Talking about sex after Traumatic Brain Injury: perceptions and experiences of professionals

Background: Research indicates that although 50-60% of people who have had a traumatic brain injury (TBI) experience changes in sexual functioning, sexuality issues remain largely unaddressed in rehabilitation. Studies have investigated professionals’ perspectives about communicating about sexual issues with service-users2 post-TBI, with a number of barriers being identified. However, as studies have tended to use quantitative methodologies, it was felt that qualitative research would provide a richer understanding. Aim: This study aimed to explore professionals’ perceptions and experiences of discussing sexuality with service-users who have had a TBI. Method: This study employed a qualitative design. Purposeful sampling was used to recruit 24 participants from two local National Health Service (NHS) trusts, and from a national charity. Four focus groups were carried out with pre-existing teams of professionals, using a semi-structured interview schedule. Focus group data were transcribed verbatim and analysed using thematic analysis. Results: Six main themes were derived from the analysis: 1) Sexuality after TBI is a specialist issue; 2) Sexuality is a sensitive subject; 3) Practicalities of discussing sexuality; 4) Roles and responsibilities; 5) Dilemmas about risk and vulnerabilities, and 6) Organisational and structural factors. Each of these themes have between two and five subthemes. Conclusions and recommendations: In order that sexuality becomes accepted as an integral part of holistic rehabilitation, it is recommended that a more proactive approach is taken. It is recommended that sexuality is incorporated into assessments, and that written information is available for service-users. Support for professionals is also needed in the form of the development of policy, on-going training, and supervision

Versatile, Cheap, Readily Modifiable Sample Delivery Method for Analysis of Air-/Moisture-Sensitive Samples Using Atmospheric Pressure Solids Analysis Probe Mass Spectrometry

A cheap, versatile, readily modified, and reusable glass probe system enabling delivery of solid air-/moisture-sensitive samples for mass spectrometric (MS) analysis using an Atmospheric pressure Solids Analysis Probe (ASAP) is described. The simplicity of the design allows quick and easy ASAP MS analyses of sensitive solid and liquid samples without the need for any modifications to commercially available vertically loaded ASAP mass spectrometers. A comparison of ASAP mass spectra obtained for metal complexes under air and an inert atmosphere is given

Evaluation of Parental Phone Calls to Cardiac Services

Background: Heart defects are the most common congenital anomaly in babies born in the UK. Standards set by NHS England (2016) state children with a confirmed cardiac abnormality will have ongoing access to a children’s cardiac specialist nurse telephone advice service for patients/families/carers. Currently there is little published information to describe the workload associated with ongoing support for families following discharge from hospital by Clinical Nurse Specialist (CNS) teams and other health care professionals (HCP). Aim: to review phone calls received by HCP working in cardiac services in a tertiary children’s hospital from parents following discharge from hospital. To include: the number of calls, which service(s) received the calls, nature of queries and the time spent on telephone enquiries. Method A data collection tool to capture information about parent phone calls was developed, piloted and implemented for use with cardiac secretaries, two inpatient cardiac wards areas, cardiac outpatients department and Clinical Nurse Specialist (CNS) office (CNS and family support workers) (April-May 2019). The work was classed as service evaluation and registered on the organisation audit database. Data was entered into a secure database and analysed using descriptive statistics and thematic analysis. Results In a 3 week period 119 telephone calls were documented; 41% (n=49) received by CNS office, 28% (n=34) by secretaries, 18% (n=21) by cardiac ward staff and 13% (n=15) by cardiac outpatient department (OPD). In total (across all HCP groups) 11 hours of time was spent taking phone calls; 0.8hrs (OPD), 1.6 (ward staff), 2.6hrs (secretaries) and 6hrs (CNS). This did not include time to deal with any action required as a result of the calls. The biggest reason for phone calls related to appointments (n=27, * %) although the majority of these were appropriately directed to secretaries and medications 34 (*%). 15 calls related to repeat prescriptions or problems obtaining specialist medications and 14 concerned medication dose, duration and potential error. Conclusion HCP working across cardiac services experience a high volume of telephone calls from parents. Telephone calls associated with prescriptions, obtaining medications and medicine administration were prevalent. Further research is being conducted to identify the time implications of dealing with these phone calls, staff confidence in advising on these issues and families views on the discharge process

