Statin usage, vascular diagnosis and vascular risk factors in Parkinson's disease

Background and aims: Vascular disease is a common comorbidity in Parkinson’s disease patients. Statins are potentially neuroprotective for Parkinson’s disease through non-vascular mechanisms. We investigated prevailing statin use in a Parkinson’s disease cohort. Methods and results: Data on diagnostic indication for statins, anti-Parkinson therapy, vascular risk factors, and statin prescription, were obtained from electronic medical record review for consecutive Parkinson’s disease patients. The ASsessing cardiac risk using Scottish Intercollegiate Guidelines Network system was used to calculate future cardiovascular risk and identify those warranting statin use. Of 441 patients included, 59.9% were male, with a mean age of 68.9 years (standard deviation 10.3). One hundred and seventy-four (39.5%) patients had at least one diagnostic indication for statin use, of whom 136 (78.2%) were prescribed a statin. In the 267 (60.5%) cases without a diagnostic indication, 54 (20.2%) were excluded owing to age limitations defined in ASsessing cardiac risk using Scottish Intercollegiate Guidelines Network. Of the remaining 213, 62 (29.1%) had an ASsessing cardiac risk using Scottish Intercollegiate Guidelines Network score in the recommended range for statin therapy, of whom 15 (24.1%) were prescribed statins. Conclusion: There is suboptimal implementation of statin therapy in Parkinson’s disease patients. Given the possible neuroprotective effects of statins in Parkinson’s disease in addition to reducing cardiovascular risk, reasons for suboptimal implementation warrant further investigation

Emerging communities of child-healthcare practice in the management of long-term conditions such as chronic kidney disease: Qualitative study of parents' accounts

Background: Parents of children and young people with long-term conditions who need to deliver clinical care to their child at home with remote support from hospital-based professionals, often search the internet for care-giving information. However, there is little evidence that the information available online was developed and evaluated with parents or that it acknowledges the communities of practice that exist as parents and healthcare professionals share responsibility for condition management. Methods. The data reported here are part of a wider study that developed and tested a condition-specific, online parent information and support application with children and young people with chronic-kidney disease, parents and professionals. Semi-structured interviews were conducted with 19 fathers and 24 mothers who had recently tested the novel application. Data were analysed using Framework Analysis and the Communities of Practice concept. Results: Evolving communities of child-healthcare practice were identified comprising three components and several sub components: (1) Experiencing (parents making sense of clinical tasks) through Normalising care, Normalising illness, Acceptance & action, Gaining strength from the affected child and Building relationships to formalise a routine; (2) Doing (Parents executing tasks according to their individual skills) illustrated by Developing coping strategies, Importance of parents' efficacy of care and Fear of the child's health failing; and (3) Belonging/Becoming (Parents defining task and group members' worth and creating a personal identity within the community) consisting of Information sharing, Negotiation with health professionals and Achieving expertise in care. Parents also recalled factors affecting the development of their respective communities of healthcare practice; these included Service transition, Poor parent social life, Psycho-social affects, Family chronic illness, Difficulty in learning new procedures, Shielding and avoidance, and Language and cultural barriers. Health care professionals will benefit from using the communities of child-healthcare practice model when they support parents of children with chronic kidney disease. Conclusions: Understanding some of the factors that may influence the development of communities of child-healthcare practice will help professionals to tailor information and support for parents learning to manage their child's healthcare. Our results are potentially transferrable to professionals managing the care of children and young people with other long-term conditions. © 2014 Carolan et al.; licensee BioMed Central Ltd

Designing a web-application to support home-based care of childhood CKD stages 3-5: Qualitative study of family and professional preferences

Background: There is a lack of online, evidence-based information and resources to support home-based care of childhood CKD stages 3-5. Methods. Qualitative interviews were undertaken with parents, patients and professionals to explore their views on content of the proposed online parent information and support (OPIS) web-application. Data were analysed using Framework Analysis, guided by the concept of Self-efficacy. Results: 32 parents, 26 patients and 12 professionals were interviewed. All groups wanted an application that explains, demonstrates, and enables parental clinical care-giving, with condition-specific, continously available, reliable, accessible material and a closed communication system to enable contact between families living with CKD. Professionals advocated a regularly updated application to empower parents to make informed health-care decisions. To address these requirements, key web-application components were defined as: (i) Clinical care-giving support (information on treatment regimens, video-learning tools, condition-specific cartoons/puzzles, and a question and answer area) and (ii) Psychosocial support for care-giving (social-networking, case studies, managing stress, and enhancing families' health-care experiences). Conclusions: Developing a web-application that meets parents' information and support needs will maximise its utility, thereby augmenting parents' self-efficacy for CKD caregiving, and optimising outcomes. Self-efficacy theory provides a schema for how parents' self-efficacy beliefs about management of their child's CKD could potentially be promoted by OPIS. © 2014 Swallow et al.; licensee BioMed Central Ltd

