Mini High Velocity Clouds

Neutral hydrogen mapping of several small, very low column density High Velocity Clouds (HVC), using the Arecibo telescope, is reported. Some were found serendipitously superimposed at distinct velocities on largerHVCs; others were found to comprise the four most isolated low column density sources in the observations of Lockman et al. but proved to be individually much smaller than the Green Bank 140 Foot telescope beam. We call these clouds ``mini-HVC'' to distinguish them from the larger and denser Compact High Velocity Clouds (CHVC). Peak column densities are typically a few X 10^18 cm^-2 averaged over the Arecibo 3.2' beam, and diameters to our detection limit ~ 10^18 cm^-2 range from 9' to 35'. These column densities and angular diameters overlap with those for CHVC, but are typically smaller. We consider three possiblities: (1) that most mini-HVC are related to the Magellanic Stream, (2) that most mini-HVC are part of M31's retinue of CHVC, or (3) that the mini-HVC are simply the low column density tail of the distribution of CHVC. None of these possibilities can be rejected as yet, given the selection biases in our sample. We also discuss controversies about the amount of ionized hydrogen in CHVC and mini-HVC, which may be mainly ionized, and the implications of these small clouds for Lyman Limit Systems.Comment: Astronomical Journal, in pres

Knowledge, attitudes and practices of medical staff towards obesity management in patients with spinal cord injuries: an International survey of four western European countries

Objective: To (1) examine the opinions of medical staff working in spinal cord injury (SCI) centres (SCICs); (2) evaluate their knowledge, attitudes and practices towards obesity prevention and management; (3) report the number of beds and dietitians available at each SCIC. Methods: A 37-item questionnaire was sent to 23 SCICs in the UK, the Netherlands, Belgium and the Republic of Ireland between September 2012 and January 2013. Results: Eighteen SCICs returned the questionnaires for analysis. All respondents stated that they had an interest in obesity treatment but only 2.3% of the respondents received training in obesity management. Sixty-one percent of staff did not consider body mass index (BMI) to be appropriate for use in SCI patients and subsequently less than half of the respondents use BMI routinely. The majority of respondents reported that they are confident in dealing with overweight (74.5%) and obese (66.1%) SCI adults, less than half (44.1%) are confident in treating overweight and obese SCI children. Respondents also indicated the need for nationally adopted guidelines and a lack of physical activity provision. There were 17.5 whole-time equivalent (WTE) dietitians recorded in 22 SCICs, equivalent to 47.8 beds per WTE dietitians (range 10–420). Non-UK SCIC dietitians are significantly better resourced than in UK SCICs (beds per WTE dietitian: 36 vs 124, P=0.035). Conclusion: Medical staff expressed the need to participate in obesity prevention and management. Appropriate training should be considered for all medical staff and the development of specific weight management guidelines and dietetic provision should be considered

Solvent–surface interactions between nanodiamond and ethanol studied with in situ infrared spectroscopy

In situ Attenuated Total reflectance infrared (ATR IR) spectroscopy is used to study the interaction between ethanol vapour and oxidised nanodiamond (ND) surfaces. On initial exposure an amorphous multilayer of adsorbed ethanol is observed, but over ca. 30 min a loss in intensity of ν(OH) and δ(OH) bands indicates a preferential binding of the ethanol –OH with the ND surface. Other spectral changes indicate ordering of the ethanol molecules on the surface and their confinement within the pores of the ND structure in specific conformations. Changes in the IR spectrum also suggest that vibrational frequencies of carbonyl groups on the ND surface are affected by the adsorption of ethanol and that surface-bound water is either displaced or involved in hydrogen-bonding with ethanol

