The blossom method: development of a somatic psychotherapy model, its use in clinical and everyday settings: a heuristic, reflexive inquiry

The Public Works considered for this submission include The Blossom Method Model, a parenting book on this approach, and a therapeutic children’s book. The submission includes a detailed, heuristic and reflexive account of the life experiences, clinical and linguistic training, and influences which have contributed to these works, and considers the impact the works have made to the field of psychotherapy. Originally, The Blossom Method was developed with a focus upon non-verbal communication between parent and infant, using an integrative, relational approach with a particular emphasis on visual, kinaesthetic, gestural, sensorimotor communication. The model’s key components and the theoretical framework that it provides can be considered for use in psychotherapy training and practice. In this account the submission reflects upon the author’s formative years and the experience of being raised by a profoundly deaf, non-signing mother. It is recognised that parent-child communication and connectivity has been complex for the author, which influenced their decision to study linguistics and undertake immersion training as a sign language interpreter with a university, developing fluency in both BSL and English. The context statement explores the author’s leadership role in a charitable organisation; the various professional and personal challenges which led to psychotherapy training; the experience of infant loss; and motherhood which provided an opportunity to experiment with non-verbal communication and promote connection with the author’s daughter, Blossom. The model has been developed through heuristic learning, reflexive study and anecdotal research undertaken with parents and their infants, and it brings together linguistic training and therapeutic experience. The concepts of the model have been disseminated internationally through a popular parenting book, which has led to further research, speaking engagements, article writing, course content writing, and an involvement in training and developing a practice with parents and their infants, both Deaf and hearing. The submission provides the model explanation initially published in the book and discusses the theoretical influences which form the content for the Public Works. During the course of writing this submission, a particular feature in relation to influence and impact emerged, as the author noted that recognition reach has been achieved through the careful use of social media platforms. This has resulted in the author reaching international audiences in India, Australia, South Korea and South America. Although the model is perhaps not distinctly a ‘new’ approach to psychotherapy, the considerations and findings in relation to the ‘language of infants’ provide a platform for additional research in the field of infant somatic narratives. Furthermore, there is a distinctive synthesis of personal background, linguistic training, professional knowledge and expertise as a psychotherapist with both Deaf and non-deaf adults, children and infants

Mapping horizontal and vertical urban densification in Denmark with Landsat time-series from 1985 to 2018: a semantic segmentation solution

Landsat imagery is an unparalleled freely available data source that allows reconstructing horizontal and vertical urban form. This paper addresses the challenge of using Landsat data, particularly its 30m spatial resolution, for monitoring three-dimensional urban densification. We compare temporal and spatial transferability of an adapted DeepLab model with a simple fully convolutional network (FCN) and a texture-based random forest (RF) model to map urban density in the two morphological dimensions: horizontal (compact, open, sparse) and vertical (high rise, low rise). We test whether a model trained on the 2014 data can be applied to 2006 and 1995 for Denmark, and examine whether we could use the model trained on the Danish data to accurately map other European cities. Our results show that an implementation of deep networks and the inclusion of multi-scale contextual information greatly improve the classification and the model's ability to generalize across space and time. DeepLab provides more accurate horizontal and vertical classifications than FCN when sufficient training data is available. By using DeepLab, the F1 score can be increased by 4 and 10 percentage points for detecting vertical urban growth compared to FCN and RF for Denmark. For mapping the other European cities with training data from Denmark, DeepLab also shows an advantage of 6 percentage points over RF for both the dimensions. The resulting maps across the years 1985 to 2018 reveal different patterns of urban growth between Copenhagen and Aarhus, the two largest cities in Denmark, illustrating that those cities have used various planning policies in addressing population growth and housing supply challenges. In summary, we propose a transferable deep learning approach for automated, long-term mapping of urban form from Landsat images.Comment: Accepted manuscript including appendix (supplementary file

Pathological completion in the intact visual field of hemianopia patients

We investigated figure segregation in the intact visual field (VF) of hemianopia patients. Three patients and matched controls performed a Yes–No figure detection task, where square or square fragments were embedded in a background of randomly oriented Gabor elements. We varied orientation and number of the fragment elements, stimulus eccentricity and background density (BD). Figure detection was impaired in all three patients in the entire intact VF, but potentially more pronounced in patients with cortical lesions. “Pathological completion” was most frequently observed for high BDs and for square fragments oriented towards the blind hemifield. Our findings confirm contour integration deficits in the intact VF of hemianopia patients. Further, our results indicate that (1) contour integration deficits are exacerbated by contextual interaction and (2) “pathological completion” appears to be more likely associated with lesions of cortical rather than geniculo-striate origin. The deficits point to increased lateral suppressive inputs from background elements

Spatial analysis of bladder, kidney, and pancreatic cancer on upper Cape Cod: an application of generalized additive models to case-control data

<p>Abstract</p> <p>Background</p> <p>In 1988, elevated cancer incidence in upper Cape Cod, Massachusetts prompted a large epidemiological study of nine cancers to investigate possible environmental risk factors. Positive associations were observed, but explained only a portion of the excess cancer incidence. This case-control study provided detailed information on individual-level covariates and residential history that can be spatially analyzed using generalized additive models (GAMs) and geographical information systems (GIS).</p> <p>Methods</p> <p>We investigated the association between residence and bladder, kidney, and pancreatic cancer on upper Cape Cod. We estimated adjusted odds ratios using GAMs, smoothing on location. A 40-year residential history allowed for latency restrictions. We mapped spatially continuous odds ratios using GIS and identified statistically significant clusters using permutation tests.</p> <p>Results</p> <p>Maps of bladder cancer are essentially flat ignoring latency, but show a statistically significant hot spot near known Massachusetts Military Reservation (MMR) groundwater plumes when 15 years latency is assumed. The kidney cancer map shows significantly increased ORs in the south of the study area and decreased ORs in the north.</p> <p>Conclusion</p> <p>Spatial epidemiology using individual level data from population-based studies addresses many methodological criticisms of cluster studies and generates new exposure hypotheses. Our results provide evidence for spatial clustering of bladder cancer near MMR plumes that suggest further investigation using detailed exposure modeling.</p

