78 research outputs found
CLASSIFICATION OF RISK IN PSYCHIATRY
Psychiatric risk-assessments generally quantify risk using broad, categorical, indicators (e.g., high-risk, low-risk). We examined
reliability of such indicators when applied by mental-health professionals. Four versions of a questionnaire were used, each
specifying a different clinical outcome along with a range of different probabilities at which that outcome might occur. Respondents
classified each probability, allowing a comparison of the level of likelihood at which different professionals would apply the terms
\u27high-risk\u27, \u27medium-risk\u27 and \u27low-risk\u27. We found little consistency among professionals who assessed risk for the same outcomes.
Moreover, there were also large and unpredicted differences in response-profiles between the 4 clinical outcomes. These findings
raise concerns about the communication value of current risk-assessment terminology
White Light Flare Continuum Observations with ULTRACAM
We present sub-second, continuous-coverage photometry of three flares on the
dM3.5e star, EQ Peg A, using custom continuum filters with WHT/ULTRACAM. These
data provide a new view of flare continuum emission, with each flare exhibiting
a very distinct light curve morphology. The spectral shape of flare emission
for the two large-amplitude flares is compared with synthetic ULTRACAM
measurements taken from the spectra during the large 'megaflare' event on a
similar type flare star. The white light shape during the impulsive phase of
the EQ Peg flares is consistent with the range of colors derived from the
megaflare continuum, which is known to contain a Hydrogen recombination
component and compact, blackbody-like components. Tentative evidence in the
ULTRACAM photometry is found for an anti-correlation between the emission of
these components.Comment: 8 pages, 3 figures. Proceedings of the 16th Workshop on Cool Stars,
Stellar Systems, and the Sun (PASP conference series, in press
Measurement of Plasmodium falciparum transmission intensity using serological cohort data from Indonesian schoolchildren.
BACKGROUND: As malaria transmission intensity approaches zero, measuring it becomes progressively more difficult and inefficient because parasite-positive individuals are hard to detect. This situation may arise shortly before achieving local elimination, or during surveillance post-elimination to prevent reintroduction. Antibody responses against the parasite last longer than the infections themselves. This "footprint" of infection may thus be used for assessing transmission intensity. A statistical approach is presented for measuring the seroconversion rate (SCR), a correlate of the force of infection, from individual-level longitudinal data on antibody titres in an area of low Plasmodium falciparum transmission. METHODS: Blood samples were collected from 160 Indonesian schoolchildren every month for six months. Titres of antibodies against AMA-1 and MSP-1(19) antigens of P. falciparum were measured using ELISA. The distribution of antibody titres among seronegative and -positive individuals, respectively, was estimated by comparing the titres from the study data (a mixture of both seropositive and -negative individuals) with titres from a (unexposed) negative control group of Indonesian individuals. Two Markov-Chain models for the transition of individuals between serological states were fitted to individual anti-PfAMA-1 or anti-PfMSP-1 titre time series using Bayesian Markov-Chain-Monte-Carlo (MCMC). This yielded estimates of SCR as well as of the duration of seropositivity. RESULTS: A posterior median SCR of 0.02 (Pf AMA-1) and 0.09 (PfMSP-1) person(-1) year(-1) was estimated, with credible intervals ranging from 1E-4 to 0.2 person(-1) year(-1). This level of transmission intensity is at the lower range of what can reliably be measured with the present study size. A Bayesian test for seroconversion of an individual between two observations is presented and used to identify the subjects who have most likely experienced an infection. Furthermore, the theoretical limits of measuring transmission intensity, and how these depend on duration and size of a study as well as on transmission intensity itself, is illustrated. CONCLUSIONS: This analysis shows that it is possible to measure SCR's from individual-level longitudinal data on antibody titres. In addition, individual seroconversion events can be identified, which can be useful in assessing interruption of transmission. Analyses of further serological datasets using the present method are required to improve and validate it. This includes measurement of the duration of antibody responses, how it depends on host age or cumulative exposure, or on the particular antigen used
Whole Life: a feasibility study of a recovery-focussed intervention in patients with stabilised schizophrenia [version 2; peer review: 2 approved, 1 approved with reservations]
