Large Interferometer For Exoplanets (LIFE): VIII. Where is the phosphine? Observing exoplanetary PH3 with a space based MIR nulling interferometer

Phosphine could be a key molecule in the understanding of exotic chemistry happening in (exo)planetary atmospheres. While it has been detected in the Solar System's giant planets, it has not been observed in exoplanets yet. In the exoplanetary context however it has been theorized as a potential biosignature molecule. The goal of our study is to identify which illustrative science cases for PH3 chemistry are observable with a space-based mid-infrared nulling interferometric observatory like the LIFE (Large Interferometer For Exoplanets) concept. We identified a representative set of scenarios for PH3 detections in exoplanetary atmospheres varying over the whole dynamic range of the LIFE mission. We used chemical kinetics and radiative transfer calculations to produce forward models of these informative, prototypical observational cases for LIFEsim, our observation simulator software for LIFE. In a detailed, yet first order approximation it takes a mission like LIFE: (i) about 1h to find phosphine in a warm giant around a G star at 10 pc, (ii) about 10 h in H2 or CO2 dominated temperate super-Earths around M star hosts at 5 pc, (iii) and even in 100h it seems very unlikely that phosphine would be detectable in a Venus-Twin with extreme PH3 concentrations at 5 pc. Phosphine in concentrations previously discussed in the literature is detectable in 2 out of the 3 cases and about an order of magnitude faster than comparable cases with JWST. We show that there is a significant number of objects accessible for these classes of observations. These results will be used to prioritize the parameter range for the next steps with more detailed retrieval simulations. They will also inform timely questions in the early design phase of a mission like LIFE and guide the community by providing easy-to-scale first estimates for a large part of detection space of such a mission.Comment: In press. Accepted for publication in Astrobiology on 02 November 2022. 26 pages, 5 figures and 8 table

A neurophenomenological approach to non-ordinary states of consciousness: hypnosis, meditation, and psychedelics

No contemporary unifying framework has been provided for the study of non-ordinary states of consciousness (NSCs) despite increased interest in hypnosis, meditation, and psychedelics. NSCs induce shifts in experiential contents (what appears to the experiencer) and/or structure (how it appears). This can allow the investigation of the plastic and dynamic nature of experience from a multiscale perspective that includes mind, brain, body, and context. We propose a neurophenomenological (NP) approach to the study of NSCs which highlights their role as catalysts of transformation in clinical practice by refining our understanding of the relationships between experiential (subjective) and neural dynamics. We outline the ethical implications of the NP approach for standard conceptions of health and pathology as well as the crucial role of experience-based know-how in NSC-related research and application

Online, Group-Based Psychological Support for Adolescent and Young Adult Cancer Survivors: Results from the Recapture Life Randomized Trial

Telehealth interventions offer a practical platform to support adolescent and young adult (AYA) cancer survivors' mental health needs after treatment, yet efficacy data are lacking. We evaluated an online, group-based, videoconferencing-delivered cognitive-behavioral therapy (CBT) intervention ('Recapture Life') in a 3-arm randomized-controlled trial comparing Recapture Life with an online peer-support group, and a waitlist control, with the aim of testing its impact on quality of life, emotional distress and healthcare service use. Forty AYAs (Mage = 20.6 years) within 24-months of completing treatment participated, together with 18 support persons. No groupwise impacts were measured immediately after the six-week intervention. However, Recapture Life participants reported using more CBT skills at the six-week follow-up (OR = 5.58, 95% CI = 2.00-15.56, p = 0.001) than peer-support controls. Recapture Life participants reported higher perceived negative impact of cancer, anxiety and depression at 12-month follow-up, compared to peer-support controls. Post-hoc analyses suggested that AYAs who were further from completing cancer treatment responded better to Recapture Life than those who had completed treatment more recently. While online telehealth interventions hold promise, recruitment to this trial was challenging. As the psychological challenges of cancer survivorship are likely to evolve with time, different support models may prove more or less helpful for different sub-groups of AYA survivors at different times

Large Interferometer For Exoplanets (LIFE). III. Spectral resolution, wavelength range, and sensitivity requirements based on atmospheric retrieval analyses of an exo-Earth

