Co-producing principles to guide health research: an illustrative case study from an eating disorder research clinic

There is significant value in co-produced health research, however power-imbalances within research teams can pose a barrier to people with lived experience of an illness determining the direction of research in that area. This is especially true in eating disorder research, where the inclusion of co-production approaches lags other research areas. Appealing to principles or values can serve to ground collaborative working. Despite this, there has not been any prior attempt to co-produce principles to guide the work of a research group and serve as a basis for developing future projects. The aim of this piece of work was to co-produce a set of principles to guide the conduct of research within our lived experience led research clinic, and to offer an illustrative case for the value of this as a novel co-production methodology. A lived experience panel were recruited to our eating disorder research group. Through an iterative series of workshops with the members of our research clinic (composed of a lived experience panel, clinicians, and researchers) we developed a set of principles which we agreed were important in ensuring both the direction of our research, and the way in which we wanted to work together. Six key principles were developed using this process. They were that research should aim to be: 1) real world—offering a clear and concrete benefit to people with eating disorders, 2) tailored—suitable for marginalised groups and people with atypical diagnoses, 3) hopeful—ensuring that hope for recovery was centred in treatment, 4) experiential—privileging the ‘voice’ of people with eating disorders, 5) broad—encompassing non-standard therapeutic treatments and 6) democratic—co-produced by people with lived experience of eating disorders. We reflect on some of the positives as well as limitations of the process, highlighting the importance of adequate funding for longer-term co-production approaches to be taken, and issues around ensuring representation of minority groups. We hope that other health research groups will see the value in co-producing principles to guide research in their own fields, and will adapt, develop, and refine this novel methodology

Galaxy And Mass Assembly: the evolution of the cosmic spectral energy distribution from z = 1 to z = 0

We present the evolution of the cosmic spectral energy distribution (CSED) from z = 1 to 0. Our CSEDs originate from stacking individual spectral energy distribution (SED) fits based on panchromatic photometry from the Galaxy And Mass Assembly (GAMA) and COSMOS data sets in 10 redshift intervals with completeness corrections applied. Below z = 0.45, we have credible SED fits from 100 nm to 1 mm. Due to the relatively low sensitivity of the far-infrared data, our far-infrared CSEDs contain a mix of predicted and measured fluxes above z = 0.45. Our results include appropriate errors to highlight the impact of these corrections. We show that the bolometric energy output of the Universe has declined by a factor of roughly 4 – from 5.1 ± 1.0 at z ∼ 1 to 1.3 ± 0.3 × 1035 h70 W Mpc−3 at the current epoch. We show that this decrease is robust to cosmic sample variance, the SED modelling and other various types of error. Our CSEDs are also consistent with an increase in the mean age of stellar populations. We also show that dust attenuation has decreased over the same period, with the photon escape fraction at 150 nm increasing from 16 ± 3 at z ∼ 1 to 24 ± 5 per cent at the current epoch, equivalent to a decrease in AFUV of 0.4 mag. Our CSEDs account for 68 ± 12 and 61 ± 13 per cent of the cosmic optical and infrared backgrounds, respectively, as defined from integrated galaxy counts and are consistent with previous estimates of the cosmic infrared background with redshift

The Dark Matter halo of the Milky Way, AD 2013

We derive the mass model of the Milky Way (MW) using a cored dark matter (DM) halo profile and recent data. The method used consists in fitting a spherically symmetric model of the Galaxy with a Burkert DM halo profile to available data: MW terminal velocities in the region inside the solar circle, circular velocity as recently estimated from maser star forming regions at intermediate radii, and velocity dispersions of stellar halo tracers for the outermost Galactic region. The latter are reproduced by integrating the Jeans equation for every modeled mass distribution, and by allowing for different velocity anisotropies for different tracer populations. For comparison we also consider a Navarro-Frenk-White profile. We find that the cored profile is the preferred one, with a shallow central density of rho_H~4x10^7M_s/kpc^3 and a large core radius R_H~10 kpc, as observed in external spirals and in agreement with the mass model underlying the Universal Rotation Curve of spirals. We describe also the derived model uncertainties, which are crucially driven by the poorly constrained velocity dispersion anisotropies of halo tracers. The emerging cored DM distribution has implications for the DM annihilation angular profile, which is much less boosted in the Galactic center direction with respect to the case of the standard \Lambda CDM, NFW profile. Using the derived uncertainties we discuss finally the limitations and prospects to discriminate between cored and cusped DM profile with a possible observed diffuse DM annihilation signal. The present mass model aims to characterize the present-day description of the distribution of matter in our Galaxy, which is needed to frame current crucial issues of Cosmology, Astrophysics and Elementary Particles

Self-medication and non-doctor prescription practices in Pokhara valley, Western Nepal: a questionnaire-based study