Cohort Profile: The Health Survey for England

To monitor the health of the public in England, UK, the Central Health Monitoring Unit within the UK Department of Health commissioned an annual health examination survey, which became known as the Health Survey for England (HSE). The first survey was completed in 1991. The HSE covers all of England and is a nationally representative sample of those residing at private residential addresses. Each survey year consists of a new sample of private residential addresses and people. The HSE collects detailed information on mental and physical health, health-related behaviour, and objective physical and biological measures in relation to demographic and socio-economic characteristics of people aged 16 years and over at private residential addresses. There are two parts to the HSE; an interviewer visit, to conduct an interview and measure height and weight, then a nurse visit, to carry out further measurements and take biological samples. Since 1994, survey participants aged 16 years and over have been asked for consent to follow-up through linkage to mortality and cancer registration data, and from 2003, to the Hospital Episode Statistics database, thus converting annual cross-sectional survey data into a longitudinal study. Annual survey data (1994–2009) are available through the UK Data Archive

Self- and proxy-reported impaired social interaction in young adults with simple congenital heart defects

BackgroundSimple Congenital Heart Defects such as septal defects constitute a large proportion of Congenital Heart Defects. New research has demonstrated more co-morbidities than previously thought. In particular, co-morbidities involving neurocognitive, psychiatric, and social difficulties have been described. Neurocognitive and psychiatric morbidities affect social interaction. Social interaction is important in everyday social life (education, work life, family life). In this study, we investigated social interaction through self- and proxy-answered Social Responsiveness Scale 2 (SRS-2) in young adults with simple Congenital Heart Defects and compared their social interaction profile to healthy matched controls.MethodsWe included a total of 80 patients with either atrial or ventricular septal defect (age 26.6 years) and 38 heart-healthy, age, sex, and ISCED educational matched controls (age: 25.3 years). A close relative proxy from each participant took part in the study as well. All participants answered the Social Responsiveness Scale 2 (SRS-2) (n = 225). Our primary and secondary outcomes were the SRS-2 Total score and the SRS-2 sub-scores.ResultsIn the Congenital Heart Defects group, 31.3% had a Total score above 60 compared to 7.9% in the control group (p = 0.005, RR = 3.96). The participants with a septal defect had a higher Total score (52.5 vs. 45.5, p = 0.004), a higher Social Cognition sub-score (55.0 vs. 47.0, p = 0.0004), and a higher Social Motivation sub-score (50.0 vs. 45.0, p = 0.003) than the heart-healthy participants. We found no difference between the two groups regarding the sub-scores of Social Awareness and Social Communication. A multiple linear regression model showed that the variable that explained most of the variation in Total Score was having a previously diagnosed psychiatric disorder.ConclusionWe found that young adults with atrial or ventricular septal defects have a fourfold increased risk of social interaction difficulties compared to heart-healthy peers. They have a social interaction profile, with difficulties in social cognition and social motivation, and preserved social awareness and social communication. Psychiatric morbidity explained most of the variation in social interaction problems. As social difficulties and psychiatric morbidities are intertwined, social interaction difficulties could be an indication of already underlying psychiatric morbidities or a risk factor for future psychiatric morbidity

Microinfusion of Pituitary Adenylate Cyclase-Activating Polypeptide into the Central Nucleus of Amygdala of the Rat Produces a Shift from an Active to Passive Mode of Coping in the Shock-Probe Fear/Defensive Burying Test

High concentrations of pituitary adenylate cyclase-activating polypeptide (PACAP) nerve fibers are present in the central nucleus of amygdala (CeA), a brain region implicated in the control of fear-related behavior. This study evaluated PACAPergic modulation of fear responses at the CeA in male Sprague-Dawley rats. PACAP (50–100 pmol) microinfusion via intra-CeA cannulae produced increases in immobility and time the rats spent withdrawn into a corner opposite to the electrified probe compared to controls in the shock-probe fear/defensive burying test. Shock-probe burying and exploration, numbers of shocks received, locomotion distance, and velocity were all reduced by intra-CeA PACAP injection. Further, intra-CeA PACAP effects were manifested only when the animals were challenged by shock, as intra-CeA PACAP injections did not cause significant changes in the behaviors of unshocked rats. Thus, intra-CeA administration of PACAP produces a distinct reorganization of stress-coping behaviors from active (burying) to passive modes, such as withdrawal and immobility. These findings are potentially significant toward enhancing our understanding of the involvement of PACAP and the CeA in the neural basis of fear and anxiety

