Effectiveness of nurse home-visiting for disadvantaged families: results of a natural experiment

Extent: 9p.Objective: To evaluate the effects of a postnatal home-visiting programme delivered by community health nurses to socially disadvantaged mothers in South Australia. Design: The intervention group of 428 mothers lived in metropolitan Adelaide and the comparison group of 239 mothers lived in regional towns where the programme was not yet available. All participating mothers met health service eligibility criteria for enrolment in the home-visiting programme. Participants in both groups were assessed at baseline (mean child age=14.4 weeks SD=2.3), prior to programme enrolment, and again when the children were aged 9, 18 and 24 months. Setting: State-wide community child health service. Participants: 667 socially disadvantaged mothers enrolled consecutively. 487 mothers (73%) completed the 24-month assessment. Intervention: Two-year postnatal home-visiting programme based on the Family Partnership Model. Primary outcome measures: Parent Stress Index (PSI), Kessler Psychological Distress Scale and the Ages and Stages Questionnaire. Results: Mixed models adjusting for baseline differences were used to compare outcomes in the two groups. The mothers in the home-visiting group reported greater improvement on the PSI subscales assessing a mother's perceptions on the quality of their relationship with their child (1.10, 95% CI 0.06 to 2.14) and satisfaction with their role as parents (0.46, 95% CI −0.15 to 1.07) than mothers in the comparison group. With the exception of childhood sleeping problems, there were no other significant differences in the outcomes across the two groups. Conclusions: The findings suggest that home-visiting programmes delivered by community health nurses as part of routine clinical practice have the potential to improve maternal–child relationships and help mothers adjust to their role as parents.Michael Gifford Sawyer, Linda Frost, Kerrie Bowering, John Lync

Free healthy breakfasts in primary schools: A cluster randomised controlled trial of a policy intervention in Wales, UK

Objective: The present study evaluated the impact of a national school programme of universal free healthy breakfast provision in Wales, UK. Design: A cluster randomised controlled trial with repeated cross-sectional design and a 12-month follow-up. Primary outcomes were breakfast skipping, breakfast diet and episodic memory. Secondary outcomes were frequency of eating breakfast at home and at school, breakfast attitudes, rest-of-day diet and class behaviour. Setting: Primary schools in nine local education authority areas. Subjects: A total of 4350 students (aged 9–11 years) at baseline and 4472 at follow-up in 111 schools. Results: Students in intervention schools reported significantly higher numbers of healthy food items consumed at breakfast and more positive attitudes towards breakfast eating at 12 months. Parents in intervention schools reported significantly higher rates of consumption of breakfast at school and correspondingly lower rates of breakfast consumption at home. No other significant differences were found. Conclusions: The intervention did not reduce breakfast skipping; rather, pupils substituted breakfast at home for breakfast at school. However, there were improvements in children’s nutritional intake at breakfast time, if not the rest of the day, and more positive attitudes to breakfast, which may have implications for life-course dietary behaviours. There was no impact on episodic memory or classroom behaviour, which may require targeting breakfast skippers

Comment on 'Non-equilibrium thermodynamics of light absorption'

A recent paper by Meszéna and Westerhoff (1999 J. Phys. A: Math. Gen. 32 301) has aimed to address what is referred to as a principal question of biological thermodynamics, the possibility of describing photosynthesis in terms of non-equilibrium thermodynamics. The issue is associated with a misrepresentation of the fundamental photophysics involved, and as a result the analysis is invalid

Mid-Infrared Ethane Emission on Neptune and Uranus

We report 8- to 13-micron spectral observations of Neptune and Uranus from the NASA Infrared Telescope Facility spanning more than a decade. The spectroscopic data indicate a steady increase in Neptune's mean atmospheric 12-micron ethane emission from 1985 to 2003, followed by a slight decrease in 2004. The simplest explanation for the intensity variation is an increase in stratospheric effective temperature from 155 +/- 3 K in 1985 to 176 +/- 3 K in 2003 (an average rate of 1.2 K/year), and subsequent decrease to 165 +/- 3 K in 2004. We also detected variation of the overall spectral structure of the ethane band, specifically an apparent absorption structure in the central portion of the band; this structure arises from coarse spectral sampling coupled with a non-uniform response function within the detector elements. We also report a probable direct detection of ethane emission on Uranus. The deduced peak mole fraction is approximately an order of magnitude higher than previous upper limits for Uranus. The model fit suggests an effective temperature of 114 +/- 3 K for the globally-averaged stratosphere of Uranus, which is consistent with recent measurements indicative of seasonal variation.Comment: Accepted for publication in ApJ. 16 pages, 10 figures, 2 table

Setting priorities to inform assessment of care homes’ readiness to participate in healthcare innovation: a systematic mapping review and consensus process

