The role of the default mode network in contextual control

While extensive theories outline the importance of meaningful context in guiding goal directed behaviour, little evidence has emerged about the underlying cognitive mechanisms involved. This thesis aims to addresses this gap in the literature by integrating two commonly disparate topics in neuroscience: cognitive control and the default mode network. Chapter 2 considers why current studies of contextual control do not implicate DMN regions by comparing context-dependent decision making using rich, meaningful scenes, in comparison to arbitrary letter stimuli. DMN regions of the posterior cingulate cortex, parahippocampus and posterior inferior parietal cortex are found to show increased activity during decision making in the lifelike context only. Chapter 3 asks whether regions beyond the ‘task-positive’ multiple demand network are necessary for adequate performance in more lifelike naturalistic tasks. This neuropsychology experiment used behavioural data accumulated from brain lesioned patients across a series of naturalistic tasks and a standard IQ task. Naturalistic tasks were found to capture control processes beyond IQ and multiple demand network function, most likely depending on many processes and brain regions. Chapter 4 aims to understand to what extent the DMN contributes to non-spatial executive tasks. Replicating (Crittenden et al. 2015), DMN regions were found to represent the broader task domain and respond with greater activation to larger task switches and task restarts. A role for the DMN in transitions between distinct cognitive tasks is suggested. Chapter 5 assesses an alternative explanation for the switch effects of the previous chapter. The fMRI experiment presented in this chapter asks whether the activation of the DMN at cognitive transitions reflects changes in task rule retrieval difficulty instead of degree of task switch. To this end, this study directly manipulated the rule retrieval demands. Contrary to the retrieval account, increased retrieval demand led to reduced DMN activity, accompanied by increased activation in MD regions.This PhD was funded by the Medical Research Counci

Between security, law enforcement and harm reduction: drug policing at commercial music festivals in England

In this thesis, I use an ethnographic methodology to explore the implementation of drug policing at commercial music festivals in England. I argue that festival drug policing is primarily concerned with the anticipation and mitigation of drug-related risk, and festivals adopt an array of security, enforcement and harm reduction approaches under the ‘3: Ps’ (Prevent, Pursue and Protect) in pursuit of this. With an lens on the in-situ decision making of policing, security and management actors on the ground, I illustrate how drug policies are negotiated between agencies, in order to satisfy their sometimes competing risk-perceptions and interests in their pursuit of drug security

The effect of rule retrieval on activity in the default mode network.

The default mode network (DMN) is often associated with internally-directed cognition, distinct from the constraints of the external environment. However, a recent finding is that the DMN shows strong activation after large task switches during a demanding externally-directed task (Crittenden et al., 2015; Smith et al., 2018). Following other proposals, we have suggested that the DMN encodes cognitive or environmental context, and that context representations are momentarily strengthened during large cognitive switches, perhaps so that new activity can be checked against current environmental constraints. An alternative account, consistent with the role of the DMN in episodic memory, might be that switches to a substantially new task increase demands on rule retrieval. To test this alternative, we directly manipulated rule retrieval demands. Contrary to the retrieval account, increased retrieval demand led to reduced DMN activity, accompanied by increased activation in prefrontal and lateral parietal cognitive control areas. Unlike episodic retrieval, with its rich contextual representations, rule retrieval does not drive DMN activity. Accordingly, it cannot explain increased DMN activity during large cognitive switches

Psychosocial care for persons affected by emergencies and major incidents: a Delphi study to determine the needs of professional first responders for education, training and support

Background The role of ambulance clinicians in providing psychosocial care in major incidents and emergencies is recognised in recent Department of Health guidance. The study described in this paper identified NHS professional first responders’ needs for education about survivors’ psychosocial responses, training in psychosocial skills, and continuing support. Method Ambulance staff participated in an online Delphi questionnaire, comprising 74 items (Round 1) on 7-point Likert scales. Second-round and third-round participants each received feedback based on the previous round, and responded to modified versions of the original items and to new items for clarification. Results One hundred and two participants took part in Round 1; 47 statements (64%) achieved consensus. In Round 2, 72 people from Round 1 participated; 15 out of 39 statements (38%) achieved consensus. In Round 3, 49 people from Round 2 participated; 15 out of 27 statements (59%) achieved consensus. Overall, there was consensus in the following areas: ‘psychosocial needs of patients’ (consensus in 34/37 items); ‘possible sources of stress in your work’ (8/9); ‘impacts of distress in your work’ (7/10); ‘meeting your own emotional needs’ (4/5); ‘support within your organisation’ (2/5); ‘needs for training in psychosocial skills for patients’ (15/15); ‘my needs for psychosocial training and support’ (5/6). Conclusions Ambulance clinicians recognise their own education needs and the importance of their being offered psychosocial training and support. The authors recommend that, in order to meet patients’ psychosocial needs effectively, ambulance clinicians are provided with education and training in a number of skills and their own psychosocial support should be enhanced

Seasonal distribution of genetic types of planktonic foraminifer morphospecies in the Santa Barbara Channel and its paleoceanographic implications