Vascular disease and vascular risk factors in relation to motor features and cognition in early Parkinson's disease

Funded by Parkinson's UK National Institute for Health Research (NIHR) DeNDRoN network NIHR Newcastle Biomedical Research Unit Newcastle University NIHR funded Biomedical Research Centre in CambridgePeer reviewedPublisher PD

Improved KL->pi e nu Form Factor and Phase Space Integral with Reduced Model Uncertainty

Using the published KTeV sample of 2 million KL-> pi e nu decays and a new form factor expansion with a rigorous bound on higher order terms, we present a new determination of the KL->pi e nu form factor and phase space integral. Compared to the previous KTeV result, the uncertainty in the new form factor expansion is negligible and results in an overall uncertainty in the phase space integral (IKe) that is a factor of two smaller: IKe = 0.15392 +- 0.00048 \.Comment: 3 pages, 2 figures, submitted to PRD Rapid Communicatio

Radiative Decay Width Measurements of Neutral Kaon Excitations Using the Primakoff Effect

We produce a sample consisting of 147 candidate events, with minimal backgrounds, of the mixed axial vector pair K1(1270)-K1(1400) by exciting Kl's in the Coulomb field of lead and report the first measurements of the radiative widths Gamma_r(K1(1400)) = 280.8+-23.2(stat)+-40.4(syst) keV and Gamma_r(K1(1270)) = 73.2+- 6.1(stat)+-28.3(syst) keV. We also place 90% CL upper limits Gamma_r(K*(1410)) < 52.9 keV for the vector state and Gamma_r(K2*(1430)) < 5.4 keV for the tensor state. These measurements allow for significant tests of quark-model predictions of radiative widths for the low-lying vector mesons.Comment: PRL-size article, 4 figure

Search for the Rare Decay K_{L}\to\pi^{0}\pi^{0}\gamma

The KTeV E799 experiment has conducted a search for the rare decay $K_{L}\to\pi^{0}\pi^{0}\gamma$ via the topology $K_{L}\to\pi^{0}\pi^{0}_D\gamma$ (where $\pi^0_D\to\gamma e^+e^-$). Due to Bose statistics of the $\pi^0$ pair and the real nature of the photon, the $K_{L}\to\pi^{0}\pi^{0}\gamma$ decay is restricted to proceed at lowest order by the CP conserving direct emission (DE) of an E2 electric quadrupole photon. The rate of this decay is interesting theoretically since chiral perturbation theory predicts that this process vanishes at level $O(p^4)$. Therefore, this mode probes chiral perturbation theory at $O(p^6)$. In this paper we report a determination of an upper limit of $2.43\times 10^{-7}$ (90% CL) for $K_{L}\to\pi^{0}\pi^{0}\gamma$. This is approximately a factor of 20 lower than previous results.Comment: six pages and six figures in the submission. Reformatted for Physics Review

Measurements of the Decay KL→e+e−γK_L \to e^+e^-\gamma

The E799-II (KTeV) experiment at Fermilab has collected 83262 $K_L \to e^+e^-\gamma$ events above a background of 79 events. We measure a decay width, normalized to the $K_L \to \pi^0\pi^0\pi^0_D$ (\pi^0 \to \gamma\gamma, \pi^0 to \gamma\gamma, \pi^0_D \to e^+e^-\gamma) decay width, of $\Gamma($K_L \to e^+e^-\gamma$)/\Gamma(K_L \to \pi^0\pi^0\pi^0_D) = (1.3302 \pm 0.0046_{stat} \pm 0.0102_{syst}) \times 10^{-3}$. We also measure parameters of two $K_L \gamma^{\ast}\gamma$ form factor models. In the Bergstrom, Masso, and Singer (BMS) parametrization, we find \caks = -0.517 \pm 0.030_{stat} \pm 0.022_{syst}. We separately fit for the first parameter of the D'Ambrosio, Isidori, and Portoles (DIP) model and find \adip = -1.729 \pm 0.043_{stat} \pm 0.028_{syst}.Comment: 5 pages, 3 figures, submitted to PR

First Observation of the decay KL -> pi0 e e gamma

We report on the first observation of the decay KL -> pi0 ee gamma by the KTeV E799 experiment at Fermilab. Based upon a sample of 48 events with an estimated background of 3.6 +/- 1.1 events, we measure the KL -> pi0 ee gamma branching ratio to be (2.34 +/- 0.35 +/- 0.13)x10^{-8}. Our data agree with recent O(p^6) calculations in chiral perturbation theory that include contributions from vector meson exchange through the parameter a_V. A fit was made to the KL -> pi0 ee gamma data for a_V with the result -0.67 +/- 0.21 +/- 0.12, which is consistent with previous results from KTeV.Comment: Submitted to Physical Review Letters, 5 pages, 5 figure