Perceptions of Self-Efficacy and Experiences of Mindfulness on Pain and Anxiety in Patients Undergoing a Colorectal Surgery: A Prospective Mixed Methods Study

Introduction • Pain and anxiety have a physiological response on the body. • Increased heart rate, respiratory rate and blood pressure can lead to complications, and thus longer hospitalization along with decreased patient satisfaction.https://knowledgeconnection.mainehealth.org/lambrew-retreat-2021/1031/thumbnail.jp

Vδ2+ T cell response to malaria correlates with protection from infection but is attenuated with repeated exposure.

Vδ2+ γδ T cells are semi-innate T cells that expand markedly following P. falciparum (Pf) infection in naïve adults, but are lost and become dysfunctional among children repeatedly exposed to malaria. The role of these cells in mediating clinical immunity (i.e. protection against symptoms) to malaria remains unclear. We measured Vδ2+ T cell absolute counts at acute and convalescent malaria timepoints (n = 43), and Vδ2+ counts, cellular phenotype, and cytokine production following in vitro stimulation at asymptomatic visits (n = 377), among children aged 6 months to 10 years living in Uganda. Increasing age was associated with diminished in vivo expansion following malaria, and lower Vδ2 absolute counts overall, among children living in a high transmission setting. Microscopic parasitemia and expression of the immunoregulatory markers Tim-3 and CD57 were associated with diminished Vδ2+ T cell pro-inflammatory cytokine production. Higher Vδ2 pro-inflammatory cytokine production was associated with protection from subsequent Pf infection, but also with an increased odds of symptoms once infected. Vδ2+ T cells may play a role in preventing malaria infection in children living in endemic settings; progressive loss and dysfunction of these cells may represent a disease tolerance mechanism that contributes to the development of clinical immunity to malaria

Measuring patients' experience with renal services in the UK: development and validation of the Kidney PREM

© The Author(s) 2022. Published by Oxford University Press on behalf of the ERA. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non Commercial License (https://creativecommons.org/licenses/by-nc/4.0/).Background Patient experience is a recognised aspect of quality of care for people with chronic kidney disease (CKD), but current patient-reported experience measures (PREMs) only focus on dialysis care. We developed and validated the Kidney PREM to assess patients’ experience with renal services in secondary care for any CKD stage or treatment (transplant, haemodialysis, peritoneal dialysis). Methods We developed the Kidney PREM in two phases, informed by a multidisciplinary expert group to ensure face validity. We organised three national data collections (2016 to 2018) to investigate item response profiles and to conduct exploratory and confirmatory analyses to assess internal consistency. We also explored content validity in cognitive interviews and evaluated test-retest reliability. Finally, we developed the Kidney PREM Short Form for more frequent measurement of patient experience to inform local service improvements. Results We analysed 32,959 responses across data collections, the 2018 collection covering all 71 UK renal centres. The Kidney PREM final version consisted of 38 items grouped in 13 themes, all pertaining to one underlying dimension reflecting the construct of ‘patient experience’ with high internal consistency (Cronbach’s α, .94). The Kidney PREM Short Form consisted of 15 items across the same 13 themes. Conclusions The Kidney PREM supports collection of reliable information on patient experience that people with CKD consider relevant, regardless of CKD stage or treatment modality. Kidney PREM data has the potential to guide local and national initiatives to improve patients’ experience with renal services in the UK and other countries.Peer reviewedFinal Published versio

Visual Orbits of Spectroscopic Binaries with the CHARA Array. III. HD 8374 and HD 24546

We present the visual orbits of two long period spectroscopic binary stars, HD 8374 and HD 24546, using interferometric observations acquired with the CHARA Array and the Palomar Testbed Interferometer. We also obtained new radial velocities from echelle spectra using the APO 3.5 m and Fairborn 2.0 m telescopes. By combining the visual and spectroscopic observations, we solve for the full, three-dimensional orbits and determine the stellar masses and distances to within 3% uncertainty. We then estimate the effective temperature and radius of each component star through Doppler tomography and spectral energy distribution analyses, in order to compare the observed stellar parameters to the predictions of stellar evolution models. For HD 8374, we find masses of M1 = 1.636 +/- 0.050 Msun and M2 = 1.587 +/- 0.049 Msun, radii of R1 = 1.84 +/- 0.05 Rsun and R2 = 1.66 +/- 0.12 Rsun, temperatures of Teff1 = 7280 +/- 110 K and Teff2 = 7280 +/- 120 K, and an estimated age of 1.0 Gyr. For HD 24546, we find masses of M1 = 1.434 +/- 0.014 Msun and M2 = 1.409 +/- 0.014 Msun, radii of R1 = 1.67 +/- 0.06 Rsun and R2 = 1.60 +/- 0.10 Rsun, temperatures of Teff1 = 6790 +/- 120 K and Teff2 = 6770 +/- 90 K, and an estimated age of 1.4 Gyr. HD 24546 is therefore too old to be a member of the Hyades cluster, despite its physical proximity to the group.Comment: 18 pages, 10 figures. Accepted for publication in A

Spectroscopy, MOST Photometry, and Interferometry of MWC 314: Is it an LBV or an interacting binary?