We present data on the temporal distribution of planktonic foraminifer genotypes (small subunit (SSU) ribosomal (r) RNA gene) and morphospecies (sediment traps) collected during 1999 in the Santa Barbara Channel. The sampling was undertaken with special emphasis on paleoceanographically important morphospecies, predominantly Globigerina bulloides. We found the same genotype of G. bulloides (type IId) in all the changing hydrographic regimes associated with this region throughout the annual cycle with the exception of January, when we recorded the additional presence of the high-latitude G. bulloides type IIa. We identified three new genotypes: Neogloboquadrina dutertrei type Ic, N. pachyderma dextral type II, and Turborotalita quinqueloba type IId. Our data suggest that G. bulloides type IId and possibly even the new genotypes listed above may be associated specifically with the complex hydrography or other environmental features characteristic of this area. Since G. bulloides type IId occurs throughout the year and its peak fluxes are related to different hydrographic regimes, we argue that the physical properties of the water column are not the major factor influencing the distribution and growth of this genotype. In sediment trap samples we found a skewed coiling ratio for G. bulloides (most likely representing type IId), which is related neither to sea surface temperature nor to genotypic difference. This study illustrates the necessity to map both the spatial and temporal distribution of the genetic types, especially in areas of paleoceanographic interest, where geochemical and paleontological proxies are being calibrated

Minimum data elements for the Australian Particle Therapy Clinical Quality Registry

Introduction: Construction of the first Australian particle therapy (PT) centre is underway. Establishment of a national registry, to be known as the Australian Particle Therapy Clinical Quality Registry (ASPIRE), has been identified as a mandatory requirement for PT treatment to be reimbursed by the Australian Medicare Benefits Schedule. This study aimed to determine a consensus set of Minimum Data Elements (MDEs) for ASPIRE. Methods: A modified Delphi and expert consensus process was completed. Stage 1 compiled currently operational English-language international PT registries. Stage 2 listed the MDEs included in each of these four registries. Those included in three or four registries were automatically included as a potential MDE for ASPIRE. Stage 3 interrogated the remaining data items, and involved three rounds – an online survey to a panel of experts, followed by a live poll session of PT-interested participants, and finally a virtual discussion forum of the original expert panel. Results: One hundred and twenty-three different MDEs were identified across the four international registries. The multi-staged Delphi and expert consensus process resulted in a total of 27 essential MDEs for ASPIRE; 14 patient factors, four tumour factors and nine treatment factors. Conclusions: The MDEs provide the core mandatory data items for the national PT registry. Registry data collection for PT is paramount in the ongoing global effort to accumulate more robust clinical evidence regarding PT patient and tumour outcomes, quantifying the magnitude of clinical benefit and justifying the relatively higher costs of PT investment.</p

Minimum data elements for the Australian Particle Therapy Clinical Quality Registry

Introduction: Construction of the first Australian particle therapy (PT) centre is underway. Establishment of a national registry, to be known as the Australian Particle Therapy Clinical Quality Registry (ASPIRE), has been identified as a mandatory requirement for PT treatment to be reimbursed by the Australian Medicare Benefits Schedule. This study aimed to determine a consensus set of Minimum Data Elements (MDEs) for ASPIRE. Methods: A modified Delphi and expert consensus process was completed. Stage 1 compiled currently operational English-language international PT registries. Stage 2 listed the MDEs included in each of these four registries. Those included in three or four registries were automatically included as a potential MDE for ASPIRE. Stage 3 interrogated the remaining data items, and involved three rounds – an online survey to a panel of experts, followed by a live poll session of PT-interested participants, and finally a virtual discussion forum of the original expert panel. Results: One hundred and twenty-three different MDEs were identified across the four international registries. The multi-staged Delphi and expert consensus process resulted in a total of 27 essential MDEs for ASPIRE; 14 patient factors, four tumour factors and nine treatment factors. Conclusions: The MDEs provide the core mandatory data items for the national PT registry. Registry data collection for PT is paramount in the ongoing global effort to accumulate more robust clinical evidence regarding PT patient and tumour outcomes, quantifying the magnitude of clinical benefit and justifying the relatively higher costs of PT investment.</p

Minimum data elements for the Australian Particle Therapy Clinical Quality Registry

Introduction: Construction of the first Australian particle therapy (PT) centre is underway. Establishment of a national registry, to be known as the Australian Particle Therapy Clinical Quality Registry (ASPIRE), has been identified as a mandatory requirement for PT treatment to be reimbursed by the Australian Medicare Benefits Schedule. This study aimed to determine a consensus set of Minimum Data Elements (MDEs) for ASPIRE. Methods: A modified Delphi and expert consensus process was completed. Stage 1 compiled currently operational English-language international PT registries. Stage 2 listed the MDEs included in each of these four registries. Those included in three or four registries were automatically included as a potential MDE for ASPIRE. Stage 3 interrogated the remaining data items, and involved three rounds – an online survey to a panel of experts, followed by a live poll session of PT-interested participants, and finally a virtual discussion forum of the original expert panel. Results: One hundred and twenty-three different MDEs were identified across the four international registries. The multi-staged Delphi and expert consensus process resulted in a total of 27 essential MDEs for ASPIRE; 14 patient factors, four tumour factors and nine treatment factors. Conclusions: The MDEs provide the core mandatory data items for the national PT registry. Registry data collection for PT is paramount in the ongoing global effort to accumulate more robust clinical evidence regarding PT patient and tumour outcomes, quantifying the magnitude of clinical benefit and justifying the relatively higher costs of PT investment.</p