'The person inside it has to be part of it': Empathy, Post-Conflict Heritage and 'Troubles Tourism' in Northern Ireland

April 2018 will mark twenty years since the signing of the Good Friday Agreement. Whilst defined by historic levels of peace, for the people living in Northern Ireland the past two decades have also been characterised by irreconcilable divisions over how to interpret the recent past, and rising levels of ethno-sectarian atavism amongst the nation’s interface communities. The informal heritage sector is one area where these issues manifest, where contestations over how to represent the Troubles to outsiders, and within communities, are often described as a ‘war by other means’. This thesis explores the role of empathy in relation to Belfast’s Troubles heritage, specifically in relation to the experiences of the ‘troubles tourist’. Discussions of empathy’s benefits for understanding the ‘other’ have already been advanced within heritage studies, however what is less acknowledged is its usage as a political tool, which maintains rather than overcomes structural inequalities and power relations. Combining semi-structured interviews with participant observation and autoethnography, this research moves through a range of registers on empathy, analysing discourses of innocence, kitsch, humour and authenticity in relation to the paramilitary museums and black cab mural tours that are a key part of post-Troubles heritage in Northern Ireland. Through this approach, this thesis takes a more nuanced approach to empathy than is usually found in the literature, treating it as an amorphous and contingent way of engaging with the world that is deeply entrenched in local politics. In doing so, an original contribution to broader studies of empathy is made, which draws attention to the subtle ways in which it percolates through our social economy. This study also has implications for future engagements with Northern Irish heritage, extending questions about the relevance of empathy to the field, and pushing against the general absence of emotionality from approaches to Northern Ireland’s past

‘Lacking’ subjects: challenging the construction of the ‘empowered’ graduate in museum, gallery and heritage studies

This article challenges what is now a common assumption in Higher Education; that teaching for employability will result in enabled and empowered graduates. Drawing upon empirical data, and Foucault’s concept of subjectification, we argue that discourses of employability instead encouraged museum, gallery and heritage postgraduate students at one UK-based institution to perceive themselves as subjects ‘lacking’ the resources needed for work – an understanding of self that formed prior to study, which then permeated the entire learning and teaching experience. Moreover, we note that the trajectory from ‘lacking student’ to ‘employable graduate’ is often reliant upon an accrual of assets (e.g. work experience, skills) not openly available to all. As such, the article sounds a note of caution with regards the rhetoric of employability within Higher Education, while giving voice to students’ perspectives and anxieties around employability

Why Did I Stop? Barriers and Facilitators to Uptake and Adherence to ART in Option B+ HIV Care in Lilongwe, Malawi

Causes for loss-to-follow-up, including early refusals of and stopping antiretroviral therapy (ART), in Malawi’s Option B+ program are poorly understood. This study examines the main barriers and facilitators to uptake and adherence to ART under Option B+. In depth interviews were conducted with HIV-infected women who were pregnant or postpartum in Lilongwe, Malawi (N = 65). Study participants included women who refused ART initiation (N = 10), initiated ART and then stopped (N = 26), and those who initiated ART and remained on treatment (N = 29). The barriers to ART initiation were varied and included concerns about partner support, feeling healthy, and needing time to think. The main reasons for stopping ART included side effects and lack of partner support. A substantial number of women started ART after initially refusing or stopping ART. There were several facilitators for re-starting ART, including encouragement from community health workers, side effects subsiding, decline in health, change in partner, and fear of future sickness. Amongst those who remained on ART, desire to prevent transmission and improve health were the most influential facilitators. Reasons for refusing and stopping ART were varied. ART-related side effects and feeling healthy were common barriers to ART initiation and adherence. Providing consistent pre-ART counseling, early support for patients experiencing side effects, and targeted efforts to bring women who stop treatment back into care may improve long term health outcomes

The Video intervention to Inspire Treatment Adherence for Life (VITAL Start): protocol for a multisite randomized controlled trial of a brief video-based intervention to improve antiretroviral adherence and retention among HIV-infected pregnant women in Malawi

Abstract Background Improving maternal antiretroviral therapy (ART) retention and adherence is a critical challenge facing prevention of mother-to-child transmission (PMTCT) of HIV programs. There is an urgent need for evidence-based, cost-effective, and scalable interventions to improve maternal adherence and retention that can be feasibly implemented in overburdened health systems. Brief video-based interventions are a promising but underutilized approach to this crisis. We describe a trial protocol to evaluate the effectiveness and implementation of a standardized educational video-based intervention targeting HIV-infected pregnant women that seeks to optimize their ART retention and adherence by providing a VITAL Start (Video intervention to Inspire Treatment Adherence for Life) before committing to lifelong ART. Methods This study is a multisite parallel group, randomized controlled trial assessing the effectiveness of a brief facility-based video intervention to optimize retention and adherence to ART among pregnant women living with HIV in Malawi. A total of 892 pregnant women living with HIV and not yet on ART will be randomized to standard-of-care pre-ART counseling or VITAL Start. The primary outcome is a composite of retention and adherence (viral load < 1000 copies/ml) 12 months after starting ART. Secondary outcomes include assessments of behavioral adherence (self-reported adherence, pharmacy refill, and tenofovir diphosphate concentration), psychosocial impact, and resource utilization. We will also examine the implementation of VITAL Start via surveys and qualitative interviews with patients, partners, and health care workers and conduct cost-effectiveness analyses. Discussion This is a robust evaluation of an innovative facility-based video intervention for pregnant women living with HIV, with the potential to improve maternal and infant outcomes. Trial registration ClinicalTrials.gov, NCT03654898. Registered on 31 August 2018

