Virtual reality Post Traumatic Stress Disorder (PTSD) exposure therapy results with active duty Iraq war combatants

Post Traumatic Stress Disorder (PTSD) is reported to be caused by traumatic events that are outside the range of usual human experience including (but not limited to) military combat, violent personal assault, being kidnapped or taken hostage and terrorist attacks. Initial data suggests that at least 1 out of 6 Iraq War veterans are exhibiting symptoms of depression, anxiety and PTSD. Virtual Reality (VR) delivered exposure therapy for PTSD has been used with reports of positive outcomes. The aim of the current paper is to present the rationale and brief description of a Virtual Iraq PTSD VR therapy application and present initial findings from its use with PTSD patients. Thus far, Virtual Iraq consists of a series of customizable virtual scenarios designed to represent relevant Middle Eastern VR contexts for exposure therapy, including a city and desert road convoy environment. User-centered design feedback needed to iteratively evolve the system was gathered from returning Iraq War veterans in the USA and from a system deployed in Iraq and tested by an Army Combat Stress Control Team. Results from an open clinical trial at San Diego Naval Medical Center of the first 18 treatment completers indicate that 14 no longer meet PTSD diagnostic criteria at post-treatment, with only one not maintaining treatment gains at 3 month follow-up. Clinical tests are also currently underway at Ft. Lewis, Emory University, Weill Cornell Medical College, Walter Reed Army Medical Center and 10 other sites. Other sites are preparing to use the application for a variety of PTSD and VR research purposes.

Adapting to the effects of climate change on water supply reliability

This paper presents preliminary results from an assessment of the barriers to adaptation to water supply shortage in a case study catchment in south east England with multiple supply companies. The investigation applies a conceptual framework, which distinguishes between generic barriers affecting the ability of supply companies to make adaptation decisions, and specific barriers to the implementation of each option. The preliminary analysis suggests that whilst there is a widespread awareness of the challenge of climate change, and a conceptual understanding of the need for adaptation, some of the generic barriers that will affect detailed evaluations and actual adaptation decisions have yet to be approached. The analysis also shows that different individual adaptation options are assessed differently by different stakeholders, and that there are differences in the barriers to adoption between supply-side and demand-side measures. First, however, the paper develops the general conceptual framework for the characterisation of the barriers to adaptation used in the study.

‘Pre-plan mapping’, networks, capital resources and community strategies in England

In this working paper we discuss current attempts to engage communities in planning policy formulation in the UK. In particular we focus on the preparation of Community Strategies (CS) in England to inform local public policy and the wider proposals recently published by the UK government to move towards enhanced community engagement in planning (DTLR, 2001). We discuss how such strategies could be operationalised with a conceptual framework developed following ideas derived from ANT (cf. Murdoch, 1997, 1998; Selman, 2000; Parker & Wragg, 1999; Callon, 1986, 1998) and the ‘capitals’ literature (Lin, 2002; Fine, 2001; Selman, 2000; Putnam, 1993). We see this as an expression of neo-pragmatic planning theory, (Hoch, 1996; Stein & Harper, 2000) to develop a form of ‘pre-plan mapping’.

Virtual reality Post Traumatic Stress Disorder (PTSD) exposure therapy results with active duty OIF/OEF service members

Posttraumatic stress disorder (PTSD) is reported to be caused by exposure to traumatic events including (but not limited to) military combat, violent personal assault, being kidnapped or taken hostage and terrorist attacks. Initial data suggest that at least 1 out of 6 Iraq War veterans are exhibiting symptoms of depression, anxiety and PTSD. Virtual reality (VR) delivered exposure therapy for PTSD has been used with reports of positive outcomes. The aim of the current paper, is to present the rationale and brief description of a Virtual Iraq/Afghanistan PTSD VR therapy application and present initial findings from its use with PTSD patients. Thus far, Virtual Iraq/Afghanistan consists of a series of customizable virtual scenarios designed to represent relevant Middle Eastern VR contexts for exposure therapy, including a city and desert road convoy environment. User-centered design feedback, needed to iteratively evolve the system, was gathered from returning Iraq War veterans in the USA and from a system deployed in Iraq and tested by an Army Combat Stress Control Team. Results from an open clinical trial at San Diego Naval Medical Center of the first 20 treatment completers indicate that 16 no longer met PTSD screening criteria at post-treatment, with only one not maintaining treatment gains at 3 month follow-up.

The use of cursor measures for motion-impaired computer users

“Point and click” interactions remain one of the key features of graphical user interfaces (GUIs). People with motion-impairments, however, can often have difficulty with accurate control of standard pointing devices. This paper discusses work that aims to reveal the nature of these difficulties through analyses that consider the cursor’s path of movement. A range of cursor measures was applied, and a number of them were found to be significant in capturing the differences between able-bodied users and motion-impaired users, as well as the differences between a haptic force feedback condition and a control condition. The cursor measures found in the literature, however, do not make up a comprehensive list, but provide a starting point for analysing cursor movements more completely. Six new cursor characteristics for motion-impaired users are introduced to capture aspects of cursor movement different from those already proposed.

