Rural and Remote Pharmacy Workforce Development Program

Executive SummaryMany authors have commented upon the potential of pharmacies as a health promotion setting due to their ease of accessibility for the public, high level of use, and respected position of pharmacists.Research has demonstrated that pharmacist led health promotion can be successful in assisting people to make lifestyle changes around smoking, diet, and more specifically, lipid management. There is also preliminary evidence to suggest that pharmacists can provide physical activity and alcohol consumption recommendations to their customers.Presently pharmacists have mainly been involved in information provision and screening activities. This forms one component of a health promotion approach and particularly in rural regions, community pharmacies could be performing a greater role in community health promotion activities.A model was piloted in four rural pharmacies with each pharmacy provided with a small grant to cover community activities and in store health promotion advice provision. The primary researcher on the project offered consultation support to the pharmacies as well as conducting the literature review and project evaluation.Needs analyses were conducted in the pharmacies and feedback revealed a low level of interest in health behaviour topics although some customers mentioned an interest in receiving dietary advice. This reflected the lower use of the in-store component of the project with few customers utilising the free dietary checks. Falls prevention screening and diabetes screening were more popular.The pharmacies were able to organise and sponsor a wide range of health promotion community activities. These included workshops on health topics, physical activity programs, home reviews for falls prevention, and early years and school health promotion programs. These programs reached over 500 people across the four communities.The results showed the considerable potential for community pharmacies in rural areas to organise community health promotion activities. As well as the direct benefit to the people involved in these activities, having the pharmacy sponsor and organise the events contributes to changing the perceptions of the general public to realise the broad health expertise of pharmacies roles.Based on the literature review and findings of the project a model has been developed in the recommendations section to imbed health promotion within rural community pharmacies. Important aspects of this model are health promotion training for pharmacists and pharmacy assistants, provision of grant money support, consultation support from a health promotion worker and promotional material to advertise using the pharmacy for health promotion advice

TEAMwork: Testing Emotional Attunement and Mutuality During Parent-Adolescent fMRI.

The parent-child relationship and family context influence the development of emotion regulation (ER) brain circuitry and related skills in children and adolescents. Although both parents' and children's ER neurocircuitry simultaneously affect how they interact with one another, neuroimaging studies of parent-child relationships typically include only one member of the dyad in brain imaging procedures. The current study examined brain activation related to parenting and ER in parent-adolescent dyads during concurrent fMRI scanning with a novel task - the Testing Emotional Attunement and Mutuality (TEAM) task. The TEAM task includes feedback trials indicating the other dyad member made an error, resulting in a monetary loss for both participants. Results indicate that positive parenting practices as reported by the adolescent were positively correlated with parents' hemodynamic activation of the ventromedial prefrontal cortex, a region related to empathy, during these error trials. Additionally, during feedback conditions both parents and adolescents exhibited fMRI activation in ER-related regions, including the dorsolateral prefrontal cortex, anterior insula, fusiform gyrus, thalamus, caudate, precuneus, and superior parietal lobule. Adolescents had higher left amygdala activation than parents during the feedback condition. These findings demonstrate the utility of dyadic fMRI scanning for investigating relational processes, particularly in the parent-child relationship

Always on my mind: Cross-brain associations of mental health symptoms during simultaneous parent-child scanning.

How parents manifest symptoms of anxiety or depression may affect how children learn to modulate their own distress, thereby influencing the children's risk for developing an anxiety or mood disorder. Conversely, children's mental health symptoms may impact parents' experiences of negative emotions. Therefore, mental health symptoms can have bidirectional effects in parent-child relationships, particularly during moments of distress or frustration (e.g., when a parent or child makes a costly mistake). The present study used simultaneous functional magnetic resonance imaging (fMRI) of parent-adolescent dyads to examine how brain activity when responding to each other's costly errors (i.e., dyadic error processing) may be associated with symptoms of anxiety and depression. While undergoing simultaneous fMRI scans, healthy dyads completed a task involving feigned errors that indicated their family member made a costly mistake. Inter-brain, random-effects multivariate modeling revealed that parents who exhibited decreased medial prefrontal cortex and posterior cingulate cortex activation when viewing their child's costly error response had children with more symptoms of depression and anxiety. Adolescents with increased anterior insula activation when viewing a costly error made by their parent had more anxious parents. These results reveal cross-brain associations between mental health symptomatology and brain activity during parent-child dyadic error processing