Background: The Recovery Approach is about supporting people to live the best life they possibly can. This paper reports on a 2008-11 study of a recovery-focussed, one-to-one coaching programme called Whole Life (WL) in a group of people with stabilised schizophrenia. WL comprises 15 modules, each addressing an aspect of life that may pose challenges for someone with mental illness. It involves regular meetings with a coach, additional homework activities and lasts approximately one-year. This level of commitment requires participants to be motivated and enthusiastic. Methods: This was a non-randomised feasibility study, designed to assess acceptability and potential benefits of WL. The WL group was compared to another group of people with the same diagnosis, who received their usual treatment. This was not a strict control group. The primary outcome measure was the Social Adaptation Self-Assessment Scale. Results: Of those recruited to the WL group, 33/44 (75%) completed the full programme. WL participants showed an 11-point increase in mean SASS between baseline and Week 60. Subjective ratings showed benefits of WL at 3 and 6 months after the intervention had ceased, with most saying they felt better and none saying that they felt worse. The comparison group was more ill than the WL group at baseline and showed some improvement over the course of the study, albeit at a lower level than the WL group. However, controlling for baseline group differences meant that none of the outcome measures could reliably distinguish between WL and comparison groups. Conclusions: The study showed that WL is an acceptable and helpful intervention for motivated and enthusiastic individuals. It may have wider applicability for people with a less serious and chronic mental illness, although we do not know how it compares to other interventions. We discuss some methodological limitations of the study
Seasonal changes in the antibody responses against Plasmodium falciparum merozoite surface antigens in areas of differing malaria endemicity in Indonesia.
BACKGROUND: The transmission of malaria in Indonesia is highly heterogeneous spatially and seasonally. Anti-malaria antibody responses can help characterize this variation. In the present study antibody responses to Plasmodium falciparum MSP-1 and AMA-1 were measured to assess the transmission intensity in a hypo-endemic area of Purworejo and a meso-endemic area of Lampung during low and high transmission seasons. METHODS: Filter-paper blood spot samples collected from Purworejo and Lampung by cross-sectional survey during high and low transmission season were stored at -20°C. Indirect ELISA assays were carried out using PfMSP1-19 and PfAMA1 antigens. A positivity threshold was determined by samples from local unexposed individuals, and the differences in seroprevalence, antibody level and correlation between antibody level and age in each site were statistically analysed. RESULTS: Prevalence of antibodies to either PfMSP1-19 or PfAMA1 was higher in Lampung than in Purworejo in both the low (51.3 vs 25.0%) and high transmission season (53.9 vs 37.5%). The magnitude of antibody responses was associated with increasing age in both sites and was higher in Lampung. Age-adjusted seroconversion rates showed an approximately ten-fold difference between Lampung and Purowejo. Two different seroconversion rates were estimated for Lampung suggesting behaviour-related differences in exposure. In both settings antibody responses to PfMSP1-19 were significantly lower in the low season compared to the high season. CONCLUSION: Seasonal changes may be detectable by changes in antibody responses. This is particularly apparent in lower transmission settings and with less immunogenic antigens (in this case PfMSP1-19). Examination of antibody levels rather than seroprevalence is likely to be a more sensitive indicator of changes in transmission. These data suggest that sero-epidemiological analysis may have a role in assessing short-term changes in exposure especially in low or seasonal transmission settings
The magnetic nature of disk accretion onto black holes
Although disk accretion onto compact objects - white dwarfs, neutron stars,
and black holes - is central to much of high energy astrophysics, the
mechanisms which enable this process have remained observationally elusive.
Accretion disks must transfer angular momentum for matter to travel radially
inward onto the compact object. Internal viscosity from magnetic processes and
disk winds can in principle both transfer angular momentum, but hitherto we
lacked evidence that either occurs. Here we report that an X-ray-absorbing wind
discovered in an observation of the stellar-mass black hole binary GRO J1655-40
must be powered by a magnetic process that can also drive accretion through the
disk. Detailed spectral analysis and modeling of the wind shows that it can
only be powered by pressure generated by magnetic viscosity internal to the
disk or magnetocentrifugal forces. This result demonstrates that disk accretion
onto black holes is a fundamentally magnetic process.Comment: 15 pages, 2 color figures, accepted for publication in Nature.
