Combining and integrating life /social sciences and citizen trainers in Nurse Education - a N. Ireland initiative

Before commencement of the academic year 2012/2013 the social sciences, public health and the biomedical sciences were taught to separate modules. This reinforced the idea off separate disciplines certainly for some of the younger students and a failure to appreciate the interconnectedness (whole person) perspective on health; separately modules taught and assessed in separate silos. There was limited understanding by the lecturers of the other areas that they were not teaching to -reflecting perhaps a dis-coordinated approach to health sciences (Mason and Whitehead 2003). As a result of significant discussion and interdisciplinary negotiation the life, social sciences public health/ health education were drawn together in the one module for the academic year 2012/13. The module provides the undergraduate students with an introduction to an understanding of Life Sciences, psychology, sociology and public health and their contribution within the context of nursing and midwifery. Each week’s teaching seeks to reflect against the other module delivered in first year - addressing clinical skills. The teaching is developing innovative e-learning approaches, including the use of a virtual community. The intention is to provide the student with a more integrated understanding and teaching to the individual’s health and to health within a social context (Lin 2001; Iles- Shih 2011). The focus is on health promotion rather than disease management. The module runs in three phases across the student’s first-year and teachers to the field of adult mental health, learning disability, children’s nursing and the midwifery students -progressively building on the student’s clinical experience. The predominant focus of the module remains on health and reflecting aspects of life and social life within N. Ireland. One of the particular areas of interest and an area of particular sensitivity is engaging the students to the context of the Northern Ireland civil unrest (the Troubles); this involves a co-educational initiative with service users, only previously attempted with social work students (Duffy 2012). The service users are represented by WAVE an organisation offering care and support to bereaved, traumatised or injured as a result of the violent civil conflict `the Troubles’. The `Troubles’ had ranged over an extended period and apart from the more evident and visual impact of death and injury, the community is marked by a disproportionate level of civil unrest, the extremes of bereavement, imprisonment, displacement antisocial behaviour and family dysfunction (Coulter et al. 2012). As co-educators with the School of Nursing and Midwifery, WAVE deliver a core lecture (augmented by online material), then followed by tutorials. The tutorials are substantially led by those who had been involved with and experienced loss and trauma as a result of the conflict (Health Service users) as `citizen trainers’ and provide an opportunity for them to share their experience and their recollection of personal interaction with nursing and midwifery students; in improving their understanding of the impact of `The Troubles’ on patients and clients affected by the events (Coulter et al. 2012) and to help better provide a quality of care cognisant of the particular needs of those affected by `the Troubles’ in N.Ireland. This approach is relatively unique to nursing in N. Ireland in that it involves many of those directly involved with and injured by the `Troubles’ as `citizen trainers’ and clearly reflects the School’s policy of progressively engaging with users and carers of nursing and midwifery services as co-educators to students (Repper & Breeze 2006). Only now could perhaps such a sensitive level of training to student nurses and midwives be delivered across communities with potential educative lessons for other communities experiencing significant civil unrest and sectarian conflict.

Selection of burst-like transients and stochastic variables using multi-brand image differencing in the Pan-STARRS1 Medium Deep Survey

We present a novel method for the light-curve characterization of Pan-STARRS1 Medium Deep Survey (PS1 MDS) extragalactic sources into stochastic variables (SVs) and burst-like (BL) transients, using multi-band image-differencing time-series data. We select detections in difference images associated with galaxy hosts using a star/galaxy catalog extracted from the deep PS1 MDS stacked images, and adopt a maximum a posteriori formulation to model their difference-flux time-series in four Pan-STARRS1 photometric bands gP1, rP1, iP1, and zP1. We use three deterministic light-curve models to fit BL transients; a Gaussian, a Gamma distribution, and an analytic supernova (SN) model, and one stochastic light-curve model, the Ornstein-Uhlenbeck process, in order to fit variability that is characteristic of active galactic nuclei (AGNs). We assess the quality of fit of the models band-wise and source-wise, using their estimated leave-out-one cross-validation likelihoods and corrected Akaike information criteria. We then apply a K-means clustering algorithm on these statistics, to determine the source classification in each band. The final source classification is derived as a combination of the individual filter classifications, resulting in two measures of classification quality, from the averages across the photometric filters of (1) the classifications determined from the closest K-means cluster centers, and (2) the square distances from the clustering centers in the K-means clustering spaces. For a verification set of AGNs and SNe, we show that SV and BL occupy distinct regions in the plane constituted by these measures. We use our clustering method to characterize 4361 extragalactic image difference detected sources, in the first 2.5 yr of the PS1 MDS, into 1529 BL, and 2262 SV, with a purity of 95.00% for AGNs, and 90.97% for SN based on our verification sets. We combine our light-curve classifications with their nuclear or off-nuclear host galaxy offsets, to define a robust photometric sample of 1233 AGNs and 812 SNe. With these two samples, we characterize their variability and host galaxy properties, and identify simple photometric priors that would enable their real-time identification in future wide-field synoptic surveys.