Perception and haptics

For people with motion impairments, access to and independent control of a computer can be essential. Symptoms such as tremor and spasm, however, can make the typical keyboard and mouse arrangement for computer interaction difficult or even impossible to use. This paper describes three approaches to improving computer input effectivness for people with motion impairments. The three approaches are: (1) to increase the number of interaction channels, (2) to enhance commonly existing interaction channels, and (3) to make more effective use of all the available information in an existing input channel. Experiments in multimodal input, haptic feedback, user modelling, and cursor control are discussed in the context of the three approaches. A haptically enhanced keyboard emulator with perceptive capability is proposed, combining approaches in a way that improves computer access for motion impaired users.

The property development industry and sustainable urban brownfield regeneration in England: an analysis of case studies in Thames Gateway and Greater Manchester

The property development industry is a key actor in UK brownfield regeneration projects. UK policy has attempted to interlink ‘sustainable development’ and ‘sustainable brownfield’ policy agendas, which have found an additional focus through the UK government’s ‘Sustainable Communities Plan’, part of a growing international emphasis on sustainable development. This paper examines the emergence of these agendas and related policies, and the role of the property development industry in the regeneration of six differing brownfield sites, based in Thames Gateway and Greater Manchester. Using a conceptual framework, the paper investigates aspects of the sustainability of these projects and highlights key lessons from them for both the UK and overseas. The research is based on structured interviews with a variety of stakeholders, including developers, planners, consultants and community representatives to highlight emerging best practice and related policy implications.

Aligning business and IT from multi-level learning perspectives

Business and IT alignment is increasingly acknowledged as a key for organisational performance. However, alignment research lack to mechanisms that enable for on-going process with multi-level effects. Multi-level learning allows on-going effectiveness through development of the organisation and improved quality of business and IT strategies. In particular, exploration and exploitation enable effective process of alignment across dynamic multi-level of learning. Hence, this paper proposes a conceptual framework that links multi-level learning and business-IT strategy through the concept of exploration and exploitation, which considers short-term and long-term alignment together to address the challenges of strategic alignment faced in sustaining organisational performance.

Comparative biology of mammalian telomeres: hypotheses on ancestral states and the roles of telomeres in longevity determination

Progressive telomere shortening from cell division (replicative aging) provides a barrier for human tumor progression. This program is not conserved in laboratory mice, which have longer telomeres and constitutive telomerase. Wild species that do ⁄ do not use replicative aging have been reported, but the evolution of different phenotypes and a conceptual framework for understanding their uses of telomeres is lacking. We examined telomeres ⁄ telomerase in cultured cells from > 60 mammalian species to place different uses of telomeres in a broad mammalian context. Phylogeny-based statistical analysis reconstructed ancestral states. Our analysis suggested that the ancestral mammalian phenotype included short telomeres (< 20 kb, as we now see in humans) and repressed telomerase. We argue that the repressed telomerase was a response to a higher mutation load brought on by the evolution of homeothermy. With telomerase repressed, we then see the evolution of replicative aging. Telomere length inversely correlated with lifespan, while telomerase expression co-evolved with body size. Multiple independent times smaller, shorter-lived species changed to having longer telomeres and expressing telomerase. Trade-offs involving reducing the energetic ⁄ cellular costs of specific oxidative protection mechanisms (needed to protect < 20 kb telomeres in the absence oftelomerase) could explain this abandonment of replicative aging. These observations provide a conceptual framework for understanding different uses of telomeres in mammals, support a role for human-like telomeres in allowing longer lifespans to evolve, demonstrate the need to include telomere length in the analysis of comparative studies of oxidative protection in the biology of aging, and identify which mammals can be used as appropriate model organisms for the study of the role of telomeres in human cancer and aging. Key words: evolution of telomeres; immortalization; telomerase; replicative aging; senescence.

System dynamics mapping of acute patient flows

Department of Health staff wished to use systems modelling to discuss acute patient flows with groups of NHS staff. The aim was to assess the usefulness of system dynamics (SD) in a healthcare context and to elicit proposals concerning ways of improving patient experience. Since time restrictions excluded simulation modelling, a hybrid approach using stock/flow symbols from SD was created. Initial interviews and hospital site visits generated a series of stock/flow maps. A ‘Conceptual Framework’ was then created to introduce the mapping symbols and to generate a series of questions about different patient paths and what might speed or slow patient flows. These materials formed the centre of three workshops for NHS staff. The participants were able to propose ideas for improving patient flows and the elicited data was subsequently employed to create a finalized suite of maps of a general acute hospital. The maps and ideas were communicated back to the Department of Health and subsequently assisted the work of the Modernization Agency.