© 2020 The Author(s). This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly citedOrganisational context is known to impact on the successful implementation of healthcare initiatives in care homes. We undertook a systematic mapping review to examine whether researchers have considered organisational context when planning, conducting, and reporting the implementation of healthcare innovations in care homes. Review data were mapped against the Alberta Context Tool, which was designed to assess organizational context in care homes. The review included 56 papers. No studies involved a systematic assessment of organisational context prior to implementation, but many provided post hoc explanations of how organisational context affected the success or otherwise of the innovation. Factors identified to explain a lack of success included poor senior staff engagement, non-alignment with care home culture, limited staff capacity to engage, and low levels of participation from health professionals such as general practitioners (GPs). Thirty-five stakeholders participated in workshops to discuss findings and develop questions for assessing care home readiness to participate in innovations. Ten questions were developed to initiate conversations between innovators and care home staff to support research and implementation. This framework can help researchers initiate discussions about health-related innovation. This will begin to address the gap between implementation theory and practice.Peer reviewe

Silicate Emission in the TW Hydrae Association

The TW Hydrae Association is the nearest young stellar association. Among its members are HD 98800, HR 4796A, and TW Hydrae itself, the nearest known classical T Tauri star. We have observed these three stars spectroscopically between 3 and 13 microns. In TW Hya the spectrum shows a silicate emission feature that is similar to many other young stars with protostellar disks. The 11.2 micron feature indicative of significant amounts of crystalline olivine is not as strong as in some young stars and solar system comets. In HR 4796A, the thermal emission in the silicate feature is very weak, suggesting little in the way of (small silicate) grains near the star. The silicate band of HD 98800 (observed by us but also reported by Sylvester and Skinner (1996)) is intermediate in strength between TW Hya and HR 4796.Comment: 22 pages, 11 figures, LaTeX2e and AAS LaTeX macros v5.0. Accepted for publication in A

Dispersion monitoring for high-speed WDM networks via two-photon absorption in a semiconductor microcavity

Due to the continued demand for bandwidth, network operators have to increase the data rates at which individual wavelengths operate at. As these data rates will exceed 100 Gbit/s in the next 5-10 years, it will be crucial to be able to monitor and compensate for the amount of chromatic dispersion encountered by individual wavelength channels. This paper will focus on the use of the novel nonlinear optical-to-electrical conversion process of two-photon absorption (TPA) for dispersion monitoring. By incorporating a specially designed semiconductor microcavity, the TPA response becomes wavelength dependent, thus allowing simultaneous channel selection and monitoring without the need for external wavelength filterin

Noninvasive Monitoring of Elevated Intramuscular Pressure in a Model Compartment Syndrome via Quantitative Fascial Motion

Compartment syndromes, conditions of elevated intramuscular pressure (IMP) resulting from trauma or chronic overuse, frequently require invasive IMP monitoring for accurate diagnosis. Our objective was to test a noninvasive ultrasound technique For estimating IMP based on fascial displacement waveforms from arterial blood pressure pulses. IMP was increased in the legs of 23 healthy adult subjects LIP to 80 mmHg Using two blood pressure cuffs covering the region from the knee to the ankle. Receiver operator characteristic curves and recursive partitioning were used to determine the sensitivity and specificity of diagnosing elevated IMP using fascial displacement, For one curve. in which several ultrasonic measurement parameters were used along with subject body mass index and blood pressure, the sensitivity and specificity for diagnosing normal IMP (below 30 mmHg) from elevated IMP (30 mm Hg and up) was 0.61 and 0.94, respectively. Recursive partitioning, in which IMP was divided into three ranges (normal \u3c30 \u3emmHg, midrange of 30-40 mmHg, and elevated \u3e= 50 mmHg), resulted in improved diagnostic sensitivity (0.77) with almost no change in specificity (0.93). (C) 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27:489-494 200

The continued optical to mid-IR evolution of V838 Monocerotis

The eruptive variable V838 Monocerotis gained notoriety in 2002 when it brightened nine magnitudes in a series of three outbursts and then rapidly evolved into an extremely cool supergiant. We present optical, near-IR, and mid-IR spectroscopic and photometric observations of V838 Monocerotis obtained between 2008 and 2012 at the Apache Point Observatory 3.5m, NASA IRTF 3m, and Gemini South 8m telescopes. We contemporaneously analyze the optical & IR spectroscopic properties of V838 Monocerotis to arrive at a revised spectral type L3 supergiant and effective temperature Teff~2000--2200 K. Because there are no existing optical observational data for L supergiants in the optical, we speculate that V838 Monocerotis may represent the prototype for L supergiants in this wavelength regime. We find a low level of Halpha emission present in the system, consistent with interaction between V838 Monocerotis and its B3V binary; however, we cannot rule out a stellar collision as the genesis event, which could result in the observed Halpha activity. Based upon a two-component blackbody fit to all wavelengths of our data, we conclude that, as of 2009, a shell of ejecta surrounded V838 Monocerotis at a radius of R=263+/-10 AU with a temperature of T=285+/-2 K. This result is consistent with IR interferometric observations from the same era and predictions from the Lynch et al. model of the expanding system, which provides a simple framework for understanding this complicated system.Comment: 6 pages, 2 tables, 6 figures; accepted to A