165 research outputs found

    The Utilization of Video-Conference Shared Medical Appointments in Rural Diabetes Care

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    Aim To explore whether Video-Shared Medical Appointments (video-SMA), where group education and medication titration were provided remotely through video-conferencing technology would improve diabetes outcomes in remote rural settings. Methods We conducted a pilot where a team of a clinical pharmacist and a nurse practitioner from Honolulu VA hospital remotely delivered video-SMA in diabetes to Guam. Patients with diabetes and HbA1c ≥7% were enrolled into the study during 2013–2014. Six groups of 4–6 subjects attended 4 weekly sessions, followed by 2 bi-monthly booster video-SMA sessions for 5 months. Patients with HbA1c ≥7% that had primary care visits during the study period but not referred/recruited for video-SMA were selected as usual-care comparators. We compared changes from baseline in HbA1c, blood-pressure, and lipid levels using mixed-effect modeling between video-SMA and usual care groups. We also analyzed emergency department (ED) visits and hospitalizations. Focus groups were conducted to understand patient’s perceptions. Results Thirty-one patients received video-SMA and charts of 69 subjects were abstracted as usual-care. After 5 months, there was a significant decline in HbA1c in video-SMA vs. usual-care (9.1 ± 1.9 to 8.3 ± 1.8 vs. 8.6 ± 1.4 to 8.7 ± 1.6, P = 0.03). No significant change in blood-pressure or lipid levels was found between the groups. Patients in the video-SMA group had significantly lower rates of ED visits (3.2% vs. 17.4%, P = 0.01) than usual-care but similar hospitalization rates. Focus groups suggested patient satisfaction with video-SMA and increase in self-efficacy in diabetes self-care. Conclusion Video-SMA is feasible, well-perceived and has the potential to improve diabetes outcomes in a rural setting. Abbreviations ACE-inhibitor, angiotensin converting enzyme-inhibitor; ARB, angiotensin receptor blocker; CBOC, community-based outpatient clinic; DM, diabetes mellitus; ED, emergency department; PACIC, patient assessment of care in chronic conditions; VAMC, Veterans Affairs Medical Center; VHA, Veterans Health Administration; video-SMA, video-shared medical appointment

    Les droits disciplinaires des fonctions publiques : « unification », « harmonisation » ou « distanciation ». A propos de la loi du 26 avril 2016 relative à la déontologie et aux droits et obligations des fonctionnaires

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    The production of tt‾ , W+bb‾ and W+cc‾ is studied in the forward region of proton–proton collisions collected at a centre-of-mass energy of 8 TeV by the LHCb experiment, corresponding to an integrated luminosity of 1.98±0.02 fb−1 . The W bosons are reconstructed in the decays W→ℓν , where ℓ denotes muon or electron, while the b and c quarks are reconstructed as jets. All measured cross-sections are in agreement with next-to-leading-order Standard Model predictions.The production of ttt\overline{t}, W+bbW+b\overline{b} and W+ccW+c\overline{c} is studied in the forward region of proton-proton collisions collected at a centre-of-mass energy of 8 TeV by the LHCb experiment, corresponding to an integrated luminosity of 1.98 ±\pm 0.02 \mbox{fb}^{-1}. The WW bosons are reconstructed in the decays WνW\rightarrow\ell\nu, where \ell denotes muon or electron, while the bb and cc quarks are reconstructed as jets. All measured cross-sections are in agreement with next-to-leading-order Standard Model predictions

