Lifting the veil of depression and alcoholism in sport coaching: how do we care for carers?

The purpose of this article is to explore the insights of an elite sport coach living with comorbid depression and alcohol misuse. Such consideration is necessary because as coaching is increasingly repositioned as a caring activity the wellbeing of coaches themselves has rarely been considered. To address this gap, a narrative analysis methodology and a story telling approach was used to present the experiences of a case study coach (Steve). The story is derived from Steve’s own perspective and the perspective of his wife, Jane. This novel multi-voiced approach reveals the complex interplay between the sporting environment, Steve’s depression and his alcohol-related problems. In doing so, Steve’s story makes an original contribution by unveiling the issue of mental health in elite sport coaching. Steve’s story depicts the significant impact of depressive symptoms, coupled by excessive alcohol use on a coach, their personal life and their career. Using the work of Goffman and Sartre, the story alludes to how such symptoms can be hidden, to greater and lesser extents, from professional colleagues. This is an important theoretical contribution, because to care for coaches, colleagues, employers and health professionals will need to understand the needs of individuals such as Steve. Developing an open and supportive culture, which accepts that coaches are fallible, may however be a challenge within professional sport contexts

Assessing policy stability in Iraq: a fuzzy approach to modeling preferences

The first Council of Representatives elected under the new Iraqi Constitution was unable to pass legislation required to achieve the political benchmarks set by the government. We argue that the exercise of a qualified veto by the three-member Presidency Council essentially required near unanimity among the nine parties of the governing coalition. Given the policy positions of these parties, unanimity was not possible. Our analysis makes use of a fuzzy veto players model. The placement of the government parties along a single dimension based on fuzzy preference measures derived from party text data reveals no common area of agreement

Motor unit discharge variability is increased in mild-to-moderate Parkinson\u27s disease

Individuals with Parkinson\u27s disease (PD) demonstrate deficits in muscle activation such as decreased amplitude and inappropriate bursting. There is evidence that some of these disturbances are more pronounced in extensor vs. flexor muscles. Surface EMG has been used widely to quantify muscle activation deficits in PD, but analysis of discharge of the underlying motor units may provide greater insight and be more sensitive to changes early in the disease. Of the few studies that have examined motor unit discharge in PD, the majority were conducted in the first dorsal interosseous, and no studies have measured motor units from extensor and flexor muscles within the same cohort. The objective of this study was to characterize the firing behavior of single motor units in the elbow flexor and extensor muscles during isometric contractions in people with mild-to-moderate PD. Ten individuals with PD (off-medication) and nine healthy controls were tested. Motor unit spike times were recorded via intramuscular EMG from the biceps and triceps brachii muscles during 30-s isometric contractions at 10% maximum voluntary elbow flexion and elbow extension torque, respectively. We selected variables of mean motor unit discharge rate, discharge variability, and torque variability to evaluate motor abnormalities in the PD group. The effects of group, muscle, and group-by-muscle on each variable were determined using separate linear mixed models. Discharge rate and torque variability were not different between groups, but discharge variability was significantly higher in the PD group for both muscles combined

Constitutional Analogies in the International Legal System

This Article explores issues at the frontier of international law and constitutional law. It considers five key structural and systemic challenges that the international legal system now faces: (1) decentralization and disaggregation; (2) normative and institutional hierarchies; (3) compliance and enforcement; (4) exit and escape; and (5) democracy and legitimacy. Each of these issues raises questions of governance, institutional design, and allocation of authority paralleling the questions that domestic legal systems have answered in constitutional terms. For each of these issues, I survey the international legal landscape and consider the salience of potential analogies to domestic constitutions, drawing upon and extending the writings of international legal scholars and international relations theorists. I also offer some preliminary thoughts about why some treaties and institutions, but not others, more readily lend themselves to analysis in constitutional terms. And I distinguish those legal and political issues that may generate useful insights for scholars studying the growing intersections of international and constitutional law from other areas that may be more resistant to constitutional analogies

