The Confidential Inquiry into premature deaths of people with intellectual disabilities in the UK: a population-based study

SummaryBackgroundThe Confidential Inquiry into premature deaths of people with intellectual disabilities in England was commissioned to provide evidence about contributory factors to avoidable and premature deaths in this population.MethodsThe population-based Confidential Inquiry reviewed the deaths of people with intellectual disabilities aged 4 years and older who had been registered with a general practitioner in one of five Primary Care Trust areas of southwest England, who died between June 1, 2010, and May 31, 2012. A network of health, social-care, and voluntary-sector services; community contacts; and statutory agencies notified the Confidential Inquiry of all deaths of people with intellectual disabilities and provided core data. The Office for National Statistics provided data about the coding of individual cause of death certificates. Deaths were described as avoidable (preventable or amenable), according to Office for National Statistics definitions. Contributory factors to deaths were identified and quantified by the case investigator, verified by a local review panel meeting, and agreed by the Confidential Inquiry overview panel. Contributory factors were grouped into four domains: intrinsic to the individual, within the family and environment, care provision, and service provision. The deaths of a comparator group of people without intellectual disabilities but much the same in age, sex, and cause of death and registered at the same general practices as those with intellectual disabilities were also investigated.FindingsThe Confidential Inquiry reviewed the deaths of 247 people with intellectual disabilities. Nearly a quarter (22%, 54) of people with intellectual disabilities were younger than 50 years when they died, and the median age at death was 64 years (IQR 52–75). The median age at death of male individuals with intellectual disabilities was 65 years (IQR 54–76), 13 years younger than the median age at death of male individuals in the general population of England and Wales (78 years). The median age at death of female individuals with intellectual disabilities was 63 years (IQR 54–75), 20 years younger than the median age at death for female individuals in the general population (83 years). Avoidable deaths from causes amenable to change by good quality health care were more common in people with intellectual disabilities (37%, 90 of 244) than in the general population of England and Wales (13%). Contributory factors to premature deaths in a subset of people with intellectual disabilities compared with a comparator group of people without intellectual disabilities included problems in advanced care planning (p=0·0003), adherence to the Mental Capacity Act (p=0·0008), living in inappropriate accommodation (p<0·0001), adjusting care as needs changed (p=0·009), and carers not feeling listened to (p=0·006).InterpretationThe Confidential Inquiry provides evidence of the substantial contribution of factors relating to the provision of care and health services to the health disparities between people with and without intellectual disabilities. It is imperative to examine care and service provision for this population as potentially contributory factors to their deaths—factors that can largely be ameliorated.FundingDepartment of Health for England

On Four-Point Functions of Half-BPS Operators in General Dimensions

We study four-point correlation functions of half-BPS operators of arbitrary weight for all dimensions d=3,4,5,6 where superconformal theories exist. Using harmonic superspace techniques, we derive the superconformal Ward identities for these correlators and present them in a universal form. We then solve these identities, employing Jack polynomial expansions. We show that the general solution is parameterized by a set of arbitrary two-variable functions, with the exception of the case d=4, where in addition functions of a single variable appear. We also discuss the operator product expansion using recent results on conformal partial wave amplitudes in arbitrary dimension.Comment: The discussion of the case d=6 expanded; references added/correcte

Fermi surface and order parameter driven vortex lattice structure transitions in twin-free YBa2Cu3O7

We report on small-angle neutron scattering studies of the intrinsic vortex lattice (VL) structure in detwinned YBa2Cu3O7 at 2 K, and in fields up to 10.8 T. Because of the suppressed pinning to twin-domain boundaries, a new distorted hexagonal VL structure phase is stabilized at intermediate fields. It is separated from a low-field hexagonal phase of different orientation and distortion by a first-order transition at 2.0(2) T that is probably driven by Fermi surface effects. We argue that another first-order transition at 6.7(2) T, into a rhombic structure with a distortion of opposite sign, marks a crossover from a regime where Fermi surface anisotropy is dominant, to one where the VL structure and distortion is controlled by the order-parameter anisotropy.Comment: 4 pages, 3 figures (2 color), minor change

Positive energy unitary irreducible representations of D=6 conformal supersymmetry

We give a constructive classification of the positive energy (lowest weight) unitary irreducible representations of the D=6 superconformal algebras osp(8*/2N). Our results confirm all but one of the conjectures of Minwalla (for N=1,2) on this classification. Our main tool is the explicit construction of the norms of the states that has to be checked for positivity. We give also the reduction of the exceptional UIRs.Comment: 27 pages, TeX with harvmac, amssym.def, amssym.tex; v.2: minor corrections and references added; v.3: minor corrections; v.4: to appear in J. Phys.