    Neuropsychosocial profiles of current and future adolescent alcohol misusers

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    A comprehensive account of the causes of alcohol misuse must accommodate individual differences in biology, psychology and environment, and must disentangle cause and effect. Animal models1 can demonstrate the effects of neurotoxic substances; however, they provide limited insight into the psycho-social and higher cognitive factors involved in the initiation of substance use and progression to misuse. One can search for pre-existing risk factors by testing for endophenotypic biomarkers2 in non-using relatives; however, these relatives may have personality or neural resilience factors that protect them from developing dependence3. A longitudinal study has potential to identify predictors of adolescent substance misuse, particularly if it can incorporate a wide range of potential causal factors, both proximal and distal, and their influence on numerous social, psychological and biological mechanisms4. Here we apply machine learning to a wide range of data from a large sample of adolescents (n = 692) to generate models of current and future adolescent alcohol misuse that incorporate brain structure and function, individual personality and cognitive differences, environmental factors (including gestational cigarette and alcohol exposure), life experiences, and candidate genes. These models were accurate and generalized to novel data, and point to life experiences, neurobiological differences and personality as important antecedents of binge drinking. By identifying the vulnerability factors underlying individual differences in alcohol misuse, these models shed light on the aetiology of alcohol misuse and suggest targets for prevention

    Differential predictors for alcohol use in adolescents as a function of familial risk

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    Abstract: Traditional models of future alcohol use in adolescents have used variable-centered approaches, predicting alcohol use from a set of variables across entire samples or populations. Following the proposition that predictive factors may vary in adolescents as a function of family history, we used a two-pronged approach by first defining clusters of familial risk, followed by prediction analyses within each cluster. Thus, for the first time in adolescents, we tested whether adolescents with a family history of drug abuse exhibit a set of predictors different from adolescents without a family history. We apply this approach to a genetic risk score and individual differences in personality, cognition, behavior (risk-taking and discounting) substance use behavior at age 14, life events, and functional brain imaging, to predict scores on the alcohol use disorders identification test (AUDIT) at age 14 and 16 in a sample of adolescents (N = 1659 at baseline, N = 1327 at follow-up) from the IMAGEN cohort, a longitudinal community-based cohort of adolescents. In the absence of familial risk (n = 616), individual differences in baseline drinking, personality measures (extraversion, negative thinking), discounting behaviors, life events, and ventral striatal activation during reward anticipation were significantly associated with future AUDIT scores, while the overall model explained 22% of the variance in future AUDIT. In the presence of familial risk (n = 711), drinking behavior at age 14, personality measures (extraversion, impulsivity), behavioral risk-taking, and life events were significantly associated with future AUDIT scores, explaining 20.1% of the overall variance. Results suggest that individual differences in personality, cognition, life events, brain function, and drinking behavior contribute differentially to the prediction of future alcohol misuse. This approach may inform more individualized preventive interventions

    Observation of the B0 → ρ0ρ0 decay from an amplitude analysis of B0 → (π+π−)(π+π−) decays

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    Proton–proton collision data recorded in 2011 and 2012 by the LHCb experiment, corresponding to an integrated luminosity of 3.0 fb−1 , are analysed to search for the charmless B0→ρ0ρ0 decay. More than 600 B0→(π+π−)(π+π−) signal decays are selected and used to perform an amplitude analysis, under the assumption of no CP violation in the decay, from which the B0→ρ0ρ0 decay is observed for the first time with 7.1 standard deviations significance. The fraction of B0→ρ0ρ0 decays yielding a longitudinally polarised final state is measured to be fL=0.745−0.058+0.048(stat)±0.034(syst) . The B0→ρ0ρ0 branching fraction, using the B0→ϕK⁎(892)0 decay as reference, is also reported as B(B0→ρ0ρ0)=(0.94±0.17(stat)±0.09(syst)±0.06(BF))×10−6

    Measurement of the (eta c)(1S) production cross-section in proton-proton collisions via the decay (eta c)(1S) -> p(p)over-bar

