Understanding Media Production: A rejoinder to Murdock and Golding

This article is a rejoinder to Murdock and Golding’s response to my critique of the political economy of communications (PEC) analysis of media production (see Author 2015). This article sets this exchange in the context of a broader debate in recent editions of Media, Culture & Society (Garnham 2016, Fuchs, 2016) about the value of PEC. Much of this debate stems from Garnham’s (2011) critical review of 40 years of PEC research.

Visual Dependency and Dizziness after Vestibular Neuritis

Symptomatic recovery after acute vestibular neuritis (VN) is variable, with around 50% of patients reporting long term vestibular symptoms; hence, it is essential to identify factors related to poor clinical outcome. Here we investigated whether excessive reliance on visual input for spatial orientation (visual dependence) was associated with long term vestibular symptoms following acute VN. Twenty-eight patients with VN and 25 normal control subjects were included. Patients were enrolled at least 6 months after acute illness. Recovery status was not a criterion for study entry, allowing recruitment of patients with a full range of persistent symptoms. We measured visual dependence with a laptop-based Rod-and-Disk Test and severity of symptoms with the Dizziness Handicap Inventory (DHI). The third of patients showing the worst clinical outcomes (mean DHI score 36–80) had significantly greater visual dependence than normal subjects (6.35° error vs. 3.39° respectively, p = 0.03). Asymptomatic patients and those with minor residual symptoms did not differ from controls. Visual dependence was associated with high levels of persistent vestibular symptoms after acute VN. Over-reliance on visual information for spatial orientation is one characteristic of poorly recovered vestibular neuritis patients. The finding may be clinically useful given that visual dependence may be modified through rehabilitation desensitization techniques.

Longitudinal evaluation of quality of life in 288 patients with Neurofibromatosis 2

Advances in molecular biology have resulted in novel therapy for neurofibromatosis 2-related (NF2) tumours, highlighting the need for robust outcome measures. The disease-focused NF2 impact on quality of life (NFTI-QOL) patient questionnaire was assessed as an outcome measure for treatment in a multi-centre study. NFTI-QOL was related to clinician-rated severity (ClinSev) and genetic severity (GenSev) over repeated visits. Data were evaluated for 288 NF2 patients (n = 464 visits) attending the English national NF2 clinics from 2010 to 2012. The male-to-female ratio was equal and the mean age was 42.2 (SD 17.8) years. The analysis included NFTI-QOL eight-item score, ClinSev graded as mild, moderate, or severe, and GenSev as a rank order of the number of NF2 mutations (graded as mild, moderate, severe). The mean (SD) 8.7 (5.4) score for NFTI-QOL for either a first visit or all visits 9.2 (5.4) was similar to the published norm of 9.4 (5.5), with no significant relationships with age or gender. NFTI-QOL internal reliability was good, with a Cronbach’s alpha score of 0.85 and test re-test reliability r = 0.84. NFTI related to ClinSev (r = 0.41, p < 0.001; r = 0.46 for all visits), but weakly to GenSev (r = 0.16, p < 0.05; r = 0.15 for all visits). ClinSev related to GenSev (r = 0.41, p < 0.001; r = 0.42 for all visits). NFTI-QOL showed a good reliability and ability to detect significant longitudinal changes in the QOL of individuals. The moderate relationships of NFTI-QOL with clinician- and genetic-rated severity suggest that NFTI-QOL taps into NF2 patient experiences that are not encompassed by ClinSev rating or genotype.

Invited lectures from a spatial orientation symposium in honor of Frederick Guedry, Day 2

This report contains the invited lectures from day 2 of a Spatial Orientation Symposium in honor of the late Dr. Frederick Guedry, held at the Institute of Human and Machine Cognition (IHMC) in Pensacola, Florida in November of 2010. The conference was sponsored by the Coalition Warfare Program of the Office of the Under Secretary of Defense for Acquisition, Technology, and Logistics. It was organized by Drs. Angus Rupert and Ben Lawson (USAARL) and hosted by Drs. Anil Raj and Ken Ford (IHMC). The lectures from day 1 are in Lawson et al., 2014. Day 2 includes lectures by Drs. Scott, Ben Lawson, Angus Rupert, Owen Black, Karen Atkins, Kim Gottshall, Anil Raj, and Måns Magnusson. The lectures focus on the structure, function and reflexes of the vestibular system, orientation perceptions, motion sickness, adaptation, and rehabilitation. This report also features banquet talks given by Drs. Lawson and Rupert, in which they honor Dr. Fred Guedry. Also featured is an interview with Dr. Guedry, conducted by a Navy historian, in which the reader can catch a glimpse into Dr. Guedry's wartime experiences and early days as a researcher.