External beam radiation therapy and enadenotucirev: inhibition of the DDR and mechanisms of radiation-mediated virus increase

Ionising radiation causes cell death through the induction of DNA damage, particularly double-stranded DNA (dsDNA) breaks. Evidence suggests that adenoviruses inhibit proteins involved in the DNA damage response (DDR) to prevent recognition of double-stranded viral DNA genomes as cellular dsDNA breaks. We hypothesise that combining adenovirus treatment with radiotherapy has the potential for enhancing tumour-specific cytotoxicity through inhibition of the DDR and augmentation of virus production. We show that EnAd, an Ad3/Ad11p chimeric oncolytic adenovirus currently being trialled in colorectal and other cancers, targets the DDR pathway at a number of junctures. Infection is associated with a decrease in irradiation-induced 53BP1 and Rad51 foci formation, and in total DNA ligase IV levels. We also demonstrate a radiation-associated increase in EnAd production in vitro and in a pilot in vivo experiment. Given the current limitations of in vitro techniques in assessing for synergy between these treatments, we adapted the plaque assay to allow monitoring of viral plaque size and growth and utilised the xCELLigence cell adhesion assay to measure cytotoxicity. Our study provides further evidence on the interaction between adenovirus and radiation in vitro and in vivo and suggests these have at least an additive, and possibly a synergistic, impact on cytotoxicity

Talking about sex after traumatic brain injury: perceptions and experiences of multidisciplinary rehabilitation professionals

Purpose: Research indicates that although 50–60% of people who have had a traumatic brain injury (TBI) experience changes in sexual functioning, sexuality issues remain largely unaddressed in rehabilitation. This study aimed to explore rehabilitation professionals’ perceptions and experiences of discussing sexuality with service-users who have had a TBI. Method: Purposeful sampling was used to recruit 24 participants from two local National Health Service trusts and from a national charity. Four focus groups were conducted with pre-existing groups of professionals, using a semi-structured interview schedule. Focus group data were transcribed verbatim and analysed using thematic analysis. Results: Six main themes were derived from the analysis: (1) sexuality after TBI is a specialist issue; (2) sexuality is a sensitive subject; (3) practicalities of discussing sexuality; (4) roles and responsibilities; (5) dilemmas about risk and vulnerabilities; and (6) organisational and structural issues. Conclusions: Our findings suggest that a more proactive approach to addressing sexuality issues be taken by incorporating sexuality into assessments and by having sexuality information available for service-users. Support for professionals is also needed in the form of the development of policy, on-going training and supervision

System parameters of three short-period cataclysmic variable stars

Using photometric ULTRACAM observations of three new short period cataclysmic variables, we model the primary eclipse lightcurves to extract the orbital separation, masses, and radii of their component stars. We find donor masses of 0.060 +/- 0.008 solar masses, 0.042 +/- 0.001 solar masses, and 0.042 +/- 0.004 solar masses, two being very low-mass sub-stellar donors, and one within 2 sigma of the hydrogen burning limit. All three of the new systems lie close to the modified, "optimal" model evolutionary sequence of Knigge et al. (2011). We briefly re-evaluate the long-standing discrepancy between observed donor mass and radius data, and theoretical CV evolutionary tracks. By looking at the difference in the observed period at each mass and the period predicted by the Knigge et al. (2011) evolutionary sequence, we qualitatively examine the form of excess angular momentum loss that is missing from the models below the period gap. We show indications that the excess angular momentum loss missing from CV models grows in importance relative to gravitational losses as the period decreases. Detailed CV evolutionary models are necessary to draw more quantitative conclusions in the future

Characterising eclipsing white dwarf M dwarf binaries from multi-band eclipse photometry

