Characteristics of patients with haematological and breast cancer (1996–2009) who died of heart failure-related causes after cancer therapy

Aims: To describe the characteristics and time to death of patients with breast or haematological cancer who died of heart failure (HF) after cancer therapy. Patients with an index admission for HF who died of HF-related causes (IAHF) and those with no index admission for HF who died of HF-related causes (NIAHF) were compared. Methods and results: We performed a linked data analysis of cancer registry, death registry, and hospital administration records (n = 15 987). Index HF admission must have occurred after cancer diagnosis. Of the 4894 patients who were deceased (30.6% of cohort), 734 died of HF-related causes (50.1% female) of which 279 (38.0%) had at least one IAHF (41.9% female) post-cancer diagnosis. Median age was 71 years [interquartile range (IQR) 62–78] for IAHF and 66 years (IQR 56–74) for NIAHF. There were fewer chemotherapy separations for IAHF patients (median = 4, IQR 2–9) compared with NIAHF patients (median = 6, IQR 2–12). Of the IAHF patients, 71% had died within 1 year of the index HF admission. There was no significant difference in HF-related mortality in IAHF patients compared with NIAHF (HR, 1.10, 95% CI, 0.94–1.29, P = 0.225). Conclusions: The profile of IAHF patients who died of HF-related causes after cancer treatment matched the current profile of HF in the general population (over half were aged ≥70 years). However, NIAHF were younger (62% were aged ≤69 years), female patients with breast cancer that died of HF-related causes before hospital admission for HF-related causes—a group that may have been undiagnosed or undertreated until death

Investigating energetic electron precipitation through combining ground-based and balloon observations

A detailed comparison is undertaken of the energetic electron spectra and fluxes of two precipitation events that were observed in 18/19 January 2013. A novel but powerful technique of combining simultaneous ground-based subionospheric radio wave data and riometer absorption measurements with X-ray fluxes from a Balloon Array for Relativistic Radiation-belt Electron Losses (BARREL) balloon is used for the first time as an example of the analysis procedure. The two precipitation events are observed by all three instruments, and the relative timing is used to provide information/insight into the spatial extent and evolution of the precipitation regions. The two regions were found to be moving westward with drift periods of 5–11 h and with longitudinal dimensions of ~20° and ~70° (1.5–3.5 h of magnetic local time). The electron precipitation spectra during the events can be best represented by a peaked energy spectrum, with the peak in flux occurring at ~1–1.2 MeV. This suggests that the radiation belt loss mechanism occurring is an energy-selective process, rather than one that precipitates the ambient trapped population. The motion, size, and energy spectra of the patches are consistent with electromagnetic ion cyclotron-induced electron precipitation driven by injected 10–100 keV protons. Radio wave modeling calculations applying the balloon-based fluxes were used for the first time and successfully reproduced the ground-based subionospheric radio wave and riometer observations, thus finding strong agreement between the observations and the BARREL measurements

Measuring Gas Accretion and Angular Momentum near Simulated Supermassive Black Holes

Using cosmological simulations with a dynamic range in excess of 10 million, we study the transport of gas mass and angular momentum through the circumnuclear region of a disk galaxy containing a supermassive black hole (SMBH). The simulations follow fueling over relatively quiescent phases of the galaxy's evolution (no mergers) and without feedback from active galactic nuclei (AGNs), as part of the first stage of using state-of-the-art, high-resolution cosmological simulations to model galaxy and black hole co-evolution. We present results from simulations at different redshifts (z=6, 4, and 3) and three different black hole masses (30 million, 90 million, and 300 million solar masses; at z=4), as well as a simulation including a prescription that approximates optically thick cooling in the densest regions. The interior gas mass throughout the circumnuclear disk shows transient and chaotic behavior as a function of time. The Fourier transform of the interior gas mass follows a power law with slope -1 throughout the region, indicating that, in the absence of the effects of galaxy mergers and AGN feedback, mass fluctuations are stochastic with no preferred timescale for accretion over the duration of each simulation (~ 1-2 Myr). The angular momentum of the gas disk changes direction relative to the disk on kiloparsec scales over timescales less than 1 Myr, reflecting the chaotic and transient gas dynamics of the circumnuclear region. Infalling clumps of gas, which are driven inward as a result of the dynamical state of the circumnuclear disk, may play an important role in determining the spin evolution of an SMBH, as has been suggested in stochastic accretion scenarios.Comment: 13 pages, 10 figures; accepted to ApJ; corrected minor typos and reference error

