A systematic review evaluating the impact of paid home carer training, supervision, and other interventions on the health and well-being of older home care clients

BACKGROUND: Interventions to support and skill paid home carers and managers could potentially improve health and well-being of older home care clients. This is the first systematic review of interventions to improve how home carers and home care agencies deliver care to older people, with regard to clients’ health and wellbeing and paid carers’ well-being, job satisfaction, and retention. METHODS: We reviewed 10/731 papers found in the electronic search (to January 2016) fitting predetermined criteria, assessed quality using a checklist, and synthesized data using quantitative and qualitative techniques. RESULTS: Ten papers described eight interventions. The six quantitative evaluations used diverse outcomes that precluded meta-analysis. In the only quantitative study (a cluster Randomized Controlled Trial), rated higher quality, setting meaningful goals, carer training, and supervision improved client health-related quality of life. The interventions that improved client outcomes comprised training with additional implementation, such as regular supervision and promoted care focused around clients’ needs and goals. In our qualitative synthesis of four studies, intervention elements carers valued were greater flexibility to work to a needs-based rather than a task-based model, learning more about clients, and improved communication with management and other workers. CONCLUSION: There is a dearth of evidence regarding effective strategies to improve how home care is delivered to older clients, particularly those with dementia. More research in this sector including feasibility testing of the first home care intervention trials to include health and life quality outcomes for clients with more severe dementia is now needed

Optical/UV-to-X-Ray Echoes from the Tidal Disruption Flare ASASSN-14li

We carried out the first multi-wavelength (optical/UV and X-ray) photometric reverberation mapping of a tidal disruption flare (TDF) ASASSN-14li. We find that its X-ray variations are correlated with and lag the optical/UV fluctuations by 32$\pm$4 days. Based on the direction and the magnitude of the X-ray time lag, we rule out X-ray reprocessing and direct emission from a standard circular thin disk as the dominant source of its optical/UV emission. The lag magnitude also rules out an AGN disk-driven instability as the origin of ASASSN-14li and thus strongly supports the tidal disruption picture for this event and similar objects. We suggest that the majority of the optical/UV emission likely originates from debris stream self-interactions. Perturbations at the self-interaction sites produce optical/UV variability and travel down to the black hole where they modulate the X-rays. The time lag between the optical/UV and the X-rays variations thus correspond to the time taken by these fluctuations to travel from the self-interaction site to close to the black hole. We further discuss these time lags within the context of the three variants of the self-interaction model. High-cadence monitoring observations of future TDFs will be sensitive enough to detect these echoes and would allow us to establish the origin of optical/UV emission in TDFs in general.Comment: Publish in ApJ Letter

Swift J1112.2-8238: A Candidate Relativistic Tidal Disruption Flare

We present observations of Swift J1112.2-8238, and identify it as a candidate relativistic tidal disruption flare (rTDF). The outburst was first detected by Swift/BAT in June 2011 as an unknown, long-lived (order of days) $\gamma$-ray transient source. We show that its position is consistent with the nucleus of a faint galaxy for which we establish a likely redshift of $z=0.89$ based on a single emission line that we interpret as the blended [OII]$\lambda3727$ doublet. At this redshift, the peak X/$\gamma$-ray luminosity exceeded $10^{47}$ ergs s$^{-1}$, while a spatially coincident optical transient source had $i^{\prime} \sim 22$ (M$_g \sim -21.4$ at $z=0.89$) during early observations, $\sim 20$ days after the Swift trigger. These properties place Swift J1112.2-8238 in a very similar region of parameter space to the two previously identified members of this class, Swift J1644+57 and Swift J2058+0516. As with those events the high-energy emission shows evidence for variability over the first few days, while late time observations, almost 3 years post-outburst, demonstrate that it has now switched off. Swift J1112.2-8238 brings the total number of such events observed by Swift to three, interestingly all detected by Swift over a $\sim$3 month period ($<3\%$ of its total lifetime as of March 2015). While this suggests the possibility that further examples may be uncovered by detailed searches of the BAT archives, the lack of any prime candidates in the years since 2011 means these events are undoubtedly rare.Comment: 11 pages, 5 figures, accepted for publication by MNRA

Preliminary Results from the Caltech Core-Collapse Project (CCCP)

We present preliminary results from the Caltech Core-Collapse Project (CCCP), a large observational program focused on the study of core-collapse SNe. Uniform, high-quality NIR and optical photometry and multi-epoch optical spectroscopy have been obtained using the 200'' Hale and robotic 60'' telescopes at Palomar, for a sample of 50 nearby core-collapse SNe. The combination of both well-sampled optical light curves and multi-epoch spectroscopy will enable spectroscopically and photometrically based subtype definitions to be disentangled from each other. Multi-epoch spectroscopy is crucial to identify transition events that evolve among subtypes with time. The CCCP SN sample includes every core-collapse SN discovered between July 2004 and September 2005 that was visible from Palomar, found shortly (< 30 days) after explosion (based on available pre-explosion photometry), and closer than ~120 Mpc. This complete sample allows, for the first time, a study of core-collapse SNe as a population, rather than as individual events. Here, we present the full CCCP SN sample and show exemplary data collected. We analyze available data for the first ~1/3 of the sample and determine the subtypes of 13 SNe II based on both light curve shapes and spectroscopy. We discuss the relative SN II subtype fractions in the context of associating SN subtypes with specific progenitor stars.Comment: To appear in the proceedings of the meeting "The Multicoloured Landscape of Compact Objects and their Explosive Origins", Cefalu, Italy, June 2006, to be published by AIP, Eds. L. Burderi et a