Emerging agricultural hydrology problems in post-conflict Libya

This paper develops a conceptual framework for analyzing emerging agricultural hydrology problems in post-conflict Libya. Libya is one of the most arid regions on the planet. Thus, as well as substantial political and social changes, post-conflict Libyan administrators are confronted with important hydrological issues in Libya’s emerging water-landuse complex. This paper presents a substantial background to the water-land-use problem in Libya; reviews previous work in Libya and elsewhere on water-land-use issues and water-land-use conflicts in the dry and arid zones; outlines a conceptual framework for fruitful research interventions; and details the results of a survey conducted on Libyan farmers’ water usage, perceptions of emerging water-land-use conflicts and the appropriate value one should place on agricultural-use hydrological resources in Libya. Extensions are discussed.

Rights, symbolic violence and the micro-politics of the rural: the case of the Parish Paths Partnership scheme

In this paper microlevel politics and conflict associated with social and economic change in the countryside and linked changes in rural governance are explored with a focus upon research carried out on a recent rural policy initiative aimed at local 'empowerment'. This acts as a touchstone for a wider theoretical discussion. The paper is theorised within a conceptual framework derived and extended from the work of Pierre Bourdieu and others in order to explore case studies of the English Countryside Commission's Parish Paths Partnership scheme. The micropolitics involved with this scheme are examined and used to highlight more general issues raised by increased 'parish empowerment' in the 'postrural'.

Farmers’ attitudes to disease risk management in England: a comparative analysis of sheep and pig farmers

The UK Department for Environment, Food and Rural Affairs (Defra) identified practices to reduce the risk of animal disease outbreaks. We report on the response of sheep and pig farmers in England to promotion of these practices. A conceptual framework was established from research on factors influencing adoption of animal health practices, linking knowledge, attitudes, social influences and perceived constraints to the implementation of specific practices. Qualitative data were collected from nine sheep and six pig enterprises in 2011. Thematic analysis explored attitudes and responses to the proposed practices, and factors influencing the likelihood of implementation. Most feel they are doing all they can reasonably do to minimise disease risk and that practices not being implemented are either not relevant or ineffective. There is little awareness and concern about risk from unseen threats. Pig farmers place more emphasis than sheep farmers on controlling wildlife, staff and visitor management and staff training. The main factors that influence livestock farmers’ decision on whether or not to implement a specific disease risk measure are: attitudes to, and perceptions of, disease risk; attitudes towards the specific measure and its efficacy; characteristics of the enterprise which they perceive as making a measure impractical; previous experience of a disease or of the measure; and the credibility of information and advice. Great importance is placed on access to authoritative information with most seeing vets as the prime source to interpret generic advice from national bodies in the local context. Uptake of disease risk measures could be increased by: improved risk communication through the farming press and vets to encourage farmers to recognise hidden threats; dissemination of credible early warning information to sharpen farmers’ assessment of risk; and targeted information through training events, farming press, vets and other advisers, and farmer groups, tailored to the different categories of livestock farmer.

The impact of overseas training on curriculum innovation and change in English language education in Western China

This article assesses the impact of a UK-based professional development programme on curriculum innovation and change in English Language Education (ELE) in Western China. Based on interviews, focus group discussions and observation of a total of 48 English teachers who had participated in an overseas professional development programme influenced by modern approaches to education and ELE, and 9 of their colleagues who had not taken part, it assesses the uptake of new approaches on teachers’ return to China. Interviews with 10 senior managers provided supplementary data. Using Diffusion of Innovations Theory as the conceptual framework, we examine those aspects of the Chinese situation that are supportive of change and those that constrain innovation. We offer evidence of innovation in classroom practice on the part of returnees and ‘reinvention’ of the innovation to ensure a better fit with local needs. The key role of course participants as opinion leaders in the diffusion of new ideas is also explored. We conclude that the selective uptake of this innovation is under way and likely to be sustained against a background of continued curriculum reform in China.

Employees' external representation of their workplace: key antecedents

Drawing on attitude theory, this study investigates the drivers of employees' expression of favorable opinions about their workplace. Despite its theoretical and managerial importance, the marketing literature largely ignores the topic. This study advances prior research by developing, and empirically testing, a conceptual framework of the relationship between workgroup support and favorable external representation of the workplace, mediated by emotional responses to this support. The present research investigates four new relationships: between workgroup support and emotional exhaustion, workgroup support and organizational commitment, workgroup support and job satisfaction, and emotional exhaustion and external representation of the workplace. Based on a sample of over 700 frontline service employees, this study finds that workgroup support affects favorable external representation of the workplace through various emotional responses (i.e., emotional exhaustion, organizational commitment and job satisfaction). In addition, the results identify employees' organizational commitment as the most important determinant of favorable external representation of the workplace, followed by job satisfaction and reduced emotional exhaustion. These results suggest that companies should develop practices that encourage workgroup support and organizational commitment to achieve favorable external representation of the workplace.