Rich pictures for stakeholder dialogue:A polyphonic picture book

We describe the design and use of a ‘polyphonic picture book’ for engaging stakeholders and research participants with findings from an interdisciplinary project investigating how UK citizens create and manage online identities at three significant life transitions. The project delivered socio-cultural and technical findings to inform policy-making and service innovation for enhancing digital literacy in online self-representation. The picture book presented findings through multi-perspectival, fictional scenarios about experiences of life transition. We describe our use of the book with our stakeholders in five workshop settings and our evaluation of the visual format for fostering stakeholder dialogue around the findings and their transferability. This paper contributes methodological insights about using visual storytelling to scaffold interpretative, dialogical contexts of research engagement

Defining Professional Self: Teacher Educator Perspectives of the Pre-ECR Journey.

This paper examines the situations of four teacher educators working within academic contexts, but who do not as yet qualify as early career researchers (ECRs) by definition. Within this paper, we define this group as ‘pre-ECRs’; those working and teaching within contexts of academia whilst undertaking a PhD or similar higher education qualification. Critical comparative analysis is used to examine the nexus between what is currently known about becoming an ECR and narrative accounts of the authors’ experiences of negotiating Faculty expectations for research output, teaching and postgraduate study. This approach provides rich insight into what happens prior to and during the initial stages of what we define as the pre-ECR journey. Through the examination of our storied experiences within the context of the existing body of knowledge, the implications of not being able to locate ourselves within a distinctive and appropriate professional identity become apparent. This paper offers a unique insight as it is researched from the perspectives of four pre-ECRs working within an Australian University Faculty of Education. This is valuable given that current research around ECRs provides minimal insight into experiences and challenges unique to those working toward ECR status

Nightingallery: theatrical framing and orchestration in participatory performance

The Nightingallery project encouraged participants to converse, sing, and perform with a musically responsive animatronic bird, playfully interacting with the character while members of the public could look on and observe. We used Nightingallery to frame an HCI investigation into how people would engage with one another when confronted with unfamiliar technologies in conspicuously public, social spaces. Structuring performances as improvisational street theatre, we styled our method of exhibiting the bird character. We cast ourselves in supporting roles as carnival barkers and minders of the bird, presenting him as if he were a fantastical creature in a fairground sideshow display, allowing him the agency to shape and maintain dialogues with participants, and positioning him as the focal character upon which the encounter was centred. We explored how the anthropomorphic nature of the bird itself, along with the cultural connotations associated with the carnival/sideshow tradition helped signpost and entice participants through the trajectory of their encounters with the exhibit. Situating ourselves as secondary characters within the narrative defining the performance/use context, our methods of mediation, observation, and evaluation were integrated into the performance frame. In this paper, we explore recent HCI theories in mixed reality performance to reflect upon how genre-based cultural connotations can be used to frame trajectories of experience, and how manipulation of roles and agency in participatory performance can facilitate HCI investigation of social encounters with playful technologies. © 2014 Springer-Verlag London

The word-level prosody of Samoan

This paper documents and analyses stress and vowel length in Samoan words. The domain of footing, the Prosodic Word, appears to be a root and cohering suffixes; prefixes and most disyllabic suffixes form a separate domain. Vowel sequences that disrupt the normal stress pattern require constraints matching sonority prominence to metrical prominence, sensitive to degree of mismatch and to the number of vowels involved. Two suffixes unexpectedly have an idiosyncratic footing constraint, observable only in a limited set of words. We also discuss trochaic shortening and its asymmetrical productivity, and the marginal contrastiveness of some features in loans. While Samoan does not appear to be typologically unusual, it does offer arguments (i) in favour of alignment constraints on Prosodic Words rather than only on feet directly, and (ii) against simple cyclicity. Some of the strongest evidence comes from stress patterns of the rich inventory of phonotactically licit vowel sequences

