The use and limitation of realistic evaluation as a tool for evidence-based practice: a critical realist perspective

In this paper, we assess realistic evaluation’s articulation with evidence-based practice (EBP) from the perspective of critical realism. We argue that the adoption by realistic evaluation of a realist causal ontology means that it is better placed to explain complex healthcare interventions than the traditional method used by EBP, the randomized controlled trial (RCT). However, we do not conclude from this that the use of RCTs is without merit, arguing that it is possible to use both methods in combination under the rubric of realist theory. More negatively, we contend that the rejection of critical theory and utopianism by realistic evaluation in favour of the pragmatism of piecemeal social engineering means that it is vulnerable to accusations that it promotes technocratic interpretations of human problems. We conclude that, insofar as realistic evaluation adheres to the ontology of critical realism, it provides a sound contribution to EBP, but insofar as it rejects the critical turn of Bhaskar’s realism, it replicates the technocratic tendencies inherent in EBP.

“A Labour Leader in a Frothy Scoundrel”: Farce and Social Justice in the Popular Dramaturgy of George Shiels

In the financially precarious period which followed the partition of Ireland (1922) the Northern Irish playwright George Shiels kept The Abbey Theatre, Dublin, open for business with a series of ‘box-office’ successes. Literary Dublin was not so appreciative of his work as the Abbey audiences dubbing his popular dramaturgy mere ‘kitchen comedy’. However, recent analysts of Irish theatre are beginning to recognise that Shiels used popular theatre methods to illuminate and interrogate instances of social injustice both north and south of the Irish border. In doing so, such commentators have set up a hierarchy between the playwright’s early ‘inferior’ comedies and his later ‘superior’ works of Irish Realism. This article rejects this binary by suggesting that in this early work Shiels’s intent is equally socially critical and that in the plays Paul Twyning, Professor Tim and The Retrievers he is actively engaging with the farcical tradition in order to expose the marginalisation of the landless classes in Ireland in the post-colonial jurisdictions.

Distinguishing between direct and indirect effects of predators in complex ecosystems

1. Global declines in biodiversity have stimulated much research into the consequences of species loss for ecosystems and the goods and services they provide. Species at higher trophic levels are at greater risk of human-induced extinction yet remarkably little is known about the effects of consumer species loss across multiple trophic levels in natural complex ecosystems. Previous studies have been criticized for lacking experimental realism and appropriate temporal scale, running for short periods that are not sufficient to detect many of the mechanisms operating in the field.
2. We manipulated the presence of two predator species and two groups of their prey (primary consumers) and measured their independent and interactive effects on primary producers in a natural marine benthic system. The presence of predators and their prey was manipulated in the field for 14 months to distinguish clearly the direct and indirect effects of predators on primary producers and to identify mechanisms driving responses.
3. We found that the loss of either predator species had indirect negative effects on species diversity and total cover of primary producers. These cascading effects of predator species loss were mediated by the presence of intermediate consumers. Moreover, the presence of different intermediate consumers, irrespective of the presence or absence of their predators, determined primary producer assemblage structure. We identified direct negative effects of predators on their prey and several indirect effects of predators on primary producers but not all interactions could have been predicted based on trophic level.
4. Our findings demonstrate the importance of trophic cascade effects coupled with non-trophic interactions when predicting the effects of loss of predator species on primary producers and consequently for ecosystem functioning. There is a pressing need for improved understanding of the effects of loss of consumers, based on realistic scenarios of diversity loss, to test conceptual frameworks linking predator diversity to variation in ecosystem functioning and for the protection of biodiversity, ecosystem functioning and related services.

