Customary physical activity and psychological wellbeing: a longitudinal study

Objectives: to assess longitudinal relationships between habitual levels of physical activity and indices of psychological wellbeing in older people. Design: baseline assessment with 4- and 8-year follow-ups. Subjects: 1042 people originally aged 65 and over randomly sampled from general practitioner Lists in Nottingham, UK. Methods: logistic regression analysis of selected T1 (1985) and T2 (1989) variables, with depression at T2 as dependent; multiple regression analyses of selected T1, T2 and T3 (1993) variables, with life Satisfaction at T2 (model 1) or T3 (model 2) as dependent. Main outcome measures: questionnaire-assessed levels of physical activity; 14-item Symptoms of Anxiety and Depression scale; 13-item Life Satisfaction Index; health, demographic and social activity variables. Results: in the logistic regression model, depression at T2 was most strongly associated with depression [odds ratio (OR) = 7.13; 95% confidence interval (CI) = 3.25 -15.64; P < 0.001] and lower physical health status (OR = 1.26 per unit change in score; 95% CI = 1.17 - 1.42; P < 0.001) at T1. Lower levels of outdoor/leisure activities at T1 were also associated with some increased risk of depression 4 years later (OR = 0.92 per hour of activity; 95% CI = 0.85 - 0.99; P < 0.05). Similar predictive patterns emerged from the multiple regression analyses where, in both models, earlier levels of life satisfaction, social engagement and health accounted for most of the explained variance in life satisfaction (R-2 = 0.42 for model I; R-2 = 0.35 for model 2). Again, however, earlier levels of physical activity (as walking and housework) did contribute significantly, although modestly: to longitudinal changes in morale. Conclusions: while the results provide some support for the conclusion that physical activity contributes independently to the promotion and maintenance of psychological wellbeing in later life, this contribution is, at best, extremely modest

On the Correlated X-ray and Optical Evolution of SS Cygni

We have analyzed the variability and spectral evolution of the prototype dwarf nova system SS Cygni using RXTE data and AAVSO observations. A series of pointed RXTE/PCA observations allow us to trace the evolution of the X-ray spectrum of SS Cygni in unprecedented detail, while 6 years of optical AAVSO and RXTE/ASM light curves show long-term patterns. Employing a technique in which we stack the X-ray flux over multiple outbursts, phased according to the optical light curve, we investigate the outburst morphology. We find that the 3-12 keV X-ray flux is suppressed during optical outbursts, a behavior seen previously, but only in a handful of cycles. The several outbursts of SS Cygni observed with the more sensitive RXTE/PCA also show a depression of the X-rays during optical outburst. We quantify the time lags between the optical and X-ray outbursts, and the timescales of the X-ray recovery from outburst. The optical light curve of SS Cygni exhibits brief anomalous outbursts. During these events the hard X-rays and optical flux increase together. The long-term data suggest that the X-rays decline between outburst. Our results are in general agreement with modified disk instability models (DIM), which invoke a two-component accretion flow consisting of a cool optically thick accretion disk truncated at an inner radius, and a quasi-spherical hot corona-like flow extending to the surface of the white dwarf. We discuss our results in the framework of one such model, involving the evaporation of the inner part of the optically thick accretion disk, proposed by Meyer & Meyer-Hofmeister (1994).Comment: 24 pages, 8 figures, 2 tables, accepted for publication in Ap

PHEON: Practicing Problem Solving and Gaining Museum Literacy from Transmedia and Alternate Reality Games in Museums

The Luce Foundation Center of the Smithsonian American Art Museum ran a transmedia game, called PHEON, as an in-museum scavenger hunt-style game from October 2010 through September 2011. Players took on missions that sent them throughout the Museum\u27s collections. From a summative evaluation of the game, we learned that PHEON supported problem solving skills, increased museum literacy, and help players connect with the Museum and its resources. Players also identified opportunities for improvement related to the game materials and its narrative. The paper offers a summary of lessons learned for others hoping to deploy an ARG or transmedia game in their learning setting

Synthetic NLTE accretion disc spectra for the dwarf nova SS Cyg during an outburst cycle

Dwarf nova outbursts result from enhanced mass transport through the accretion disc of a cataclysmic variable system. We assess the question of whether these outbursts are caused by an enhanced mass transfer from the late-type main sequence star onto the white dwarf (so-called mass transfer instability model, MTI) or by a thermal instability in the accretion disc (disc instability model, DIM). We compute non-LTE models and spectra of accretion discs in quiescence and outburst and construct spectral time sequences for discs over a complete outburst cycle. We then compare our spectra to published optical spectroscopy of the dwarf nova SS Cygni. In particular, we investigate the hydrogen and helium line profiles that are turning from emission into absorption during the rise to outburst. The evolution of the hydrogen and helium line profiles during the rise to outburst and decline clearly favour the disc-instability model. Our spectral model sequences allow us to distinguish inside-out and outside-in moving heating waves in the disc of SS Cygni, which can be related to symmetric and asymmetric outburst light curves, respectively.Comment: 8 pages, 8 figures; accepted to A&