An L Band Spectrum of the Coldest Brown Dwarf

The coldest brown dwarf, WISE 0855, is the closest known planetary-mass, free-floating object and has a temperature nearly as cold as the solar system gas giants. Like Jupiter, it is predicted to have an atmosphere rich in methane, water, and ammonia, with clouds of volatile ices. WISE 0855 is faint at near-infrared wavelengths and emits almost all its energy in the mid-infrared. Skemer et al. 2016 presented a spectrum of WISE 0855 from 4.5-5.1 micron (M band), revealing water vapor features. Here, we present a spectrum of WISE 0855 in L band, from 3.4-4.14 micron. We present a set of atmosphere models that include a range of compositions (metallicities and C/O ratios) and water ice clouds. Methane absorption is clearly present in the spectrum. The mid-infrared color can be better matched with a methane abundance that is depleted relative to solar abundance. We find that there is evidence for water ice clouds in the M band spectrum, and we find a lack of phosphine spectral features in both the L and M band spectra. We suggest that a deep continuum opacity source may be obscuring the near-infrared flux, possibly a deep phosphorous-bearing cloud, ammonium dihyrogen phosphate. Observations of WISE 0855 provide critical constraints for cold planetary atmospheres, bridging the temperature range between the long-studied solar system planets and accessible exoplanets. JWST will soon revolutionize our understanding of cold brown dwarfs with high-precision spectroscopy across the infrared, allowing us to study their compositions and cloud properties, and to infer their atmospheric dynamics and formation processes.Comment: 19 pages, 21 figures. Accepted for publication in Ap

Masses, Radii, and Cloud Properties of the HR 8799 Planets

The near-infrared colors of the planets directly imaged around the A star HR 8799 are much redder than most field brown dwarfs of the same effective temperature. Previous theoretical studies of these objects have concluded that the atmospheres of planets b, c, and d are unusually cloudy or have unusual cloud properties. Some studies have also found that the inferred radii of some or all of the planets disagree with expectations of standard giant planet evolution models. Here we compare the available data to the predictions of our own set of atmospheric and evolution models that have been extensively tested against observations of field L and T dwarfs, including the reddest L dwarfs. Unlike some previous studies we require mutually consistent choices for effective temperature, gravity, cloud properties, and planetary radius. This procedure thus yields plausible values for the masses, effective temperatures, and cloud properties of all three planets. We find that the cloud properties of the HR 8799 planets are not unusual but rather follow previously recognized trends, including a gravity dependence on the temperature of the L to T spectral transition--some reasons for which we discuss. We find the inferred mass of planet b is highly sensitive to whether or not we include the H and K band spectrum in our analysis. Solutions for planets c and d are consistent with the generally accepted constraints on the age of the primary star and orbital dynamics. We also confirm that, like in L and T dwarfs and solar system giant planets, non-equilibrium chemistry driven by atmospheric mixing is also important for these objects. Given the preponderance of data suggesting that the L to T spectral type transition is gravity dependent, we present an exploratory evolution calculation that accounts for this effect. Finally we recompute the the bolometric luminosity of all three planets.Comment: 52 pages, 12 figures, Astrophysical Journal, in press. v2 features minor editorial updates and correction

