144 research outputs found
Strange Carers
The present comment focuses on the distinction between attachment as bond formation and expectations of availability and responsiveness (security) within attachment relationships. We enumerate key components of bonding and functions of carer secure base support. Our analysis has implications for design and suggests that robots are unlikely to serve effectively as sole carers. Even with robots as part-time carers, attachment-like bonds would likely focus on human carers. Similarly, although infants and children would certainly build expectations regarding the availability and responsiveness of robot carers, the quality of human care would probably be the determining influence on later development and competence. Notwithstanding their limitations of robots as attachment figures they have considerable potential to extend parental care and enrich infant exploration. The Sharkey’s paper and further consideration of robots as carers for infants, children, older adults, an
Mental health nurses’ attitudes, experience, and knowledge regarding routine physical healthcare:systematic, integrative review of studies involving 7,549 nurses working in mental health settings
Background: There has been a recent growth in research addressing mental health nurses’ routine physical healthcare knowledge and attitudes. We aimed to systematically review the empirical evidence about i) mental health nurses’ knowledge, attitudes, and experiences of physical healthcare for mental health patients, and ii) the effectiveness of any interventions to improve these aspects of their work.Methods: Systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Multiple electronic databases were searched using comprehensive terms. Inclusion criteria: English language papers recounting empirical studies about: i) mental health nurses’ routine physical healthcare-related knowledge, skills, experience, attitudes, or training needs; and ii) the effectiveness of interventions to improve any outcome related to mental health nurses' delivery of routine physical health care for mental health patients. Effect sizes from intervention studies were extracted or calculated where there was sufficient information. An integrative, narrative synthesis of study findings was conducted.Results: Fifty-one papers covering studies from 41 unique samples including 7,549 mental health nurses in 14 countries met inclusion criteria. Forty-two (82.4%) papers were published since 2010. Eleven were intervention studies; 40 were cross-sectional. Observational and qualitative studies were generally of good quality and establish a baseline picture of the issue. Intervention studies were prone to bias due to lack of randomisation and control groups but produced some large effect sizes for targeted education innovations. Comparisons of international data from studies using the Physical Health Attitudes Scale for Mental Health Nursing revealed differences across the world which may have implications for different models of student nurse preparation.Conclusions: Mental health nurses' ability and increasing enthusiasm for routine physical healthcare has been highlighted in recent years. Contemporary literature provides a base for future research which must now concentrate on determining the effectiveness of nurse preparation for providing physical health care for people with mental disorder, determining the appropriate content for such preparation, and evaluating the effectiveness both in terms of nurse and patient- related outcomes. At the same time, developments are needed which are congruent with the needs and wants of patients
On the diversity and complexity of absorption line profiles produced by outflows in Active Galactic Nuclei
Understanding the origin of AGN absorption line profiles and their diversity
could help to explain the physical structure of the accretion flow, and also to
assess the impact of accretion on the evolution of the AGN host galaxies. Here
we present our first attempt to systematically address the issue of the origin
of the complexities observed in absorption profiles. Using a simple method, we
compute absorption line profiles against a continuum point source for several
simulations of accretion disk winds. We investigate the geometrical,
ionization, and dynamical effects on the absorption line shapes. We find that
significant complexity and diversity of the absorption line profile shapes can
be produced by the non-monotonic distribution of the wind velocity, density,
and ionization state. Non-monotonic distributions of such quantities are
present even in steady-state, smooth disk winds, and naturally lead to the
formation of multiple and detached absorption troughs. These results
demonstrate that the part of a wind where an absorption line is formed is not
representative of the entire wind. Thus, the information contained in the
absorption line is incomplete if not even insufficient to well estimate gross
properties of the wind such as the total mass and energy fluxes. In addition,