Early Education and Employment Outcomes After Cancer in Adolescents and Young Adults

Purpose: This study describes the early educational and vocational outcomes of Australian adolescents and young adults (AYAs) after cancer diagnosis and examines factors associated with these outcomes. Methods: Within this cross-sectional national Australian study, 196 AYAs aged 15-25 years at cancer diagnosis and within 6-24 months of diagnosis were recruited from 18 sites. Participants completed a survey that included questions about school and work outcomes, support received regarding necessary changes to education and vocation, and validated measures of anxiety, depression, and post-traumatic stress. Results: Almost half of the sample (43%) was not fully "back on track" with their previous educational and vocational plans. Post-traumatic stress and emotional symptoms were associated with poorer school/work functioning (beta = -0.95, p = 0.009 and beta = -1.27, p = 0.001, respectively). Higher PedsQL school/work functioning was associated with a slightly greater likelihood of being "back on track" with education and work plans (OR 1.03, p = 0.001). AYAs who felt well supported regarding changes to education and work plans more frequently reported receiving support from formal sources and from more sources than those who felt less supported. Unmet need of accessing an educational or vocational advisor was significantly more frequent in adult than in pediatric settings (42% vs. 17%; p = 0.024). Parents were the most common source of educational or vocational support for AYAs rather than professionals. Conclusion: This study highlights the connection between school and work participation and mental health in a national sample of AYAs with cancer. It suggests distinct benefits of educational and vocational support.Peer reviewe

Financial Challenges of Cancer for Adolescents and Young Adults and Their Parent Caregivers

This study examined the financial impact of cancer and the use of income support in adolescents and young adults (AYAs) with cancer and their parent caregivers. As part of a national Australian study exploring the psychosocial impacts of cancer, 196 AYAs ages 15 to 25 years, six to 24 months from diagnosis, and 204 parent caregivers from 18 cancer sites were surveyed. Logistic regression and chi-square analyses were conducted to assess the influence of clinical and sociodemographic variables on financial status. Qualitative responses were coded, and key themes were identified using thematic analysis. The findings indicate that more than half of AYAs and parents reported financial issues as a consequence of AYA cancer. Financial issues resulted from direct medical costs, associated costs from treatment, and indirect costs from loss of income. AYAs and parents reported that it was important for them to receive income support, both during and after cancer treatment. However, large proportions of those who reported needing income support had difficulty accessing it. AYAs and their families are substantially financially disadvantaged by cancer, many for a prolonged time. Patient- and family-centered assessments and interventions are required to reduce the financial burden of AYA cancer.Peer reviewe

Associations between prenatal alcohol exposure and early education outcomes: a matched controls study using the born in Bradford dataset

Prenatal alcohol exposure (PAE) is associated with cognitive, behavioural, and developmental impairments throughout the lifespan of affected individuals, but there is limited evidence on how early this impact can be identified through routinely collected childhood data. This paper explores the relationship between PAE and the Early Years Foundation Stage Profile (EYFSP), a statutory teacher-based summative assessment of early development in relation to learning goals. This analysis uses the Born in Bradford dataset, a UK based cohort (n = 13,959; full dataset), which collected self-reported PAE from 11,905 mothers, with 19.8% reporting drinking alcohol at some point during pregnancy. Coarsened exact matching was conducted to examine relationships between patterns of PAE and children achieving a ‘Good Level of Development’ on the EYFSP, a binary variable assessed at 4–5 years of age, controlling for known confounders, including deprivation, mother’s education, exposure to other teratogenic substances, and child’s age at assessment. Additionally, we examined EYFSP sub-scores to identify specific developmental deficits associated with PAE.The key finding is a statistically significant association between PAE at a level of consuming 5 or more units of alcohol (equivalent to 50 ml or 40 g of pure alcohol) at least once per week from the 4th month of pregnancy onwards and lower EYFSP scores when accounting for established confounding variables. These findings highlight that the detrimental impact of alcohol during pregnancy can be identified using statutory educational assessments. This has implications internationally for prevention work, policy, and commissioning of support services for people impacted by PAE