Anticipatory Planning Reveals Segmentation of Cortical Motor Output During Action Observation

It has been argued that the variation in brain activity that occurs when observing another person reflects a representation of actions that is indivisible, and which plays out in full once the intent of the actor can be discerned. We used transcranial magnetic stimulation to probe the excitability of corticospinal projections to 2 intrinsic hand muscles while motions to reach and grasp an object were observed. A symbolic cue either faithfully indicated the required final orientation of the object and thus the nature of the grasp that was required, or was in conflict with the movement subsequently displayed. When the cue was veridical, modulation of excitability was in accordance with the functional role of the muscles in the action observed. If however the cue had indicated that the alternative grasp would be required, modulation of output to first dorsal interosseus was consistent with the action specified, rather than the action observed-until the terminal phase of the motion sequence during which the object was seen lifted. Modulation of corticospinal output during observation is thus segmented-it progresses initially in accordance with the action anticipated, and if discrepancies are revealed by visual input, coincides thereafter with that of the action seen.

Older People's Conceptualisation of Elder and neglect

Purpose

To be effective, definitions of elder abuse should be informed by the perspectives of older people themselves.

Methods

This qualitative study used data from eight focus groups involving 58 people aged over 65 years in both urban and rural settings across Northern Ireland and the Republic of Ireland. Following training, four older people assisted in facilitation and analysis as ‘peer-researchers'.

Findings

Increasing lack of respect within society was experienced as abusive. The vulnerability of older people to abuse was perceived as relating to the need for help and support, where standing up for themselves might have repercussions for the person's health or safety. Emotional abusiveness was viewed as underpinning all forms of abuse, and as influencing its experienced severity. Respondents' views as to whether an action was abusive required an understanding of intent; some actions that professionals might view as abusive were regarded as acceptable if they were in the older person's best interests.

Implications

Preventing abuse requires a wide-ranging approach including re-building respect for older people within society. Procedures to prevent elder abuse need to take into account the emotional impact of family relationships and intent, not just a description of behaviours that have occurred.

The impact of peer review on the radiotherapy treatment planning process in the treatment of lung cancer

Background:
Advanced radiotherapy techniques permit accurate delivery of radiotherapy to lung tumours. Improved accuracy increases the possibility of radiotherapy field geographic miss of the tumour. One source of error is the accuracy of target volume (TV) delineation by the clinical oncologist. Colleague peer review of all curative intent lung cancer plans has been mandatory in our institution since May 2013. At least 2 clinical oncologists review plans checking treatment paradigm, TV delineated, dose to tumour and dose to critical organs. We report the impact of peer review on the radiotherapy planning process for lung cancer.

Methods:
The radiotherapy treatment plans of all patients receiving radical radiotherapy were presented at weekly peer review meetings after their TVs volumes were provisionally signed off by the treating consultant or post-fellowship registrar. All cases and any resultant change to the treatment plan were recorded in our prospective peer review database. We present the summary of changes agreed following the peer review process for a 6 month period.

Results:
Fifteen peer review sessions, including 46 patients (36 NSCLC, 10 SCLC) were analysed. An average of 3 cases were discussed per meeting (range 1 5). 24% of treatment courses were changed. In 4% there was a complete change in paradigm
of treatment (1 patient proceeded to induction chemotherapy, 1 patient had high dose palliative radiotherapy). In 16% there was a change in TV delineated and in 9% a change in dose (2 dose reductions and 2 alterations to post-operative dose fractionations).

Conclusions:
Consultant led peer review resulted in a change in a component of the treatment plan for 28% of patients that would not otherwise have taken place. Given this impact, consultant led peer review should be considered as an essential component in the radiotherapy planning process for all patients treated with curative radiotherapy.

Automated Methods for Aircraft Design Integrated with Manufacturing

Aircraft design is a complex, long and iterative process that requires the use of various specialties and optimization tools. However these tools and specialities do not include manufacturing, which is often considered later in the product development process leading to higher cost and time delays. This work focuses on the development of an automated design tool that accounts for manufacture during the design process focusing on early geometry definition which in turn informs assembly planning. To accomplish this task the design process needs to be open to any variation in structural configuration while maintaining the design intent. Redefining design intent as a map which links a set of requirements to a set of functions using a numerical approach enables the design process itself to be considered as a mathematical function. This definition enables the design process to utilise captured design knowledge and translate it into a set of mathematical equations that design the structure. This process is articulated in this paper using the structural design and definition for an aircraft fuselage section as an exemplar.