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    The production of the ηc(1S)\eta_c (1S) state in proton-proton collisions is probed via its decay to the ppˉp \bar{p} final state with the LHCb detector, in the rapidity range 2.06.52.0 6.5 GeV/c. The cross-section for prompt production of ηc(1S)\eta_c (1S) mesons relative to the prompt J/ψJ/\psi cross-section is measured, for the first time, to be σηc(1S)/σJ/ψ=1.74±0.29±0.28±0.18B\sigma_{\eta_c (1S)}/\sigma_{J/\psi} = 1.74 \pm 0.29 \pm 0.28 \pm 0.18 _{B} at a centre-of-mass energy s=7\sqrt{s} = 7 TeV using data corresponding to an integrated luminosity of 0.7 fb1^{-1}, and σηc(1S)/σJ/ψ=1.60±0.29±0.25±0.17B\sigma_{\eta_c (1S)}/\sigma_{J/\psi} = 1.60 \pm 0.29 \pm 0.25 \pm 0.17 _{B} at s=8\sqrt{s} = 8 TeV using 2.0 fb1^{-1}. The uncertainties quoted are, in order, statistical, systematic, and that on the ratio of branching fractions of the ηc(1S)\eta_c (1S) and J/ψJ/\psi decays to the ppˉp \bar{p} final state. In addition, the inclusive branching fraction of bb-hadron decays into ηc(1S)\eta_c (1S) mesons is measured, for the first time, to be B(bηcX)=(4.88±0.64±0.25±0.67B)×103B ( b \rightarrow \eta_c X ) = (4.88 \pm 0.64 \pm 0.25 \pm 0.67 _{B}) \times 10^{-3}, where the third uncertainty includes also the uncertainty on the J/ψJ/\psi inclusive branching fraction from bb-hadron decays. The difference between the J/ψJ/\psi and ηc(1S)\eta_c (1S) meson masses is determined to be 114.7±1.5±0.1114.7 \pm 1.5 \pm 0.1 MeV/c2^2.The production of the ηc(1S)\eta _c (1S) state in proton-proton collisions is probed via its decay to the ppp\overline{p} final state with the LHCb detector, in the rapidity range 2.06.5GeV/c2.0 6.5 \mathrm{{\,GeV/}{ c}} . The cross-section for prompt production of ηc(1S)\eta _c (1S) mesons relative to the prompt J/ψ{{ J}}/{\psi } cross-section is measured, for the first time, to be σηc(1S)/σJ/ψ=1.74±0.29±0.28±0.18B\sigma _{\eta _c (1S)}/\sigma _{{{{ J}}/{\psi }}} = 1.74\, \pm \,0.29\, \pm \, 0.28\, \pm \,0.18 _{{\mathcal{B}}} at a centre-of-mass energy s=7 TeV{\sqrt{s}} = 7 {~\mathrm{TeV}} using data corresponding to an integrated luminosity of 0.7 fb1^{-1} , and σηc(1S)/σJ/ψ=1.60±0.29±0.25±0.17B\sigma _{\eta _c (1S)}/\sigma _{{{{ J}}/{\psi }}} = 1.60 \pm 0.29 \pm 0.25 \pm 0.17 _{{\mathcal{B}}} at