Size and location of radish 1 chromosome regions carrying the fertility restorer Rfk1 gene in spring turnip rape

In spring turnip rape (Brassica rapa L. spp. oleifera) the most promising F1 hybrid system would be the Ogu-INRA CMS/Rf system. A Kosena fertility restorer gene Rfk1, homologue of the Ogura restorer gene Rfo, was successfully transferred from oilseed rape into turnip rape and that restored the fertility in female lines carrying Ogura cms. The trait was, however, unstable in subsequent generations. The physical localization of the radish chromosomal region carrying the Rfk1 gene was investigated using 8 GISH (genomic in situ hybridization) and BAC-FISH (bacterial artificial chromosome fluorescence in situ hybridization) methods. The metaphase chromosomes were hybridized using radish DNA as the genomic probe and BAC64 probe, which is linked with Rfo gene. Both probes showed a signal in the chromosome spreads of the restorer line 4021-2 Rfk of turnip rape but not in the negative control line 4021B. The GISH analyses clearly showed that the turnip rape restorer plants were either monosomic (2n=2x=20+1R) or disomic (2n=2x=20+2R) addition lines with one or two copies of a single alien chromosome region originating from radish. In the BAC-FISH analysis, double dot signals were detected in sub-terminal parts of the radish chromosome arms showing that the fertility restorer gene Rfk1 was located in this additional radish chromosome. Detected disomic addition lines were found to be unstable for turnip rape hybrid production. Using the BAC-FISH analysis, weak signals were sometimes visible in two chromosomes of turnip rape and a homologous region of Rfk1 in chromosome 9 of the B. rapa A genome was verified with BLAST analysis. In the future this homologous area in A genome could be substituted with radish chromosome area carrying the Rfk1 gene.Comment: "The final publication is available at http://www.springerlink.com". http://www.springer.com/open+access/authors+rights?SGWID=0-176704-12-683201-0 non-commercial pre-print servers like arXiv.org can ... be updated with the author's accepted version. ... Acknowledgement ... accompanied by the text "The final publication is available at http://www.springerlink.com

Characterisation of Perennial Ryegrass Parental Inbred Lines for Generating Recombinant Inbred Lines for Fine Mapping and Gene Cloning

Intermated recombinant inbred lines (IRIs) are a powerful tool for fine mapping and cloning of genes. Such population structures have been particularly helpful for cloning of genes in the model genetic plant Arabidopsis thaliana. IRIs or recombinant inbred lines (RILs) would be valuable for perennial ryegrass (Lolium perenne), but its allogamous character means that the construction of RILs is a difficult task. The international Lolium community would benefit from the development of such lines. The aims of the projects are to characterise the parental lines and initial generations at the (1) phenotypic, (2) molecular and (3) molecular cytogenetic level

Magnetic unmixing of first-order reversal curve diagrams using principal component analysis

We describe a quantitative magnetic unmixing method based on principal component analysis (PCA) of first-order reversal curve (FORC) diagrams. For PCA we resample FORC distributions on grids that capture diagnostic signatures of single-domain (SD), pseudo-single-domain (PSD), and multidomain (MD) magnetite, as well as of minerals such as hematite. Individual FORC diagrams are recast as linear combinations of end-member (EM) FORC diagrams, located at user-defined positions in PCA space. The EM selection is guided by constraints derived from physical modeling and imposed by data scatter. We investigate temporal variations of two EMs in bulk North Atlantic sediment cores collected from the Rockall Trough and the Iberian Continental Margin. Sediments from each site contain a mixture of magnetosomes and granulometrically distinct detrital magnetite. We also quantify the spatial variation of three EM components (a coarse silt-sized MD component, a fine silt-sized PSD component, and a mixed clay-sized component containing both SD magnetite and hematite) in surficial sediments along the flow path of the North Atlantic Deep Water (NADW). These samples were separated into granulometric fractions, which helped constrain EM definition. PCA-based unmixing reveals systematic variations in EM relative abundance as a function of distance along NADW flow. Finally, we apply PCA to the combined dataset of Rockall Trough and NADW sediments, which can be recast as a four-EM mixture, providing enhanced discrimination between components. Our method forms the foundation of a general solution to the problem of unmixing multi-component magnetic mixtures, a fundamental task of rock magnetic studies.The research leading to these results has received funding from the European Research Council under the European Union's Seventh Framework Programme (FP/2007-2013)/ERC grant agreement 320750.This is the author accepted manuscript. The final version is available from Wiley via http://dx.doi.org/10.1002/2015GC00590

Stress appraisal, coping, and work engagement among police recruits: an exploratory study.

This study investigated the influence of stress appraisal and coping on work engagement levels (Absorption, Vigour, and Dedication) of police recruits. Participants were 387 men, ages 20 to 33 yr. (M = 24.1, SD = 2.4), in their last month of academy training before becoming police officers. Partially in support of predictions, work engagement was associated with Stressor control perceived, but not Stress intensity experienced over a self-selected stressor. Although the three dimensions of work engagement were explained by Stressor control and coping, Absorption was the dimension better explained by these variables. Police recruits reporting higher Absorption, Vigour, and Dedication reported using more Active coping and less Behavioural disengagement. Results showed that stress appraisal and coping are important variables influencing work engagement among police recruits. Findings suggested that future applied interventions fostering work engagement among police recruits should reinforce perceptions of control over a stressor as well as Active coping strategies