The role of fingerprints in the coding of tactile information probed with a biomimetic sensor

In humans, the tactile perception of fine textures (spatial scale <200 micrometers) is mediated by skin vibrations generated as the finger scans the surface. To establish the relationship between texture characteristics and subcutaneous vibrations, a biomimetic tactile sensor has been designed whose dimensions match those of the fingertip. When the sensor surface is patterned with parallel ridges mimicking the fingerprints, the spectrum of vibrations elicited by randomly textured substrates is dominated by one frequency set by the ratio of the scanning speed to the interridge distance. For human touch, this frequency falls within the optimal range of sensitivity of Pacinian afferents, which mediate the coding of fine textures. Thus, fingerprints may perform spectral selection and amplification of tactile information that facilitate its processing by specific mechanoreceptors.Comment: 25 pages, 11 figures, article + supporting materia

The lived experience of dysphagia following non-surgical treatment for head and neck cancer

The prevalence and severity of dysphagia in people treated non-surgically for primary head and neck cancer (HNC) is well documented. However, few studies have looked beyond the physiological impairment to explore the lived experience of dysphagia in the post-treatment period of HNC. The current study adopted a person-centred, qualitative approach to describe the experiences of people living with dysphagia in the months and years following non-surgical treatment for HNC. Using maximum variation sampling, 24 participants who had undergone radiotherapy treatment for HNC were recruited. Individual interviews were conducted to explore the impact of dysphagia on participants' everyday lives. The themes identified included: (1) physical changes related to swallowing; (2) emotions evoked by living with dysphagia; (3) altered perceptions and changes in appreciation of food; and (4) personal and lifestyle impacts. The data revealed the breadth and significance of the impact of dysphagia on the lives of people treated curatively for HNC. Assessment and management in the post-treatment period must be sufficiently holistic to address both the changing physical states and the psychosocial needs of people with dysphagia following HNC. Rehabilitation services which focus only on impairment-based management will fail to fully meet the support needs of this clinical population

Survivors' experiences of dysphagia-related services following head and neck cancer: implications for clinical practice

Backgroun

Peacebuilding and governance in a post-conflict society: a comparative analysis of Northern Ireland and Colombia

When the Government of Colombia formally ratified a peace accord in November 2016 with the left-wing guerrilla group FARC (Revolutionary Armed Forces of Colombia)it promised an end to more than 50 years of conflictwhich claimed the lives of 220,000 and displaced nearly 8 million people (Guardian, 2016). The hope for peace in Colombiawas further strengthened by promising early signs of a similar agreement forming as the National Liberation Army (ELN) called a 102 day truce in October 2017 (Al Jazeera, 2017a). If Colombian peace is to be successful in the rebuilding of a stable and cohesive society, it will take concerted political efforts towards peacebuilding and governance on both the domestic and international levels. In light of this significant peace brokerage in a protracted civil conflict, the aim of this paper is to provide a comparative analysis of the nascent Colombian peace agreement alongside the Northern Irish peace process on its 20th year anniversary, in order to identifysome of the key challenges faced and methods of peacebuilding which have proven successful in increasing social capital and structural stability. Over the last twenty years, Northern Ireland has been the focus of many international peacebuilding strategies and conflict research programmes, and as such offers opportunity for detailed comparative analysis against the conflict transformation journey which has only just started in Colombia. Protracted conflicts have a lasting impact on civil society creating division along ethnic or political lines, and this translates into low levels of support for state governance structures. Indeed, there is significant evidence to suggest that without government social integration interventions these divisions can become trans-generational conflicts. By using World Bank governance indicators to measure the changes in civil society after peace, acknowledging that positive performance against governance indicators correlates with a reduced capacity for conflict (Fearon, 2010), this paper identifiesthe challenges faced by post-conflict societies and proposes several effective frameworks for long-term development and peacebuilding. Several common themes emerge, including: the necessity of international stewardship during peace negotiation to lend legitimacy to the process, the need for development models focusing on conflict transformation, and lastly the use of spatial planning to combat development duality and as a long-term strategy towards social cohesion

Gestural communication in orangutans (Pongo pygmaeus and Pongo abelii) : a cognitive approach

While most human language is expressed verbally, the gestures produced concurrent to speech provide additional information, help listeners interpret meaning, and provide insight into the cognitive processes of the speaker. Several theories have suggested that gesture played an important, possibly central, role in the evolution of language. Great apes have been shown to use gestures flexibly in different situations and to modify their gestures in response to changing contexts. However, it has not previously been determined whether ape gestures are defined by structural variables, carry meaning, are used to intentionally communicate specific information to others, or can be used strategically to overcome miscommunication. To investigate these questions, I studied three captive populations of orangutans (Pongo pygmaeus and P. abelii) in European zoos for 10 months. Sixty-four different gestures, defined through similarities in structure and use, were included in the study after meeting strict criteria for intentional usage. More than half of the gesture types were found to coincide frequently with specific goals of signallers, and were accordingly identified as having meanings. Both structural and social variables were found to determine gesture meaning. The recipient’s gaze in both the present and the past, and the recipient’s apparent understanding of the signaller’s gestures, affected the strategies orangutans employed in their attempts to communicate when confronted with different types of communicative failure (e.g. not seeing, ignoring, misunderstanding, or rejecting a gesture). Maternal influence affected the object-directed behaviour and gestures of infants, who shared more gestures with their mothers than with other females. These findings demonstrate that gesture can be used as a medium to investigate not only the communication but also the cognition of great apes, and indicate that orangutans are more sensitive to the perceptions and knowledge states of others than previously thought