Scholarly Communication Task Force Report and Recommendations

To address issues resulting from the serials crisis at Kansas State University, Provost Charles Taber, Faculty Senate President Tanya González, and Dean of Libraries Lori Goetsch created the Scholarly Communication Task Force during the 2019 fall semester. The purpose of this task force is to gather stakeholders in the K-State community to review the current landscape of scholarly communication practices on campus and offer recommendations to improve not only access to information at K-State but direct our institutional participation in the movement toward open scholarship. The task force reviewed scholarly communication initiatives at K-State and other higher education institutions and sought input from the campus community. Based on this information, the task force made several recommendations with accompanying budget implications. Recognizing that maintaining the status quo is not fiscally sustainable, we make the following recommendations: • We recommend that the University adopt an Open Access Policy to self-archive articles that it produces • We recommend the Library continue to monitor/manage subscription efficiencies • We recommend greater usage of interlibrary loan as an option for materials not subscribed to by K-State Libraries, while transitioning to transformational agreements and multipayer models • We recommend changes to how research is evaluated based on best practices • We recommend that faculty to write publication costs into their grant proposals • We recommend, continuing the Open Access fee fund, only if it is fully funded and higher priority recommendations are adequately supported Additional information about the task force’s findings and process for gathering information from the campus community are included later in this report

The Video intervention to Inspire Treatment Adherence for Life (VITAL Start): protocol for a multisite randomized controlled trial of a brief video-based intervention to improve antiretroviral adherence and retention among HIV-infected pregnant women in Malawi

Background Improving maternal antiretroviral therapy (ART) retention and adherence is a critical challenge facing prevention of mother-to-child transmission (PMTCT) of HIV programs. There is an urgent need for evidence-based, cost-effective, and scalable interventions to improve maternal adherence and retention that can be feasibly implemented in overburdened health systems. Brief video-based interventions are a promising but underutilized approach to this crisis. We describe a trial protocol to evaluate the effectiveness and implementation of a standardized educational video-based intervention targeting HIV-infected pregnant women that seeks to optimize their ART retention and adherence by providing a VITAL Start (Video intervention to Inspire Treatment Adherence for Life) before committing to lifelong ART. Methods This study is a multisite parallel group, randomized controlled trial assessing the effectiveness of a brief facility-based video intervention to optimize retention and adherence to ART among pregnant women living with HIV in Malawi. A total of 892 pregnant women living with HIV and not yet on ART will be randomized to standard-of-care pre-ART counseling or VITAL Start. The primary outcome is a composite of retention and adherence (viral load < 1000 copies/ml) 12 months after starting ART. Secondary outcomes include assessments of behavioral adherence (self-reported adherence, pharmacy refill, and tenofovir diphosphate concentration), psychosocial impact, and resource utilization. We will also examine the implementation of VITAL Start via surveys and qualitative interviews with patients, partners, and health care workers and conduct cost-effectiveness analyses. Discussion This is a robust evaluation of an innovative facility-based video intervention for pregnant women living with HIV, with the potential to improve maternal and infant outcomes. Trial registration ClinicalTrials.gov, NCT03654898. Registered on 31 August 2018

Sex Differences in Social Interaction Behavior Following Social Defeat Stress in the Monogamous California Mouse (Peromyscus californicus)

Stressful life experiences are known to be a precipitating factor for many mental disorders. The social defeat model induces behavioral responses in rodents (e.g. reduced social interaction) that are similar to behavioral patterns associated with mood disorders. The model has contributed to the discovery of novel mechanisms regulating behavioral responses to stress, but its utility has been largely limited to males. This is disadvantageous because most mood disorders have a higher incidence in women versus men. Male and female California mice (Peromyscus californicus) aggressively defend territories, which allowed us to observe the effects of social defeat in both sexes. In two experiments, mice were exposed to three social defeat or control episodes. Mice were then behaviorally phenotyped, and indirect markers of brain activity and corticosterone responses to a novel social stimulus were assessed. Sex differences in behavioral responses to social stress were long lasting (4 wks). Social defeat reduced social interaction responses in females but not males. In females, social defeat induced an increase in the number of phosphorylated CREB positive cells in the nucleus accumbens shell after exposure to a novel social stimulus. This effect of defeat was not observed in males. The effects of defeat in females were limited to social contexts, as there were no differences in exploratory behavior in the open field or light-dark box test. These data suggest that California mice could be a useful model for studying sex differences in behavioral responses to stress, particularly in neurobiological mechanisms that are involved with the regulation of social behavior