BACKGROUND: Self-medication and non-doctor prescribing of drugs is common in developing countries. Complementary and alternative medications, especially herbs, are also commonly used. There are few studies on the use of these medications in Pokhara Valley, Western Nepal. METHODS: Previously briefed seventh semester medical students, using a semi-structured questionnaire, carried out the study on 142 respondents. Demographic information and information on drugs used for self-medication or prescribed by a non-allopathic doctor were collected. RESULTS: Seventy-six respondents (54%) were aged between 20 to 39 years. The majority of the respondents (72 %) stayed within 30 minutes walking distance of a health post/medical store. 59% of these respondents had taken some form of self-medication in the 6-month period preceding the study. The common reasons given for self-medication were mild illness, previous experience of treating a similar illness, and non-availability of health personnel. 70% of respondents were prescribed allopathic drugs by a non-allopathic doctor. The compounder and health assistant were common sources of medicines. Paracetamol and antimicrobials were the drugs most commonly prescribed. A significantly higher proportion of young (<40 years) male respondents had used self-medication than other groups. CONCLUSIONS: Self-medication and non-doctor prescribing are common in the Pokhara valley. In addition to allopathic drugs, herbal remedies were also commonly used for self-medication. Drugs, especially antimicrobials, were not taken for the proper duration. Education to help patients decide on the appropriateness of self-medication is required

Hiding in plain sight: discovery and phylogeography of a cryptic species of Trichinella (Nematoda: Trichinellidae) in wolverine (Gulo gulo)

Understanding parasite diversity and distribution is essential in managing the potential impact of para- sitic diseases in animals and people. Imperfect diagnostic methods, however, may conceal cryptic species. Here, we report the discovery and phylogeography of a previously unrecognized species of Trichinella in wolverine (Gulo gulo) from northwestern Canada that was indistinguishable from T. nativa using the stan- dard multiplex PCR assay based on the expansion segment 5 (ESV) of ribosomal DNA. The novel genotype, designated as T13, was discovered when sequencing the mitochondrial genome. Phylogenetic analyses of the mitochondrial genome and of 15 concatenated single-copy orthologs of nuclear DNA indicated a com- mon ancestor for the encapsulated clade is shared by a subclade containing Trichinella spiralis and Trichinella nelsoni, and a subclade containing T13 and remaining taxa: T12 + (T2 + T6) + [(T5 + T9) + (T 3 + T8)]. Of 95 individual hosts from 12 species of mammalian carnivores from northwestern Canada from which larvae were identified as T. nativa on multiplex PCR, only wolverines were infected with T13 (14 of 42 individuals). These infections were single or mixed with T. nativa and/or T6. Visual examination and motility testing confirmed that T13 is encapsulated and likely freeze-tolerant. We developed a new Polymerase Chain Reaction-Restriction Fragment Length Polymorphism which unequivocally distinguishes between T13 and T. nativa. We propose Trichinella chanchalensis n. sp. for T13, based on significant genetic divergence from other species of Trichinella and broad-based sampling of the Trichinella genome. Exploration of Alaskan and Siberian isolates may contribute to further resolution of a phylogeo- graphically complex history for species of Trichinella across Beringia, including Trichinella chanchalensis n. sp. (T13

Removing Algebraic Data Types from Constrained Horn Clauses Using Difference Predicates

We address the problem of proving the satisfiability of Constrained Horn Clauses (CHCs) with Algebraic Data Types (ADTs), such as lists and trees. We propose a new technique for transforming CHCs with ADTs into CHCs where predicates are defined over basic types, such as integers and booleans, only. Thus, our technique avoids the explicit use of inductive proof rules during satisfiability proofs. The main extension over previous techniques for ADT removal is a new transformation rule, called differential replacement, which allows us to introduce auxiliary predicates corresponding to the lemmas that are often needed when making inductive proofs. We present an algorithm that uses the new rule, together with the traditional folding/unfolding transformation rules, for the automatic removal of ADTs. We prove that if the set of the transformed clauses is satisfiable, then so is the set of the original clauses. By an experimental evaluation, we show that the use of the differential replacement rule significantly improves the effectiveness of ADT removal, and we show that our transformation-based approach is competitive with respect to a well-established technique that extends the CVC4 solver with induction.Comment: 10th International Joint Conference on Automated Reasoning (IJCAR 2020) - version with appendix; added DOI of the final authenticated Springer publication; minor correction

Beta Dips in the Gaia Era: Simulation Predictions of the Galactic Velocity Anisotropy Parameter (β) for Stellar Halos

The velocity anisotropy parameter, β, is a measure of the kinematic state of orbits in the stellar halo, which holds promise for constraining the merger history of the Milky Way (MW). We determine global trends for β as a function of radius from three suites of simulations, including accretion-only and cosmological hydrodynamic simulations. We find that the two types of simulations are consistent and predict strong radial anisotropy ($\langle \beta \rangle \sim 0.7$) for Galactocentric radii greater than 10 kpc. Previous observations of β for the MW's stellar halo claim a detection of an isotropic or tangential "dip" at r ~ 20 kpc. Using the N-body+SPH simulations, we investigate the temporal persistence, population origin, and severity of "dips" in β. We find that dips in the in situ stellar halo are long-lived, while dips in the accreted stellar halo are short-lived and tied to the recent accretion of satellite material. We also find that a major merger as early as z ~ 1 can result in a present-day low (isotropic to tangential) value of β over a broad range of radii and angles. While all of these mechanisms are plausible drivers for the β dip observed in the MW, each mechanism in the simulations has a unique metallicity signature associated with it, implying that future spectroscopic surveys could distinguish between them. Since an accurate knowledge of β(r) is required for measuring the mass of the MW halo, we note that significant transient dips in β could cause an overestimate of the halo's mass when using spherical Jeans equation modeling