Supplemental materials may be obtained by clicking
http://www.astro.lsa.umich.edu/~jonmm/nature1655.p
Implementation of the StandingTall programme to prevent falls in older people:a process evaluation protocol
INTRODUCTION: One in three people aged 65 years and over fall each year. The health, economic and personal impact of falls will grow substantially in the coming years due to population ageing. Developing and implementing cost-effective strategies to prevent falls and mobility problems among older people is therefore an urgent public health challenge. StandingTall is a low-cost, unsupervised, home-based balance exercise programme delivered through a computer or tablet. StandingTall has a simple user-interface that incorporates physical and behavioural elements designed to promote compliance. A large randomised controlled trial in 503 community-dwelling older people has shown that StandingTall is safe, has high adherence rates and is effective in improving balance and reducing falls. The current project targets a major need for older people and will address the final steps needed to scale this innovative technology for widespread use by older people across Australia and internationally. METHODS AND ANALYSIS: This project will endeavour to recruit 300 participants across three sites in Australia and 100 participants in the UK. The aim of the study is to evaluate the implementation of StandingTall into the community and health service settings in Australia and the UK. The nested process evaluation will use both quantitative and qualitative methods to explore uptake and acceptability of the StandingTall programme and associated resources. The primary outcome is participant adherence to the StandingTall programme over 6âmonths. ETHICS AND DISSEMINATION: Ethical approval has been obtained from the South East Sydney Local Health District Human Research Ethics Committee (HREC reference 18/288) in Australia and the North West- Greater Manchester South Research Ethics Committee (IRAS ID: 268954) in the UK. Dissemination will be via publications, conferences, newsletter articles, social media, talks to clinicians and consumers and meetings with health departments/managers. TRIAL REGISTRATION NUMBER: ACTRN12619001329156
A Giant Metrewave Radio Telescope/Chandra view of IRAS 09104+4109: A type 2 QSO in a cooling flow
IRAS 09104+4109 is a rare example of a dust enshrouded type 2 QSO in the
centre of a cool-core galaxy cluster. Previous observations of this z=0.44
system showed that as well as powering the hyper-luminous infrared emission of
the cluster-central galaxy, the QSO is associated with a double-lobed radio
source. However, the steep radio spectral index and misalignment between the
jets and ionised optical emission suggested that the orientation of the QSO had
recently changed. We use a combination of new, multi-band Giant Metrewave Radio
Telescope observations and archival radio data to confirm that the jets are no
longer powered by the QSO, and estimate their age to be 120-160 Myr. This is in
agreement with the ~70-200 Myr age previously estimated for star-formation in
the galaxy. Previously unpublished Very Long Baseline Array data reveal a 200
pc scale double radio source in the galaxy core which is more closely aligned
with the current QSO axis and may represent a more recent period of jet
activity. These results suggest that the realignment of the QSO, the cessation
of jet activity, and the onset of rapid star-formation may have been caused by
a gas-rich galaxy merger. A Chandra X-ray observation confirms the presence of
cavities associated with the radio jets, and we estimate the energy required to
inflate them to be ~7.7x10^60 erg. The mechanical power of the jets is
sufficient to balance radiative cooling in the cluster, provided they are
efficiently coupled to the intra-cluster medium (ICM). We find no evidence of
direct radiative heating and conclude that the QSO either lacks the radiative
luminosity to heat the ICM, or that it requires longer than 100-200 Myr to
significantly impact its environment. [Abridged]Comment: 23 pages, 18 figures and 7 tables. Accepted for publication in MNRA
The Fifth Data Release of the Sloan Digital Sky Survey
This paper describes the Fifth Data Release (DR5) of the Sloan Digital Sky
Survey (SDSS). DR5 includes all survey quality data taken through June 2005 and
represents the completion of the SDSS-I project (whose successor, SDSS-II will
continue through mid-2008). It includes five-band photometric data for 217
million objects selected over 8000 square degrees, and 1,048,960 spectra of
galaxies, quasars, and stars selected from 5713 square degrees of that imaging
data. These numbers represent a roughly 20% increment over those of the Fourth
Data Release; all the data from previous data releases are included in the
present release. In addition to "standard" SDSS observations, DR5 includes
repeat scans of the southern equatorial stripe, imaging scans across M31 and
the core of the Perseus cluster of galaxies, and the first spectroscopic data
from SEGUE, a survey to explore the kinematics and chemical evolution of the
Galaxy. The catalog database incorporates several new features, including
photometric redshifts of galaxies, tables of matched objects in overlap regions
of the imaging survey, and tools that allow precise computations of survey
geometry for statistical investigations.Comment: ApJ Supp, in press, October 2007. This paper describes DR5. The SDSS
Sixth Data Release (DR6) is now public, available from http://www.sdss.or
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