the highly dynamical nature of certain portions of disk winds can have
important effects on the estimates of the wind properties. For example, the
mass outflow rates can be off up to two orders of magnitude with respect to
estimates based on a spherically symmetric, homogeneous, constant velocity
wind.Comment: 10 pages, 10 figures, to appear in Ap
The secure base script and the task of caring for elderly parents: implications for attachment theory and clinical practice
This study explores links between adults’ attachment representations and the task of caring for elderly parents with dementia. Participants were 87 adults serving as primary caregivers of a parent or parent-in-law with dementia. Waters and Waters’ (2006) Attachment Script Assessment was adapted to assess script-like attachment representation in the context of caring for their elderly parent. The quality of adult-elderly parent interactions was assessed using the Level of Expressed Emotions Scale (Cole & Kazarian, 1988) and self-report measures of caregivers’ perception of caregiving as difficult. Caregivers’ secure base script knowledge predicted lower levels of negative expressed emotion. This effect was moderated by the extent to which participants experienced caring for elderly parents as difficult. Attachment representations played a greater role in caregiving when caregiving tasks were perceived as more difficult. These results support the hypothesis that attachment representations influence the quality of care that adults provide their elderly parents. Clinical implications are discussed
A study in high-risk, maximally pretreated patients to determine the potential use of PCSK9 inhibitors at various thresholds of total and LDL cholesterol levels
PURPOSE OF THE STUDY: Statins and ezetimibe reduce low-density lipoprotein cholesterol (LDL-c) and cardiovascular disease (CVD) risk. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors lower LDL-c by 50%-70% and might be useful in refractory patients. The National Institute for Health and Care Excellence (NICE) technology appraisal guidance (TAG) recommends use of these drugs in secondary prevention and familial hypercholesterolaemia (FH) at differing LDL-c thresholds. We have estimated the proportion of patients in whom this third-line drug might be useful.
STUDY DESIGN: We used data from a lipid-lowering audit programme to study 72 with FH and/or CVD of 271 patients referred over 12 months who failed to achieve target total cholesterol (TC) and LDL-c levels. All 72 patients were treated with ezetimibe, and 69 cases also received statins. We used LDL-c thresholds 1.5-5.5 mmol/L to estimate how many of these refractory patients could benefit from PCSK9 inhibitors.
RESULTS: In 72 patients, TC and LDL-c targets were not met by 64 and 53 patients, respectively. We judged using the NICE TAG that only one patient (1.4% ezetimibe requiring and 0.4% total referrals) required a PCSK9 inhibitor.
CONCLUSIONS: We determined that the proportion of patients eligible for a PCSK9 inhibitor at various TC and LDL-c levels is modest. This may reflect the use of all available statins in UK lipid clinics often at non-daily frequency. We suggest that cost-effective use of PCSK9 inhibitors requires prescribing being restricted to clinicians working in specialised lipid clinics
Exploring pre-main sequence variables of ONC: The new variables
Since 2004, we have been engaged in a long-term observing program to monitor
young stellar objects in the Orion Nebula Cluster. We have collected about two
thousands frames in V, R, and I broad-band filters on more than two hundred
nights distributed over five consecutive observing seasons. The high-quality
and time-extended photometric data give us an opportunity to address various
phenomena associated with young stars. The prime motivations of this project
are i) to explore various manifestations of stellar magnetic activity in very
young low-mass stars; ii) to search for new pre-main sequence eclipsing
binaries; and iii) to look for any EXor and FUor like transient activities
associated with YSOs. Since this is the first paper on this program, we give a
detailed description of the science drivers, the observation and the data
reduction strategies as well. In addition to these, we also present a large
number of new periodic variables detected from our first five years of
time-series photometric data. Our study reveals that about 72% of CTTS in our
FoV are periodic, whereas, the percentage of periodic WTTS is just 32%. This
indicates that inhomogeneities patterns on the surface of CTTS of the ONC stars
are much more stable than on WTTS. From our multi-year monitoring campaign we
found that the photometric surveys based on single-season are incapable of
identifying all periodic variables. And any study on evolution of angular
momentum based on single-season surveys must be carried out with caution.Comment: Accepted for publication by MNRAS, 26 pages, 17 figures, 6 table