An exploration of integrated data on the social dynamics of suicide among women

The gender based nature of suicide related behaviour is largely accepted.However, studies which report exclusively on female fatal suicides are rare.Here we demonstrate how female fatal suicide has effectively been ‘othered’ and appears ‘incidental’ in studies which compare female behaviour with that of their male counterparts. We highlight how recent studies of suicide have tended to be dominated by male only approaches,which increasingly link issues of masculinity with male death by suicide.Drawing on data collected from the GP and Coroner’s office, we then apply the Sociological Autopsy approach to a cohort of 78 deaths recorded as suicides in the UK between 2007 and 2009. By focusing on females in isolation from males, we demonstrate that as in male suicide only studies,it is similarly possible to draw out issues associated with the feminine identity which can be linked to death by suicide. We identify that bereavement, sexual violence and motherhood could all be linked to the lives and help-seeking of the females who died. In closing, we suggest are orientation towards sociological analytic approaches of female suicide may help to produce further reductions in the rate of female death by suicide.

Representing Irishness in Belfast’s Gaeltacht Quarter

This paper examines a place-making project in post-conflict Belfast, analyzing efforts to transform an area which has often been used as a byword for militant Irish nationalism and social deprivation into an inclusive, vibrant tourist destination and cultural hub themed around the Irish language (called the "Gaeltacht Quarter‟). The antagonistic and territorial assumptions about place that characterize divided cities now co-exist with global trends towards the commodification of difference as recreation or spectacle, and longstanding struggles over the representation of contested identities are intertwined with the struggle to compete for international tourism and investment. The proliferation of officially themed quarters in many cities across the world reflects the enthusiasm with which planning authorities have embraced the vision of difference as a benign resource for the creation of tourist revenue. Yet, analysis of „quartering‟ processes reveals that such commodification does not neutralise or evade the political potency of naming, representing and delimiting cultural difference. Indeed, this paper argues that such projects offer a valuable insight into the inseparable roles of physical and representational space as both loci and catalysts of contestation in urban conflicts. Bringing together a wide range of public and private interest groups, projects redefining parts of Belfast as distinctive quarters have been explicitly linked with efforts to deterritorialize the city. The creation of bounded, themed spaces as an attempt to leave behind the ethno-sectarian geographical segregation that parts of Belfast still experience has its particular ironies, but is in many ways typical of contemporary trends in urban planning. The Gaeltacht Quarter exemplifies both the importance and the challenge of representation within cities where culturally distinguishing features have acted as markers of violent division, and where negotiations about how to successfully encompass difference necessarily address multiple local and international audiences simultaneously.

Improvisation, Indeterminacy and Game-Mediated Participation in Network Music Performance

This chapter focuses on the relationship between improvisation and indeterminacy. We discuss the two practices by referring to play theory and game studies and situate it in recent network music performance. We will develop a parallel with game theory in which indeterminacy is seen as a way of articulating situations where structural decisions are left to the discernment of the performers and discuss improvisation as a method of play. The improvisation-indeterminacy relationship is discussed in the context of network music performance, which employs digital networks in the exchange of data between performers and hence relies on topological structures with varying degrees of openness and flexibility. Artists such as Max Neuhaus and The League of Automatic Music Composers initiated the development of a multitude of practices and technologies exploring the network as an environment for music making. Even though the technologies behind “the network” have shifted dramatically since Neuhaus’ use of radio in the 1960’s, a preoccupation with distribution and sharing of artistic agency has remained at the centre of networked practices. Gollo Föllmer, after undertaking an extensive review of network music initiatives, produced a typology that comprises categories as diverse as remix lists, sound toys, real/virtual space installations and network performances. For Föllmer, “the term ‘Net music’ comprises all formal and stylistic kinds of music upon which the specifics of electronic networks leave considerable traces, whereby the electronic networks strongly influence the process of musical production, the musical aesthetic, or the way music is received” (2005: 185).