The peculiar Type Ia supernova iPTF14atg: Chandrasekhar-mass explosion or violent merger?

iPTF14atg, a subluminous peculiar Type Ia supernova (SN Ia) similar to SN 2002es, is the first SN Ia for which a strong UV flash was observed in the early-time light curves. This has been interpreted as evidence for a single-degenerate (SD) progenitor system where such a signal is expected from interactions between the SN ejecta and the non-degenerate companion star. Here, we compare synthetic observables of multi-dimensional state-of-the-art explosion models for different progenitor scenarios to the light curves and spectra of iPTF14atg. From our models, we have difficulties explaining the spectral evolution of iPTF14atg within the SD progenitor channel. In contrast, we find that a violent merger of two carbon-oxygen white dwarfs with 0.9 and 0.76 solar masses, respectively, provides an excellent match to the spectral evolution of iPTF14atg from 10d before to several weeks after maximum light. Our merger model does not naturally explain the initial UV flash of iPTF14atg. We discuss several possibilities like interactions of the SN ejecta with the circum-stellar medium and surface radioactivity from a He ignited merger that may be able to account for the early UV emission in violent merger models.Comment: 12 pages, 7 figures, accepted for publication in MNRA

Multiwaveband analysis of brightest GRB070125

We present a comprehensive multiwavelength analysis of the bright, long duration gamma-ray burst GRB 070125, comprised of observations in gamma-ray, X-ray, optical, millimeter and centimeter wavebands. Radio light curves show rapid flux variations, which are interpreted as due to interstellar scintillation, and are used to derive an upper limit of 2.4×10^17 cm on the radius of the fireball. Radio light curves and spectra suggest that the afterglow shock wave is moving in a dense medium. Our broadband modeling favors a constant density profile for the circumburst medium over a wind-like profile (R^−2). GRB 070125 is a burst with high radiative efficiency (>60%)

Spectropolarimetry of SN 2011dh in M51: geometric insights on a Type IIb supernova progenitor and explosion

We present seven epochs of spectropolarimetry of the Type IIb supernova (SN) 2011dh in M51, spanning 86 days of its evolution. The first epoch was obtained 9 days after the explosion, when the photosphere was still in the depleted hydrogen layer of the stripped-envelope progenitor. Continuum polarization is securely detected at the level of P~0.5% through day 14 and appears to diminish by day 30, which is different from the prevailing trends suggested by studies of other core-collapse SNe. Time-variable modulations in P and position angle are detected across P-Cygni line features. H-alpha and HeI polarization peak after 30 days and exhibit position angles roughly aligned with the earlier continuum, while OI and CaII appear to be geometrically distinct. We discuss several possibilities to explain the evolution of the continuum and line polarization, including the potential effects of a tidally deformed progenitor star, aspherical radioactive heating by fast-rising plumes of Ni-56 from the core, oblique shock breakout, or scattering by circumstellar material. While these possibilities are plausible and guided by theoretical expectations, they are not unique solutions to the data. The construction of more detailed hydrodynamic and radiative-transfer models that incorporate complex aspherical geometries will be required to further elucidate the nature of the polarized radiation from SN 2011dh and other Type IIb supernovae.Comment: Post-proof edit. Accepted to MNRAS 2015 Aug 1

Seminal plasma and prostaglandin E2 up-regulate fibroblast growth factor 2 expression in endometrial adenocarcinoma cells via E-series prostanoid-2 receptor-mediated transactivation of the epidermal growth factor receptor and extracellular signal-regulated kinase pathway

We report a multiwavelength (X-ray, ultraviolet/optical/infrared, radio) analysis of the relativistic tidal disruption event candidate Sw J2058+05 from 3 months to 3 yr post-discovery in order to study its properties and compare its behavior with that of Sw J1644+57. Our main results are as follows. (1) The long-term X-ray light curve of Sw J2058+05 shows a remarkably similar trend to that of Sw J1644+57. After a prolonged power-law decay, the X-ray flux drops off rapidly by a factor of $\gtrsim 160$ within a span of $\Delta$$t$/$t$ $\le$ 0.95. Associating this sudden decline with the transition from super-Eddington to sub-Eddington accretion, we estimate the black hole mass to be in the range of $10^{4-6}$ M$_{\odot}$. (2) We detect rapid ($\lesssim 500$ s) X-ray variability before the dropoff, suggesting that, even at late times, the X-rays originate from close to the black hole (ruling out a forward-shock origin). (3) We confirm using HST and VLBA astrometry that the location of the source coincides with the galaxy's center to within $\lesssim 400$ pc (in projection). (4) We modeled Sw J2058+05's ultraviolet/optical/infrared spectral energy distribution with a single-temperature blackbody and find that while the radius remains more or less constant at a value of $63.4 \pm 4.5$ AU ($\sim 10^{15}$ cm) at all times during the outburst, the blackbody temperature drops significantly from $\sim$ 30,000 K at early times to a value of $\sim$ 15,000 K at late times (before the X-ray dropoff). Our results strengthen Sw J2058+05's interpretation as a tidal disruption event similar to Sw J1644+57.Comment: Replaced with the published version of the manuscrip