Evidence of complex involvement of serotonergic genes with restrictive and binge purge subtypes of anorexia nervosa

Peer reviewedPreprin

Transportation challenges for persons aging with mobility disability: Qualitative insights and policy implications

Background Persons aging with mobility disability (PAwMD) experience transportation barriers, which can hinder their ability to fully participate in society. Despite a vast infrastructure of federal laws and programs designed to ensure access to transportation, PAwMD remain a transportation-disadvantaged population. Objectives This paper presents detailed insights on transportation challenges experienced by PAwMD along with recent Federal programmatic initiatives designed to enhance access and mobility for transportation for older adults and people with disabilities. To identify policy gaps and opportunities to improve transportation services, we compared individual-level challenges from PAwMD to national survey data about barriers associated with delivering transportation services at state and local levels. Methods To assess individual-level transportation challenges, we conducted in-depth, structured interviews with sixty older adult participants with self-identified mobility disabilities for at least 10 years. We also conducted a content analysis of end-user transportation challenges and agency-level transportation coordination barriers to identify correspondences. Results Participants reported challenges utilizing public and private modes of transportation, related to availability; accessibility; safety; advanced planning; as well as societal attitudes. Barriers to the availability, delivery, and coordination of access and mobility services are linked directly or indirectly to the PAwMD reports of experiencing a shortage of accessible transportation options. Conclusions Findings highlight the complexity of federal transportation policies and programmatic initiatives designed to support older adults and people with disabilities, which contribute to implementation barriers and transportation challenges. Results highlight the importance of integrating end-user and state and local provider input into transportation policy development and program implementation

Compressed Sensing MRI Reconstruction Regularized by VAEs with Structured Image Covariance

Objective: This paper investigates how generative models, trained on ground-truth images, can be used \changes{as} priors for inverse problems, penalizing reconstructions far from images the generator can produce. The aim is that learned regularization will provide complex data-driven priors to inverse problems while still retaining the control and insight of a variational regularization method. Moreover, unsupervised learning, without paired training data, allows the learned regularizer to remain flexible to changes in the forward problem such as noise level, sampling pattern or coil sensitivities in MRI. Approach: We utilize variational autoencoders (VAEs) that generate not only an image but also a covariance uncertainty matrix for each image. The covariance can model changing uncertainty dependencies caused by structure in the image, such as edges or objects, and provides a new distance metric from the manifold of learned images. Main results: We evaluate these novel generative regularizers on retrospectively sub-sampled real-valued MRI measurements from the fastMRI dataset. We compare our proposed learned regularization against other unlearned regularization approaches and unsupervised and supervised deep learning methods. Significance: Our results show that the proposed method is competitive with other state-of-the-art methods and behaves consistently with changing sampling patterns and noise levels

An Extremely Bright Echo Associated With SN 2002hh

We present new, very late-time optical photometry and spectroscopy of the interesting Type II-P supernova, SN 2002hh, in NGC 6946. Gemini/GMOS-N has been used to acquire visible spectra at six epochs between 2004 August and 2006 July, following the evolution of the SN from age 661 to 1358 days. Few optical spectra of Type II supernovae with ages greater than one year exist. In addition, g'r'i' images were acquired at all six epochs. The spectral and photometric evolution of SN 2002hh has been very unusual. Measures of the brightness of this SN, both in the R and I bands as well as in the H-alpha emission flux, show no significant fading over an interval of nearly two years. The most straightforward explanation for this behavior is that the light being measured comes not only from the SN itself but also from an echo off of nearby dust. Echoes have been detected previously around several SNe but these echoes, at their brightest, were ~8 mag below the maximum brightness of the SN. At V~21 mag, the putative echo dominates the light of SN 2002hh and is only ~4 mag below the outburst's peak brightness. There is an estimated 6 magnitudes of total extinction in V towards SN 2002hh. The proposed explanation of a differential echo/SN absorption is inconsistent with the observed BVRI colors.Comment: 24 pages, 6 figures. Accepted for publication in the Ap

Dignity, Death, and Dilemma: A Study of Washington Hospices and Physician-Assisted Death

The extensive literature in biomedical ethics on physician-assisted death has represented the debate to involve three parties with significant interests. First, there are arguments regarding the legitimacy of terminally patients seeking to exercise an expanded right of self-determination. Furthermore, questions have been posed regarding the compatibility of a patient request for physician-assisted death with the professional ethics of medicine and of pharmacy, and of the ethics of individual practitioners who may or may not collaborate with this request for a prescription to end the patient’s life. Third, discussion has address the role of the state, which requires assurance in public policy of both patient decision-making capacity and professional accountability to warrant rescinding paternalistic laws that prohibit or restrict patient rights at the end-of-life.Keywords: hospice, death with dignity, hospice ethics, physician-assisted deat

MMT Extremely Metal Poor Galaxy Survey I. An Efficient Technique to Identify Metal Poor Galaxies

We demonstrate a successful strategy for identifying extremely metal poor galaxies. Our preliminary survey of 24 candidates contains 10 metal poor galaxies of which 4 have 12+log(O/H)<7.65, some of the lowest metallicity blue compact galaxies known to date. Interestingly, our sample of metal poor galaxies have systematically lower metallicity for their luminosity than comparable samples of blue compact galaxies, dIrrs, and normal star-forming galaxies. Our metal poor galaxies share very similar properties, however, with the host galaxies of nearby long-duration gamma-ray bursts (GRBs), including similar metallicity, stellar ages, and star formation rates. We use H\beta to measure the number of OB stars present in our galaxies and estimate a core-collapse supernova rate of ~10^-3 yr^-1. A larger sample of metal poor galaxies may provide new clues into the environment where GRBs form and may provide a list of potential GRB hosts.Comment: Accepted to AJ, 8 pages using emulateap

