A fine balance and a shared learning journey: Exploring healthcare engagement through the experiences of youth with neuromuscular disorders

BACKGROUND: Youth with Neuromuscular Disorders (NMD) who are wheelchair users can now survive well into adulthood if their multisystem comorbidities are prudently managed. Uptake of health behaviors may optimize their health outcomes. OBJECTIVE: To explore youths’ perceptions of health, health behaviors and healthcare engagement. METHODS: This qualitative study purposefully recruited 11 youth with NMD from a concurrent, population-based study for variability of age, gender, type of NMD and their ratings of motivation and engagement. Interview data were analyzed and synthesized by thematic content. RESULTS: Participants perceived healthcare engagement as being given tools (knowledge and responsibility) and using them to maintain their finely balanced health. Nested in adequate social, emotional and physical support, they took responsibility for creatively integrating health behaviors they felt were informed by credible knowledge, gained primarily through personal experience. CONCLUSION: Cognizant of their compromised health, youth with NMD in this study were motivated to maintain their physical health. Limited NMD condition specific knowledge challenged youths’ uptake of health behaviors. They valued a learning partnership with their healthcare professionals. By embracing the youth’s experience based knowledge and through facilitating supportive relationships, healthcare professionals co-construct youth’s healthcare engagement that may optimize health behaviors and outcomes

Assessing the effects of the first 2 years of industry-led badger culling in England on the incidence of bovine tuberculosis in cattle in 2013–2015

Culling badgers to control the transmission of bovine tuberculosis (TB) between this wildlife reservoir and cattle has been widely debated. Industry-led culling began in Somerset and Gloucestershire between August and November 2013 to reduce local badger populations. Industry-led culling is not designed to be a randomised and controlled trial of the impact of culling on cattle incidence. Nevertheless, it is important to monitor the effects of the culling and, taking the study limitations into account, perform a cautious evaluation of the impacts. A standardised method for selecting areas matched to culling areas in factors found to affect cattle TB risk has been developed to evaluate the impact of badger culling on cattle TB incidence. The association between cattle TB incidence and badger culling in the first two years has been assessed. Descriptive analyses without controlling for confounding showed no association between culling and TB incidence for Somerset, or for either of the buffer areas for the first two years since culling began. A weak association was observed in Gloucestershire for Year 1 only. Multivariable analysis adjusting for confounding factors showed that reductions in TB incidence were associated with culling in the first two years in both the Somerset and Gloucestershire intervention areas when compared to areas with no culling (IRR: 0.79, 95%CI: 0.72-0.87, p<0.001 and IRR: 0.42, 95%CI: 0.34-0.51, p<0.001 respectively). An increase in incidence was associated with culling in the 2 km buffer surrounding the Somerset intervention area (IRR: 1.38, 95%CI: 1.09-1.75, p=0.008), but not in Gloucestershire (IRR: 0.91, 95%CI: 0.77-1.07, p=0.243). As only two intervention areas with two years’ of data are available for analysis, and the biological cause-effect relationship behind the statistical associations is difficult to determine, it would be unwise to use these findings to develop generalisable inferences about the effectiveness of the policy at present

Coupling of Coronal and Heliospheric Magnetohydrodynamic Models: Solution Comparisons and Verification

Two well-established magnetohydrodynamic (MHD) codes are coupled to model the solar corona and the inner heliosphere. The corona is simulated using the MHD algorithm outside a sphere (MAS) model. The Lyon–Fedder–Mobarry (LFM) model is used in the heliosphere. The interface between the models is placed in a spherical shell above the critical point and allows both models to work in either a rotating or an inertial frame. Numerical tests are presented examining the coupled model solutions from 20 to 50 solar radii. The heliospheric simulations are run with both LFM and the MAS extension into the heliosphere, and use the same polytropic coronal MAS solutions as the inner boundary condition. The coronal simulations are performed for idealized magnetic configurations, with an out-of-equilibrium flux rope inserted into an axisymmetric background, with and without including the solar rotation. The temporal evolution at the inner boundary of the LFM and MAS solutions is shown to be nearly identical, as are the steady-state background solutions, prior to the insertion of the flux rope. However, after the coronal mass ejection has propagated through the significant portion of the simulation domain, the heliospheric solutions diverge. Additional simulations with different resolution are then performed and show that the MAS heliospheric solutions approach those of LFM when run with progressively higher resolution. Following these detailed tests, a more realistic simulation driven by the thermodynamic coronal MAS is presented, which includes solar rotation and an azimuthally asymmetric background and extends to the Earth’s orbit

A proposed approach to monitor private-sector policies and practices related to food environments, obesity and non-communicable disease prevention