Stellar Populations at the Center of IC 1613

We have observed the center of the Local Group dwarf irregular galaxy IC 1613 with WFPC2 aboard the Hubble Space Telescope in the F439W, F555W, and F814W filters. We find a dominant old stellar population (aged ~7 Gyr), identifiable by the strong red giant branch (RGB) and red clump populations. From the (V-I) color of the RGB, we estimate a mean metallicity of the intermediate-age stellar population [Fe/H] = -1.38 +/- 0.31. We confirm a distance of 715 +/- 40 kpc using the I-magnitude of the RGB tip. The main-sequence luminosity function down to I ~25 provides evidence for a roughly constant SFR of approximately 0.00035 solar masses per year across the WFPC2 field of view (0.22 square kpc) during the past 250-350 Myr. Structure in the blue loop luminosity function implies that the SFR was ~50% higher 400-900 Myr ago than today. The mean heavy element abundance of these young stars is 1/10th solar. The best explanation for a red spur on the main-sequence at I = 24.7 is the blue horizontal branch component of a very old stellar population at the center of IC 1613. We have also imaged a broader area of IC 1613 using the 3.5-meter WIYN telescope under excellent seeing conditions. The AGB-star luminosity function is consistent with a period of continuous star formation over at least the age range 2-10 Gyr. We present an approximate age-metallicity relation for IC 1613, which appears similar to that of the Small Magellanic Cloud. We compare the Hess diagram of IC 1613 to similar data for three other Local Group dwarf galaxies, and find that it most closely resembles the nearby, transition-type dwarf galaxy Pegasus (DDO 216).Comment: To appear in the September 1999 Astronomical Journal. LaTeX, uses AASTeX v4.0, emulateapj style file, 19 pages, 12 postscript figures, 2 tables. 5 of the figures available separately via the WW

Gamma Rays and the Decay of Neutrinos from SN1987A

We calculate limits to the properties of massive, unstable neutrinos using data from gamma-ray detectors on the Pioneer Venus Orbiter Satellite; a massive neutrino emitted from SN1987A that decayed in flight and produced gamma rays would be detectable by this instruments. The lack of such a signal allows us to constrain the branching ratio to photons (\Bg), mass (\mnu), and radiative lifetime (\tau_\gamma = \tau/\Bg). For low mass (m) neutrinos decaying $\nu\rightarrow\nu'\gamma$, \Bg<3\times 10^{-7}, for \mt\lesssim 10^6 \keV\sec, and \Bg<6\times 10^{-14} \mt/\keV\sec for \mt\gtrsim 10^6 \keV\sec; limits for high-mass neutrinos are somewhat weaker due to Boltzmann suppression. We also calculate limits for decays that produce gamma rays through the \brem channel, $\nu\rightarrow\nu'e^+e^-\gamma$. In the case that neutrino mass states are nearly degenerate, $\delta m^2/m^2\ll1$, our limits for the mode $\nu\rightarrow\nu'\gamma$ become more stringent by a factor of $\delta m^2/m^2$, because more of the decay photons are shifted into the PVO detector energy window.Comment: 17 pages, 6 postscript figures, uses revtex, epsf.sty. Submitted to PRD. Also available at file://ftp.cita.utoronto.ca/cita/jaffe/papers/pvoflux.ps.g

The Shaping of T Cell Receptor Recognition by Self-Tolerance

SummaryDuring selection of the T cell repertoire, the immune system navigates the subtle distinction between self-restriction and self-tolerance, yet how this is achieved is unclear. Here we describe how self-tolerance toward a trans-HLA (human leukocyte antigen) allotype shapes T cell receptor (TCR) recognition of an Epstein-Barr virus (EBV) determinant (FLRGRAYGL). The recognition of HLA-B8-FLRGRAYGL by two archetypal TCRs was compared. One was a publicly selected TCR, LC13, that is alloreactive with HLA-B44; the other, CF34, lacks HLA-B44 reactivity because it arises when HLA-B44 is coinherited in trans with HLA-B8. Whereas the alloreactive LC13 TCR docked at the C terminus of HLA-B8-FLRGRAYGL, the CF34 TCR docked at the N terminus of HLA-B8-FLRGRAYGL, which coincided with a polymorphic region between HLA-B8 and HLA-B44. The markedly contrasting footprints of the LC13 and CF34 TCRs provided a portrait of how self-tolerance shapes the specificity of TCRs selected into the immune repertoire