Context. Temperate terrestrial exoplanets are likely to be common objects, but their discovery and characterization is very challenging because of the small intrinsic signal compared to that of their host star. Various concepts for optimized space missions to overcome these challenges are currently being studied. The Large Interferometer For Exoplanets (LIFE) initiative focuses on the development of a spacebased mid-infrared (MIR) nulling interferometer probing the thermal emission of a large sample of exoplanets. Aims. This study derives the minimum requirements for the signal-to-noise ratio (S/N), the spectral resolution (R), and the wavelength coverage for the LIFE mission concept. Using an Earth-twin exoplanet as a reference case, we quantify how well planetary and atmospheric properties can be derived from its MIR thermal emission spectrum as a function of the wavelength range, S/N, and R. Methods. We combined a cloud-free 1D atmospheric radiative transfer model, a noise model for observations with the LIFE interferometer, and the nested sampling algorithm for Bayesian parameter inference to retrieve planetary and atmospheric properties. We simulated observations of an Earth-twin exoplanet orbiting a G2V star at 10 pc from the Sun with different levels of exozodiacal dust emissions. We investigated a grid of wavelength ranges (3–20 μm, 4–18.5 μm, and 6–17 μm), S/Ns (5, 10, 15, and 20 determined at a wavelength of 11.2 μm), and Rs (20, 35, 50, and 100). Results. We find that H2O, CO2, and O3 are detectable if S/N ≥ 10 (uncertainty ≤ ± 1.0 dex). We find upper limits for N2O (abundance ≲10−3). In conrtrast, CO, N2, and O2 are unconstrained. The lower limits for a CH4 detection are R = 50 and S/N = 10. Our retrieval framework correctly determines the exoplanet’s radius (uncertainty ≤ ± 10%), surface temperature (uncertainty ≤ ± 20 K), and surface pressure (uncertainty ≤ ± 0.5 dex) in all cloud-free retrieval analyses. Based on our current assumptions, the observation time required to reach the specified S/N for an Earth-twin at 10 pc when conservatively assuming a total instrument throughput of 5% amounts to ≈6−7 weeks with four 2m apertures. Conclusions. We provide first order estimates for the minimum technical requirements for LIFE via the retrieval study of an Earth-twin exoplanet. We conclude that a minimum wavelength coverage of 4–18.5 μm, an R of 50, and an S/N of at least 10 is required. With the current assumptions, the atmospheric characterization of several Earth-like exoplanets at a distance of 10 pc and within a reasonable amount of observing time will require apertures ≥ 2m

Implementing a quality improvement programme in palliative care in care homes: a qualitative study

<p>Abstract</p> <p>Background</p> <p>An increasing number of older people reach the end of life in care homes. The aim of this study is to explore the perceived benefits of, and barriers to, implementation of the Gold Standards Framework for Care Homes (GSFCH), a quality improvement programme in palliative care.</p> <p>Methods</p> <p>Nine care homes involved in the GSFCH took part. We conducted semi-structured interviews with nine care home managers, eight nurses, nine care assistants, eleven residents and seven of their family members. We used the Framework approach to qualitative analysis. The analysis was deductive based on the key tasks of the GSFCH, the 7Cs: communication, coordination, control of symptoms, continuity, continued learning, carer support, and care of the dying. This enabled us to consider benefits of, and barriers to, individual components of the programme, as well as of the programme as a whole.</p> <p>Results</p> <p>Perceived benefits of the GSFCH included: improved symptom control and team communication; finding helpful external support and expertise; increasing staff confidence; fostering residents' choice; and boosting the reputation of the home. Perceived barriers included: increased paperwork; lack of knowledge and understanding of end of life care; costs; and gaining the cooperation of GPs. Many of the tools and tasks in the GSFCH focus on improving communication. Participants described effective communication within the homes, and with external providers such as general practitioners and specialists in palliative care. However, many had experienced problems with general practitioners. Although staff described the benefits of supportive care registers, coding predicted stage of illness and advance care planning, which included improved communication, some felt the need for more experience of using these, and there were concerns about discussing death.</p> <p>Conclusions</p> <p>Most of the barriers described by participants are relevant to other interventions to improve end of life care in care homes. There is a need to investigate the impact of quality improvement programmes in care homes, such as the GSFCH, on a wider range of outcomes for residents and their families, and to monitor the sustainability of any resulting improvements. It is also important to explore the impact of the different components of these complex interventions.</p