MWC 314 is a bright candidate luminous blue variable that resides in a fairly close binary system, with an orbital period of 60.753$\pm$0.003 d. We observed MWC 314 with a combination of optical spectroscopy, broad-band ground- and space-based photometry, as well as with long baseline, near-infrared interferometry. We have revised the single-lined spectroscopic orbit and explored the photometric variability. The orbital light curve displays two minima each orbit that can be partially explained in terms of the tidal distortion of the primary that occurs around the time of periastron. The emission lines in the system are often double-peaked and stationary in their kinematics, indicative of a circumbinary disc. We find that the stellar wind or circumbinary disc is partially resolved in the K\prime-band with the longest baselines of the CHARA Array. From this analysis, we provide a simple, qualitative model in an attempt to explain the observations. From the assumption of Roche Lobe overflow and tidal synchronisation at periastron, we estimate the component masses to be M1 $\approx 5$ M$_\odot$ and M2$\approx 15$ M$_\odot$, which indicates a mass of the LBV that is extremely low. In addition to the orbital modulation, we discovered two pulsational modes with the MOST satellite. These modes are easily supported by a low-mass hydrogen-poor star, but cannot be easily supported by a star with the parameters of an LBV. The combination of these results provides evidence that the primary star was likely never a normal LBV, but rather is the product of binary interactions. As such, this system presents opportunities for studying mass-transfer and binary evolution with many observational techniques.Comment: 26 pages, 7 figures, 5 tables, 2 appendices with 7 additional tables and 2 additional figures. Accepted for publication in MNRA

Framework for a Community Health Observing System for the Gulf of Mexico Region: Preparing for Future Disasters

© Copyright © 2020 Sandifer, Knapp, Lichtveld, Manley, Abramson, Caffey, Cochran, Collier, Ebi, Engel, Farrington, Finucane, Hale, Halpern, Harville, Hart, Hswen, Kirkpatrick, McEwen, Morris, Orbach, Palinkas, Partyka, Porter, Prather, Rowles, Scott, Seeman, Solo-Gabriele, Svendsen, Tincher, Trtanj, Walker, Yehuda, Yip, Yoskowitz and Singer. The Gulf of Mexico (GoM) region is prone to disasters, including recurrent oil spills, hurricanes, floods, industrial accidents, harmful algal blooms, and the current COVID-19 pandemic. The GoM and other regions of the U.S. lack sufficient baseline health information to identify, attribute, mitigate, and facilitate prevention of major health effects of disasters. Developing capacity to assess adverse human health consequences of future disasters requires establishment of a comprehensive, sustained community health observing system, similar to the extensive and well-established environmental observing systems. We propose a system that combines six levels of health data domains, beginning with three existing, national surveys and studies plus three new nested, longitudinal cohort studies. The latter are the unique and most important parts of the system and are focused on the coastal regions of the five GoM States. A statistically representative sample of participants is proposed for the new cohort studies, stratified to ensure proportional inclusion of urban and rural populations and with additional recruitment as necessary to enroll participants from particularly vulnerable or under-represented groups. Secondary data sources such as syndromic surveillance systems, electronic health records, national community surveys, environmental exposure databases, social media, and remote sensing will inform and augment the collection of primary data. Primary data sources will include participant-provided information via questionnaires, clinical measures of mental and physical health, acquisition of biological specimens, and wearable health monitoring devices. A suite of biomarkers may be derived from biological specimens for use in health assessments, including calculation of allostatic load, a measure of cumulative stress. The framework also addresses data management and sharing, participant retention, and system governance. The observing system is designed to continue indefinitely to ensure that essential pre-, during-, and post-disaster health data are collected and maintained. It could also provide a model/vehicle for effective health observation related to infectious disease pandemics such as COVID-19. To our knowledge, there is no comprehensive, disaster-focused health observing system such as the one proposed here currently in existence or planned elsewhere. Significant strengths of the GoM Community Health Observing System (CHOS) are its longitudinal cohorts and ability to adapt rapidly as needs arise and new technologies develop

Personalised Care Interprofessional Education Framework (PerCIE): Social prescribing placement curriculum document and guiding principles for undergraduate/postgraduate health and social care students

This Personalised Care Interprofessional Education (PerCIE) Framework has been designed to guide and support HEIs, and PEFs to enable health and social care students to learn about strengths-based approaches to health and wellbeing delivered by services that provide a social prescribing offer. It has been co-created by a network of experts from a broad range of professional backgrounds from seven universities (HEIs), Private Independent and Voluntary Organisations (PIVO sector also known as Voluntary Community Social Enterprise VCSE), National Social Prescribing Network Special Interest Group (SigSpn), Health Education England (Greater Manchester) and the NHS England (NHSe) Personalised Care team. It is underpinned by contemporary practice-based theory and evidence of impact from a range of successful UK projects. The PerCIE Framework is designed to enable universities to work in partnership with VCSE/PIVO partners to create collaborative and inclusive test beds for social action. It can help to support the generation of new socially connected learning opportunities that could provide rich and meaningful insight into health and health inequalities, our BAME communities and marginalised groups. It builds on and recognises the power of community resilience through asset-based working