Lifting the veil of depression and alcoholism in sport coaching: how do we care for carers?

The purpose of this article is to explore the insights of an elite sport coach living with comorbid depression and alcohol misuse. Such consideration is necessary because as coaching is increasingly repositioned as a caring activity the wellbeing of coaches themselves has rarely been considered. To address this gap, a narrative analysis methodology and a story telling approach was used to present the experiences of a case study coach (Steve). The story is derived from Steve’s own perspective and the perspective of his wife, Jane. This novel multi-voiced approach reveals the complex interplay between the sporting environment, Steve’s depression and his alcohol related problems. In doing so, Steve’s story makes an original contribution by unveiling the issue of mental health in elite sport coaching. Steve’s story depicts the significant impact of depressive symptoms, coupled by excessive alcohol use on a coach, their personal life, and their career. Using the work of Goffman and Sartre, the story alludes to how such symptoms can be hidden, to greater and lesser extents, from professional colleagues. This is an important theoretical contribution, because to care for coaches, colleagues, employers, and health professionals will need to understand the needs of individuals such as Steve. Developing an open and supportive culture, which accepts that coaches are fallible, may however be a challenge within professional sport contexts

Monolithically integrated heterodyne optical phase-lock loop with RF XOR phase detector

We present results for an heterodyne optical phase-lock loop (OPLL), monolithically integrated on InP with external phase detector and loop filter, which phase locks the integrated laser to an external source, for offset frequencies tuneable between 0.6 GHz and 6.1 GHz. The integrated semiconductor laser emits at 1553 nm with 1.1 MHz linewidth, while the external laser has a linewidth less than 150 kHz. To achieve high quality phase locking with lasers of these linewidths, the loop delay has been made less than 1.8 ns. Monolithic integration reduces the optical path delay between the laser and photodiode to less than 20 ps. The electronic part of the OPLL was implemented using a custom-designed feedback circuit with a propagation delay of similar to 1 ns and an open-loop bandwidth greater than 1 GHz. The heterodyne signal between the locked slave laser and master laser has phase noise below. 90 dBc/Hz for frequency offsets greater than 20 kHz and a phase error variance in 10 GHz bandwidth of 0.04 rad(2). (C) 2011 Optical Society of Americ

Multi-proxy record of ocean-climate variability during the last two millennia on the Mackenzie Shelf, Beaufort Sea

A 2,000 year-long oceanographic history, in sub-centennial resolution, from a Canadian Beaufort Sea continental shelf site (60 meters water depth) near the Mackenzie River outlet is reconstructed from ostracode and foraminifera faunal assemblages, shell stable isotopes (δ18O, δ13C) and sediment biogenic silica. The chronology of three sediment cores making up the composite section was established using 137Cs and 210Pb dating for the most recent 150 years and combined with linear interpolation of radiocarbon dates from bivalve shells and foraminifera tests. Continuous centimeter-sampling of the multicore and high-resolution sampling of a gravity and piston core yielded a time-averaged faunal record of every ~40 years from 0 to 1850 CE and every ~24 years from 1850 to 2013 CE. Proxy records were consistent with temperature oscillations and related changes in organic carbon cycling associated with the Medieval Climate Anomaly (MCA) and the Little Ice Age (LIA). Abundance changes in dominant microfossil species, such as the ostracode Paracyprideis pseudopunctillata and agglutinated foraminifers Spiroplectammina biformis and S. earlandi, are used as indicators of less saline, and possibly corrosive/turbid bottom conditions associated with the MCA (~800-1200 CE) and the most recent ~60 years (1950-2013). During these periods, pronounced fluctuations in these species suggest that prolonged seasonal sea-ice melting, changes in riverine inputs and sediment dynamics affected the benthic environment. Taxa analyzed for stable oxygen isotope composition of carbonates show the lowest δ18O values during intervals within the MCA and the highest during the late LIA, which is consistent with a 1° to 2°C cooling of bottom waters. Faunal and isotopic changes during the cooler LIA (1300-1850 CE) are most apparent at ~1500-1850 CE and are particularly pronounced during 1850 to ~1900 CE, with a ~0.5 per mil increase in δ18O values of carbonates from median values in the analyzed taxa. This very cold 50-year period suggests that enhanced summer sea ice suppressed productivity, which is indicated by low sediment biogenic silica values and lower δ13C values in analyzed species. From 1900 CE to present, declines in calcareous faunal assemblages and changes in dominant species (Cassidulina reniforme and P. pseudopunctillata) are associated with less hospitable bottom waters, indicated by a peak in agglutinated foraminifera from 1950-1990 CE

Ocean temperature and salinity components of the Madden-Julian oscillation observed by Argo floats

