The views of general practitioners on advance care planning for patients living with dementia

Background Advance care planning (ACP) facilitates communication
and understanding of preferences, nevertheless the use of
ACPs in primary care for patients with dementia is low. The disease’s
uncertain course and the inability to communicate with
the patient living with dementia are significant challenges for
GPs.
Aim The purpose of this study was to describe the attitudes and
practice preferences of GPs working within the UK’s National
Health System (NHS) regarding communication, and decisionmaking
for patients with dementia and their families
Methods A cross-sectional survey, using a purposive, cluster sample
of GPs across Northern Ireland with registered dementia
patients was used.
Results One hundred and thirty-three GPs (40.6%) participated
in the survey, representing 60.9% of surveyed practices. While
most respondents regarded dementia as a terminal disease
(96.2%) only 37.6% felt that palliative care applied equally from
the time of diagnosis to severe dementia. While most respondents
thought that early discussions would facilitate decision-making
during advanced dementia (61%), respondents were divided
on whether ACP should be initiated at the time of diagnoses
(39.8% in favour vs 45.8% disagreed). Interestingly, GPs who
were longer in practice placed greater importance on the presence
of an advance directive (F (2, 124) = 3.38, p = 0.037).
Discussion The timing of initiating ACP varies across individuals
requiring GPs to carefully consider strategies and receptiveness
of the patient and family carer.
Conclusion The findings promote both ongoing training in communication
and dementia management for GPs to meet the
needs of their patients living with dementia.

Understanding Nonviolence

The use of nonviolent action is on the rise. From the Occupy Movement to the Arab Spring and mass protests on the streets of Brazil, activists across the world are increasingly using unarmed tactics to challenge oppressive, corrupt and unjust systems. But what exactly do we mean by nonviolence? How is it deployed and to what effect? Do nonviolent campaigns with political motivations differ from those driven by primarily economic concerns? What are the limits and opportunities for activists engaging in nonviolent action today? Is the growing number of nonviolence protests indicative of a new type of twenty-first century struggle or is it simply a passing trend?
Understanding Nonviolence: Contours and Contexts is the first book to offer a comprehensive introduction to nonviolence in theory and practice. Combining insightful analysis of key theoretical debates with fresh perspectives on contemporary and historical case studies, it explores the varied approaches, aims, and trajectories of nonviolent campaigns from Gandhi to the present day. With cutting-edge contributions from leading scholars and practitioners in the field, this accessible and lively book will be essential reading for activists, students and teachers of contentious politics, international security, and peace and conflict studies.

A constructive approach for examination timetabling based on adaptive decomposition and ordering

In this study, we investigate an adaptive decomposition and ordering strategy that automatically divides examinations into difficult and easy sets for constructing an examination timetable. The examinations in the difficult set are considered to be hard to place and hence are listed before the ones in the easy set in the construction process. Moreover, the examinations within each set are ordered using different strategies based on graph colouring heuristics. Initially, the examinations are placed into the easy set. During the construction process, examinations that cannot be scheduled are identified as the ones causing infeasibility and are moved forward in the difficult set to ensure earlier assignment in subsequent attempts. On the other hand, the examinations that can be scheduled remain in the easy set.

Within the easy set, a new subset called the boundary set is introduced to accommodate shuffling strategies to change the given ordering of examinations. The proposed approach, which incorporates different ordering and shuffling strategies, is explored on the Carter benchmark problems. The empirical results show that the performance of our algorithm is broadly comparable to existing constructive approaches.

Comparing Social Work Students' Perceptions of Risk Using Online Discussion Fora: Lessons Learned from a European Pilot Project

Comparisons of international child welfare systems have identified two basic orientations to practice; a ‘child protection’ orientation and a ‘child welfare’ orientation, which are founded upon fundamentally different values and assumptions regarding the family, the origins of child care problems, and the proper role of the state in relation to the family. This paper describes a project which sought to compare how undergraduate social work students from three European Universities perceive risk in referrals about the welfare of children and to explore the impact of different cultural, ideological and educational contexts on the way in which risk is constructed by students. Students from Northern Ireland, Germany and Poland examined three vignettes via ten online discussion fora each of which provided a narrative summary of their discussion. The paper presents some findings from the analysis of the qualitative data emerging from the student discussions and draws out the lessons learned in terms of how the project was designed and implemented using online discussion fora.