Som da Maré: Um Projeto Participativo de Arte Sonora

In May 2014, the participative Project Som da Maré brings together the creative energy of a group of inhabitants from a cluster of favelas in Maré (Rio de Janeiro)* through the sonic arts. The work recalls everyday experiences, memories, stories and places. These memories elicit narratives that leave traces in space while contributing to the workings of local cultural.

The result of four months of workshops and fieldwork forms the basis of two cultural interventions: an exhibition in Museu da Maré** and guided soundwalks in the city of Rio de Janeiro. These interventions present realities, histories and ambitions of everyday life in the Maré favelas through immersive sound installation, documentary photography, text and objects.

Som da Maré brings together various groups of participants who together have developed themes, materials and strategies for the articulation of elements of everyday life in Maré. Participants include secondary level students under the Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ) “Young Talent” scholarships and their families, post-graduate students at the Universidade Federal do Rio de Janeiro (UFRJ), PhD students from the Sonic Arts Research Centre (Queen’s University Belfast) and members of the Cia Marginal, a theatre company based in Maré. The project also counts with the participation of academics from music, ethnomusicology, visual art and architecture at the UFRJ and a partnership with the Museu da Maré. Over thirty people have come together to make this project possible.

Studying administrative reforms through textual analysis: the case of Italian central government accounting

This paper contributes to the literature on public-sector reforms by proposing textual analysis as a useful research strategy to explore how reform archetypes and related ideas are deployed in the parliamentary debate and regulations advancing reforms. Public Administration (PA) (Wilson 1887; Weber 1922), New Public Management (NPM) (Hood 1991, 1995; Dunleavy and Hood 1994; Ferlie et al. 1996) and Public Governance (GOV) (Osborne 2010; Rhodes 1997) can be depicted as three different archetypes providing characteristic administrative ideas and concepts (i.e. interpretive schemes) and related tools and practices (i.e. structures and systems) which lead reforms. We use textual analysis to look into more than twenty years of Italian central government accounting reforms and investigate how the three administrative archetypes have evolved, intertwined and replaced each other. Textual analysis proves a useful tool to investigate reform processes and allows highlighting that in neo-Weberian countries, such as Italy, NPM and GOV, far from being revolutionary paradigms, may represent fashionable trends that did not leave significant traces in the practice and rhetoric of reforms. These results also suggest interesting implications for practitioners and policy makers.

Enabling Robust and Efficient Distributed Computation in Dynamic Peer-to-Peer Networks

Motivated by the need for designing efficient and robust fully-distributed computation in highly dynamic networks such as Peer-to-Peer (P2P) networks, we study distributed protocols for constructing and maintaining dynamic network topologies with good expansion properties. Our goal is to maintain a sparse (bounded degree) expander topology despite heavy {\em churn} (i.e., nodes joining and leaving the network continuously over time). We assume that the churn is controlled by an adversary that has complete knowledge and control of what nodes join and leave and at what time and has unlimited computational power, but is oblivious to the random choices made by the algorithm. Our main contribution is a randomized distributed protocol that guarantees with high probability the maintenance of a {\em constant} degree graph with {\em high expansion} even under {\em continuous high adversarial} churn. Our protocol can tolerate a churn rate of up to $O(n/\poly\log(n))$ per round (where $n$ is the stable network size). Our protocol is efficient, lightweight, and scalable, and it incurs only $O(\poly\log(n))$ overhead for topology maintenance: only polylogarithmic (in $n$) bits needs to be processed and sent by each node per round and any node's computation cost per round is also polylogarithmic. The given protocol is a fundamental ingredient that is needed for the design of efficient fully-distributed algorithms for solving fundamental distributed computing problems such as agreement, leader election, search, and storage in highly dynamic P2P networks and enables fast and scalable algorithms for these problems that can tolerate a large amount of churn.