Pilot clinical observations between food and drug seeking derived from fifty cases attending an eating disorder clinic

Background The reward deficiency syndrome hypothesis posits that genes are responsible for reward dependence and related behaviors. There is evidence that both bulimia and anorexia nervosa, especially in women, have been linked to a lifetime history of substance use disorder (SUD). There are difficulties in accepting food as an addiction similar to drugs; however, increasingly neuroimaging studies favor such an assertion. Case presentations We are reporting the evidence of comorbidity of eating disorders with SUD found within these case presentations. We show 50 case reports derived from two independent treatment centers in Florida that suggest the commonality between food and drug addictions. In an attempt to provide data from this cohort, many participants did not adequately respond to our questionnaire. Discussion We propose that dopamine agonist therapy may be of common benefit. Failure in the past may reside in too powerful D2 agonist activity leading to D2 receptor downregulation, while the new methodology may cause a reduction of “dopamine resistance” by inducing “dopamine homeostasis.” While this is not a definitive study, it does provide some additional clinical evidence that these two addictions are not mutually exclusive. Conclusion Certainly, it is our position that there is an overlap between food- and drug-seeking behavior. We propose that the studies focused on an effort to produce natural activation of dopaminergic reward circuitry as a type of common therapy may certainly be reasonable. Additional research is warranted

Childbearing practices in Kanadier Mennonite Women

© Canadian Nurses Association. Reproduced with permission. Further reproduction is prohibited.Cross-cultural nursing practices call for attention to be paid to the unique beliefs and practices of the groups with which nurses come in contact. The Kanadier Mennonites are a conservative religious group who live in Alberta, Manitoba and Ontario. An exploratory, descriptive study was conducted with this group in southern Alberta to generate information about their health and illness beliefs. This article focuses on their knowledge, beliefs and practices in relation to childbearing interviews were conducted with 45 women, the majority of whom were married and had been born in Mexico. Among the sample there had been a range of one to 16 pregnancies. The participants noted that childbearing Is not a topic openly discussed with others. Women learn about childbearing from their mothers and other women but also from physicians and books. During pregnancy there are particular activities to be avoided including the use of strong cleaning fluids and hand milking of cows. Foods such as milk need to be ingested to ensure a healthy pregnancy. Prenatal care was not emphasized in Mexico nor has it become a customary practice in Canada but deliveries in hospital are the norm in both these countries. During the postpartum the women receive support from their immediate and extended family in order to recuperate. Nurses need to explore individual Kanadier Mennonite beliefs regarding childbearing and work with this group in developing acceptable health promotion programs to help ensure healthy pregnancy outcomes. The blending of nursing practice knowledge in a non-intrusive manner with a group of people with differing belief systems is a necessary and achievable goal.Ye

Evaluation of different recruitment and randomisation methods in a trial of general practitioner-led interventions to increase physical activity: a randomised controlled feasibility study with factorial design

Comparative StudyJournal ArticleMulticenter StudyRandomized Controlled TrialThis is a freely-available open access publication. Please cite the published version which is available via the DOI link in this record.There is another ORE record for this publication: http://hdl.handle.net/10871/39760BACKGROUND: Interventions promoting physical activity by General Practitioners (GPs) lack a strong evidence base. Recruiting participants to trials in primary care is challenging. We investigated the feasibility of (i) delivering three interventions to promote physical activity in inactive participants and (ii) different methods of participant recruitment and randomised allocation. METHODS: We recruited general practices from Devon, Bristol and Coventry. We used a 2-by-2 factorial design for participant recruitment and randomisation. Recruitment strategies were either opportunistic (approaching patients attending their GP surgery) or systematic (selecting patients from practice lists and approaching them by letter). Randomisation strategies were either individual or by practice cluster. Feasibility outcomes included time taken to recruit the target number of participants within each practice. Participants were randomly allocated to one of three interventions: (i) written advice (control); (ii) brief GP advice (written advice plus GP advice on physical activity), and (iii) brief GP advice plus a pedometer to self-monitor physical activity during the trial. Participants allocated to written advice or brief advice each received a sealed pedometer to record their physical activity, and were instructed not to unseal the pedometer before the scheduled day of data collection. Participant level outcomes were reported descriptively and included the mean number of pedometer steps over a 7-day period, and European Quality of Life (EuroQoL)-5 dimensions (EQ-5D) scores, recorded at 12 weeks' follow-up. RESULTS: We recruited 24 practices (12 using each recruitment method; 18 randomising by cluster, 6 randomising by individual participant), encompassing 131 participants. Opportunistic recruitment was associated with less time to target recruitment compared with systematic (mean difference (days) -54.9, 95% confidence interval (CI) -103.6; -6.2) but with greater loss to follow up (28.8% versus. 6.9%; mean difference 21.9% (95% CI 9.6%; 34.1%)). There were differences in the socio-demographic characteristics of participants according to recruitment method. There was no clear pattern of change in participant level outcomes from baseline to 12 weeks across the three arms. CONCLUSIONS: Delivering and trialling GP-led interventions to promote physical activity is feasible, but trial design influences time to participant recruitment, participant withdrawal, and possibly, the socio-demographic characteristics of participants. TRIAL REGISTRATION NUMBER: ISRCTN73725618.Medical Research Counci