Forgoing primacy: Damaging democratic policing in the West Bank

Since the Oslo Accords were signed between Israel and the Palestinian Liberation Organization (PLO) in September 1993, the international community has supported civil policing programmes. It has done so as part of its development commitments to Palestinian state-building. Such programmes were, until the outbreak of the second Intifada in 2000, largely regarded as successful in terms of supporting the establishment of a Palestinian civil police (PCP). Such programmes were essentially Western imported models which loosely mixed community and public order policing approaches. With re-engagement in the Palestinian security sector (PSS) in the West Bank in 2007, the international community has once again sought to play a major role in PSS reform. This role includes supporting rehabilitation and retraining of the PCP as a principal institution of state-building. Such activities alongside the so-called transformation efforts within the wider realm of the PSS have re-established as their goal law and order. Within the transformation agenda, there are inherent demands with respect to Israel and the Palestinian National Authority's security and counterterrorism agendas. This analysis examines these activities, and accompanying political intent to contend that such approaches are undermining principles of democratic policing including civil police primacy (CPP). CPP reinforces police universality and means supporting rule of law by putting security under governmental control with proper mechanisms of accountability. This article argues that support to the security sector in the West Bank has increasingly only paid lip service or sought to subvert normative approaches to democratic policing.

Listening to the World Through New Ears:Reinvention of the soundtrack in the works of Lucrecia Martel and Sofia Coppola

This paper explores the production and post-production techniques and tensions in designing sound for film. Considering the films of Lucrecia Martel and Sofia Coppola, amongst others, Greene and Yang will discuss how the soundtrack takes on a primary role in these films and becomes a medium for symbolism, reflection, characterisation, as well as storytelling. There will be a close examination of the processes involved in creating character-orientated soundscapes. These processes are sensitive to the effects sound has on an audience. Exploring how these filmmakers (with their sound teams) utilise the listening experience, including attention to point of audition and sound perception, this paper will critically unpick how such creative decisions are arrived at during various stages of the production process. Outlining the use of diegetic and non-diegetic sound and the potential musicality of sound effect design, issues of reverberation, noise and intent are discussed to highlight the sonic framing of these creative teams. Greene will approach these soundtracks from a production/post-production perspective, while Yang will explore the composer’s/designer’s ear.

OperationCheckpoint: SDN Application Control

One of the core properties of Software Defined Networking (SDN) is the ability for third parties to develop network applications. This introduces increased potential for innovation in networking from performance-enhanced to energy-efficient designs. In SDN, the application connects with the network via the SDN controller. A specific concern relating to this communication channel is whether an application can be trusted or not. For example, what information about the network state is gathered by the application? Is this information necessary for the application to execute or is it gathered for malicious intent? In this paper we present an approach to secure the northbound interface by introducing a permissions system that ensures that controller operations are available to trusted applications only. Implementation of this permissions system with our Operation Checkpoint adds negligible overhead and illustrates successful defense against unauthorized control function access attempts.

Interface management for automating finite element analysis workflows

This paper outlines the importance of robust interface management for facilitating finite element analysis workflows. Topological equivalences between analysis model representations are identified and maintained in an editable and accessible manner. The model and its interfaces are automatically represented using an analysis-specific cellular decomposition of the design space. Rework of boundary conditions following changes to the design geometry or the analysis idealization can be minimized by tracking interface dependencies. Utilizing this information with the Simulation Intent specified by an analyst, automated decisions can be made to process the interface information required to rebuild analysis models. Through this work automated boundary condition application is realized within multi-component, multi-resolution and multi-fidelity analysis workflows.

The Impact of Colleague Peer Review on the Radiotherapy Treatment Planning Process in the Radical Treatment of Lung Cancer

AIMS: Modern radiotherapy uses techniques to reliably identify tumour and reduce target volume margins. However, this can potentially lead to an increased risk of geographic miss. One source of error is the accuracy of target volume delineation (TVD). Colleague peer review (CPR) of all curative-intent lung cancer plans has been mandatory in our institution since May 2013. At least two clinical oncologists review plans, checking treatment paradigm, TVD, prescription dose tumour and critical organ tolerances. We report the impact of CPR in our institution.

