How do older adults understand and manage distress? A qualitative study.

BACKGROUND: Distress is an expected emotional response to a negative life event. Experiences common in later life may trigger distress such as bereavement or loss of physical mobility. Distress is considered to be distinct to anxiety and/or depression and is not diagnostically labelled as a mental health problem. Older adults will often manage their own distress. Previous literature has focused on how younger adults self-manage mental health problems, however little research has explored the self-management strategies used by older people. There is a need to clarify the role of primary care in the context of distressed older adults who may consult healthcare services. This study seeks to address these gaps through qualitative methods. METHODS: Keele University's ethical review panel approved this study. We recruited older adults who self-identified as distressed from community groups in North Staffordshire, England. Data were generated through semi-structured interviews and analysed thematically using constant comparison methods. A patient and public involvement and engagement group contributed to development of the research questions and methods, and offered their perspectives on the findings. RESULTS: After 18 interviews data saturation was achieved. Key themes were: experiences of distress, actions taken, help-seeking from healthcare services and perceptions of treatments offered in primary care. Various forms of loss contributed to participants' distress. Participants initiated their own self-management strategies which included: pursuing independent activities, seeking social support and attending community groups and church. Five participants reported having consulted a GP when distressed but described a lack of acceptable treatments offered. CONCLUSIONS: To support older adults who are distressed, healthcare professionals in primary care should consider exploring how patients currently manage their mood problems, provide a broad range of information about potential management options and consider sign-posting older adults to community resources

Exploiting jet binning to identify the initial state of high-mass resonances

If a new high-mass resonance is discovered at the Large Hadron Collider, model-independent techniques to identify the production mechanism will be crucial to understand its nature and effective couplings to Standard Model particles. We present a powerful and model-independent method to infer the initial state in the production of any high-mass color-singlet system by using a tight veto on accompanying hadronic jets to divide the data into two mutually exclusive event samples (jet bins). For a resonance of several hundred GeV, the jet binning cut needed to discriminate quark and gluon initial states is in the experimentally accessible range of several tens of GeV. It also yields comparable cross sections for both bins, making this method viable already with the small event samples available shortly after a discovery. Theoretically, the method is made feasible by utilizing an effective field theory setup to compute the jet cut dependence precisely and model independently and to systematically control all sources of theoretical uncertainties in the jet binning, as well as their correlations. We use a 750 GeV scalar resonance as an example to demonstrate the viability of our method.Comment: 6 pages, 2 figures, v2: journal versio

Perils, pitfalls and potential for the use of reporting guidelines in experimental research in medical education.

Commentary

Understanding patient involvement in judging students' communication skills in OSCEs.

INTRODUCTION: Communication skills are assessed by medically-enculturated examiners using consensus frameworks which were developed with limited patient involvement. Assessments consequently risk rewarding performance which incompletely serves patients' authentic communication needs. Whilst regulators require patient involvement in assessment, little is known about how this can be achieved. We aimed to explore patients' perceptions of students' communication skills, examiner feedback and potential roles for patients in assessment. METHODS: Using constructivist grounded theory we performed cognitive stimulated, semi-structured interviews with patients who watched videos of student performances in communication-focused OSCE stations and read corresponding examiner feedback. Data were analysed using grounded theory methods. RESULTS: A disconnect occurred between participants' and examiners' views of students' communication skills. Whilst patients frequently commented on students' use of medical terminology, examiners omitted to mention this in feedback. Patients' judgements of students' performances varied widely, reflecting different preferences and beliefs. Participants viewed variability as an opportunity for students to learn from diverse lived experiences. Participants perceived a variety of roles to enhance assessment authenticity. DISCUSSION: Integrating patients into communications skills assessments could help to highlight deficiencies in students' communication which medically-enculturated examiners may miss. Overcoming the challenges inherent to this is likely to enhance graduates' preparedness for practice

Pokefind: a novel topological filter for use with protein structure prediction

Motivation: Our focus has been on detecting topological properties that are rare in real proteins, but occur more frequently in models generated by protein structure prediction methods such as Rosetta. We previously created the Knotfind algorithm, successfully decreasing the frequency of knotted Rosetta models during CASP6. We observed an additional class of knot-like loops that appeared to be equally un-protein-like and yet do not contain a mathematical knot. These topological features are commonly referred to as slip-knots and are caused by the same mechanisms that result in knotted models. Slip-knots are undetectable by the original Knotfind algorithm. We have generalized our algorithm to detect them, and analyzed CASP6 models built using the Rosetta loop modeling method

Understanding and developing procedures for video-based assessment in medical education

Introduction Novel uses of video aim to enhance assessment in health-professionals education. Whilst these uses presume equivalence between video and live scoring, some research suggests that poorly understood variations could challenge validity. We aimed to understand examiners’ and students’ interaction with video whilst developing procedures to promote its optimal use. Methods Using design-based research we developed theory and procedures for video use in assessment, iteratively adapting conditions across simulated OSCE stations. We explored examiners’ and students’ perceptions using think-aloud, interviews and focus group. Data were analysed using constructivist grounded-theory methods. Results Video-based assessment produced detachment and reduced volitional control for examiners. Examiners ability to make valid video-based judgements was mediated by the interaction of station content and specifically selected filming parameters. Examiners displayed several judgemental tendencies which helped them manage videos’ limitations but could also bias judgements in some circumstances. Students rarely found carefully-placed cameras intrusive and considered filming acceptable if adequately justified. Discussion Successful use of video-based assessment relies on balancing the need to ensure station-specific information adequacy; avoiding disruptive intrusion; and the degree of justification provided by video’s educational purpose. Video has the potential to enhance assessment validity and students’ learning when an appropriate balance is achieved

Subleading Power Rapidity Divergences and Power Corrections for qTq_T

A number of important observables exhibit logarithms in their perturbative description that are induced by emissions at widely separated rapidities. These include transverse-momentum ($q_T$) logarithms, logarithms involving heavy-quark or electroweak gauge boson masses, and small-$x$ logarithms. In this paper, we initiate the study of rapidity logarithms, and the associated rapidity divergences, at subleading order in the power expansion. This is accomplished using the soft collinear effective theory (SCET). We discuss the structure of subleading-power rapidity divergences and how to consistently regulate them. We introduce a new pure rapidity regulator and a corresponding $\overline{\rm MS}$-like scheme, which handles rapidity divergences while maintaining the homogeneity of the power expansion. We find that power-law rapidity divergences appear at subleading power, which give rise to derivatives of parton distribution functions. As a concrete example, we consider the $q_T$ spectrum for color-singlet production, for which we compute the complete $q_T^2/Q^2$ suppressed power corrections at $\mathcal{O}(\alpha_s)$, including both logarithmic and nonlogarithmic terms. Our results also represent an important first step towards carrying out a resummation of subleading-power rapidity logarithms.Comment: 40 pages + appendices, 3 figures; v2: TMD collaboration included in acknowledgement; v3: minor changes, journal versio