Parent Issues: How Life on Mars Negotiates a Television Generation Gap

In defining what he termed 'Television's Second Golden Age', Robert J.Thompson refers to characteristics such as being 'not regular TV', internal continuity, mixed genres but an aspiration towards 'realism', complex writing, self-consciousness and intertextuality. Such characteristics are displayed by the BBC series Life on Mars (2006-2007) which intermingles the Seventies tough cop show with psychological fantasy. This chapter examines the way that the series can be understood as a dramatisation of the negotiation that the creators undertook with their Seventies source material to update it for the values and qualities of contemporary television drama. It will emphasise the importance of television in the generation of the imagined 1973 and its characters, but also as an ongoing connection between the real and the imagined within the programme, including forming a breach of the boundaries between the two. Sam's actions within his Seventies world to remake it to include his own ideas of justice and due process while retaining the passion and freedom of action that the milieu provides will also be be examined in relation to the series' creators' needs to remake the Seventies tough-cop show in the light of modern social and media mores. The paper will also consider how Sam has to come to terms with his father's crimes, as the series' creators had to come to terms with the 'crimes' of taste, morality and approach of their 'parent' programmes from the Seventies' Golden Age.

Theatricality, irony and artifice in Gustave Courbet's self-portraits

This article considers the role of theatre as a questioning of Realism in the art of Gustave Courbet

The Senses of Muriel Rukeyser’s The Book of the Dead

When Muriel Rukeyser travelled to Gauley Bridge in 1936 to report on the industrial disaster that had led to the deaths of over 700 miners, her findings led her to write what is arguably her masterpiece – the 1938 poem series The Book of the Dead. Of all Rukeyser's writings, this hybrid work of documentary techniques and metaphors, of testimony and elegy, has attracted the most critical attention. However, analyses of the series have tended to focus on the ways in which the poet adopted and adapted documentary methods in order to offer a leftist ideological critique on capitalist-born social injustice. The purpose of this article is not to negate such readings, but to offer alongside them insight into a more ethical-philosophical approach that I believe guided Rukeyser's entire career. Via an examination of the ways in which Rukeyser employs the human senses to articulate the complexities of human political, metaphysical and social relations, this article explores the influence of the Zionist Martin Buber on the poet. Rukeyser acknowledged Buber's writings in her later work, but I contend here that they played a large part in the formation of her poetics, especially in connection with her documentary aesthetic. Whilst several critics have noted, albeit often superficially, the Marxist flavour of Rukeyser's poetry in The Book of the Dead, I argue for the influence of Buber over Marx in terms or responsibility, community and dialogue. Both Rukeyser's and Buber's methods of expressing and promoting these ethical necessities rely on a synaesthetic response to the world. Where Buber advances a dialogue between the self and alterity through transcendent personal encounter, Rukeyser locates such encounter in the poem, arguing for an exchange that leads to creation, and to personal and interpersonal growth.

Direct, positive feedbacks produce instability in models of interrelationships among soil structure, plants and arbuscular mycorrhizal fungi

Current conceptual models of reciprocal interactions linking soil structure, plants and arbuscular mycorrhizal fungi emphasise positive feedbacks among the components of the system. However, dynamical systems with high dimensionality and several positive feedbacks (i.e. mutualism) are prone to instability. Further, organisms such as arbuscular mycorrhizal fungi (AMF) are obligate biotrophs of plants and are considered major biological agents in soil aggregate stabilization. With these considerations in mind, we developed dynamical models of soil ecosystems that reflect the main features of current conceptual models and empirical data, especially positive feedbacks and linear interactions among plants, AMF and the component of soil structure dependent on aggregates. We found that systems become increasingly unstable the more positive effects with Type I functional response (i.e., the growth rate of a mutualist is modified by the density of its partner through linear proportionality) are added to the model, to the point that increasing the realism of models by adding linear effects produces the most unstable systems. The present theoretical analysis thus offers a framework for modelling and suggests new directions for experimental studies on the interrelationship between soil structure, plants and AMF. Non-linearity in functional responses, spatial and temporal heterogeneity, and indirect effects can be invoked on a theoretical basis and experimentally tested in laboratory and field experiments in order to account for and buffer the local instability of the simplest of current scenarios. This first model presented here may generate interest in more explicitly representing the role of biota in soil physical structure, a phenomenon that is typically viewed in a more process- and management-focused context. (C) 2011 Elsevier Ltd. All rights reserved.