MATERIALS AND METHODS: Radiotherapy treatment plans of all patients receiving radical radiotherapy were presented at weekly CPR meetings after their target volumes were reviewed and signed off by the treating consultant. All cases and any resultant change to TVD (including organs at risk) or treatment intent were recorded in our prospective CPR database. The impact of CPR over a 13 month period from May 2013 to June 2014 is reported.

RESULTS: One hundred and twenty-two patients (63% non-small cell lung carcinoma, 17% small cell lung carcinoma and 20% 'clinical diagnosis') were analysed. On average, 3.2 cases were discussed per meeting (range 1-8). CPR resulted in a change in treatment paradigm in 3% (one patient proceeded to induction chemotherapy, two patients had high-dose palliative radiotherapy). Twenty-one (17%) had a change in TVD and one (1%) patient had a change in dose prescription. In total, 6% of patients had plan adjustment after review of dose volume histogram.

CONCLUSION: The introduction of CPR in our centre has resulted in a change in a component of the treatment plan for 27% of patients receiving curative-intent lung radiotherapy. We recommend CPR as a mandatory quality assurance step in the planning process of all radical lung plans.

Vision and deaf awareness training is it app.ropriate?

Title
Visual and deaf awareness training is it app.ropriate
Purpose
Some of our most vulnerable patients have a sensory deficit. An app which focused on patients with a vision and/or hearing loss was developed for healthcare students. The intent was to embed the core values necessary for students to provide appropriate care for patients with a sensory deficit.
Setting
Queen’s University Belfast, School of Nursing and Midwifery.
Methods
Stage 1
A review of current sensory awareness training in the United Kingdom
Stage 2
Application for funding
Stage 3
Development of a teaching tool template with the essential aspects required for sensory awareness training
Stage 4
Collaboration with others: Royal National Institute for the Blind, Action on Hearing Loss, Computer technician.
Stage 5
Production and transfer of multimedia outputs onto a software application system.
Stage 6
App Piloted with a sample of lecturers (n=5), undergraduate nursing students (n=20), service users (n=5)
Stage 7
Editing
Stage 8
App made available to all undergraduate nursing students
Stage 9
App evaluation (n=300)



Results
Overall nursing students positively evaluated the app, 100% of students rated the app between good and excellent. Qualitative evidence from service users and practice partnerships was extremely positive:
"At last I feel listened too in respect to my hearing loss and empowered. I don't feel like I am complaining I am actually helping to create something which should benefit staff and all of us with a hearing or vision loss". Patient
“Very insightful into the lives of those with a disability will be so useful in practice as an aid to jog my memory". 1st year nursing student
Conclusion
It is hoped that further evaluation and implementation of the app will show an improved quality to the care delivered to those with a sensory deficit. We believe that by working in partnership with service users we have helped to create an innovative tool that benefits both staff and patients.
Financial disclosure Yes
Funding of £2700 was awarded in 2014 through the Martha McMenamin Memorial Northern Ireland Scholarship.

Resilience

Over the past decade the concept of ‘resilience’ has been mobilised across an increasingly wide range of policy arenas. For example, it has featured prominently within recent discussions on the nature of warfare, the purpose of urban and regional planning, the effectiveness of development policies, the intent of welfare reform and the stability of the international financial system. The term’s origins can be traced back to the work of the ecologist Crawford S. Holling and his formulation of a science of complexity. This paper reflects on the origins of these ideas and their travels from the field of natural resource management, which it now dominates, to contemporary social practices and policy arenas. It reflects on the ways in which a lexicon of complex adaptive systems, grounded in an epistemology of limited knowledge and uncertain futures, seeks to displace ongoing ‘dependence’ on professionals by valorising self-reliance and responsibility as techniques to be applied by subjects in the making of the resilient self. In so doing, resilience is being mobilised to govern a wide range of threats and sources of uncertainty, from climate change, financial crises and terrorism, to the sustainability of development, the financing of welfare and providing for an aging population. As such, ‘resilience’ risks becoming a measure of its subjects’ ‘fitness’ to survive in what are pre-figured as natural, turbulent orders of things.