Healthcare professionals' perceived barriers and facilitators of implementing clinical practice guidelines for stroke rehabilitation: A systematic review

OBJECTIVE: To identify healthcare professionals' perceived barriers and facilitators to clinical practice guideline implementation within stroke rehabilitation. DATA SOURCES: CINAHL, MEDLINE, EMBASE, AMED, Cochrane library, Academic Search Complete and Scopus. Additional papers were identified through hand searching. REVIEW METHODS: The review followed the Preferred Reporting Item for Systematic Reviews and Meta-Analysis Protocols systematic review approach. Any empirical research that provided qualitative data on healthcare professionals' perceived factors influencing clinical guideline implementation in stroke rehabilitation was included. One reviewer screened all titles and abstract reviews (n = 669). Another two reviewers independently screened 30% of title and abstract reviews, followed by full-text reviews (n = 61). Study quality was assessed using the mixed-method appraisal tool. RESULTS: Data from 10 qualitative, six quantitative and six mixed-method studies published between 2000 and 2022, involving 1576 participants in total, were analysed and synthesised using modified thematic synthesis approach. The majority of participants were therapists n = 1297 (occupational therapists, physiotherapists, speech and language therapists). Organisational factors (time constraints, resources) alongside healthcare professionals' lack of knowledge and skills were the most cited barriers to guideline implementation. Contradictory attitudes and beliefs towards stroke guidelines applicability to real-life clinical practice and their evidence base were reported. Organisational support in the form of training, local protocols, performance monitoring and leadership were reported as perceived facilitators. CONCLUSION: Barriers and facilitators are multifactorial and were identified at guideline, individual, team and organisational levels. There is a need to translate perceived barriers and facilitators into implementation interventions especially addressing organisational-level barriers

The psychosocial and clinical outcomes following orbital decompression surgery for thyroid eye disease and predictors of change in quality of life

Objective: Thyroid eye disease (TED) has been found to reduce quality of life for many patients due to changes in their appearance and vision, although some appear to adjust better than others. This study was designed to investigate whether a patient’s quality of life changes after having orbital decompression for improvement of appearance, vision, or both, and whether any demographic, clinical or psychosocial factors can predict which patients might benefit from this surgery. Design: This study employed a within-subjects repeated measures design, where patients were assessed before, and at 6 weeks and 6 months after surgery. Subjects: One hundred and twenty-three adults (>18 years) with TED and undergoing orbital decompression surgery were recruited at Moorfields Eye Hospital. Methods: Participants received lateral wall, medial wall, 2.5 or 3 wall decompression, and were followed up after surgery with a range of psychosocial and clinical assessments. Main Outcome Measures: The Graves’ Ophthalmopathy Quality of Life (GO-QOL) scale was completed at each time point and this was used as the dependent variable in each hierarchical multiple regression model. Results: Significant improvements were found in all clinical characteristics following orbital decompression and in most psychosocial variables. GO-QOL visual function scores did not change significantly until 6 months after surgery. In contrast, GO-QOL appearance scores changed significantly by 6 weeks after surgery and continued to increase to 6 months, reaching a minimal clinically important difference for this scale. None of the changes in clinical or psychosocial outcomes significantly predicted change in GO-QOL visual function. However, the hierarchical regression model explained 79% of the variance in change in GO-QOL appearance, with change in subjective evaluation of appearance being the only unique predictor of change in appearance-related quality of life. Conclusions: This study highlights the importance of appearance-related cognitions in predicting quality of life outcomes after surgery. Implications for clinical practice need to be considered in light of the limitations of this study, but it is suggested that psychosocial interventions targeting appearance-related cognitive processes - in particular personal evaluation of appearance - could enhance the quality of life outcomes for patients with TED undergoing orbital decompression surgery