Fast Byzantine Leader Election in Dynamic Networks

We study the fundamental Byzantine leader election problem in dynamic networks where the topology can change from round to round and nodes can also experience heavy {\em churn} (i.e., nodes can join and leave the network continuously over time). We assume the full information model where the Byzantine nodes have complete knowledge about the entire state of the network at every round (including random choices made by all the nodes), have unbounded computational power and can deviate arbitrarily from the protocol. The churn is controlled by an adversary that has complete knowledge and control over which nodes join and leave and at what times and also may rewire the topology in every round and has unlimited computational power, but is oblivious to the random choices made by the algorithm. Our main contribution is an $O(\log^3 n)$ round algorithm that achieves Byzantine leader election under the presence of up to $O({n}^{1/2 - \epsilon})$ Byzantine nodes (for a small constant $\epsilon > 0$) and a churn of up to \\$O(\sqrt{n}/\poly\log(n))$ nodes per round (where $n$ is the stable network size).The algorithm elects a leader with probability at least $1-n^{-\Omega(1)}$ and guarantees that it is an honest node with probability at least $1-n^{-\Omega(1)}$; assuming the algorithm succeeds, the leader's identity will be known to a $1-o(1)$ fraction of the honest nodes. Our algorithm is fully-distributed, lightweight, and is simple to implement. It is also scalable, as it runs in polylogarithmic (in $n$) time and requires nodes to send and receive messages of only polylogarithmic size per round.To the best of our knowledge, our algorithm is the first scalable solution for Byzantine leader election in a dynamic network with a high rate of churn; our protocol can also be used to solve Byzantine agreement in a straightforward way.We also show how to implement an (almost-everywhere) public coin with constant bias in a dynamic network with Byzantine nodes and provide a mechanism for enabling honest nodes to store information reliably in the network, which might be of independent interest.

DEX: self-healing expanders

Integrative analysis of chemo-transcriptomic profiles for drug-feature specific gene expression signatures

One of the major challenges in systems biology is to understand the complex responses of a biological system to external perturbations or internal signalling depending on its biological conditions. Genome-wide transcriptomic profiling of cellular systems under various chemical perturbations allows the manifestation of certain features of the chemicals through their transcriptomic expression profiles. The insights obtained may help to establish the connections between human diseases, associated genes and therapeutic drugs. The main objective of this study was to systematically analyse cellular gene expression data under various drug treatments to elucidate drug-feature specific transcriptomic signatures. We first extracted drug-related information (drug features) from the collected textual description of DrugBank entries using text-mining techniques. A novel statistical method employing orthogonal least square learning was proposed to obtain drug-feature-specific signatures by integrating gene expression with DrugBank data. To obtain robust signatures from noisy input datasets, a stringent ensemble approach was applied with the combination of three techniques: resampling, leave-one-out cross validation, and aggregation. The validation experiments showed that the proposed method has the capacity of extracting biologically meaningful drug-feature-specific gene expression signatures. It was also shown that most of signature genes are connected with common hub genes by regulatory network analysis. The common hub genes were further shown to be related to general drug metabolism by Gene Ontology analysis. Each set of genes has relatively few interactions with other sets, indicating the modular nature of each signature and its drug-feature-specificity. Based on Gene Ontology analysis, we also found that each set of drug feature (DF)-specific genes were indeed enriched in biological processes related to the drug feature. The results of these experiments demonstrated the pot- ntial of the method for predicting certain features of new drugs using their transcriptomic profiles, providing a useful methodological framework and a valuable resource for drug development and characterization.

Urban/rural variation in the influence of widowhood on mortality risk

Death of a spouse is associated with increased mortality risk for the surviving partner (the widowhood effect), although the mechanisms driving the effect are poorly understood. After acute stress and grief have dissipated, mortality risk may be increased by loss of emotional and instrumental support for daily living and so we investigated whether social support at both the household and community levels moderated the influence of spousal bereavement on mortality risk.

We assembled death records from the Northern Ireland Mortality Study spanning almost nine years for a prospective cohort of 296,125 married couples enumerated in the 2001 Census. Presence of other adults within the household and urban/rural residence were used as measures of support at the household and community levels, with informal social support perceived to be strongest in rural areas. We used Cox proportional hazards models to estimate the effects of widowhood, sex, household composition and urban/intermediate/rural residence on all-cause mortality.

Elevated mortality risk during the first six months of widowhood was found in all areas and for both sexes (range of hazard ratios 1.24, 1.57). After more than six months the effect among men was attenuated in rural but not urban areas (HRs and 95%CIs 1.09 [0.99, 1.21] and 1.35 [1.26, 1.44] respectively). Among women the effect was attenuated in both rural and urban areas (HRs 1.06 [0.96, 1.17] and 1.09 [1.01, 1.17]). Mortality risk post bereavement was not associated with presence of other adults in the household.