New diagnostics of the Madden-Julian Oscillation (MJO) cycle in ocean temperature and, for the first time, salinity are presented. The MJO composites are based on 4 years of gridded Argo float data from 2003 to 2006, and extend from the surface to 1,400 m depth in the tropical Indian and Pacific Oceans. The MJO surface salinity anomalies are consistent with precipitation minus evaporation fluxes in the Indian Ocean, and with anomalous zonal advection in the Pacific. The Argo sea surface temperature and thermocline depth anomalies are consistent with previous studies using other data sets. The near-surface density changes due to salinity are comparable to, and partially offset, those due to temperature, emphasising the importance of including salinity as well as temperature changes in mixed-layer modelling of tropical intraseasonal processes. The MJO-forced equatorial Kelvin wave that propagates along the thermocline in the Pacific extends down into the deep ocean, to at least 1,400 m. Coherent, statistically significant, MJO temperature and salinity anomalies are also present in the deep Indian Ocean

Does clinical method mask significant VTE-related mortality and morbidity in malignant disease?

After more than 150 years of a recognised link between cancer and vascular thromboembolic events (VTE), and despite a greatly improved understanding of its pathophysiology, epidemiology and treatment, the management of patients with cancer and VTE is still limited. Limitations can be related to the thromboembolism itself, the underlying cancer, or to the management process. There is significant literature that deals with the first two, but very little regarding the systems we use, or how the inadequacies in documentation, identification and classification of VTE affect the cancer patients themselves. This review aims to raise awareness of this neglected area and stimulate research that may lead to improvements in patient care

Inter-hemispheric EEG coherence analysis in Parkinson's disease : Assessing brain activity during emotion processing

Parkinson’s disease (PD) is not only characterized by its prominent motor symptoms but also associated with disturbances in cognitive and emotional functioning. The objective of the present study was to investigate the influence of emotion processing on inter-hemispheric electroencephalography (EEG) coherence in PD. Multimodal emotional stimuli (happiness, sadness, fear, anger, surprise, and disgust) were presented to 20 PD patients and 30 age-, education level-, and gender-matched healthy controls (HC) while EEG was recorded. Inter-hemispheric coherence was computed from seven homologous EEG electrode pairs (AF3–AF4, F7–F8, F3–F4, FC5–FC6, T7–T8, P7–P8, and O1–O2) for delta, theta, alpha, beta, and gamma frequency bands. In addition, subjective ratings were obtained for a representative of emotional stimuli. Interhemispherically, PD patients showed significantly lower coherence in theta, alpha, beta, and gamma frequency bands than HC during emotion processing. No significant changes were found in the delta frequency band coherence. We also found that PD patients were more impaired in recognizing negative emotions (sadness, fear, anger, and disgust) than relatively positive emotions (happiness and surprise). Behaviorally, PD patients did not show impairment in emotion recognition as measured by subjective ratings. These findings suggest that PD patients may have an impairment of inter-hemispheric functional connectivity (i.e., a decline in cortical connectivity) during emotion processing. This study may increase the awareness of EEG emotional response studies in clinical practice to uncover potential neurophysiologic abnormalities

Epstein-Barr virus myelitis and Castleman's disease in a patient with acquired immune deficiency syndrome: a case report

<p>Abstract</p> <p>Introduction</p> <p>Few cases of Epstein-Barr virus myelitis have been described in the literature. Multi-centric Castleman's disease is a lymphoproliferative disorder that is well known for its associations with the human immunodeficiency virus, human herpes virus 8, and Kaposi's sarcoma. The concurrent presentation of these two diseases in a patient at the same time is extremely unusual.</p> <p>Case Presentation</p> <p>We describe the case of a 43-year-old Caucasian man with acquired immune deficiency syndrome who presented with fever, weight loss and diffuse lymphadenopathy, and was diagnosed with multi-centric Castleman's disease. He presented three weeks later with lower extremity weakness and urinary retention, at which time cerebrospinal fluid contained lymphocytic pleocytosis and elevated protein. Magnetic resonance imaging demonstrated abnormal spinal cord signal intensity over several cervical and thoracic segments, suggesting the diagnosis of myelitis. Our patient was ultimately diagnosed with Epstein-Barr virus myelitis, as Epstein-Barr virus DNA was detected by polymerase chain reaction in the cerebrospinal fluid.</p> <p>Conclusion</p> <p>To the best of our knowledge, this is the first case of multi-centric Castleman's disease followed by acute Epstein-Barr virus myelitis in a human immunodeficiency virus-infected patient. Clinicians caring for human immunodeficiency virus-infected patients should be vigilant about monitoring patients with increasing lymphadenopathy, prompting thorough diagnostic investigations when necessary.</p