Deep Learning Coherent Diffractive Imaging

We report the development of deep learning coherent electron diffractive imaging at sub-angstrom resolution using convolutional neural networks (CNNs) trained with only simulated data. We experimentally demonstrate this method by applying the trained CNNs to directly recover the phase images from electron diffraction patterns of twisted hexagonal boron nitride, monolayer graphene and a Au nanoparticle with comparable quality to those reconstructed by a conventional ptychographic method. Fourier ring correlation between the CNN and ptychographic images indicates the achievement of a spatial resolution in the range of 0.70 and 0.55 angstrom (depending on different resolution criteria). The ability to replace iterative algorithms with CNNs and perform real-time imaging from coherent diffraction patterns is expected to find broad applications in the physical and biological sciences.Comment: 19 pages, 7 figure

Long-Term Outcomes After Surgical Versus Transcatheter Closure of Atrial Septal Defects in Adults

ObjectivesThe purpose of this study was to assess the comparative effectiveness and long-term safety of transcatheter versus surgical closure of secundum atrial septal defects (ASD) in adults.BackgroundTranscatheter ASD closure has largely replaced surgery in most industrialized countries, but long-term data comparing the 2 techniques are limited.MethodsWe performed a retrospective population-based cohort study of all patients, ages 18 to 75 years, who had surgical or transcatheter ASD closure in Québec, Canada's second-largest province, using provincial administrative databases. Primary outcomes were long-term (5-year) reintervention and all-cause mortality. Secondary outcomes were short-term (1-year) onset of congestive heart failure, stroke, or transient ischemic attack, and markers of health service use.ResultsOf the 718 ASD closures performed between 1988 and 2005, 383 were surgical and 335 were transcatheter. The long-term reintervention rate was higher in patients with transcatheter ASD closure (7.9% vs. 0.3% at 5 years, p = 0.0038), but the majority of these reinterventions occurred in the first year. Long-term mortality with the transcatheter technique was not inferior to surgical ASD closure (5.3% vs. 6.3% at 5 years, p = 1.00). Secondary outcomes were similar in the 2 groups.ConclusionsTranscatheter ASD closure is associated with a higher long-term reintervention rate and long-term mortality that is not inferior to surgery. Overall, these data support the current practice of using transcatheter ASD closure in the majority of eligible patients and support the decision to intervene on ASD with significant shunts before symptoms become evident

Incidence, management and outcomes of the first cfr-mediated linezolid-resistant Staphylococcus epidermidis outbreak in a tertiary referral centre in the Republic of Ireland.

peer-reviewedAim: To report the first Irish outbreak of cfr-mediated linezolid-resistant Staphylococcus epidermidis. Methods: Linezolid-resistant S. epidermidis isolated at University Hospital Limerick from four blood cultures, one wound and four screening swabs (from nine patients) between April and June 2013 were characterized by pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST) and staphylococcal cassette chromosome (SCCmec) typing. Antibiotic susceptibilities were determined according to the guidelines of the British Society for Antimicrobial Chemotherapy. The outbreak was controlled through prohibiting prescription and use of linezolid, adherence to infection prevention and control practices, enhanced environmental cleaning, isolation of affected patients, and hospital-wide education programmes. Findings: PFGE showed that all nine isolates represented a single clonal strain. MLST showed that they belonged to ST2, and SCCmec typing showed that they encoded a variant of SCCmecIII. All nine isolates were cfr positive, and eight isolates were positive for the G2576T 23S rRNA mutation commonly associated with linezolid resistance. Isolates exhibited multiple antibiotic resistances (i.e. linezolid, gentamicin, methicillin, clindamycin, ciprofloxacin, fusidic acid and rifampicin). The adopted infection prevention intervention was effective, and the outbreak was limited to the affected intensive care unit.PUBLISHEDpeer-reviewe

Direct Imaging of Charge Redistribution due to Bonding at Atomic Resolution via Electron Ptychography

Phase imaging in electron microscopy is sensitive to the local potential including charge redistribution from bonding. We demonstrate that electron ptychography provides the necessary sensitivity to detect this subtle effect by directly imaging the charge redistribution in single layer boron nitride. Residual aberrations can be measured and corrected post-collection, and simultaneous atomic number contrast imaging provides unambiguous sub-lattice identification. Density functional theory calculations confirm the detection of charge redistribution