Processing the Peace:An Interview with Teya Sepinuck

In this interview, Teya Sepinuck, the Artistic Director of Theatre of Witness reflects not only on her first two projects in Northern Ireland, but also vividly illustrates her way of working by evoking seminal moments in her previous practice. Although, she has resisted attempts to systematise the Theatre of Witness process, preferring to see it as a set of principles rather than a fixed methodology, these principles have given rise to clear guidelines that have come to govern the process through which she works. As the interview illustrates, Sepinuck, a Jewish Buddhist, has no hesitation in explaining her approach within the framework of a humanist ‘spirituality’ that explicitly deploys Judeo-Christian terminology. She invites discussion of each participant's ‘prayer-life’ and positions herself primarily as a listener rather than an interlocutor. The introduction to the interview contextualises Sepinuck's practice in relation to her previous work and other drama-based interventions in Northern Ireland. Concerns that the lack of critical distance between the tellers and their stories inhibits those who see it from freely engaging with it as they might with a fictionalised account, are also critiqued. In the interview, Sepinuck directly addresses the risk of the commodification of her work, explaining the safeguards in place to protect the participants, who have repeatedly asserted how beneficial they have found their involvement in the work to be. The sense of autonomy and empowerment that emerges from these responses represent a persuasive challenge to concerns that they are passive instruments of the Theatre of Witness process.

An Integrated Approach to Quantifying Groundwater and Surface Water Contributions of Stream Flow

The management of water resources in Ireland prior to the Water Framework Directive (WFD) has focussed on surface water and groundwater as separate entities. A critical element to the successful implementation of the
WFD is to improve our understanding of the interaction between the two and flow mechanisms by which groundwaters discharge to surface waters. An improved understanding of the contribution of groundwater to surface water is required for the classification of groundwater body status and the determination of groundwater quality thresholds. The results of the study will also have a wider application to many areas of the WFD.
A subcommittee of the WFD Groundwater Working Group (GWWG) has been formed to develop a methodology to estimate the groundwater contribution to Irish Rivers. The group has selected a number of analytical techniques to quantify components of stream flow in an Irish context (Master Recession Curve, Unit Hydrograph, Flood Studies Report methodologies and
hydrogeological analytical modelling). The components of stream flow that can be identified include deep groundwater, intermediate and overland. These analyses have been tested on seven pilot catchments that have a variety of hydrogeological settings and have been used to inform and constrain a mathematical model. The mathematical model used was the NAM (NedbØr-AfstrØmnings-Model) rainfall-runoff model which is a module of DHIs MIKE 11 modelling suite. The results from these pilot catchments have been used to develop a decision model based on catchment descriptors from GIS datasets for the selection of NAM parameters. The datasets used include the mapping of aquifers, vulnerability and subsoils, soils, the Digital Terrain Model, CORINE and lakes. The national coverage of the GIS datasets has allowed the extrapolation of the mathematical model to regional catchments across Ireland.

Comparing the decline in coronary heart disease and stroke mortality in neighbouring countries with different healthcare systems

Objective
To examine age and gender specific trends in coronary heart disease (CHD) and stroke mortality in two neighbouring countries, the Republic of Ireland (ROI) and Northern Ireland (NI). Design Epidemiological study of time trends in CHD and stroke mortality.

Setting/patients
The populations of the ROI and NI, 1985–2010.

Interventions
None.

Main outcome measures
Directly age standardised CHD and stroke mortality rates were calculated and analysed using joinpoint regression to identify years where the slope of the linear trend changed significantly. This was performed separately for specific age groups (25–54, 55–64, 65–74 and 75–84 years) and by gender. Annual percentage change (APC) and 95% CIs are presented.

Results
There was a striking similarity between the two countries, with percentage change between 1985 and 1989 and between 2006 and 2010 of 67% and 69% in
CHD mortality, and 64% and 62% in stroke mortality for the ROI and NI, respectively. However, joinpoint analysis identified differences in the pace of change between the two countries. There was an accelerated pace of decline (negative APC) in mortality for both CHD and stroke in both countries from the mid-1990s (APC ROI −8% (95% CI −9.5 to 6.5) and NI −6.6% (−6.9 to −6.3)), but the accelerated decrease started later for CHD mortality in the ROI. In recent years, a levelling off in CHD mortality was observed in the 25–54 year age group in NI and in stroke mortality for men and women in the ROI.

Conclusions
While differences in the pace of change in mortality were observed at different time points, similar, substantial decreases in CHD and stroke mortality were achieved between 1985 and 1989 and between 2006 and 2010 in the ROI and NI despite important differences in health service structures. There is evidence of a levelling in mortality rates in some groups in recent years.