Airborne dust and high temperatures are risk factors for invasive bacterial disease
Background The Sahel region of West Africa has the highest bacterial meningitis attack and case fatality rate in the world. The effect of climatic factors on patterns of invasive respiratory bacterial disease is not well documented. Objective We aimed to assess the link between climatic factors and occurrence of invasive respiratory bacterial disease in a Sahel region of Niger. Methods We conducted daily disease surveillance and climatic monitoring over an 8-year period between January 1, 2003, and December 31, 2010, in Niamey, Niger, to determine risk factors for bacterial meningitis and invasive bacterial disease. We investigated the mechanistic effects of these factors on Streptococcus pneumoniae infection in mice. Results High temperatures and low visibility (resulting from high concentrations of airborne dust) were identified as significant risk factors for bacterial meningitis. Dust inhalation or exposure to high temperatures promoted progression of stable asymptomatic pneumococcal nasopharyngeal carriage to pneumonia and invasive disease. Dust exposure significantly reduced phagocyte-mediated bacterial killing, and exposure to high temperatures increased release of the key pneumococcal toxin pneumolysin through increased bacterial autolysis. Conclusion Our findings show that climatic factors can have a substantial influence on infectious disease patterns, altering density of pneumococcal nasopharyngeal carriage, reducing phagocytic killing, and resulting in increased inflammation and tissue damage and consequent invasiveness. Climatic surveillance should be used to forecast invasive bacterial disease epidemics, and simple control measures to reduce particulate inhalation might reduce the incidence of invasive bacterial disease in regions of the world exposed to high temperatures and increased airborne dust
Disorganized Attachment in Infancy: A Review of the Phenomenon and Its Implications for Clinicians and Policy-Makers
Disorganized/Disoriented (D) attachment has seen widespread interest from policy makers, practitioners, and clinicians in recent years. However, some of this interest seems to have been based on some false assumptions that (1) attachment measures can be used as definitive assessments of the individual in forensic/child protection settings and that disorganized attachment (2) reliably indicates child maltreatment, (3) is a strong predictor of pathology, and (4) represents a fixed or static trait of the child, impervious to development or help. This paper summarizes the evidence showing that these four assumptions are false and misleading. The paper reviews what is known about disorganized infant attachment and clarifies the implications of the classification for clinical and welfare practice with children. In particular, the difference between disorganized attachment and attachment disorder is examined, and a strong case is made for the value of attachment theory for supportive work with families and for the development and evaluation of evidence-based caregiving interventions
Measurement of the Forward-Backward Asymmetry in the B -> K(*) mu+ mu- Decay and First Observation of the Bs -> phi mu+ mu- Decay
We reconstruct the rare decays , , and in a data sample
corresponding to collected in collisions at
by the CDF II detector at the Fermilab Tevatron
Collider. Using and decays we report the branching ratios. In addition, we report
the measurement of the differential branching ratio and the muon
forward-backward asymmetry in the and decay modes, and the
longitudinal polarization in the decay mode with respect to the squared
dimuon mass. These are consistent with the theoretical prediction from the
standard model, and most recent determinations from other experiments and of
comparable accuracy. We also report the first observation of the {\mathcal{B}}(B^0_s \to
\phi\mu^+\mu^-) = [1.44 \pm 0.33 \pm 0.46] \times 10^{-6}27 \pm 6B^0_s$ decay observed.Comment: 7 pages, 2 figures, 3 tables. Submitted to Phys. Rev. Let
Measurements of the properties of Lambda_c(2595), Lambda_c(2625), Sigma_c(2455), and Sigma_c(2520) baryons
We report measurements of the resonance properties of Lambda_c(2595)+ and
Lambda_c(2625)+ baryons in their decays to Lambda_c+ pi+ pi- as well as
Sigma_c(2455)++,0 and Sigma_c(2520)++,0 baryons in their decays to Lambda_c+
pi+/- final states. These measurements are performed using data corresponding
to 5.2/fb of integrated luminosity from ppbar collisions at sqrt(s) = 1.96 TeV,
collected with the CDF II detector at the Fermilab Tevatron. Exploiting the
largest available charmed baryon sample, we measure masses and decay widths
with uncertainties comparable to the world averages for Sigma_c states, and
significantly smaller uncertainties than the world averages for excited
Lambda_c+ states.Comment: added one reference and one table, changed order of figures, 17
pages, 15 figure
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