Telltale Marks: Looking Beyond Censorship of Guantánamo

In the United States, the government holds a storytelling monopoly; the stories it tells of Guantánamo dictate its reality, regardless of whether or not those stories are true. I will examine the government’s public statements about Guantánamo, then contrast these with covert communications and actions taken. Additionally, I will analyze iconic American images painted by detainees in classes at Guantánamo to garner the detainee perspective on the prison and the U.S. Acceptance of a single story is the antithesis of democracy; only when we strive to uncover the whole truth can we claim we have freedom of speech

Minutes of the Classis in Ommen Starting on December 27, 1837

Minutes of the Classis in Onunen, of which Rev. Albertus C. Van Raalte, was a leading member, beginning on this date and continuing through 25 January 1844.https://digitalcommons.hope.edu/vrp_1830s/1100/thumbnail.jp

Speech diversity and speech interfaces - considering an inclusive future through stammering

The number of speech interfaces and services made available through them continue to grow. This has opened up interactions to people who rely on speech as a critical modality for interacting with systems. However, people with diverse speech patterns such as those who stammer are at risk of being negatively affected or excluded from speech interface interaction. In this paper, we consider what an inclusive speech interface future may look like for people who stammer. In doing so, we identify three key challenges: (1) developing effective speech recognition, (2) understanding the user experiences of people who stammer and (3) supporting speech interfaces designers through appropriate heuristics. We believe the interdisciplinary and cross-community strengths of venues like CUI are well positioned to address these challenges going forward

Tactical Communications for Cooperative SAR Robot Missions

This chapter describes how the ICARUS communications (COM) team defined, developed and implemented an integrated wireless communication system to ensure an interoperable and dependable networking capability for both human and robotic search and rescue field teams and crisis managers. It starts explaining the analysis of the requirements and the context of the project, the existing solutions and the design of the ICARUS communication system to fulfil all the project needs. Next, it addresses the implementation process of the required networking capabilities, and finally, it explains how the ICARUS communication system and associated tools have been integrated in the overall mission systems and have been validated to provide reliable communications for real‐time information sharing during search and rescue operations in hostile conditions

The complexity of multidisciplinary respiratory care in amyotrophic lateral sclerosis

Motor neurone disease/amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder with no known cure, where death is usually secondary to progressive respiratory failure. Assisting people with ALS through their disease journey is complex and supported by clinics that provide comprehensive multidisciplinary care (MDC). This review aims to apply both a respiratory and a complexity lens to the key roles and areas of practice within the MDC model in ALS. Models of noninvasive ventilation care, and considerations in the provision of palliative therapy, respiratory support, and speech and language therapy are discussed. The impact on people living with ALS of both inequitable funding models and the complexity of clinical care decisions are illustrated using case vignettes. Considerations of the impact of emerging antisense and gene modifying therapies on MDC challenges are also highlighted. The review seeks to illustrate how MDC members contribute to collective decision-making in ALS, how the sum of the parts is greater than any individual care component or health professional, and that the MDC per se adds value to the person living with ALS. Through this approach we hope to support clinicians to navigate the space between what are minimum, guideline-driven, standards of care and what excellent, person-centred ALS care that fully embraces complexity could be

The complexity of multidisciplinary respiratory care in amyotrophic lateral sclerosis.