Effect of feed space allowance and period of access to food on dairy cow performance

Two experiments were conducted to examine the ‘long-term’ effect of feed space allowance and period of access to feed on dairy cow performance. In Experiment 1, three horizontal feed space allowances (20, 40 and 60 cm cow−1) were examined over a 127-d period (14 cows per treatment). In Experiment 2, 48 dairy cows were used in a continuous design (10-week duration) 2 × 2 factorial design experiment comprising two horizontal feed space allowances (15 and 40 cm cow−1), and two periods of access to feed (unrestricted and restricted). With the former, uneaten feed was removed at 08·00 h, while feeding took place at 09·00 h. With the latter, uneaten feed was removed at 06·00 h, while feeding was delayed until 12·00 h. Mean total dry-matter (DM) intakes were 19·0, 18·7 and 19·3 kg cow−1 d−1 with the 20, 40 and 60 cm cow−1 treatments in Experiment 1, and 18·1 and 18·2 kg cow−1 d−1 with the ‘restricted feeding time’ treatments, and 17·8 and 18·1 kg d−1 with the ‘unrestricted feeding time’ treatments (15 and 40 cm respectively) in Experiment 2. None of milk yield, milk composition, or end-of-study live weight or condition score were significantly affected by treatment in either experiment (P > 0·05), while fat + protein yield was reduced with the 15-cm treatment in Experiment 2 (P < 0·05). When access to feed was restricted by space or time constraints, cows modified their time budgets and increased their rates of intake.

Exhaled breath temperature measurement and asthma control in children prescribed inhaled corticosteroids: A cross sectional study

BACKGROUND: Exhaled breath temperature (EBT) reflects airways (both eosinophilic and neutrophilic) inflammation in asthma and thus may aid the management of children with asthma that are treated with anti-inflammatory drugs. A new EBT monitor has become available that is cheap and easy to use and may be a suitable monitoring device for airways inflammation. Little is known about how EBT relates to asthma treatment decisions, disease control, lung function, or other non-invasive measures of airways inflammation, such as exhaled nitric oxide (ENO).

OBJECTIVE: To determine the relationships between EBT and asthma treatment decision, current control, pulmonary function, and ENO.

METHODS: Cross-sectional prospective study on 159 children aged 5-16 years attending a pediatric respiratory clinic. EBT was compared with the clinician's decision regarding treatment (decrease, no change, increase), asthma control assessment (controlled, partial, uncontrolled), level of current treatment (according to British Thoracic Society guideline, BTS step), ENO, and spirometry.

RESULTS: EBT measurement was feasible in the majority of children (25 of 159 could not perform the test) and correlated weakly with age (R = 0.33, P = <0.01). EBT did not differ significantly between the three clinician decision groups (P = 0.42), the three asthma control assessment groups (P = 0.9), or the current asthma treatment BTS step (P = 0.57).

CONCLUSIONS & CLINICAL IMPLICATIONS: EBT measurement was not related to measures of asthma control determined at the clinic. The routine intermittent monitoring of EBT in children prescribed inhaled corticosteroids who attend asthma clinics cannot be recommended for adjusting anti-inflammatory asthma therapy.

Multifocal remitting-relapsing cerebral demyelination twenty years following allogeneic bone marrow transplantation

We report a case study of a female who received an allogeneic bone marrow transplantation (BMT) from a sex-mismatched related donor and who, after a twenty-year interval, developed an acute fulminant biopsy-proven demyelinating disorder of cerebral white matter which followed a remitting-relapsing chronic course. In situ hybridization studies using Y-chromosome-specific markers revealed Y-chromosome-positive mononuclear cells in biopsy samples of white matter. Magnetic resonance imaging (MRI) studies of the asymptomatic healthy male donor showed multiple white matter lesions. These observations suggest that donor lymphocytes were sensitized to central nervous system (CNS) antigens prior to or at the time of transplantation but remained dormant for 20 years before becoming activated to cause widespread demyelination.

Potential public health impact of Age-Related Eye Disease Study results: AREDS report no. 11.

OBJECTIVE:

To estimate the potential public health impact of the findings of the Age-Related Eye Disease Study (AREDS) on reducing the number of persons developing advanced age-related macular degeneration (AMD) during the next 5 years in the United States.

METHODS:

The AREDS clinical trial provides estimates of AMD progression rates and of reduction in risk of developing advanced AMD when a high-dose nutritional supplement of antioxidants and zinc is used. These results are applied to estimates of the US population at risk, to estimate the number of people who would potentially avoid advanced AMD during 5 years if those at risk were to take a supplement such as that used in AREDS.

RESULTS:

An estimated 8 million persons at least 55 years old in the United States have monocular or binocular intermediate AMD or monocular advanced AMD. They are considered to be at high risk for advanced AMD and are those for whom the AREDS formulation should be considered. Of these people, 1.3 million would develop advanced AMD if no treatment were given to reduce their risk. If all of these people at risk received supplements such as those used in AREDS, more than 300,000 (95% confidence interval, 158,000-487,000) of them would avoid advanced AMD and any associated vision loss during the next 5 years.