With the prevalence of wide-field, time-domain photometric sky surveys, the number of eclipsing white dwarf systems being discovered is increasing dramatically. An efficient method to follow these up will be key to determining any population trends and finding any particularly interesting examples. We demonstrate that multi-band eclipse photometry of binaries containing a white dwarf and an M dwarf can be used to determine the masses and temperatures of the white dwarfs to better than 5 per cent. For the M dwarfs we measure their parameters to a precision of better than 6 per cent with the uncertainty dominated by the intrinsic scatter of the M dwarf mass-radius relationship. This precision is better than what can typically be achieved with low-resolution spectroscopy. The nature of this method means that it will be applicable to LSST data in the future, enabling direct characterisation without follow-up spectroscopy. Additionally, we characterise three new post-common-envelope binaries from their eclipse photometry, finding two systems containing hot helium-core white dwarfs with low-mass companions (one near the brown dwarf transition regime) and a possible detached cataclysmic variable at the lower edge of the period gap

Spectroscopic and photometric periods of six ultracompact accreting binaries

Ultracompact accreting binary systems each consist of a stellar remnant accreting helium-enriched material from a compact donor star. Such binaries include two related sub-classes, AM CVn-type binaries and helium cataclysmic variables, in both of which the central star is a white dwarf. We present a spectroscopic and photometric study of six accreting binaries with orbital periods in the range of 40--70 min, including phase-resolved VLT spectroscopy and high-speed ULTRACAM photometry. Four of these are AM CVn systems and two are helium cataclysmic variables. For four of these binaries we are able to identify orbital periods (of which three are spectroscopic). SDSS J1505+0659 has an orbital period of 67.8 min, significantly longer than previously believed, and longer than any other known AM CVn binary. We identify a WISE infrared excess in SDSS J1505+0659 that we believe to be the first direct detection of an AM CVn donor star in a non-direct impacting binary. The mass ratio of SDSS J1505+0659 is consistent with a white dwarf donor. CRTS J1028-0819 has an orbital period of 52.1 min, the shortest period of any helium cataclysmic variable. MOA 2010-BLG-087 is co-aligned with a K-class star that dominates its spectrum. ASASSN-14ei and ASASSN-14mv both show a remarkable number of echo outbursts following superoutbursts (13 and 10 echo outbursts respectively). ASASSN-14ei shows an increased outburst rate over the years following its superoutburst, perhaps resulting from an increased accretion rate

An Eclipsing 47 minute Double White Dwarf Binary at 400 pc

We present the discovery of the eclipsing double white dwarf (WD) binary WDJ 022558.21-692025.38 that has an orbital period of 47.19 min. Following identification with the Transiting Exoplanet Survey Satellite, we obtained time-series ground based spectroscopy and high-speed multi-band ULTRACAM photometry which indicate a primary DA WD of mass 0.40 +- 0.04 Msol and a 0.28 +- 0.02 Msol mass secondary WD, which is likely of type DA as well. The system becomes the third-closest eclipsing double WD binary discovered with a distance of approximately 400 pc and will be a detectable source for upcoming gravitational wave detectors in the mHz frequency range. Its orbital decay will be measurable photometrically within 10 yrs to a precision of better than 1%. The fate of the binary is to merge in approximately 41 Myr, likely forming a single, more massive WD.Comment: Accepted for publication in MNRAS, 8 pages + 2 appendix pages, 6 figure

The evolutionary status of Cataclysmic Variables: Eclipse modelling of 15 systems

We present measurements of the component masses in 15 Cataclysmic Variables (CVs) - 6 new estimates and 9 improved estimates. We provide new calibrations of the relationship between superhump period excess and mass ratio, and use this relation to estimate donor star masses for 225 superhumping CVs. With an increased sample of donor masses we revisit the implications for CV evolution. We confirm the high mass of white dwarfs in CVs, but find no trend in white dwarf mass with orbital period. We argue for a revision in the location of the orbital periodminimum of CVs to 79.6±0.2min, significantly shorter than previous estimates. We find that CV donors below the gap have an intrinsic scatter of only 0.005 R⊙ around a common evolutionary track, implying a correspondingly small variation in angular momentum loss (AML) rates. In contrast to prior studies, we find that standard CV evolutionary tracks - without additional AML - are a reasonable fit to the donor masses just below the period gap, but that they do not reproduce the observed period minimum, or fit the donor radii below 0.1M⊙. © 2019 The Author(s) Published by Oxford University Press on behalf of the Royal Astronomical Society