if identifiable information was being abstracted from the record. Among those not requiring consent, there was substantial variation in recognising that the abstracted information could potentially indirectly re-identify individuals. Concern over access to medical records by an outside individual was also associated with requirement for consent. Eighteen sites (60%) required full committee review. Sixteen (53%) allowed an external research assistant to abstract information from the health record. Conclusions: Large variation was found across sites in the requirement for consent for research involving access to medical records. REBs need training in best practices for protecting privacy and confidentiality in health research. A forum for REB chairs to confidentially share concerns and decisions about specific studies could also reduce variation in decisions.

Impact of Metric Selection on Wireless DeAuthentication DoS Attack Performance

DeAuthentication Denial of Service attacks in Public Access WiFi operate by exploiting the lack of authentication of management frames in the 802.11 protocol. Detection of these attacks rely almost exclusively on the selection of appropriate thresholds. In this work the authors demonstrate that there are additional, previously unconsidered, metrics which also influence DoS detection performance. A method of systematically tuning these metrics to optimal values is proposed which ensures that parameter choices are repeatable and verifiable.

Politically sensitive encounters: Ethnography, access and the benefits of ‘hanging out’

Negotiating politically sensitive research environments requires both a careful consideration of the methods involved, and a great deal of personal resolve. In drawing upon two distinct yet comparable fieldwork experiences this paper champions the benefits of ethnographic methods in seeking to gain positionality and research legitimacy amongst those identified as future research participants. The authors explore and discuss their use of the ethnographic concept of ‘hanging out’ in politically sensitive environments when seeking to negotiate access to potentially hard to reach participants living in challenging research environments. Through an illustrative examination of their experiences in researching commemorative rituals in Palestine and mental health in a Northern Irish prison, both authors reflect upon their use of hanging out when seeking to break down barriers and gain acceptance amongst their target research participants. Their involvement in a range of activities, not directly related to the overall aims of the research project, highlight a need for qualitative researchers to adopt a flexible research design, one that embraces serendipitous or chance encounters, when seeking to gain access to hard to reach research participants or when issues of researcher legitimacy are particularly pronounced such as is the case in politically sensitive research environments.

How well do the public understand palliative care? A mixed methods study

Background: International research suggests that the general public appear to be confused about what palliative care is and who provides it.1 2 An understanding of public views is needed in order to target education and policy campaigns and to manage future needs, expectations and resourcing of care.

Aim: The aim of this study was to establish the current levels of awareness and perceptions of palliative care among the general public in Northern Ireland.

Methods: A mixed methods study comprising two phases was undertaken. A community-based cross-sectional survey with a population of 3,557 individuals aged over 17 years was performed. Information was collected using a structured questionnaire consisting of 17 items. Open questions were subject to content analysis; closed questions were subject to descriptive statistics with inferential testing as appropriate. This was followed by semi structured telephone interviews (n=50).

Results: Responses indicated limited knowledge about palliative care. Respondents who worked in healthcare themselves or who had a close relative or friend who had used a palliative care service were more aware of palliative care and the availability of different palliative care services. The main barriers to raising awareness were fear, lack of interaction with health services and perception of lack of resources. A key aspect identified for promoting palliative care was the development of understanding and use of the term itself and targeted educational strategies.

Conclusions: Public awareness of the concept of palliative care and of service availability remains insufficient. An increased awareness of palliative care is needed, in order to improve knowledge of and access to services when required, empower individuals, involve communities and ultimately to improve the delivery of palliative and end-of-life care.

Access and utilisation of maternity care for disabled women who experience domestic abuse: a systematic review

Background: Although disabled women are significantly more likely to experience domestic abuse during pregnancy than non-disabled women, very little is known about how maternity care access and utilisation is affected by the co-existence of disability and domestic abuse. This systematic review of the literature explored how domestic abuse impacts upon disabled women’s access to maternity services.

Methods: Eleven articles were identified through a search of six electronic databases and data were analysed to identify: the factors that facilitate or compromise access to care; the consequences of inadequate care for pregnant women’s health and wellbeing; and the effectiveness of existing strategies for improvement.

Results: Findings indicate that a mental health diagnosis, poor relationships with health professionals and environmental barriers can compromise women’s utilisation of maternity services. Domestic abuse can both compromise, and catalyse, access to services and social support is a positive factor when accessing care. Delayed and inadequate care has adverse effects on women’s physical and psychological health, however further research is required to fully explore the nature and extent of these consequences. Only one study identified strategies currently being used to improve access to services for disabled women experiencing abuse.

