Therapists make the switch to telepsychology to safely continue treating their patients during the COVID-19 pandemic. virtual reality telepsychology may be next

Before COVID-19, most therapists had concerns about telepsychology, and only treated patients in person. During the COVID-19 lockdown, patients still needed therapy, but in-person therapy sessions became unsafe. The current study measured how many therapists are using online therapy before vs. during COVID-19, how much training they have received, and their knowledge about legal restrictions on using telepsychology. A sample of 768 U.S.A. mental health professionals completed a 29-item online survey. Results show that before COVID-19, most therapists only saw their patients in person (e.g., at the therapists office), but during the COVID-19 pandemic, nearly all therapists used a wide range of telecommunication technologies to communicate with their quarantined patients, including texting, telephones, video conferences, and even virtual reality. According to within-subject related samples comparisons, 39% of survey respondents used telepsychology before COVID-19, vs. 98% during COVID-19 (χ2 = 450.02, p < 0.001). Therapists reported high treatment effectiveness using telepsychology (7.45 on 0–10 scale). However, overall, on a 0–10 scale, therapists reported a significant increase in feeling burned out during the COVID-19 pandemic, Mean = 3.93 (SD = 1.93) before vs. 6.22 (SD = 2.27) during the pandemic (Z = −18.57, p < 0.001). Although the APA ethics guidelines encourage therapists to use telepsychology with their patients during the crisis, gaps in respondents' knowledge identify a need for increased specialized training and education. Although the current study showed that virtual reality is rarely used by the therapists surveyed, virtual reality is a promising new telepsychology technology. Billions of dollars are currently being invested in mass producing immersive virtual reality systems. In the future, as networked immersive Virtual Reality becomes more widely available, therapists and patients in physically different locations will be able to “meet” in a shared computer-generated world designed for therapy sessions, potentially including group sessions. Telepsychology and virtual reality have the potential to be increasingly valuable tools to help therapists mitigate the consequences of COVID-19. Research, development and training is recommended.info:eu-repo/semantics/publishedVersio

An exploratory study on the effectiveness of virtual reality analgesia for children and adolescents with kidney diseases undergoing venipuncture

The current study evaluated the effectiveness of VR analgesia among pediatric and adolescent patients with kidney disease undergoing venipuncture. Patients at an Italian Children’s hospital (N = 82, age range 7–17 years) undergoing venipuncture were randomly assigned to a No VR group (non-medical conversation) vs. a Yes VR group (VR analgesia). After the procedure, patients gave 0–10 Verbal Numeric Pain Scale ratings. Compared with patients in the No VR Group, patients in the Yes VR group reported significantly lower “Pain intensity”(No VR mean = 2.74, SD = 2.76 vs. Yes VR mean = 1.56, SD = 1.83) and the VR group also rated “Pain unpleasantness” significantly lower than the No VR group (No VR mean = 2.41, SD = 0.94 vs. Yes VR mean = 1.17, SD = 1.80). Patients distracted with VR also reported having significantly more fun during the venipuncture procedure. No side effects emerged. In addition to reducing pain intensity, VR has the potential to make venipuncture a more fun and less unpleasant experience for children with CKD, as measured in the present study for the first time. Finally, in exploratory analyses, children aged 7–11 in the VR group reported 55% lower worst pain than control subjects in the same age range, whereas children aged 12 to 17 in the VR group only reported 35% lower worst pain than control subjects. Additional research and development using more immersive VR is recommended.info:eu-repo/semantics/publishedVersio

Molecular gas in late-type galaxies

We present $^{12}$CO(J=1--0) line observations of 22 low-luminosity spiral galaxies in the Virgo cluster. These data, together with 244 others available in the literature, allow us to build a large sample that we use to study the molecular gas properties of galaxies spanning a large range of morphological types and luminosities and belonging to different environments (clusters - field). The molecular gas content of the target galaxies is estimated using a luminosity-dependent X = $N(H_2)/I(CO)$ conversion factor that has been calibrated on a sample of nearby galaxies. $X$ spans from $\sim$ 10$^{20}$ mol cm$^{-2}$ (K km s$^{-1})^{-1}$ in giant spirals to $\sim$ 10$^{21}$ mol cm$^{-2}$ (K km s$^{-1})^{-1}$ in dwarf irregulars. The value of the $X$ conversion factor is found consistent with a value derived independently from dust masses estimated from FIR fluxes, with a metallicity-dependent dust to gas ratio. The relationships between X and the UV radiation field (as traced by the $H\alpha+[NII] E.W.$), the metallicity and the H band luminosity are analysed. We show that the molecular gas contained in molecular clouds or complexes is of the order of 15% of the total gas on average whatever the luminosity or the Hubble type of the galaxies. We discuss the relation between the star formation rate and the molecular gas content and estimate the average star formation efficiency of late-type galaxies.Comment: accepted for publication on Astronomy and Astrophysic