Temporary tattoos:a novel OSCE assessment tool

Background: There are many issues regarding the use of real patients in objective structured clinical examinations (OSCEs). In dermatology OSCE stations, standardised patients (SPs) with clinical photographs are often used. Temporary transfer tattoos can potentially simulate skin lesions when applied to an SP. This study aims to appraise the use of temporary malignant melanoma tattoos within an OSCE framework. Method: Within an 11-station OSCE, a temporary malignant melanoma tattoo was developed and applied to SPs in a 'skin lesion' OSCE station. A questionnaire captured the opinions of the candidate, SP and examiners, and the degree of perceived realism of each station was determined. Standard post hoc OSCE analysis determined the psychometric reliability of the stations. Results: The response rates were 95.9 per cent of candidates and 100 per cent of the examiners and SPs. The 'skin lesion' station achieved the highest realism score compared with other stations: 89.0 per cent of candidates felt that the skin lesion appeared realistic; only 28 per cent of candidates had ever seen a melanoma before in training. The psychometric performance of the melanoma station was comparable with, and in many instances better than, other OSCE stations. Discussion: Transfer tattoo technology facilitates a realistic dermatology OSCE station encounter. Temporary tattoos, alongside trained SPs, provide an authentic, standardised and reliable experience, allowing the assessment of integrated dermatology clinical skills.

Tests of multimode quantum nonlocality with homodyne measurements

We investigate the violation of local realism in Bell tests involving homodyne measurements performed on multimode continuous-variable states. By binning the measurement outcomes in an appropriate way, we prove that the Mermin-Klyshko inequality can be violated by an amount that grows exponentially with the number of modes. Furthermore, the maximum violation allowed by quantum mechanics can be attained for any number of modes, albeit requiring a quantum state whose generation is hardly practicable. Interestingly, this exponential increase of the violation holds true even for simpler states, such as multipartite GHZ states. The resulting benefit of using more modes is shown to be significant in practical multipartite Bell tests by analyzing the increase of the robustness to noise with the number of modes. In view of the high efficiency achievable with homodyne detection, our results thus open a possible way to feasible loophole-free Bell tests that are robust to experimental imperfections. We provide an explicit example of a three-mode state (a superposition of coherent states) which results in a significantly high violation of the Mermin-Klyshko inequality (around 10%) with homodyne measurements.

The student experience in Objective Structured Clinical Examinations (OSCEs): phenomenological analysis

Background and purpose
The dominant psychometric discourse of OSCEs may lead to unexpected problems, such as a checklist-based student performance1 which under emphasises the clinical relationship with student and standardised patient (SP). Such encounters can be dehumanising for SPs2 and have implications for what students learn about relational skills through the assessment process. In this study we explore medical students’ experiences of undertaking OSCEs using a phenomenological frame.
Methodology
Interpretative phenomenological analysis is a form of qualitative methodology which has strong resonance with existentialism and focuses on the lived experience without significant reference to external political or discursive
forces.
Six 4th year undergraduate medical students from Queen’s University Belfast were recruited in December 2013. Maximum variation sampling was used. Students were interviewed by a researcher in the week prior to the
OSCE and then again in the week following the OSCE in Jan 2014. Interviews were minimally structured in order to be open to respondents, rather than adhering to a fixed topic guide, but focussed on participants’ experiences, thoughts and feelings about taking part in OSCEs. Interviews were audio-recorded and
transcribed. Students were also asked to complete a short diary entry in the days prior to the OSCEs and another immediately following. Diary entries were written, emailed or audio-recorded at student’s preference.
Results
Transcripts are currently being analysed by interpretative phenomenological analysis. Preliminary analysis has demonstrated the significance of students’ relationships within the OSCE triad (student, SP and examiner); the effect of the immediate examination environment; realism versus roleplay; students’ perceptions of the purpose of assessment; and coping mechanisms.
Full results will be available by the time of the conference.
Conclusion and Discussion
Understanding the student experience in OSCEs is a crucial step in understanding the complex construction of relationships within the OSCE triad. The focus in OSCEs is typically on standardisation and reliability, but in exploring social interactions we may refocus attention on their inherent potential for learning and effects on both students and patients.
References
1. Hodges B. Medical education and the maintenance of incompetence. Med Teach 2006;28(8):690-6
2. Johnston JL, Lundy G, McCullough M, Gormley GJ. The view from over there: reframing the OSCE through the experience of standardised patient
raters. Med Educ 2013;47(9):899-909