Aggressiveness as a component of fighting ability in pigs using a game-theoretical framework

Understanding animal contests has benefited greatly from employing the concept of fighting ability, termed resource-holding potential (RHP), with body size/weight typically used as a proxy. However, victory does not always go to the larger/heavier contestant and the existing RHP approach thereby fails to accurately predict contest outcome. Aggressiveness, typically studied as a personality trait, might explain part of this discrepancy. We investigated whether aggressiveness forms a component of RHP, examining effects on contest outcome, duration and phases, plus physiological measures of costs (lactate and glucose). Furthermore, using the correct theoretical framework, we provide the first study to investigate whether individuals gather and use information on aggressiveness as part of an assessment strategy. Pigs, Sus scrofa, were assessed for aggressiveness in resident-intruder tests whereby attack latency reflects aggressiveness. Contests were then staged between size-matched animals diverging in aggressiveness. Individuals with a short attack latency in the resident-intruder test almost always initiated the first bite and fight in the subsequent contest. However, aggressiveness had no direct effect on contest outcome, whereas bite initiation did lead to winning in contests without an escalated fight. This indirect effect suggests that aggressiveness is not a component of RHP, but rather reflects a signal of intent. Winner and loser aggressiveness did not affect contest duration or its separate phases, suggesting aggressiveness is not part of an assessment strategy. A greater asymmetry in aggressiveness prolonged contest duration and the duration of displaying, which is in a direction contrary to assessment models based on morphological traits. Blood lactate and glucose increased with contest duration and peaked during escalated fights, highlighting the utility of physiological measures as proxies for fight cost. Integrating personality traits into the study of contest behaviour, as illustrated here, will enhance our understanding of the subtleties of agonistic interactions.

Voir Hitler en peinture

Voir Hitler en peinture / On Seeing a painting of Hitler
The article “Voir Hitler en peinture” (literally “On Seeing a painting of Hitler”) focuses on a painting by Oliver Jeffers entitled “Ginger Hitler”. This article suggests that, whatever Jeffers’ intent and inspiration were, his painting “defamiliarizes” Hitler (V. Shklovsky) and forces us to look at him afresh. For decades, Hitler has been demonised and dehumanised; yet, however unsettling this may be, he was human. As Professor Richard Evans, a leading expert in the history of Nazism, put it recently: “Viewing Hitler as a human being, which he undoubtedly was, is more challenging to our understanding, surely, than simply writing him off as a cartoon villain” (The Guardian, 30/04/2015).

Improving a regional chemotherapy service by learning from deaths occurring within 30 days of treatment with systemic anti-cancer therapy.

Background: Outwith clinical trials, patient outcomes specifically related to SACT (systemic anti-cancer therapy) are not well reported despite a significant proportion of patients receiving active treatment at the end of life. The NCEPOD reviewing deaths within 30 days of SACT found SACT caused or hastened death in 27% of cases.

Method: Across the Northern Ireland cancer network, 95 patients who died within 30 days of SACT for solid tumours were discussed at the Morbidity and Mortality monthly meeting during 2013. Using a structured template, each case was independently reviewed, with particular focus on whether SACT caused or hastened death.

Results: Lung, GI and breast cancers were the most common sites. Performance status was recorded in 92% at time of final SACT cycle (ECOG PS 0-2 89%).

In 57% the cause of death was progressive disease. Other causes included thromboembolism (13%) and infection (5% neutropenic sepsis, 6% non-neutropenic sepsis). In 26% with death from progressive disease, the patient was first cycle of first line treatment for metastatic disease. In the majority discussion regarding treatment aims and risks was documented. Only one patient was receiving SACT with curative intent, who died from appropriately managed neutropenic sepsis.

A definitive decision regarding SACT's role in death was made in 60%: in 49% SACT was deemed non-contributory and in 11% SACT was deemed the cause of death. In 40% SACT did not play a major role, but a definitive negative association could not be made.

Conclusion: Development of a robust review process of 30-day mortality after SACT established a benchmark for SACT delivery for future comparisons and identified areas for SACT service organisation improvement. Moreover it encourages individual practice reflection and highlights the importance of balancing patients' needs and concerns with realistic outcomes and risks, particularly in heavily pre-treated patients or those of poor performance status.

Handbook of International Special Education:Northern Ireland

The intent of the Handbook of International Special Education is to provide a concise overview of special education services in countries across the world using the Article on Education in the United Nations Convention on the Rights of Persons with Disabilities as the analytical frame. The Handbook will provide concise, data-driven contributions from across the globe using two primary frames: the relationship between special and general education in the country and the country’s system as aligned with the Article on Education in the UN Convention on the Rights of Person with Disabilities.