Local Ugandan Production of Stable 0.2% Chlorhexidine Eye Drops

Purpose: The purpose of this study was to develop a protocol to prepare buffered chlorhexidine (CHX) eye drops (0.2% w/v) in the United Kingdom that can be reproduced at a production facility in Uganda. Buffered CHX eye drops can prevent CHX degradation and improve ocular tolerability during the treatment of fungal keratitis. Methods: Buffered CHX eye drops in amber glass containers were prepared using sodium acetate buffer at pH 5.90 to 6.75. Two commercial CHX solutions and CHX in water were used as controls. Eye drops were stored at 40°C (70% humidity, 21 months) in the United Kingdom and at ambient temperature in Uganda (30 months). High-performance liquid chromatography was used to determine CHX stability over time, and pH was monitored. Sterility was achieved using an autoclave (121°C, 15 minutes) and water bath (100°C, 30 minutes). Results: The pH of acetate-buffered CHX eye drops did not change over 21 months a40°C or at ambient temperature (30 months), whereas the pH of the unbuffered aqueouCHX displayed significant fluctuations, with an increase in acidity. The CHX concentration remained the same in both buffered and unbuffered eye-drop solutions. Eye dropsterilization was successful using an autoclave and a water bath. Conclusions: Stable, sterile, buffered CHX eye drops (pH 6.75) were successfully prepared first in the United Kingdom and then reproducibly in Uganda. This eye drops can be prepared in a hospital or pharmacy setting with limited resources, thus providing a cost-effective treatment for fungal keratitis. Translational Relevance: A protocol has been developed to prepare buffered CHX eydrops in low-and middle-income countries to treat fungal keratitis

The Fine-Scale Structure of the neutral Interstellar Medium in nearby Galaxies

We present an analysis of the properties of HI holes detected in 20 galaxies that are part of "The HI Nearby Galaxy Survey" (THINGS). We detected more than 1000 holes in total in the sampled galaxies. Where they can be measured, their sizes range from about 100 pc (our resolution limit) to about 2 kpc, their expansion velocities range from 4 to 36 km/s, and their ages are estimated to range between 3 and 150 Myr. The holes are found throughout the disks of the galaxies, out to the edge of the HI; 23% of the holes fall outside R25. We find that shear limits the age of holes in spirals (shear is less important in dwarf galaxies) which explains why HI holes in dwarfs are rounder, on average than in spirals. Shear, which is particularly strong in the inner part of spiral galaxies, also explains why we find that holes outside R25 are larger and older. We derive the scale height of the HI disk as a function of galactocentric radius and find that the disk flares up in all galaxies. We proceed to derive the surface and volume porosity (Q2D and Q3D) and find that this correlates with the type of the host galaxy: later Hubble types tend to be more porous. The size distribution of the holes in our sample follows a power law with a slope of a ~ -2.9. Assuming that the holes are the result of massive star formation, we derive values for the supernova rate (SNR) and star formation rate (SFR) which scales with the SFR derived based on other tracers. If we extrapolate the observed number of holes to include those that fall below our resolution limit, down to holes created by a single supernova, we find that our results are compatible with the hypothesis that HI holes result from star formation.Comment: 142 pages, 55 figures, accepted for publication in the Astronomical Journa

In-spiraling Clumps in Blue Compact Dwarf Galaxies

Giant star-formation clumps in dwarf irregular galaxies can have masses exceeding a few percent of the galaxy mass enclosed inside their orbital radii. They can produce sufficient torques on dark matter halo particles, halo stars, and the surrounding disk to lose their angular momentum and spiral into the central region in 1 Gyr. Pairs of giant clumps with similarly large relative masses can interact and exchange angular momentum to the same degree. The result of this angular momentum loss is a growing central concentration of old stars, gas, and star formation that can produce a long-lived starburst in the inner region, identified with the BCD phase. This central concentration is proposed to be analogous to the bulge in a young spiral galaxy. Observations of star complexes in five local BCDs confirm the relatively large clump masses that are expected for this process. The observed clumps also seem to contain old field stars, even after background light subtraction, in which case the clumps may be long-lived. The two examples with clumps closest to the center have the largest relative clump masses and the greatest contributions from old stars. An additional indication that the dense central regions of BCDs are like bulges is the high ratio of the inner disk scale height to the scale length, which is comparable to 1 for four of the galaxies.Comment: 15 pages, 2 figures, accepted by ApJ 1/5/201