The Development of an Immersive Virtual Reality Environment for Manufacturing and Improving Organizational Learning

This paper examines the applicability of an immersive virtual reality (VR) system to the process of organizational learning in a manufacturing context. The work focuses on the extent to which realism has to be represented in a simulated product build scenario in order to give the user an effective learning experience for an assembly task. Current technologies allow the visualization and manipulation of objects in VR systems but physical behaviors such as contact between objects and the effects of gravity are not commonly represented in off the shelf simulation solutions and the computational power required to facilitate these functions remains a challenge. This work demonstrates how physical behaviors can be coded and represented through the development of more effective mechanisms for the computer aided design (CAD) and VR interface.

Fleuve glauque : les départements de la Seine, banlieue des romans « Spécial Police » de Frédéric Dard

This paper studies the representation of suburbs as a place of anguish in the “Special Police” novels (Fleuve Noir publisher, Paris) by Frédéric Dard. This anxiety, it is argued, is what lends this collection of 25 novels some of their essential qualities, their unhealthy climate and absolute darkness. Dard’s suburbs fit into the traditions of realism; but the atmosphere, characters and plots owe to the American hardboiled school and like in film noir, space is stylized and dramatized, and often used to express a judgment of moral nature. Spatial representations in these novels are part of a critique of civilization and constitute a comment on the social modernization and public intervention in the development of the French territory in the postwar period. The novels written by Frédéric Dard from the mid-1950s to mid-1960s offer a profoundly original representation of suburban angst and what was not yet known at the time as the suburban malaise. Avoiding clichés and excessively connoted referential spaces, Dard anchor these noir novels he called “novels of the night” in landscapes that are both biographical and intertextual. The West Suburbs of Paris and what was
to become the Yvelines department are at the centre of Dard’s novelistic geography, turning into a mythical and deadly space in which is negotiated an acculturation in France of the evil and ruined world described in American noir.

Should scientific realists be platonists?

Enhanced Indispensability Arguments (EIA) claim that Scientific Realists are committed to the existence of mathematical entities due to their reliance on Inference to the Best Explana- tion (IBE). Our central question concerns this purported parity of reasoning: do people who defend the EIA make an appropriate use of the resources of Scientific Realism (in particular, IBE) to achieve platonism? (§2) We argue that just because a variety of different inferential strategies can be employed by Scientific Realists does not mean that ontological conclusions concerning which things we should be Scientific Realists about are arrived at by any inferen- tial route which eschews causes (§3), and nor is there any direct pressure for Scientific Real- ists to change their inferential methods (§4). We suggest that in order to maintain inferential parity with Scientific Realism, proponents of EIA need to give details about how and in what way the presence of mathematical entities directly contribute to explanations (§5).

A review of rhizosphere carbon flow modelling

Rhizosphere processes play a key role in nutrient cycling in terrestrial ecosystems. Plant rhizodeposits supply low-molecular weight carbon substrates to the soil microbial community, resulting in elevated levels of activity surrounding the root. Mechanistic compartmental models that aim to model carbon flux through the rhizosphere have been reviewed and areas of future research necessary to better calibrate model parameters have been identified. Incorporating the effect of variation in bacterial biomass physiology on carbon flux presents a considerable challenge to experimentalists and modellers alike due to the difficulties associated with differentiating dead from dormant cells. A number of molecular techniques that may help to distinguish between metabolic states of bacterial cells are presented. The calibration of growth, death and maintenance parameters in rhizosphere models is also discussed. A simple model of rhizosphere carbon flow has been constructed and a sensitivity analysis was carried out on the model to highlight which parameters were most influential when simulating carbon flux. It was observed that the parameters that most heavily influenced long-term carbon compartmentalisation in the rhizosphere were exudation rate and biomass yield. It was concluded that future efforts to simulate carbon flow in the rhizosphere should aim to increase ecological realism in model structure.