Rehabilitation versus surgical reconstruction for non-acute anterior cruciate ligament injury (ACL SNNAP): a pragmatic randomised controlled trial

BackgroundAnterior cruciate ligament (ACL) rupture is a common debilitating injury that can cause instability of the knee. We aimed to investigate the best management strategy between reconstructive surgery and non-surgical treatment for patients with a non-acute ACL injury and persistent symptoms of instability.MethodsWe did a pragmatic, multicentre, superiority, randomised controlled trial in 29 secondary care National Health Service orthopaedic units in the UK. Patients with symptomatic knee problems (instability) consistent with an ACL injury were eligible. We excluded patients with meniscal pathology with characteristics that indicate immediate surgery. Patients were randomly assigned (1:1) by computer to either surgery (reconstruction) or rehabilitation (physiotherapy but with subsequent reconstruction permitted if instability persisted after treatment), stratified by site and baseline Knee Injury and Osteoarthritis Outcome Score—4 domain version (KOOS4). This management design represented normal practice. The primary outcome was KOOS4 at 18 months after randomisation. The principal analyses were intention-to-treat based, with KOOS4 results analysed using linear regression. This trial is registered with ISRCTN, ISRCTN10110685, and ClinicalTrials.gov, NCT02980367.FindingsBetween Feb 1, 2017, and April 12, 2020, we recruited 316 patients. 156 (49%) participants were randomly assigned to the surgical reconstruction group and 160 (51%) to the rehabilitation group. Mean KOOS4 at 18 months was 73·0 (SD 18·3) in the surgical group and 64·6 (21·6) in the rehabilitation group. The adjusted mean difference was 7·9 (95% CI 2·5–13·2; p=0·0053) in favour of surgical management. 65 (41%) of 160 patients allocated to rehabilitation underwent subsequent surgery according to protocol within 18 months. 43 (28%) of 156 patients allocated to surgery did not receive their allocated treatment. We found no differences between groups in the proportion of intervention-related complications.InterpretationSurgical reconstruction as a management strategy for patients with non-acute ACL injury with persistent symptoms of instability was clinically superior and more cost-effective in comparison with rehabilitation management

RESONANCE, REVERBERATION, AND RHYTHMS: CONCEPTUALIZING VIBRATORY POWER IN DIGITAL MEDIA

This panel explores the theories, concepts, and methodologies appropriate to the exploration of the “vibratory power” of transduction where sound and other digitally mediated forms of reverberation conjure affective and corporeal bonds of resonance and solidarity. The first three papers engage in a critical interrogation of sound as epistemology and ontologies in digital networked media, with a focus on streaming internet radio. More specifically, these papers examine diverse uses and experiences of streaming ‘radio’ and its deployments for community-building, emotional sustenance, and an online reconstitution of place. In their explorations, these papers consider which methodologies are appropriate and useful to examine the affordances of streaming radio, enabling in turn analysis of informing ideas of ‘community’, intimacy, territorialization/deterritorialization, and questions of what comprises ‘radioness’ itself. Is radio still radio if it is online? What happens to the "community" that is conjured into being by terrestrial broadcast radio when the "station" is internet only?’ What does thinking from place mean when the tangibility of place is physically transcended and thus broken up and reconstituted as elements of locality, of community? The fourth and final power transposes the “perspective of frequency, force and affective tone” in transduction to the wider field of social media practices during the early stages of COVID. In this paper, the obsessive-compulsive ritual of “doomscrolling” becomes the practice through which rhythms of resonance and reverberation become imprinted upon the flows of everyday life through the transductive modulations of digital networked media

Making Sense Of Life In 2017 - Metaphors Of The Internet

Various metaphors are used to make sense of and explain our experiences with and in digital, web, internet-mediated, or technologically saturated contexts. These thrive and dwindle as our rhetoric moves from Cyberspace and the Electronic Frontier to the World Wide Web, social network sites and networked publics. The more ubiquitous networked communication becomes, the more it is articulated as a way of being, and the more banal and invisible its properties become. Studying metaphors offers important insights about how people and groups make sense of their experience, construct the world and attribute value to various phenomena. Yet, whatever metaphor is chosen, it concurrently illuminates and distorts what we see of the world and how we understand it. This panel brings together five presentations that engage with the three-pronged metaphorical framework of the internet as a tool, a place and a way of being suggested by Annette Markham in 1998. Today, 20 years later, authors examine various commonly invoked metaphors about the internet, networked technology or socially mediated experiences and utilize or extend the original framework. Combined, the papers explore the metaphors used by people and in large discourse; how dominant metaphors shift in time, and the political, ideological and methodological implications of these metaphors