Conclusions: Based upon the barriers and facilitators identified within the review, we suggest that future strategies for improvement should focus on: understanding women’s reasons for accessing care; fostering positive relationships; being women-centred; promoting environmental accessibility; and improving the strength of the evidence base.

Creating secure wireless regions using configurable beamforming

We present a novel approach to network security against passive eavesdroppers by employing a configurable beam-forming technique to create tightly defined regions of coverage for targeted users. In contrast to conventional encryption methods, our security scheme is developed at the physical layer by configuring antenna array beam patterns to transmit the data to specific regions. It is shown that this technique can effectively reduce vulnerability of the physical regions to eavesdropping by adapting the antenna configuration according to the intended user's channel state information. In this paper we present the application of our concept to 802.11n networks where an antenna array is employed at the access point, and consider the issue of minimizing the coverage area of the region surrounding the targeted user. A metric termed the exposure region is formally defined and used to evaluate the level of security offered by this technique. A range of antenna array configurations are examined through analysis and simulation, and these are subsequently used to obtain the optimum array configuration for a user traversing a coverage area.

Developing a best practice model for partnership practice between specialist palliative care and intellectual disability services: a mixed methods study

Background: The lack of access to good quality palliative care for people with intellectual disabilities is highlighted in the international literature. In response, more partnership practice in end-of-life care is proposed. 
Aim: This study aimed to develop a best practice model to guide and promote partnership practice between specialist palliative care and intellectual disability services. 
Design: A mixed methods research design involving two phases was used, underpinned by a conceptual model for partnership practice. 
Setting/participants: Phase 1 involved scoping end-of-life care to people with intellectual disability, based on self-completed questionnaires. In all, 47 of 66 (71.2%) services responded. In Phase 2, semi-structured interviews were undertaken with a purposive sample recruited of 30 health and social care professionals working in intellectual disability and palliative care services, who had provided palliative care to someone with intellectual disability. For both phases, data were collected from primary and secondary care in one region of the United Kingdom. 
Results: In Phase 1, examples of good practice were apparent. However, partnership practice was infrequent and unmet educational needs were identified. Four themes emerged from the interviews in Phase 2: challenges and issues in end-of-life care, sharing and learning, supporting and empowering and partnership in practice. 
Conclusion: Joint working and learning between intellectual disability and specialist palliative care were seen as key and fundamental. A framework for partnership practice between both services has been developed which could have international applicability and should be explored with other services in end-of-life care.

Doing Focus Groups and Interviews with Recent Migrants to Northern Ireland: A Dynamic Interplay of Ethics, Language and Access

This case describes a qualitative social science research project that was conducted in 2009 and that examined the experiences of recent migrants to Northern Ireland. While background to the research and key findings are presented, the topic forms a backdrop to the case. The following aspects of the study are presented: the theoretical context; formulating the research question, design and methodology; key methodological issues; data collection and analysis; project dissemination; and research funding and reporting. The case pays particular attention to the needs and impact of different groups including the researcher, the funding body, the researcher’s employer and the researched. The significance of access, language and ethics to this study are examined. Finally, the way in which the research unfolded in an often-unpredictable way throughout the implementation process is highlighted in the narrative.

Methods and Metrics for Fair Server Assessment under Real-Time Financial Workloads

We present a rigorous methodology and new metrics for fair comparison of server and microserver platforms. Deploying our methodology and metrics, we compare a microserver with ARM cores against two servers with ×86 cores running the same real-time financial analytics workload. We define workload-specific but platform-independent performance metrics for platform comparison, targeting both datacenter operators and end users. Our methodology establishes that a server based on the Xeon Phi co-processor delivers the highest performance and energy efficiency. However, by scaling out energy-efficient microservers, we achieve competitive or better energy efficiency than a power-equivalent server with two Sandy Bridge sockets, despite the microserver's slower cores. Using a new iso-QoS metric, we find that the ARM microserver scales enough to meet market throughput demand, that is, a 100% QoS in terms of timely option pricing, with as little as 55% of the energy consumed by the Sandy Bridge server.

Global surveillance of cancer survival 1995–2009: analysis of individual data for 25 676 887 patients from 279 population-based registries in 67 countries (CONCORD-2)

BACKGROUND: Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control.

