“New visions of control over the environment really shook the way political orders were created on both sides of the border after Partition” – David Gilmartin

At the LSE Pakistan Summit 2017 David Gilmartin gave a talk on ‘The Indus and its Peoples’. Afterwards, Sonali Campion asked him to elaborate on some of the themes raised, from the division of the river basin during Partition and the 1960 Indus Waters Treaty, to the inter- and intra-national tensions that have played out since 1947. Part 2 of Dr Gohel’s analysis, on the challenges posed by Haqqani Network and the ISIS-affiliated Wilayat Khorasan and the geo-strategic agendas of Afghanistan’s neighbours, is available here

A Winning Combination! Leadership Skills and Formation for Catholic School Leaders

This session emphasizes the importance of balancing personal and spiritual growth with leadership skills. Some practical tips and a model that illustrates this approach to leadership development will be shared via an interactive format

On structures in medical interactions : a conversation analytic study of general practice consultations.

This thesis addresses from within the research paradigm of Conversation Analysis (CA) the question "How are interactions between patients and general practitioners organised? ". CA is a relatively recent tradition within the "interpretative paradigm" of sociology, growing out of the ethnomethodology of Garfinkel. The thesis first reviews the relevant literature of CA and medical interactions, and critically discusses the methodology. The empirical analysis used naturally occurring consultations in British general practice, video-recorded in five practices, involving 14 doctors, and about 50 hours of recording, made between 1987 and 1992. Recordings were observed first in an unmotivated way, to note occurrences of interesting interactional phenomena. Objects for further study were copied onto secondary "collection" tapes, which were then examined in depth, and transcribed in detail using conventions developed within CA. The analyses described here are: the use of time in the consultation; the impact of medical records on the interaction; prescribing and associated talk; the phenomenon of "facilitation", how doctors appear to enable patients to talk; patient-initiated questions, and rejection of patients' ideas by doctors; and finally the use of the word "we". The aim was to describe and explore, but not necessarily to explain, although in describing the mechanism of interaction in these areas of activity, empirical evidence is advanced for particular explanations. The phenomenon of patients raising new topics at the end of consultations is described, with its interactional implications: the "by-the-way" phenomenon is explored and documented. Case-notes are seen to contribute to consultations in a complex way, and like talk, are both context-dependent and context-forming. Utterances such as "right", "uhuh", "mmhm" which appear on the face of it to be facilitatory, can be the reverse. The phenomenon of dispreference for disagreements by patients is re-examined, and contexts in which patients do disagree are explored. Doctors' rejections of patients' ideas are described, and implications for teaching about the consultation are drawn. Finally the various ways in which the word "we" is used by doctors are described and critically appraised, in the context of a philosophical understanding of "intersubjectivity". The study adds to the body of transcribed interactions drawn from general practice, and sheds some light on ways in which general practitioners and patients structure their consultations. It has implications for the way medical students learn how to consult, and for how research on the consultation can be conducted. Conversation analysis is shown to be a powerful qualitative analytic methodology, relevant to the study of medical interactions

Excisional treatment in women with cervical adenocarcinoma in situ (AIS): a prospective randomised controlled noninferiority trial to compare AIS persistence/recurrence after loop electrosurgical excision procedure with cold knife cone biopsy: protocol for a pilot study

Introduction: Adenocarcinoma in situ (AIS) of the uterine cervix is the precursor to invasive endocervical adenocarcinoma. An excisional biopsy such as a cold knife cone biopsy (CKC) should be performed to exclude invasive adenocarcinoma. Loop electrosurgical excision procedure (LEEP) is an alternative modality to CKC but is controversial in AIS. There is a perception that there is a greater likelihood of incomplete excision of AIS with LEEP because the depth of excised tissue tends to be smaller and the tissue margins may show thermal artefact which can interfere with pathology assessment. In the USA, guidelines recommend that any treatment modality can be used to excise AIS, provided that the specimen remains intact with interpretable margins. However, there are no high-quality studies comparing LEEP with CKC and well-designed prospective studies are needed. If such a study were to show that LEEP was non-inferior to CKC for the outcomes of post-treatment persistence, recurrence and adenocarcinoma, LEEP could be recommended as an appropriate treatment option for AIS in selected patients. This would benefit women because, unlike CKC, LEEP does not require general anaesthesia and may be associated with reduced morbidity. Methods and analysis: The proposed exploratory study is a parallel group trial with an allocation ratio of 2:1 in favour of the intervention (LEEP: CKC). Participants are women aged ≥18 to ≤45 years diagnosed with AIS on cervical screening and/or colposcopically directed biopsy in Australia and New Zealand, who are to receive excisional treatment in a tertiary level centre. Ethics and dissemination: Ethical approval for the study has been granted by the St John of God Healthcare Human Research Ethics Committee (reference number #1137)

Neutrino production from proton-proton interactions in binary-driven hypernovae

We estimate the neutrino emission from the decay chain of the $\pi$-meson and $\mu$-lepton, produced by proton-proton inelastic scattering in energetic ($E_{\rm iso}\gtrsim 10^{52}$~erg) long gamma-ray bursts (GRBs), within the type I binary-driven hypernova (BdHN) model. The BdHN I progenitor is \textcolor{red}{a} binary system composed of a carbon-oxygen star (CO$_{\rm core}$) and a neutron star (NS) companion. The CO$_{\rm core}$ explosion as supernova (SN) triggers a massive accretion process onto the NS. For short orbital periods of few minutes, the NS reaches the critical mass, hence forming a black hole (BH). Recent numerical simulations of the above scenario show that the SN ejecta becomes highly asymmetric, creating a \textit{cavity} around the newborn BH site, due to the NS accretion and gravitational collapse. Therefore, the electron-positron ($e^{\pm}$) plasma created in the BH formation, during its isotropic and self-accelerating expansion, engulfs different amounts of ejecta baryons along different directions, leading to a direction-dependent Lorentz factor. The protons engulfed inside the high-density ($\sim 10^{23}$~particle/cm$^3$) ejecta reach energies in the range $1.24\lesssim E_p\lesssim 6.14$ GeV and interact with the unshocked protons in the ejecta. The protons engulfed from the low density region around the BH reach energies $\sim 1$ TeV and interact with the low-density ($\sim1$~particle/cm$^3$) protons of the interstellar medium (ISM). The above interactions give rise, respectively, to neutrino energies $E_{\nu}\leq 2$ GeV and $10\leq E_{\nu}\leq 10^3$ GeV, and for both cases we calculate the spectra and luminosity.Comment: 19 pages, 22 figures, 2 tables, re-submitted to Physical Review Letters

Lasers, stem cells, and COPD

The medical use of low level laser (LLL) irradiation has been occurring for decades, primarily in the area of tissue healing and inflammatory conditions. Despite little mechanistic knowledge, the concept of a non-invasive, non-thermal intervention that has the potential to modulate regenerative processes is worthy of attention when searching for novel methods of augmenting stem cell-based therapies. Here we discuss the use of LLL irradiation as a "photoceutical" for enhancing production of stem cell growth/chemoattractant factors, stimulation of angiogenesis, and directly augmenting proliferation of stem cells. The combination of LLL together with allogeneic and autologous stem cells, as well as post-mobilization directing of stem cells will be discussed