Toxicity profile of bevacizumab in the UK Neurofibromatosis Type 2 cohort

Bevacizumab is considered an established part of the treatment strategies available for schwannomas in patients with Neurofibromatosis Type 2(NF2). In the UK, it is available through NHS National Specialized Commissioning to NF2 patients with a rapidly growing target schwannoma. Regrowth of the tumour on suspension of treatment is often observed resulting in prolonged periods of exposure to bevacizumab to control the disease. Hypertension and proteinuria are common events with bevacizumab use and there are concerns with regards to the long-term risks of prolonged treatment. Dosing, demographic and adverse event(CTCAE 4.03) data from the UK NF2 bevacizumab cohort are reviewed with particular consideration of renal and cardiovascular complications. Eighty patients (48 male:32female), median age 24.5 years (range 11-66years), were followed for a median of 32.7 months (range 12.0–60.2months). The most common adverse events were fatigue, hypertension and infection. A total of 19/80 patients (24%) had either a grade 2 or grade 3 hypertension event and 14/80 patients (17.5%) had proteinuria. Of 36 patients followed for 36 months, 78% were free from hypertension and 86% were free of proteinuria. Logistic regression modeling identified age and induction dosing regime to be predictors of development of hypertension with dose of 7.5mg/kg three weekly and age >30years having higher rates of hypertension. Proteinuria persisted in one of three patients after cessation of bevacizumab. One patient developed congestive heart failure and the details of this case are described. Further work is needed to determine optimal dosing regimes to limit toxicity without impacting on efficacy.

Motion Sickness

Over 2000 years ago the Greek physician Hippocrates wrote, “sailing on the sea proves that motion disorders the body.” Indeed, the word “nausea” derives from the Greek root word naus, hence “nautical,” meaning a ship. The primary signs and symptoms of motion sickness are nausea and vomiting. Motion sickness can be provoked by a wide variety of transport environments, including land, sea, air, and space. The recent introduction of new visual technologies may expose more of the population to visually induced motion sickness. This chapter describes the signs and symptoms of motion sickness and different types of provocative stimuli. The “how” of motion sickness (i.e., the mechanism) is generally accepted to involve sensory conflict, for which the evidence is reviewed. New observations concern the identification of putative “sensory conflict” neurons and the underlying brain mechanisms. But what reason or purpose does motion sickness serve, if any? This is the “why” of motion sickness, which is analyzed from both evolutionary and nonfunctional maladaptive theoretic perspectives. Individual differences in susceptibility are great in the normal population and predictors are reviewed. Motion sickness susceptibility also varies dramatically between special groups of patients, including those with different types of vestibular disease and in migraineurs. Finally, the efficacy and relative advantages and disadvantages of various behavioral and pharmacologic countermeasures are evaluated.

Prevalence, Predictors & Prevention of Motion Sickness in Zero-G Parabolic Flights

INTRODUCTION Zero-G parabolic flight reproduces the weightlessness of space for short periods of time. However motion sickness may affect some fliers. The aim was to assess the extent of this problem and to find possible predictors and modifying factors. METHODS Airbus Zero-G flights consist of 31 parabolas performed in blocks. Each parabola consisted of 20s 0g sandwiched by 20s hypergravity of 1.5-1.8g. The survey covered n=246 person-flights (193 Males 53 Females), aged (M+/-SD) 36.0+/-11.3 years. An anonymous questionnaire included motion sickness rating (1=OK to 6=Vomiting), Motion Sickness Susceptibility Questionnaire (MSSQ), anti-motion sickness medication, prior Zero-G experience, anxiety level, and other characteristics. RESULTS Participants had lower MSSQ percentile scores 27.4+/-28.0 than the population norm of 50. Motion sickness was experienced by 33% and 12% vomited. Less motion sickness was predicted by older age, greater prior Zero-G flight experience, medication with scopolamine, lower MSSQ scores, but not gender nor anxiety. Sickness ratings in fliers pre-treated with scopolamine (1.81+/-1.58) were lower than for non-medicated fliers (2.93+/-2.16), and incidence of vomiting in fliers using scopolamine treatment was reduced by half to a third. Possible confounding factors including age, sex, flight experience, MSSQ, could not account for this. CONCLUSION Motion sickness affected one third of Zero-G fliers, despite being intrinsically less motion sickness susceptible compared to the general population. Susceptible individuals probably try to avoid such a provocative environment. Risk factors for motion sickness included younger age and higher MSSQ scores. Protective factors included prior Zero-G flight experience (habituation) and anti-motion sickness medication.

Meniere’s, Migraine & Motion Sickness

CONCLUSION Elevated MSS in MD is likely to be a consequence of the onset of MD and not migraine per se. OBJECTIVES Pathologies of the vestibular system influence motion sickness susceptibility (MSS). Bilateral vestibular deficits lower MSS, vestibular neuritis or benign paroxysmal positional vertigo have little overall effect, whereas vestibular migraine elevates MSS. However, less is known about MSS in Meniere’s disease (MD), a condition in which many patients experience vestibular loss and migraine symptoms. METHODS We conducted an online survey that posed diagnostic and disease questions before addressing frequency of headaches, migraines, visual display dizziness (VDD), syncope, social life and work impact of dizziness (SWID4) and motion sickness susceptibility (MSSQ). The two groups were: diagnosed MD individuals with hearing loss (n=751) and non-MD individuals in the control group (n=400). RESULTS The MD group showed significantly elevated MSS, more headache and migraine, increased VDD, higher SWID4 scores, and increased syncope. MSS was higher in MD than controls only after the development of MD but not before, nor in childhood. Although elevated in MD compared with controls, MSS was lower than migraine patients from past data. Multivariate analysis revealed VDD, SWID4 and MSS in adulthood as the strongest predictors of MD, but not headache nor migraine.