The impact of incident vertebral and non-vertebral fractures on health related quality of life in postmenopausal women

BACKGROUND: Little empirical research has examined the multiple consequences of osteoporosis on quality of life. METHODS: Health related quality of life (HRQL) was examined in relationship to incident fractures in 2009 postmenopausal women 50 years and older who were seen in consultation at our tertiary care, university teaching hospital-affiliated office and who were registered in the Canadian Database of Osteoporosis and Osteopenia (CANDOO) patients. Patients were divided into three study groups according to incident fracture status: vertebral fractures, non-vertebral fractures and no fractures. Baseline assessments of anthropometric data, medical history, therapeutic drug use, and prevalent fracture status were obtained from all participants. The disease-targeted mini-Osteoporosis Quality of Life Questionnaire (mini-OQLQ) was used to measure HRQL. RESULTS: Multiple regression analyses revealed that subjects who had experienced an incident vertebral fracture had lower HRQL difference scores as compared with non-fractured participants in total score (-0.86; 95% confidence intervals (CI): -1.30, -0.43) and the symptoms (-0.76; 95% CI: -1.23, -0.30), physical functioning (-1.12; 95% CI: -1.57, -0.67), emotional functioning (-1.06; 95% CI: -1.44, -0.68), activities of daily living (-1.47; 95% CI: -1.97, -0.96), and leisure (-0.92; 95% CI: -1.37, -0.47) domains of the mini-OQLQ. Patients who experienced an incident non-vertebral fracture had lower HRQL difference scores as compared with non-fractured participants in total score (-0.47; 95% CI: -0.70, -0.25), and the symptoms (-0.25; 95% CI: -0.49, -0.01), physical functioning (-0.39; 95% CI: -0.65, -0.14), emotional functioning (-0.97; 95% CI: -1.20, -0.75) and the activities of daily living (-0.47; 95% CI: -0.73, -0.21) domains. CONCLUSION: Quality of life decreased in patients who sustained incident vertebral and non-vertebral fractures

How to speak of God? Toward a postsecular apologetics

This is an Accepted Manuscript of an article published by Taylor & Francis in Practical Theology on 11/04/2018, available online: https://www.tandfonline.com/doi/full/10.1080/1756073X.2018.1460522Against most expectations religion has not vanished from Western culture. If anything, it exercises a greater fascination than ever before. Broadly, we might think of ourselves as occupying a new, 'postsecular' space between a renewed visibility of religion in public life, and a corresponding acknowledgement of the importance of religious values and actors; and persistent and widespread disillusion and scepticism towards religion, and objections to religion as a source of legitimate public discourse. In a world that is more sensitive than ever to religious belief and practice, yet often struggles to accommodate it into secular discourse, how do religious institutions justify their position in a contested and volatile public square? This article argues that the contemporary postsecular context requires a recovery of the ancient practices of Christian apologetics as a form of public, theological witness to the practical value of faith, articulated in both deed and word

Different perceptions of the burden of upper GI endoscopy: an empirical study in three patient groups

Background: Few studies have evaluated patients' perceived burden of cancer surveillance tests. Cancer screening and surveillance, however, require a large number of patients to undergo potentially burdensome tests with only some experiencing health gains from it. We investigated the determinants of patients' reported burden of upper gastrointestinal (GI) endoscopy by comparing data from three patient groups. Patients and methods: A total of 476 patients were included: 180 patients under regular surveillance for Barrett esophagus (BE), a premalignant disorder; 214 patients with non-specific upper GI symptoms (NS), and 82 patients recently diagnosed with upper GI cancer (CA). We assessed pain, discomfort and overall burden experienced during endoscopy, symptoms in the week afterwards and psychological distress over time (Hospital Anxiety and Depression scale and Impact of Event Scale). Results: Two-thirds (66%) of patients reported discomfort and overall burden of upper GI endoscopy. Only 23% reported any pain. BE patients reported significantly less discomfort, pain and overall burden than the other patients: those with NS reported more discomfort, CA patients more pain, and both more overall burden. These differences could be statistically explained by the number of previous endoscopies and whether sedation was provided or not, but not by patient characteristics. Conclusion: The perception of upper GI endoscopy varies by patient group, due to potential adaptation after multiple endoscopies and aspects of th