Advantages of a Polycentric Approach to Climate Change Policy

Lack of progress in global climate negotiations has led scholars to reconsider polycentric approaches to climate policy. Several examples of subglobal mechanisms to reduce greenhouse-gas emissions have been touted, but it remains unclear why they might achieve better climate outcomes than global negotiations alone. Decades of work conducted by researchers associated with the Vincent and Elinor Ostrom Workshop in Political Theory and Policy Analysis at Indiana University have emphasized two chief advantages of polycentric approaches over monocentric ones: they provide more opportunities for experimentation and learning to improve policies over time, and they increase communications and interactions — formal and informal, bilateral and multilateral — among parties to help build the mutual trust needed for increased cooperation. A wealth of theoretical, empirical and experimental evidence supports the polycentric approach

Combined modality chemoradiation in elderly oesophageal cancer patients

We present a single institution experience with 5-FU, mitomycin-C based chemoradiation for the primary treatment of elderly patients with oesophageal cancer. Twenty-five patients with a median age of 77 years (range 66–88) with a diagnosis of stage II–III squamous cell or adenocarcinoma of the oesophagus were treated at Memorial Sloan Kettering from 1996 to 2001 with two cycles of concurrent 5-FU, mitomycin-C and 50.4 Gy. Owing to age and comorbidity, these patients were not considered surgical candidates. The Charlson comorbidity score was used to evaluate patient comorbidity. Nine patients (36%) experienced grade 3–4 haematologic toxicity. Of the 23 patients evaluable for response, 17 patients (68%) had a negative post-treatment endoscopy and CT scan without evidence of progressive disease. Eleven patients (44%) are alive and 10 (40%) remain without evidence of recurrent or progressive oesophageal cancer at a median follow-up of 35 months. The median overall survival was 35 months and 2-year survival 64%. There was no significant difference in overall survival between Charlson score ⩽2 and those with a score ⩾2 (P=0.10). Similar survival was observed for patients with adenocarcinoma or squamous carcinoma. Primary chemoradiation with two cycles of 5-FU, mitomycin-C, and 50.4 Gy in elderly patients is an active regimen with moderate toxicity, despite the advanced age and heavy comorbidity burden of this cohort. Patients with local/regional oesophageal cancer with adequate functional status should not be excluded from potentially curative treatment based on age alone

Global, local and focused geographic clustering for case-control data with residential histories

BACKGROUND: This paper introduces a new approach for evaluating clustering in case-control data that accounts for residential histories. Although many statistics have been proposed for assessing local, focused and global clustering in health outcomes, few, if any, exist for evaluating clusters when individuals are mobile. METHODS: Local, global and focused tests for residential histories are developed based on sets of matrices of nearest neighbor relationships that reflect the changing topology of cases and controls. Exposure traces are defined that account for the latency between exposure and disease manifestation, and that use exposure windows whose duration may vary. Several of the methods so derived are applied to evaluate clustering of residential histories in a case-control study of bladder cancer in south eastern Michigan. These data are still being collected and the analysis is conducted for demonstration purposes only. RESULTS: Statistically significant clustering of residential histories of cases was found but is likely due to delayed reporting of cases by one of the hospitals participating in the study. CONCLUSION: Data with residential histories are preferable when causative exposures and disease latencies occur on a long enough time span that human mobility matters. To analyze such data, methods are needed that take residential histories into account

Changes in immunocompetent cells after interstitial laser thermotherapy of breast cancer

To access publisher full text version of this article. Please click on the hyperlink in Additional Links field.BACKGROUND: Local tumour destruction has been shown to give rise to changes in immunocompetent cells. The aim of this study was to describe the effect of interstitial laser thermotherapy (ILT) of breast carcinoma in the tumour and in regional lymph nodes. METHODS: Seventeen women that underwent radical surgical excision after non-radical ILT were studied. ILT was performed at a steady-state temperature of 48°C for 30 min. Surgical excision was performed 12 (6-23) days after ILT. Six patients with breast cancer not treated with ILT before surgery served as controls. Immunohistological reactions were performed on core needle biopsies prior to treatment and on the excised specimens. RESULTS: ILT resulted in more CD8 lymphocytes and CD68 macrophages within the tumour (P < 0.05 and P < 0.01, respectively) and higher counts of CD20 (P < 0.05), CD68 (P < 0.001) and CD83 (P < 0.01) at the tumour border, when compared to pre-treatment values. In the control patients not receiving ILT, CD8 cells increased within the tumour after resection (P < 0.05). With the probable exception of CD25 Foxp3 cells, the presence of cancer in a lymph node influenced the findings in lymph nodes (examined for CD1a, CD25, Foxp3 CD25, CD83 cells). Thus, comparisons between ILT and control patients were restricted to patients without lymph node metastases. In these patients, ILT and resection were followed by a decrease in CD25 Foxp3 lymphocytes (P < 0.05), when compared to surgical resection alone. CONCLUSIONS: ILT induced changes in immunocompetent cells in patients with breast cancer. The stimulation of the immune system is an added feature of ILT in treatment of patients with breast cancer