Protocol for a longitudinal qualitative interview study: maintaining psychological well-being in advanced cancer - what can we learn from patients' and carers' own coping strategies?

IntroductionPeople with advanced cancer and their carers experience stress and uncertainty which affects the quality of life and physical and mental health. This study aims to understand how patients and carers recover or maintain psychological well-being by exploring the strategies employed to self-manage stress and uncertainty.Methods and analysisA longitudinal qualitative interview approach with 30 patients with advanced cancer and 30 associated family or informal carers allows the exploration of contexts, mechanisms and outcomes at an individual level. Two interviews, 4–12?weeks apart, will not only enable the exploration of individuals’ evolving coping strategies in response to changing contexts but also how patients’ and carers’ strategies inter-relate. Patient and Carer focus groups will then consider how the findings may be used in developing an intervention. Recruiting through two major tertiary cancer centres in the North West and using deliberately broad and inclusive criteria will enable the sample to capture demographic and experiential breadth.Ethics and disseminationThe research team will draw on their considerable experience to ensure that the study is sensitive to a patient and carer group, which may be considered vulnerable but still values being able to contribute its views. Public and patient involvement (PPI) is integral to the design and is evidenced by: a research advisory group incorporating patient and carers, prestudy consultations with the PPI group at one of the study sites and a user as the named applicant. The study team will use multiple methods to disseminate the findings to clinical, policy and academic audiences. A key element will be engaging health professionals in patient and carer ideas for promoting self-management of psychological well-being. The study has ethical approval from the North West Research Ethics Committee and the appropriate NHS governance clearance.RegistrationNational Institute for Health Research (NIHR) Clinical Studies Portfolio, UK Clinical Research Network (UKCRN) Study number 11725

PKS 1018-42: A Powerful Kinetically Dominated Quasar

We have identified PKS 1018-42 as a radio galaxy with extraordinarily powerful jets, over twice as powerful as any 3CR source of equal or lesser redshift except for one (3C196). It is perhaps the most intrinsically powerful extragalactic radio source in the, still poorly explored, Southern Hemisphere. PKS 1018-42 belongs to the class of FR II objects that are kinetically dominated, the jet kinetic luminosity, $Q \sim 6.5 \times 10^{46}\mathrm{ergs/s}$ (calculated at 151 MHz), is 3.4 times larger than the total thermal luminosity (IR to X-ray) of the accretion flow, $L_{bol} \sim 1.9 \times 10^{46}\mathrm{ergs/s}$. It is the fourth most kinetically dominated quasar that we could verify from existing radio data. From a review of the literature, we find that kinetically dominated sources such as PKS 1018-42 are rare, and list the 5 most kinetically dominated sources found from our review. Our results for PKS 1018-42 are based on new observations from the Australia Telescope Compact Array.Comment: To appear in ApJ Letter

Effect of an extreme flood event on solute transport and resilience of a mine water treatment system in a mineralised catchment

Extreme rainfall events are predicted to become more frequent with climate change and can have a major bearing on instream solute and pollutant transport in mineralised catchments. The Coledale Beck catchment in north-west England was subject to an extreme rainfall event in December 2015 that equated to a 1 in 200-year event. The catchment contains the UK's first passive metal mine water treatment system, and as such had been subject to intense monitoring of solute dynamics before and after commissioning. Due to this monitoring record, the site provides a unique opportunity to assess the effects of a major storm event on (1) catchment-scale solute transport, and (2) the resilience of the new and novel passive treatment system to extreme events. Monitoring suggests a modest decline in treatment efficiency over time that is not synchronous with the storm event and explained instead by changes in system hydraulic efficiency. There was no apparent flushing of the mine system during the event that could potentially have compromised treatment system performance. Analysis of metal transport in the catchment downstream of the mine suggests relatively subtle changes in instream chemistry with modest but statistically-significant reductions in zinc in the lower catchment irrespective of flow condition after the extreme event, but most parameters of interest show no significant change. Increased export of colloidal iron and aluminium is associated with major landslips in the mid-catchment after the storm and provide fresh sorption sites to attenuate dissolved zinc more rapidly in these locations, corroborated by laboratory experiments utilising site materials to investigate the attenuation/release of metals from stream and terrestrial sediments. The data are important as they show both the resilience of passive mine water treatment systems to extreme events and the importance of catchment-scale monitoring to ensure continued effectiveness of treatment initiatives after major perturbation

Violent behaviour in early psychosis patients: Can we identify clinical risk profiles?