Private-sector organizations play a critical role in shaping the food environments of individuals and populations. However, there is currently very limited independent monitoring of private-sector actions related to food environments. This paper reviews previous efforts to monitor the private sector in this area, and outlines a proposed approach to monitor private-sector policies and practices related to food environments, and their influence on obesity and non-communicable disease (NCD) prevention. A step-wise approach to data collection is recommended, in which the first (‘minimal’) step is the collation of publicly available food and nutrition-related policies of selected private-sector organizations. The second (‘expanded’) step assesses the nutritional composition of each organization’s products, their promotions to children, their labelling practices, and the accessibility, availability and affordability of their products. The third (‘optimal’) step includes data on other commercial activities that may influence food environments, such as political lobbying and corporate philanthropy. The proposed approach will be further developed and piloted in countries of varying size and income levels. There is potential for this approach to enable national and international benchmarking of private-sector policies and practices, and to inform efforts to hold the private sector to account for their role in obesity and NCD prevention

Mineralogy of Vera Rubin Ridge in Gale Crater from the Mars Science Laboratory CheMin instrument

Gale crater was selected as the landing site for the Mars Science Laboratory Curiosity rover because of orbital evidence for a variety of secondary minerals in the lower slopes of Aeolis Mons (aka Mount Sharp) that indicate changes in aqueous conditions over time. Distinct units demonstrate orbital spectral signatures of hematite, phyllosilicate (smectite), and sulfate minerals, which suggest that ancient aqueous environments in Gale crater varied in oxidation potential, pH, and water activity. Vera Rubin ridge (VRR) is the first of these units identified from orbit to have been studied by Curiosity. Orbital near-infrared data from VRR show a strong band at 860 nm indicative of hematite. Before Curiosity arrived at VRR, the hypotheses to explain the formation of hematite included (1) precipitation at a redox interface where aqueous Fe2+ was oxidized to Fe3+, and (2) acidic alteration of olivine in oxic fluids. Studying the composition and sedimentology of the rocks on VRR allow us to test and refine these hypotheses and flesh out the depositional and diagenetic history of the ridge. Here, we focus on the mineralogical results of four rock powders drilled from and immediately below VRR as determined by CheMin

Glen Torridon Mineralogy and the Sedimentary History of the Clay Mineral Bearing Unit

Clay minerals are common in ancient terrains on Mars and their presence at the surface alludes to aqueous processes in the Noachian to Early Hesperian (>3.5 Ga). Gale crater was selected as Curiositys landing site largely because of the identification of clay mineral rich strata from orbit. On Earth, the types of clay minerals (i.e., smectites) identified in Gale crater are typically juvenile weathering products that ultimately record the interaction between primary igneous minerals with the hydrosphere, atmosphere, and biosphere. Trioctahedral and dioctahedral smectite were identified by Curiosity in units stratigraphically below the Clay Mineral-Bearing Unit (CBU) identified from orbit. Compositional and sedimentological data suggest the smectite formed via authigenesis in a lake environment and may have been altered during early diagenesis. The CBU is stratigraphically equivalent to a hematite-rich unit to the north and stratigraphically underlies sulfate-rich units to the south, suggesting a dynamic environment and evolving history of water in the ancient Gale crater lake. Targeting these clay mineral rich areas on Mars with rover missions provides an opportunity to explore the aqueous and sedimentary history of the planet

Detection of Siderite (FeCO3) in Glen Torridon Samples by the Mars Science Laboratory Rover

Siderite (FeCO3) has been detected in Gale Crater for the first time by the Mars Science Laboratory (MSL) Curiosity and is seen in multiple samples in the Glen Torridon (GT) region. The identification of siderite is based on evolved gas analysis (EGA) data from the Sample Analysis at Mars (SAM) instrument and X-ray diffraction (XRD) data from the Chemistry and Mineralogy (CheMin) instrument. Curiosity descended off of the Vera Rubin ridge (VRR) into the Glen Torridon region on Sol 2300. Glen Torridon is of particular interest because a strong clay mineral signature had been detected by orbital instruments [1]. To date, four drilled samples have been collected at two different drill locations: Kilmarie and Aberlady from adjacent blocks at the base of the south side of VRR in the Jura member and Glen Etive 1 and 2 on the same block in the Knockfarril member

L2 series solutions of the Dirac equation for power-law potentials at rest mass energy

We obtain solutions of the three dimensional Dirac equation for radial power-law potentials at rest mass energy as an infinite series of square integrable functions. These are written in terms of the confluent hypergeometric function and chosen such that the matrix representation of the Dirac operator is tridiagonal. The "wave equation" results in a three-term recursion relation for the expansion coefficients of the spinor wavefunction which is solved in terms of orthogonal polynomials. These are modified versions of the Meixner-Pollaczek polynomials and of the continuous dual Hahn polynomials. The choice depends on the values of the angular momentum and the power of the potential.Comment: 13 pages, 1 Tabl