METHODS: Individual tumour records were submitted by 279 population-based cancer registries in 67 countries for 25·7 million adults (age 15-99 years) and 75,000 children (age 0-14 years) diagnosed with cancer during 1995-2009 and followed up to Dec 31, 2009, or later. We looked at cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, and adult and childhood leukaemia. Standardised quality control procedures were applied; errors were corrected by the registry concerned. We estimated 5-year net survival, adjusted for background mortality in every country or region by age (single year), sex, and calendar year, and by race or ethnic origin in some countries. Estimates were age-standardised with the International Cancer Survival Standard weights.

FINDINGS: 5-year survival from colon, rectal, and breast cancers has increased steadily in most developed countries. For patients diagnosed during 2005-09, survival for colon and rectal cancer reached 60% or more in 22 countries around the world; for breast cancer, 5-year survival rose to 85% or higher in 17 countries worldwide. Liver and lung cancer remain lethal in all nations: for both cancers, 5-year survival is below 20% everywhere in Europe, in the range 15-19% in North America, and as low as 7-9% in Mongolia and Thailand. Striking rises in 5-year survival from prostate cancer have occurred in many countries: survival rose by 10-20% between 1995-99 and 2005-09 in 22 countries in South America, Asia, and Europe, but survival still varies widely around the world, from less than 60% in Bulgaria and Thailand to 95% or more in Brazil, Puerto Rico, and the USA. For cervical cancer, national estimates of 5-year survival range from less than 50% to more than 70%; regional variations are much wider, and improvements between 1995-99 and 2005-09 have generally been slight. For women diagnosed with ovarian cancer in 2005-09, 5-year survival was 40% or higher only in Ecuador, the USA, and 17 countries in Asia and Europe. 5-year survival for stomach cancer in 2005-09 was high (54-58%) in Japan and South Korea, compared with less than 40% in other countries. By contrast, 5-year survival from adult leukaemia in Japan and South Korea (18-23%) is lower than in most other countries. 5-year survival from childhood acute lymphoblastic leukaemia is less than 60% in several countries, but as high as 90% in Canada and four European countries, which suggests major deficiencies in the management of a largely curable disease.

INTERPRETATION: International comparison of survival trends reveals very wide differences that are likely to be attributable to differences in access to early diagnosis and optimum treatment. Continuous worldwide surveillance of cancer survival should become an indispensable source of information for cancer patients and researchers and a stimulus for politicians to improve health policy and health-care systems.

Defining consensus norms for palliative care of people with intellectual disabilities in Europe using Delphi methods: A White Paper from the European Association of Palliative care

Background: People with intellectual disabilities often present with unique challenges that make it more difficult to meet their
palliative care needs.
Aim: To define consensus norms for palliative care of people with intellectual disabilities in Europe.
Design: Delphi study in four rounds: (1) a taskforce of 12 experts from seven European countries drafted the norms, based on available empirical knowledge and regional/national guidelines; (2) using an online survey, 34 experts from 18 European countries evaluated the draft norms, provided feedback and distributed the survey within their professional networks. Criteria for consensus
were clearly defined; (3) modifications and recommendations were made by the taskforce; and (4) the European Association for
Palliative Care reviewed and approved the final version.
Setting and participants: Taskforce members: identified through international networking strategies. Expert panel: a purposive sample identified through taskforce members’ networks.
Results: A total of 80 experts from 15 European countries evaluated 52 items within the following 13 norms: equity of access, communication, recognising the need for palliative care, assessment of total needs, symptom management, end-of-life decision making, involving those who matter, collaboration, support for family/carers, preparing for death, bereavement support, education/training
and developing/managing services. None of the items scored less than 86% agreement, making a further round unnecessary. In light of respondents’ comments, several items were modified and one item was deleted.
Conclusion: This White Paper presents the first guidance for clinical practice, policy and research related to palliative care for people with intellectual disabilities based on evidence and European consensus, setting a benchmark for changes in policy and practice.

Event-driven implicit authentication for mobile access control

In order to protect user privacy on mobile devices, an event-driven implicit authentication scheme is proposed in this paper. Several methods of utilizing the scheme for recognizing legitimate user behavior are investigated. The investigated methods compute an aggregate score and a threshold in real-time to determine the trust level of the current user using real data derived from user interaction with the device. The proposed scheme is designed to: operate completely in the background, require minimal training period, enable high user recognition rate for implicit authentication, and prompt detection of abnormal activity that can be used to trigger explicitly authenticated access control. In this paper, we investigate threshold computation through standard deviation and EWMA (exponentially weighted moving average) based algorithms. The result of extensive experiments on user data collected over a period of several weeks from an Android phone indicates that our proposed approach is feasible and effective for lightweight real-time implicit authentication on mobile smartphones.