Care for perinatal illness in rural Nepal: a descriptive study with cross-sectional and qualitative components

BACKGROUND: Maternal, perinatal and neonatal mortality rates remain high in rural areas of developing countries. Most deliveries take place at home and care-seeking behaviour is often delayed. We report on a combined quantitative and qualitative study of care seeking obstacles and practices relating to perinatal illness in rural Makwanpur district, Nepal, with particular emphasis on consultation strategies. METHODS: The analysis included a survey of 8798 women who reported a birth in the previous two years [of whom 3557 reported illness in their pregnancy], on 30 case studies of perinatal morbidity and mortality, and on 43 focus group discussions with mothers, other family members and health workers. RESULTS: Early pregnancy was often concealed, preparation for birth was minimal and trained attendance at birth was uncommon. Family members were favoured attendants, particularly mothers-in-law. The most common recalled maternal complications were prolonged labour, postpartum haemorrhage and retained placenta. Neonatal death, though less definable, was often associated with cessation of suckling and shortness of breath. Many home-based care practices for maternal and neonatal illness were described. Self-medication was common. There were delays in recognising and acting on danger signs, and in seeking care beyond the household, in which the cultural requirement for maternal seclusion, and the perceived expense of care, played a part. Of the 760 women who sought care at a government facility, 70% took more than 12 hours from the decision to seek help to actual consultation. Consultation was primarily with traditional healers, who were key actors in the ascription of causation. Use of the government primary health care system was limited: the most common source of allopathic care was the district hospital. CONCLUSIONS: Major obstacles to seeking care were: a limited capacity to recognise danger signs; the need to watch and wait; and an overwhelming preference to treat illness within the community. Safer motherhood and newborn care programmes in rural communities, must address both community and health facility care to have an impact on morbidity and mortality. The roles of community actors such as mothers-in-law, husbands, local healers and pharmacies, and increased access to properly trained birth attendants need to be addressed if delays in reaching health facilities are to be shortened

Galaxy and mass assembly: the G02 field, Herschel–ATLAS target selection and data release 3

We describe data release 3 (DR3) of the Galaxy And Mass Assembly (GAMA) survey. The GAMA survey is a spectroscopic redshift and multiwavelength photometric survey in three equatorial regions each of 60.0 deg2 (G09, G12, and G15), and two southern regions of 55.7 deg2 (G02) and 50.6 deg2 (G23). DR3 consists of: the first release of data covering the G02 region and of data on H-ATLAS (Herschel – Astrophysical Terahertz Large Area Survey) sources in the equatorial regions; and updates to data on sources released in DR2. DR3 includes 154 809 sources with secure redshifts across four regions. A subset of the G02 region is 95.5 per cent redshift complete to r < 19.8 mag over an area of 19.5 deg2, with 20 086 galaxy redshifts, that overlaps substantially with the XXL survey (X-ray) and VIPERS (redshift survey). In the equatorial regions, the main survey has even higher completeness (98.5 per cent), and spectra for about 75 per cent of H-ATLAS filler targets were also obtained. This filler sample extends spectroscopic redshifts, for probable optical counterparts to HATLAS submillimetre sources, to 0.8 mag deeper (r < 20.6 mag) than the GAMA main survey. There are 25 814 galaxy redshifts for H-ATLAS sources from the GAMA main or filler surveys. GAMA DR3 is available at the survey website (www.gama-survey.org/dr3/)

Galaxy And Mass Assembly (GAMA): the G02 field, Herschel-ATLAS target selection and Data Release 3

We describe data release 3 (DR3) of the Galaxy And Mass Assembly (GAMA) survey. The GAMA survey is a spectroscopic redshift and multi-wavelength photometric survey in three equatorial regions each of 60.0 deg^2 (G09, G12, G15), and two southern regions of 55.7 deg^2 (G02) and 50.6 deg^2 (G23). DR3 consists of: the first release of data covering the G02 region and of data on H-ATLAS sources in the equatorial regions; and updates to data on sources released in DR2. DR3 includes 154809 sources with secure redshifts across four regions. A subset of the G02 region is 95.5% redshift complete to r<19.8 over an area of 19.5 deg^2, with 20086 galaxy redshifts, that overlaps substantially with the XXL survey (X-ray) and VIPERS (redshift survey). In the equatorial regions, the main survey has even higher completeness (98.5%), and spectra for about 75% of H-ATLAS filler targets were also obtained. This filler sample extends spectroscopic redshifts, for probable optical counterparts to H-ATLAS sub-mm sources, to 0.8 mag deeper (r<20.6) than the GAMA main survey. There are 25814 galaxy redshifts for H-ATLAS sources from the GAMA main or filler surveys. GAMA DR3 is available at the survey website (www.gama-survey.org/dr3/)