UNLABELLED: Motor neurone disease/amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder with no known cure, where death is usually secondary to progressive respiratory failure. Assisting people with ALS through their disease journey is complex and supported by clinics that provide comprehensive multidisciplinary care (MDC). This review aims to apply both a respiratory and a complexity lens to the key roles and areas of practice within the MDC model in ALS. Models of noninvasive ventilation care, and considerations in the provision of palliative therapy, respiratory support, and speech and language therapy are discussed. The impact on people living with ALS of both inequitable funding models and the complexity of clinical care decisions are illustrated using case vignettes. Considerations of the impact of emerging antisense and gene modifying therapies on MDC challenges are also highlighted. The review seeks to illustrate how MDC members contribute to collective decision-making in ALS, how the sum of the parts is greater than any individual care component or health professional, and that the MDC per se adds value to the person living with ALS. Through this approach we hope to support clinicians to navigate the space between what are minimum, guideline-driven, standards of care and what excellent, person-centred ALS care that fully embraces complexity could be. EDUCATIONAL AIMS: To highlight the complexities surrounding respiratory care in ALS.To alert clinicians to the risk that complexity of ALS care may modify the effectiveness of any specific, evidence-based therapy for ALS.To describe the importance of person-centred care and shared decision-making in optimising care in ALS

Routine lung volume recruitment in boys with Duchenne muscular dystrophy:a randomised clinical trial

Background Impaired cough results in airway secretion retention, atelectasis and pneumonia in individuals with Duchenne muscular dystrophy (DMD). Lung volume recruitment (LVR) stacks breaths to inflate the lungs to greater volumes than spontaneous effort. LVR is recommended in DMD clinical care guidelines but is not well studied. We aimed to determine whether twice-daily LVR, compared with standard of care alone, attenuates the decline in FVC at 2 years in boys with DMD. Methods In this multicentre, assessor-blinded, randomised controlled trial, boys with DMD, aged 6-16 years with FVC &gt;30% predicted, were randomised to receive conventional treatment or conventional treatment plus manual LVR twice daily for 2 years. The primary outcome was FVC % predicted at 2 years, adjusted for baseline FVC % predicted, age and ambulatory status. Secondary outcomes included change in chest wall distensibility (maximal insufflation capacity minus FVC) and peak cough flow. Results Sixty-six boys (36 in LVR group, 30 in control) were evaluated (median age (IQR): 11.5 years (9.5-13.5), median baseline FVC (IQR): 85% predicted (73-96)). Adjusted mean difference in FVC between groups at 2 years was 1.9% predicted (95% CI -6.9% to 10.7%; p=0.68) in the direction of treatment benefit. We found no differences in secondary outcomes. Conclusion There was no difference in decline in FVC % predicted with use of twice-daily LVR for boys with DMD and relatively normal lung function. The burden associated with routine LVR may outweigh the benefit. Benefits of LVR to maintain lung health in boys with worse baseline lung function still need to be clarified. Trial registration number NCT01999075. </p

Addressing the inverse care law in cardiac services.

BACKGROUND: Wide variation in rates of angiography and revascularization exist that are not explained by the level of need for these services. The National Service Framework for Coronary Heart Disease has set out a number of standards with the aim of increasing the number of revascularizations and reducing inequalities in access to care. In this study we aimed to investigate inequity in angiography and revascularization rates between the four Primary Care Group (PCG) areas in Camden and Islington Health Authority and to put in place measures to address the problems identified. METHODS: Routinely available data were collected on all residents within Camden and Islington Health Authority undergoing angiography, angioplasty (PTCA) or coronary artery bypass grafting (CABG) between 1997 and 2001. These were used to calculate intervention rates per million population for each of the three procedures within each PCG. Semi-structured interviews were carried out with a sample of clinicians to explore their views on the provision of revascularization services within the Health Authority. RESULTS: Angiography and revascularization rates varied widely between the four PCGs. In 2001 there was a two-fold difference for angiography and CABG and a 3.5-fold difference for PTCA. The variations were not explained by a measure of the level of need for these services. The highest rates were in the area with the lowest standardized mortality ratio for coronary heart disease. The interviews identified a number of possible explanations for the variations that related to differences in clinical behaviour atthe consultant level and barriers in access to interventional cardiology and cardiac services. Following this research, a further interventional cardiologist appointment is planned, joint protocols of care are being established and barriers to access are being addressed. CONCLUSIONS: The new strategic health authorities should make it a priority to assess inequity in the provision of services within their areas, investigate the possible causes and support the primary care trusts to implement plans to address them