The fluorine link between a supergiant ore deposit and a silicic large igneous province

Olympic Dam is a supergiant Fe oxide Cu-U-Au-Ag ore deposit (~9 × 109 t) that is also enriched in rare earth elements (REEs) and fluorine (F). The immediate host to the ore is hydrothermal breccia within granite and volcanic rocks of a Mesoproterozoic silicic large igneous province. Analyses of melt inclusions in quartz phenocrysts in rhyolite show that the silicic magmas of this province were unusually rich in F (up to 1.3 wt%). Fluorite and other F-rich minerals that crystallized from these magmas provided a gigantic reservoir of F. As a result, the Olympic Dam ore-forming fluid was F-rich and had exceptional capacity to transport diverse elements. Further, we infer that hydrofluoric acid, the most corrosive acid known, contributed to hydrothermal breccia formation by dissolution that in turn increased permeability and accelerated the rate of fluid-rock interaction. It is no accident that the world's largest hydrothermal ore deposit occurs in an F-rich silicic large igneous province

Validating and comparing stroke prognosis scales

Objective: To compare the prognostic accuracy of various acute stroke prognostic scales using a large, independent, clinical trials dataset. Methods: We directly compared 8 stroke prognostic scales, chosen based on focused literature review (Acute Stroke Registry and Analysis of Lausanne [ASTRAL]; iSCORE; iSCORE-revised; preadmission comorbidities, level of consciousness, age, and neurologic deficit [PLAN]; stroke subtype, Oxfordshire Community Stroke Project, age, and prestroke modified Rankin Scale [mRS] [SOAR]; modified SOAR; Stroke Prognosis Instrument 2 [SPI2]; and Totaled Health Risks in Vascular Events [THRIVE]) using individual patient-level data from a clinical trials archive (Virtual International Stroke Trials Archive [VISTA]). We calculated area under receiver operating characteristic curves (AUROC) for each scale against 90-day outcomes of mRS (dichotomized atmRS.2), Barthel Index (.85), and mortality. We performed 2 complementary analyses: the first limited to patients with complete data for all components of all scales (simultaneous) and the second using as many patients as possible for each individual scale (separate). We compared AUROCs and performed sensitivity analyses substituting extreme outcome values for missing data. Results: In total, 10,777 patients contributed to the analyses. Our simultaneous analyses suggested that ASTRAL had greatest prognostic accuracy for mRS, AUROC 0.78 (95% confidence interval [CI] 0.75–0.82), and SPI2 had poorest AUROC, 0.61 (95%CI 0.57–0.66). Our separate analyses confirmed these results: ASTRAL AUROC 0.79 (95% CI 0.78–0.80 and SPI2 AUROC 0.60 (95% CI 0.59–0.61). On formal comparative testing, there was a significant difference in modified Rankin Scale AUROC between ASTRAL and all other scales. Sensitivity analysis identified no evidence of systematic bias from missing data. Conclusions: Our comparative analyses confirm differences in the prognostic accuracy of stroke scales. However, even the best performing scale had prognostic accuracy that may not be sufficient as a basis for clinical decision-making

Barriers and facilitators to taking on diabetes self-management tasks in pre-adolescent children with type 1 diabetes: a qualitative study.

BACKGROUND: When children with type 1 diabetes approach adolescence, they are encouraged to become more involved in diabetes self-management. This study explored the challenges pre-adolescent children encounter when self-managing diabetes and the factors which motivate and enable them to take on new diabetes-related tasks. A key objective was to inform the support offered to pre-adolescent children. METHODS: In-depth interviews using age-appropriate questioning with 24 children (aged 9-12 years) with type 1 diabetes. Data were analysed using an inductive, thematic approach. RESULTS: Children reported several barriers to taking on self-management tasks. As well as seeking respite from managing diabetes, children described relying on their parents to: perform the complex maths involved in working out carbohydrate content in food; calculate insulin doses if they did not use a bolus advisor; and administer injections or insert a cannula in hard-to-reach locations. Children described being motivated to take on diabetes tasks in order to: minimise the pain experienced when others administered injections; alleviate the burden on their parents; and participate independently in activities with their peers. Several also discussed being motivated to take on diabetes-management responsibilities when they started secondary school. Children described being enabled to take on new responsibilities by using strategies which limited the need to perform complex maths. These included using labels on food packaging to determine carbohydrate contents, or choosing foods with carbohydrate values they could remember. Many children discussed using bolus advisors with pre-programmed ratios and entering carbohydrate on food labels or values provided by their parents to calculate insulin doses. Several also described using mobile phones to seek advice about carbohydrate contents in food. CONCLUSIONS: Our findings highlight several barriers which deter children from taking on diabetes self-management tasks, motivators which encourage them to take on new responsibilities, and strategies and technologies which enable them to become more autonomous. To limit the need to perform complex maths, children may benefit from using bolus advisors provided they receive regular review from healthcare professionals to determine and adjust pre-programmed insulin-to-carbohydrate ratios. Education and support should be age-specific to reflect children's changing involvement in self-managing diabetes