CONCLUSION:

If people at high risk for advanced AMD received supplements such as those suggested by AREDS results, the potential impact on public health in the United States would be considerable during the next 5 years.

A review of the welfare of dairy cows in continuously housed and pasture-based production systems.

There is increasing interest in the use of continuous housing systems for dairy cows, with various reasons put forward to advocate such systems. However, the welfare of dairy cows is typically perceived to be better within pasture-based systems, although such judgements are often not scientifically based. The aim of this review was to interrogate the existing scientific literature to compare the welfare, including health, of dairy cows in continuously housed and pasture-based systems. While summarising existing work, knowledge gaps and directions for future research are also identified. The scope of the review is broad, examining relevant topics under three main headings; health, behaviour, and physiology. Regarding health, cows on pasture-based systems had lower levels of lameness, hoof pathologies, hock lesions, mastitis, uterine disease, and mortality compared to cows on continuously housed systems. Pasture access also had benefits for dairy cow behaviour, in terms of grazing, improved lying / resting times, and lower levels of aggression. Moreover, when given the choice between pasture and indoor housing, cows showed an overall preference for pasture, particularly at night. However, the review highlighted the need for a deeper understanding of cow preference and behaviour. Potential areas for concern within pasture-based systems included physiological indicators of more severe negative energy balance, and in some situations, the potential for compromised welfare with exposure to unpredictable weather conditions. In summary, the results from this review highlight that there remain considerable animal welfare benefits from incorporating pasture access into dairy production systems.

A comparison of individual cow versus group concentrate allocation strategies on dry matter intake, milk production, tissue changes, and fertility of Holstein-Friesian cows offered a grass silage diet

A diverse range of concentrate allocation strategies are adopted on dairy farms. The objectives of this study were to examine the effects on cow performance [dry matter (DM) intake (DMI), milk yield and composition, body tissue changes, and fertility] of adopting 2 contrasting concentrate allocation strategies over the first 140 d of lactation. Seventy-seven Holstein-Friesian dairy cows were allocated to 1 of 2 concentrate allocation strategies at calving, namely group or individual cow. Cows on the group strategy were offered a mixed ration comprising grass silage and concentrates in a 50:50 ratio on a DM basis. Cows on the individual cow strategy were offered a basal mixed ration comprising grass silage and concentrates (the latter included in the mix to achieve a mean intake of 6 kg/cow per day), which was formulated to meet the cow’s energy requirements for maintenance plus 24 kg of milk/cow per day. Additional concentrates were offered via an out-of-parlor feeding system, with the amount offered adjusted weekly based on each individual cow’s milk yield during the previous week. In addition, all cows received a small quantity of straw in the mixed ration part of the diet (approximately 0.3 kg/cow per day), plus 0.5 kg of concentrate twice daily in the milking parlor. Mean concentrate intakes over the study period were similar with each of the 2 allocation strategies (11.5 and 11.7 kg of DM/cow per day for group and individual cow, respectively), although the pattern of intake with each treatment differed over time. Concentrate allocation strategy had no effect on either milk yield (39.3 and 38.0 kg/d for group and individual cow, respectively), milk composition, or milk constituent yield. The milk yield response curves with each treatment were largely aligned with the concentrate DMI curves. Cows on the individual cow treatment had a greater range of concentrate DMI and milk yields than those on the group treatment. With the exception of a tendency for cows on the individual cow treatment to lose more body weight to nadir than cows on the group treatment, concentrate allocation strategy had little effect on either body weight or body condition score over the experimental period. Cows on the individual cow treatment had a higher pregnancy rate to first and second service and tended to have a higher 100-d in calf rate than cows on the group treatment. This study demonstrates that concentrate allocation strategy had little effect on overall production performance.

Variation in pre-PCR processing of FFPE samples leads to discrepancies in BRAF and EGFR mutation detection: a diagnostic RING trial.

AIMS: Mutation detection accuracy has been described extensively; however, it is surprising that pre-PCR processing of formalin-fixed paraffin-embedded (FFPE) samples has not been systematically assessed in clinical context. We designed a RING trial to (i) investigate pre-PCR variability, (ii) correlate pre-PCR variation with EGFR/BRAF mutation testing accuracy and (iii) investigate causes for observed variation. METHODS: 13 molecular pathology laboratories were recruited. 104 blinded FFPE curls including engineered FFPE curls, cell-negative FFPE curls and control FFPE tissue samples were distributed to participants for pre-PCR processing and mutation detection. Follow-up analysis was performed to assess sample purity, DNA integrity and DNA quantitation. RESULTS: Rate of mutation detection failure was 11.9%. Of these failures, 80% were attributed to pre-PCR error. Significant differences in DNA yields across all samples were seen using analysis of variance (p