The emerging role of virtual reality as an adjunct to procedural sedation and anesthesia: a narrative review

Over the past 20 years, there has been a significant reduction in the incidence of adverse events associated with sedation outside of the operating room. Non-pharmacologic techniques are increasingly being used as peri-operative adjuncts to facilitate and promote anxiolysis, analgesia and sedation, and to reduce adverse events. This narrative review will briefly explore the emerging role of immersive reality in the peri-procedural care of surgical patients. Immersive virtual reality (VR) is intended to distract patients with the illusion of “being present” inside the computer-generated world, drawing attention away from their anxiety, pain, and discomfort. VR has been described for a variety of procedures that include colonoscopies, venipuncture, dental procedures, and burn wound care. As VR technology develops and the production costs decrease, the role and application of VR in clinical practice will expand. It is important for medical professionals to understand that VR is now available for prime-time use and to be aware of the growing body in the literature that supports VR.info:eu-repo/semantics/publishedVersio

Using immersive virtual reality distraction to reduce fear and anxiety before surgery

Presurgical anxiety is very common and is often treated with sedatives. Minimizing or avoiding sedation reduces the risk of sedation-related adverse events. Reducing sedation can increase early cognitive recovery and reduce time to discharge after surgery. The current case study is the first to explore the use of interactive eye-tracked VR as a nonpharmacologic anxiolytic customized for physically immobilized presurgery patients. Method: A 44-year-old female patient presenting for gallbladder surgery participated. Using a within-subject repeated measures design (treatment order randomized), the participant received no VR during one portion of her preoperative wait and interactive eye-tracked virtual reality during an equivalent portion of time in the presurgery room. After each condition (no VR vs. VR), the participant provided subjective 0–10 ratings and state–trait short form Y anxiety measures of the amount of anxiety and fear she experienced during that condition. Results: As predicted, compared to treatment as usual (no VR), the patient reported having 67% lower presurgical anxiety during VR. She also experienced “strong fear” (8 out of 10) during no VR vs. “no fear” (0 out of 10) during VR. She reported a strong sense of presence during VR and zero nausea. She liked VR, she had fun during VR, and she recommended VR to future patients during pre-op. Interactive VR distraction with eye tracking was an effective nonpharmacologic technique for reducing anticipatory fear and anxiety prior to surgery. The results add to existing evidence that supports the use of VR in perioperative settings. VR technology has recently become affordable and more user friendly, increasing the potential for widespread dissemination into medical practice. Although case studies are scientifically inconclusive by nature, they help identify new directions for future larger, carefully controlled studies. VR sedation is a promising non-drug fear and anxiety management technique meriting further investigation.info:eu-repo/semantics/publishedVersio

Galactic interstellar 18O/17O ratios - a radial gradient?

(Abridged) Our aim is to determine 18O/17O abundance ratios across the entire Galaxy. These provide a measure of the amount of enrichment by high-mass versus intermediate-mass stars. Such ratios, derived from the C18O and C17O J=1-0 lines alone, may be affected by systematic errors. Therefore, the C18O and C17O (1-0), (2-1), and (3-2), as well as the 13CO (1-0) and (2-1) lines, were observed towards 18 prominent galactic targets (a total of 25 positions). The combined dataset was analysed with an LVG model, accounting for optical depth effects. The data cover galactocentric radii R between 0.1 and 16.9 kpc (solar circle at 8.5 kpc). Near the centre of the Galaxy, 18O/17O = 2.88 +/- 0.11. For the galactic disc out to an R of ca. 10 kpc, 18O/17O = 4.16 +/- 0.09. At ca. R = 16.5 kpc, 18O/17O = 5.03 +/- 0.46. Assuming that 18O is synthesised predominantly in high-mass stars (M > 8 Msun), while C17O is mainly a product of lower-mass stars, the ratio from the inner Galaxy indicates a dominance of CNO-hydrogen burning products that is also apparent in the C- and N-isotope ratios. The high 18O/17O value of the solar system (5.5) relative to that of the ambient ISM suggests contamination by nearby high-mass stars during its formation. High values in the metal-poor environment of the outer Galaxy are not matched by the low values observed towards the even more metal-poor LMC. Apparently, the outer Galaxy cannot be considered as an intermediate environment between the solar neighbourhood and the ISM of small metal-poor galaxies. The apparent 18O/17O gradient along the galactic disc and the discrepancy between outer disc and LMC isotope ratios may be explained by different ages of the respective stellar populations.Comment: Accepted by Astron. & Astroph.; 10 pages + 4 pages on-line material (figs