Non-thermal processes in coronae and beyond

This contribution summarizes the splinter session ``Non-thermal processes in coronae and beyond'' held at the Cool Stars 17 workshop in Barcelona in 2012. It covers new developments in high energy non-thermal effects in the Earth's exosphere, solar and stellar flares, the diffuse emission in star forming regions and reviews the state and the challenges of the underlying atomic databases.

A Hybrid Swarm Based Approach in Addressing University Timetabling Problems

This paper is concerned with the application of an automated hybrid approach in addressing the university timetabling problem. The approach described is based on the nature-inspired artificial bee colony (ABC) algorithm. An ABC algorithm is a biologically-inspired optimization approach, which has been widely implemented in solving a range of optimization problems in recent years such as job shop scheduling and machine timetabling problems. Although the approach has proven to be robust across a range of problems, it is acknowledged within the literature that there currently exist a number of inefficiencies regarding the exploration and exploitation abilities. These inefficiencies can often lead to a slow convergence speed within the search process. Hence, this paper introduces a variant of the algorithm which utilizes a global best model inspired from particle swarm optimization to enhance the global exploration ability while hybridizing with the great deluge (GD) algorithm in order to improve the local exploitation ability. Using this approach, an effective balance between exploration and exploitation is attained. In addition, a traditional local search approach is incorporated within the GD algorithm with the aim of further enhancing the performance of the overall hybrid method. To evaluate the performance of the proposed approach, two diverse university timetabling datasets are investigated, i.e., Carter's examination timetabling and Socha course timetabling datasets. It should be noted that both problems have differing complexity and different solution landscapes. Experimental results demonstrate that the proposed method is capable of producing high quality solutions across both these benchmark problems, showing a good degree of generality in the approach. Moreover, the proposed method produces best results on some instances as compared with other approaches presented in the literature.

Internationalising the Social Work Curriculum: A Working Toolkit for Higher Education Facilities

This toolkit was collated by social work academics at Queen’s University Belfast (QUB), United Kingdom in collaboration with social work educators nationally and internationally who are committed to the internationalisation of the social work curriculum. The information and examples contained in this document offer a practical guide for the development and evaluation of international opportunities for students and academics. The resources were designed with diverse educational settings in mind for the enhancement of social work learning and teaching.

Autonomous COLREGs Compliant Ship Navigation, Using BridgeSimulators and an Unmanned Vessel

This paper presents an approach to COLREGs compliant ship navigation. A system architecture is proposed, which will be implemented and tested on two platforms: networked bridge simulators and at sea trials using an autonomous unmanned surface vessel. Attention is paid to collision avoidance software and its risk mitigation.

Initiating advance care planning on end-of-life issues in dementia: Ambiguity among UK and Dutch physicians

Background
In dementia, advance care planning (ACP) of end-of-life issues may start as early as possible in view of the patient’s decreasing ability to participate in decision making. We aimed to assess whether practicing physicians in the Netherlands and the United Kingdom who provide most of the end-of-life care, differ in finding that ACP in dementia should start at diagnosis.

Methods
In a cross-sectional study, we surveyed 188 Dutch elderly care physicians who are on the staff of nursing homes and 133 general practitioners from Northern Ireland. We compared difference by country in the outcome (perception of ACP timing), rated on a 1–5 agreement scale. Regression analyses examined whether a country difference can be explained by contrasts in demographics, presence, exposure and role perceptions.

Results
There was wide variability in agreement with the initiation of ACP at dementia diagnosis, in particular in the UK but also in the Netherlands (60.8% agreed, 25.3% disagreed and 14.0% neither agreed, nor disagreed). Large differences in physician characteristics (Dutch physicians being more present, exposed and adopting a stronger role perception) hardly explained the modest country difference. The perception that the physician should take the initiative was independently associated with agreeing with ACP at diagnosis.

Conclusions
There is considerable ambiguity about initiating ACP in dementia at diagnosis among physicians practicing in two different European health care systems and caring for different patient populations. ACP strategies should accommodate not only variations in readiness to engage in ACP early among patient and families, but also among physicians.