s=8 TeV{\sqrt{s}} = 8 {~\mathrm{TeV}} using 2.0 fb1^{-1} . The uncertainties quoted are, in order, statistical, systematic, and that on the ratio of branching fractions of the ηc(1S)\eta _c (1S) and J/ψ{{ J}}/{\psi } decays to the ppp\overline{p} final state. In addition, the inclusive branching fraction of b{b} -hadron decays into ηc(1S)\eta _c (1S) mesons is measured, for the first time, to be B(bηcX)=(4.88±0.64±0.29±0.67B)×103{\mathcal{B}}( b {\rightarrow } \eta _c X ) = (4.88\, \pm \,0.64\, \pm \,0.29\, \pm \, 0.67 _{{\mathcal{B}}}) \times 10^{-3} , where the third uncertainty includes also the uncertainty on the J/ψ{{ J}}/{\psi } inclusive branching fraction from b{b} -hadron decays. The difference between the J/ψ{{ J}}/{\psi } and ηc(1S)\eta _c (1S) meson masses is determined to be 114.7±1.5±0.1MeV ⁣/c2114.7 \pm 1.5 \pm 0.1 {\mathrm {\,MeV\!/}c^2} .The production of the ηc(1S)\eta_c (1S) state in proton-proton collisions is probed via its decay to the ppˉp \bar{p} final state with the LHCb detector, in the rapidity range 2.06.52.0 6.5 GeV/c. The cross-section for prompt production of ηc(1S)\eta_c (1S) mesons relative to the prompt J/ψJ/\psi cross-section is measured, for the first time, to be σηc(1S)/σJ/ψ=1.74±0.29±0.28±0.18B\sigma_{\eta_c (1S)}/\sigma_{J/\psi} = 1.74 \pm 0.29 \pm 0.28 \pm 0.18 _{B} at a centre-of-mass energy s=7\sqrt{s} = 7 TeV using data corresponding to an integrated luminosity of 0.7 fb1^{-1}, and σηc(1S)/σJ/ψ=1.60±0.29±0.25±0.17B\sigma_{\eta_c (1S)}/\sigma_{J/\psi} = 1.60 \pm 0.29 \pm 0.25 \pm 0.17 _{B} at s=8\sqrt{s} = 8 TeV using 2.0 fb1^{-1}. The uncertainties quoted are, in order, statistical, systematic, and that on the ratio of branching fractions of the ηc(1S)\eta_c (1S) and J/ψJ/\psi decays to the ppˉp \bar{p} final state. In addition, the inclusive branching fraction of bb-hadron decays into ηc(1S)\eta_c (1S) mesons is measured, for the first time, to be B(bηcX)=(4.88±0.64±0.29±0.67B)×103B ( b \rightarrow \eta_c X ) = (4.88 \pm 0.64 \pm 0.29 \pm 0.67 _{B}) \times 10^{-3}, where the third uncertainty includes also the uncertainty on the J/ψJ/\psi inclusive branching fraction from bb-hadron decays. The difference between the J/ψJ/\psi and ηc(1S)\eta_c (1S) meson masses is determined to be 114.7±1.5±0.1114.7 \pm 1.5 \pm 0.1 MeV/c2^2