Physiological changes to the swallowing mechanism following (Chemo)radiotherapy for head and neck cancer: a systematic review

Emerging research suggests that preventative swallowing rehabilitation, undertaken before or during (chemo)radiotherapy ([C]RT), can significantly improve early swallowing outcomes for head and neck cancer (HNC) patients. However, these treatment protocols are highly variable. Determining specific physiological swallowing parameters that are most likely to be impacted post-(C)RT would assist in refining clear targets for preventative rehabilitation. Therefore, this systematic review (1) examined the frequency and prevalence of physiological swallowing deficits observed post-(C)RT for HNC, and (2) determined the patterns of prevalence of these key physiological deficits over time post-treatment. Online databases were searched for relevant papers published between January 1998 and March 2013. A total of 153 papers were identified and appraised for methodological quality and suitability based on exclusionary criteria. Ultimately, 19 publications met the study’s inclusion criteria. Collation of reported prevalence of physiological swallowing deficits revealed reduced laryngeal excursion, base-of-tongue (BOT) dysfunction, reduced pharyngeal contraction, and impaired epiglottic movement as most frequently reported. BOT dysfunction and impaired epiglottic movement showed a collective prevalence of over 75 % in the majority of patient cohorts, whilst reduced laryngeal elevation and pharyngeal contraction had a prevalence of over 50 %. Subanalysis suggested a trend that the prevalence of these key deficits is dynamic although persistent over time. These findings can be used by clinicians to inform preventative intervention and support the use of specific, evidence-based therapy tasks explicitly selected to target the highly prevalent deficits post-(C)RT for HNC

Agency and the telephone: Patient contributions to the clinical and interactional agendas in telehealth consultations

Objective: Patient-centredness is central to providing safe care and is achieved, in part, through involving patients in developing the agenda of the consultation. Medical consultations have changed significantly over the last two years as a result of COVID-19 and thus understanding how patients contribute to the clinical and interactional agendas within a telehealth consultation is important to supporting quality care. Methods: A collection (15) of consultations (in English) between specialists (3) and patients (14) were recorded in a metropolitan gastrointestinal clinic in Australia. These recordings were closely examined using conversation analysis, which focuses on the structural and sequential organisation of interaction. Results: Patients used a variety of interactional approaches to contribute to the agenda throughout the consultations. This was achieved in collaboration with the doctors, whose responses generally allowed for these contributions. However, there were few doctor-driven, explicit opportunities provided to patients to contribute to the agenda. Conclusion: Many patients and doctors are adept at managing the interactional challenges of telehealth consultations but there are clear opportunities to extend this advantage to those patients with less agency. Practice implications: Providing an explicit space for patients to ask questions within the consultation would support those patients less inclined or able to assert themselves during a telehealth consultation

Communication changes following non-glottic head and neck cancer management: The perspectives of survivors and carers

Purpose. Head and neck cancer (HNC) survivors may experience functional changes to their voice, speech and hearing following curative chemoradiotherapy. However, few studies have explored the impact of living with such changes from the perspective of the HNC survivor and their carer. The current study employed a person-centred approach to explore the lived experience of communication changes following chemoradiotherapy treatment for HNC from the perspective of survivors and carers. Method. Participants included 14 survivors with non-glottic HNC and nine carers. All participants took part in in-depth interviews where they were encouraged to describe their experiences of living with and adjusting to communication changes following treatment. Interviews were analysed as a single data set. Result. Four themes emerged including: (1) impairments in communication sub-systems; (2) the challenges of communicating in everyday life; (3) broad ranging effects of communication changes; and (4) adaptations as a result of communication changes. Conclusion. These data confirm that communication changes following chemoradiotherapy have potentially negative psychosocial impacts on both the HNC survivor and their carer. Clinicians should consider the impact of communication changes on the life of the HNC survivor and their carer and provide adequate and timely education and management to address the needs of this population

Long-term functional outcomes and the patient perspective following altered fractionation with concomitant boost for oropharyngeal cancer

With no long-term data available in published research to date, this study presents details of the swallowing outcomes as well as barriers to and facilitators of oral intake and weight maintenance at 2 years after altered fractionation radiotherapy with concomitant boost (AFRT-CB). Twelve patients with T1-T3 oropharyngeal cancer who received AFRT-CB were assessed at baseline, 6 months, and 2 years post-treatment for levels of dysphagia and salivary toxicity, food and fluid tolerance, functional swallowing outcomes, patient-reported function, and weight. At 2 years, participants were also interviewed to explore barriers and facilitators of oral intake. Outcomes were significantly worse at 2 years when compared to baseline for late toxicity, functional swallowing, and patient-rated physical aspects of swallowing. Most patients (83%) tolerated a full diet pretreatment, but the rate fell to 42% (remainder tolerated soft diets) at 2 years. Multiple barriers to oral intake that impacted on activity and participation levels were identified. Participants lost 11 kg from baseline to 2 years, which was not regained between 6 months and 2 years. Global, social, and emotional domains of patient-reported function returned to pretreatment levels. At 2 years post AFRT-CB, worsening salivary and dysphagia toxicity, declining functional swallowing, and multiple reported ongoing barriers to oral intake had a negative impact on participants' activity and participation levels relating to eating. These ongoing deficits contributed to significant deterioration in physical swallowing functioning determined by the MDADI. In contrast, patients perceived their broader functioning had improved at 2 years, suggesting long-term adjustment to ongoing swallowing deficits