The objective of this study is to explore, within a sample of early psychosis patients (EPP), if subgroups regarding rate of violent behaviour (VB) against others can be identified on the basis of dynamic risk factors (treatment modifiable characteristics). In a sample of 265 EPP, treated at the Treatment and Early Intervention in Psychosis Program in Lausanne, we conducted a latent-class analysis on the basis of the main dynamic VB risk factors (substance use disorder [SUD], positive symptoms, insight, and impulsivity). VB were restricted to "serious violence" and were assessed through patients self-report, interview with relatives or forensic services and with a standardized instrument. The analysis confirmed the heterogeneity of the sample regarding rate of VB. Patients could be stratified within 4 subgroups, 3 of which were at increased risk of VB. The two groups with the highest rates of VB displayed specific clinical profiles. The first one was characterized by high levels of impulsivity, hostility, positive symptoms and SUD, and the second, by low level of insight and low social functioning. These patterns suggest that significant difficulties in social interaction may contribute to the emergence of aggressive reactions against others. Identification of EPP at increased risk of VB seems possible on the basis of dynamic risk factors. If confirmed prospectively, this could pave the way to the development of preventive strategies and specific interventions

The CCSM4 ocean component

Author Posting. © American Meteorological Society, 2012. This article is posted here by permission of American Meteorological Society for personal use, not for redistribution. The definitive version was published in Journal of Climate 25 (2012): 1361–1389, doi:10.1175/JCLI-D-11-00091.1.The ocean component of the Community Climate System Model version 4 (CCSM4) is described, and its solutions from the twentieth-century (20C) simulations are documented in comparison with observations and those of CCSM3. The improvements to the ocean model physical processes include new parameterizations to represent previously missing physics and modifications of existing parameterizations to incorporate recent new developments. In comparison with CCSM3, the new solutions show some significant improvements that can be attributed to these model changes. These include a better equatorial current structure, a sharper thermocline, and elimination of the cold bias of the equatorial cold tongue all in the Pacific Ocean; reduced sea surface temperature (SST) and salinity biases along the North Atlantic Current path; and much smaller potential temperature and salinity biases in the near-surface Pacific Ocean. Other improvements include a global-mean SST that is more consistent with the present-day observations due to a different spinup procedure from that used in CCSM3. Despite these improvements, many of the biases present in CCSM3 still exist in CCSM4. A major concern continues to be the substantial heat content loss in the ocean during the preindustrial control simulation from which the 20C cases start. This heat loss largely reflects the top of the atmospheric model heat loss rate in the coupled system, and it essentially determines the abyssal ocean potential temperature biases in the 20C simulations. There is also a deep salty bias in all basins. As a result of this latter bias in the deep North Atlantic, the parameterized overflow waters cannot penetrate much deeper than in CCSM3.NCAR is sponsored by the National Science Foundation. The CCSM is also sponsored by the Department of Energy. SGY was supported by the NOAA Climate Program Office under Climate Variability and Predictability Program Grant NA09OAR4310163.2012-09-0

Dynamical Stability of Six-Dimensional Warped Brane-Worlds

We study a generalization of the Randall-Sundrum mechanism for generating the weak/Planck hierarchy, which uses two rather than one warped extra dimension, and which requires no negative tension branes. A 4-brane with one exponentially large compact dimension plays the role of the Planck brane. We investigate the dynamical stability with respect to graviton, graviphoton and radion modes. The radion is shown to have a tachyonic instability for certain models of the 4-brane stress-energy, while it is stable in others, and massless in a special case. If stable, its mass is in the milli-eV range, for parameters of the model which solve the hierarchy problem. The radion is shown to couple to matter with gravitational strength, so that it is potentially detectable by submillimeter-range gravity experiments. The radion mass can be increased using a bulk scalar field in the manner of Goldberger and Wise, but only to order MeV, due to the effect of the large extra dimension. The model predicts a natural scale of 10^{13} GeV on the 4-brane, making it a natural setting for inflation from the ultraviolet brane.Comment: 28 pages, 7 figure