    Angular analysis of the B-0 -> K*(0) e(+) e(-) decay in the low-q(2) region

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    An angular analysis of the B0K0e+eB^0 \rightarrow K^{*0} e^+ e^- decay is performed using a data sample, corresponding to an integrated luminosity of 3.0 {\mbox{fb}^{-1}}, collected by the LHCb experiment in pppp collisions at centre-of-mass energies of 7 and 8 TeV during 2011 and 2012. For the first time several observables are measured in the dielectron mass squared (q2q^2) interval between 0.002 and 1.120GeV2 ⁣/c4{\mathrm{\,Ge\kern -0.1em V^2\!/}c^4}. The angular observables FLF_{\mathrm{L}} and ATReA_{\mathrm{T}}^{\mathrm{Re}} which are related to the K0K^{*0} polarisation and to the lepton forward-backward asymmetry, are measured to be FL=0.16±0.06±0.03F_{\mathrm{L}}= 0.16 \pm 0.06 \pm0.03 and ATRe=0.10±0.18±0.05A_{\mathrm{T}}^{\mathrm{Re}} = 0.10 \pm 0.18 \pm 0.05, where the first uncertainty is statistical and the second systematic. The angular observables AT(2)A_{\mathrm{T}}^{(2)} and ATImA_{\mathrm{T}}^{\mathrm{Im}} which are sensitive to the photon polarisation in this q2q^2 range, are found to be AT(2)=0.23±0.23±0.05A_{\mathrm{T}}^{(2)} = -0.23 \pm 0.23 \pm 0.05 and ATIm=0.14±0.22±0.05A_{\mathrm{T}}^{\mathrm{Im}} =0.14 \pm 0.22 \pm 0.05. The results are consistent with Standard Model predictions.An angular analysis of the B0^{0} → K^{*}^{0} e+^{+} e^{−} decay is performed using a data sample, corresponding to an integrated luminosity of 3.0 fb1^{−1}, collected by the LHCb experiment in pp collisions at centre-of-mass energies of 7 and 8 TeV during 2011 and 2012. For the first time several observables are measured in the dielectron mass squared (q2^{2}) interval between 0.002 and 1.120 GeV2^{2} /c4^{4}. The angular observables FL_{L} and ATRe_{T}^{Re} which are related to the K^{*}^{0} polarisation and to the lepton forward-backward asymmetry, are measured to be FL_{L} = 0.16 ± 0.06 ± 0.03 and ATRe_{T}^{Re}  = 0.10 ± 0.18 ± 0.05, where the first uncertainty is statistical and the second systematic. The angular observables AT(2)_{T}^{(2)} and ATIm_{T}^{Im} which are sensitive to the photon polarisation in this q2^{2} range, are found to be AT(2)_{T}^{(2)}  = − 0.23 ± 0.23 ± 0.05 and ATIm_{T}^{Im}  = 0.14 ± 0.22 ± 0.05. The results are consistent with Standard Model predictions.An angular analysis of the B0K0e+eB^0 \rightarrow K^{*0} e^+ e^- decay is performed using a data sample, corresponding to an integrated luminosity of 3.0 {\mbox{fb}^{-1}}, collected by the LHCb experiment in pppp collisions at centre-of-mass energies of 7 and 8 TeV during 2011 and 2012. For the first time several observables are measured in the dielectron mass squared (q2q^2) interval between 0.002 and 1.120GeV2 ⁣/c4{\mathrm{\,Ge\kern -0.1em V^2\!/}c^4}. The angular observables FLF_{\mathrm{L}} and ATReA_{\mathrm{T}}^{\mathrm{Re}} which are related to the K0K^{*0} polarisation and to the lepton forward-backward asymmetry, are measured to be FL=0.16±0.06±0.03F_{\mathrm{L}}= 0.16 \pm 0.06 \pm0.03 and ATRe=0.10±0.18±0.05A_{\mathrm{T}}^{\mathrm{Re}} = 0.10 \pm 0.18 \pm 0.05, where the first uncertainty is statistical and the second systematic. The angular observables AT(2)A_{\mathrm{T}}^{(2)} and ATImA_{\mathrm{T}}^{\mathrm{Im}} which are sensitive to the photon polarisation in this q2q^2 range, are found to be AT(2)=0.23±0.23±0.05A_{\mathrm{T}}^{(2)} = -0.23 \pm 0.23 \pm 0.05 and ATIm=0.14±0.22±0.05A_{\mathrm{T}}^{\mathrm{Im}} =0.14 \pm 0.22 \pm 0.05. The results are consistent with Standard Model predictions

    A study of CP violation in B-+/- -> DK +/- and B-+/- -> D pi(+/-) decays with D -> (KSK +/-)-K-0 pi(-/+) final states

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    A first study of CP violation in the decay modes B±[KS0K±π]Dh±B^\pm\to [K^0_{\rm S} K^\pm \pi^\mp]_D h^\pm and B±[KS0Kπ±]Dh±B^\pm\to [K^0_{\rm S} K^\mp \pi^\pm]_D h^\pm, where hh labels a KK or π\pi meson and DD labels a D0D^0 or D0\overline{D}^0 meson, is performed. The analysis uses the LHCb data set collected in pppp collisions, corresponding to an integrated luminosity of 3 fb1^{-1}. The analysis is sensitive to the CP-violating CKM phase γ\gamma through seven observables: one charge asymmetry in each of the four modes and three ratios of the charge-integrated yields. The results are consistent with measurements of γ\gamma using other decay modes
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