We found some support for the hypothesis that informal social support is beneficial for reducing the impacts of spousal loss. Rural residence had a positive effect especially among men but presence of other adults in the household had no effect. The reasons for this discrepancy require further investigation and we identify men in urban areas as being at greatest risk in the long term.

Recovery of Sleep or Recovery of Self? A Grounded Theory Study of Residents’ Decision Making Regarding How to Spend Their Nonclinical Postcall Time

Purpose: As resident work hours policies evolve, residents’ off-duty time remains poorly understood. Despite assumptions about how residents should be using their postcall, off-duty time, there is little research on how residents actually use this time and the reasoning underpinning their activities. This study sought to understand residents’ nonclinical postcall activities when they leave the hospital, their decision-making processes, and their perspectives on the relationship between these activities and their well-being or recovery.

Method: The study took place at a Liaison Committee on Medical Education–accredited Canadian medical school from 2012 to 2014. The authors recruited a purposive and convenience sample of postgraduate year 1–5 residents from six surgical and nonsurgical specialties at three hospitals affiliated with the medical school. Using a constructivist grounded theory approach, semistructured interviews were conducted, audio-taped, transcribed, anonymized, and combined with field notes. The authors analyzed interview transcripts using constant comparative analysis and performed post hoc member checking.

Results: Twenty-four residents participated. Residents characterized their predominant approach to postcall decision making as one of making trade-offs between multiple, competing, seemingly incompatible, but equally valuable, activities. Participants exhibited two different trade-off orientations: being oriented toward maintaining a normal life or toward mitigating fatigue.

Conclusions: The authors’ findings on residents’ trade-off orientations suggest a dual recovery model with postcall trade-offs motivated by the recovery of sleep or of self. This model challenges the dominant viewpoint in the current duty hours literature and suggests that the duty hours discussion must be broadened to include other recovery processes.

Exodus? The training paths and plans of postgraduate medical trainees, under the Royal College of Physicians of Ireland

Background: In 2006, the Buttimer report highlighted the paucity of demographic data on those applying for and entering postgraduate medical education and training (PGMET) in Ireland. Today, concerns that there is an "exodus" of graduates of Irish medical schools are at the forefront of national discussion, however, published data on PGMET remains inadequate.

Aims: The objectives of this study were to collate existing data relating to trainees and training programmes at three stages of training and to examine the career plans of junior trainees.

Methods: Data from application forms for training programmes, commencing July 2012, under the Royal College of Physicians of Ireland (n = 870), were integrated with data from other existing sources. Candidates entering basic specialist training were surveyed with regard to career plans. Descriptive and comparative analysis was performed in SPSS version 18.

Results: Graduates of Irish medical schools made up over 70 % of appointees. Over 80 % of BST trainees aspired to work as consultants in Ireland, but 92.5 % planned to spend time working abroad (response rate 77 %). Decisions to leave the Irish system were linked to lifestyle, but also to failure to be appointed to higher specialist training. Significant numbers of trainees return to Ireland after a period abroad.

Conclusions: The trainee "exodus" is more complex than is often portrayed. The desire to spend time working outside Ireland must be accounted for in workforce planning and configuration of training programmes. Expansion of HST is a potential solution to reduce the numbers of graduates leaving Ireland post-BST.

Turing’s Menagerie: Talking Lions, Virtual Bats, Electric Sheep and Analogical Peacocks: Common Ground and Common Interest are Necessary Components of Engagement

This theoretical paper attempts to define some of the key components and challenges required to create embodied conversational agents that can be genuinely interesting conversational partners. Wittgenstein’s argument concerning talking lions emphasizes the importance of having a shared common ground as a basis for conversational interactions. Virtual bats suggests that–for some people at least–it is important that there be a feeling of authenticity concerning a subjectively experiencing entity that can convey what it is like to be that entity. Electric sheep reminds us of the importance of empathy in human conversational interaction and that we should provide a full communicative repertoire of both verbal and non-verbal components if we are to create genuinely engaging interactions. Also we may be making the task more difficult rather than easy if we leave out non-verbal aspects of communication. Finally, analogical peacocks highlights the importance of between minds alignment and establishes a longer term goal of being interesting, creative, and humorous if an embodied conversational is to be truly an engaging conversational partner. Some potential directions and solutions to addressing these issues are suggested.