ORFEUS II and IUE Spectroscopy of EX Hydrae

Using ORFEUS-SPAS II FUV spectra, IUE UV spectra, and archival EUVE deep survey photometry, we present a detailed picture of the behavior of the magnetic cataclysmic variable EX Hydrae. Like HUT spectra of this source, the FUV and UV spectra reveal broad emission lines of He II, C II-IV, N III and V, O VI, Si III-IV, and Al III superposed on a continuum which is blue in the UV and nearly flat in the FUV. Like ORFEUS spectra of AM Her, the O VI doublet is resolved into broad and narrow emission components. Consistent with its behavior in the optical, the FUV and UV continuum flux densities, the FUV and UV broad emission line fluxes, and the radial velocity of the O VI broad emission component all vary on the spin phase of the white dwarf, with the maximum of the FUV and UV continuum and broad emission line flux light curves coincident with maximum blueshift of the broad O VI emission component. On the binary phase, the broad dip in the EUV light curve is accompanied by strong eclipses of the UV emission lines and by variations in both the flux and radial velocity of the O VI narrow emission component. The available data are consistent with the accretion funnel being the source of the FUV and UV continuum and the O VI broad emission component, and the white dwarf being the source of the O VI narrow emission component.Comment: 21 pages, 10 Postscript figures; LaTeX format, uses aaspp4.sty; table2.tex included separately because it must be printed sideways - see instructions in the file; accepted on 1999 Feb 20 for publication in The Astrophysical Journa

Therapeutic potential of transdermal glyceryl trinitrate in the management of acute stroke

The nitric oxide donor, glyceryl trinitrate (GTN), is a candidate treatment for the management of acute stroke with haemodynamic and potential reperfusion and neuroprotective effects. When administered as a transdermal patch during the acute and subacute phases after stroke, GTN was safe, lowered blood pressure, maintained cerebral blood flow, and did not induce cerebral steal or alter functional outcome. However, when given within 6 h of stroke onset, GTN reduced death and dependency (odds ratio 0.52; 95% confidence interval 0.34–0.78), death, disability, cognitive impairment and mood disturbance, and improved quality of life (data from two trials, n = 312). In a pooled analysis of four studies (n = 186), GTN reduced between-visit systolic blood pressure variability over days 1–7 compared with no GTN (mean difference -2.09; 95% confidence interval -3.83 to -0.35; p = 0.019). The efficacy of GTN given in the ultra-acute/pre-hospital setting is currently being assessed and, if found to be beneficial, the implications for hyperacute stroke practice are significant. Here, we discuss the evidence to date, potential mechanisms of action and future possibilities, including unanswered questions, for the therapeutic potential of GTN in acute stroke

The Landscape of Videofluoroscopy in the UK: A Web-Based Survey

Videofluoroscopy (VFS) is considered one of the gold-standard assessments of swallowing. Whilst guidelines for the application and conduct of VFS exist, their translation into clinical practice remain challenging. To build a greater understanding on how VFS clinics operate in the UK. A web-based survey was shared with speech and language therapists (SLTs) working in VFS clinics via professional networks and social media from October 2018 to January 2019. 101 responses were received. Two thirds of clinics were SLT-led, with the majority of clinics being run by two SLTs (73.6%) and a radiographer (95.5%) also known as radiologic technologists, diagnostic radiographers and medical radiation technologists. Less than 50% of radiographers had received specialist training. Around half of the clinics used a standard assessment or analysis protocol and 88.1% a rating scale. Set recipes for a range of textures were used in 53.4% of VFS clinics. Barium and water soluble contrasts were used, but only 15.8% knew the concentration of contrast used. The most commonly reported VFS pulse and frame rate was 15 per second. There was evidence of a lack of SLT knowledge regarding technical operation of VFS. Screening times varied from 0.7–10 min (median 3 min, IQR 2.5–3.5). Around 50% of respondents reported quality issues affecting analysis. In a survey of UK SLTs, translation of VFS guidance into practice was found to be limited which may impact on the quality of assessment and analysis. Collaboration with radiology, strengthening of guidelines and greater uptake of specialist training is deemed essential