The Near-Infrared Extinction Law in Regions of High Av

We present a spectroscopic study of the shape of the dust-extinction law between 1.0 and 2.2um towards a set of nine ultracompact HII regions with Av > 15 mag. We find some evidence that the reddening curve may tend to flatten at higher extinctions, but just over half of the sample has extinction consistent with or close to the average for the interstellar medium. There is no evidence of extinction curves significantly steeper than the standard law, even where water ice is present. Comparing the results to the predictions of a simple extinction model, we suggest that a standard extinction law implies a robust upper limit to the grain-size distribution at around 0.1 - 0.3um. Flatter curves are most likely due to changes in this upper limit, although the effects of flattening due to unresolved clumpy extinction cannot be ruled out.Comment: 9 pages, 7 figure

An Exploration of the Help-Seeking Experiences of Patients in an Allied Professions-Led Rapid Access Chest Pain Pathway – A Qualitative Study

Objective: A number of studies have explored delayed help-seeking practices for acute coronary syndrome (ACS) and have cited multiple intersecting factors which may play a role (e.g. attributing symptoms, age, gender, ethnicity and contextual influences). However, the pathway to diagnosis for suspected Coronary Heart Disease (CHD) symptoms in a Rapid Acess Chest Pain Clinic (RACPC) context is underexplored. The objective of this study was to explore patients’ help-seeking experiences of accessing RACPC services: from the point at which they notice and interpret symptoms to their decision to seek help from their GP, attend a RACPC, and receive a diagnosis Design: Qualitative study Setting: Interviews were conducted in RACPC at Queen Mary’s Roehampton Hospital, London, United Kingdom Participants: Maximium Variation sampling was used to recruit 30 participants referred to a RACPC, including 15 men and 15 women utilising sampling dimensions of age, ethnicity and occupation. Methods: Semi-structured interviews that focused on the patient experience of their pathway to diagnosis in RACPC. Thematic analysis was used to interpret the interview data. Results: The interpretation of symptoms was shaped by multiple factors; reluctance to seek help contributed to delay; with various factors acting as drivers as well as barriers to help-seeking; and referrals to RACPC were based on symptoms as well as patient need reassurance. Conclusion: We found complex issues shaped the patient decision-making when accessing the RACPC, including making sense of symptoms and help-seeking practices. These findings can be used to develop health promotion literature to encourage early help-seeking and improve of RACPC services

Helium and Hydrogen Line Ratios and The Stellar Content of Compact HII Regions

We present observations and models of the behaviour of the HI and HeI lines between 1.6 and 2.2um in a small sample of compact HII regions. As in our previous papers on planetary nebulae, we find that the `pure' 1.7007um 4^3D-3^3P and 2.16475um 7^(3,1)G-4^(3,1)F HeI recombination lines behave approximately as expected as the effective temperature of the central exciting star(s) increases. However, the 2.058um 2^1P-2^1S HeI line does not behave as the model predicts, or as seen in planetary nebulae. Both models and planetary nebulae showed a decrease in the HeI 2^1P-2^1S/HI Br gamma ratio above an effective temperature of 40000K. The compact HII regions do not show any such decrease. The problem with this line ratio is probably due to the fact that the photoionisation model does not account correctly for the high densities seen in these HII regions, and that we are therefore seeing more collisional excitation of the 2^1P level than the model predicts. It may also reflect some deeper problem in the assumed model stellar atmospheres. In any event, although the normal HeI recombination lines can be used to place constraints on the temperature of the hottest star present, the HeI 2^1P-2^1S/HI Br gamma ratio should not be used for this purpose in either Galactic HII regions or in starburst galaxies, and conclusions from previous work using this ratio should be regarded with extreme caution. We also show that the combination of the near infrared `pure' recombination line ratios with mid-infrared forbidden line data provides a good discriminant of the form of the far ultraviolet spectral energy distribution of the exciting star(s). From this we conclude that CoStar models are a poor match to the available data for our sources, though the more recent WM-basic models are a better fit.Comment: Accepted for publication in MNRA

Exploring the lived experience of Long Covid in black and minority ethnic groups in the UK: Protocol for qualitative interviews and art-based methods

Some people experience prolonged symptoms following an acute COVID-19 infection including fatigue, chest pain and breathlessness, headache and cognitive impairment. When symptoms persist for over 12 weeks following the initial infection, and are not explained by an alternative diagnosis, the term post-COVID-19 syndrome is used, or the patient-defined term of Long Covid. Understanding the lived experiences of Long Covid is crucial to supporting its management. However, research on patient experiences of Long Covid is currently not ethnically diverse enough. The study aim is to explore the lived experience of Long Covid, using qualitative interviews and art-based methods, among people from ethnically diverse backgrounds (in the UK), to better understand wider systems of support and healthcare support needs. Co-created artwork will be used to build on the interview findings. A purposive sampling strategy will be used to gain diverse experiences of Long Covid, sampling by demographics, geographic locations and experiences of Long Covid. Individuals (aged >18 years) from Black and ethnic minority backgrounds, who self-report Long Covid symptoms, will be invited to take part in a semi-structured interview. Interviews will be analysed thematically. A sub-sample of participants will be invited to co-create visual artwork to further explore shared narratives of Long Covid, enhance storytelling and increase understanding about the condition. A patient advisory group, representing diversity in ethnicity and experiences of Long Covid, will inform all research stages. Stakeholder workshops with healthcare professionals and persons, systems or networks important to people’s management of Long Covid, will advise on the integration of findings to inform management of Long Covid. The study will use patient narratives from people from diverse ethnic backgrounds, to raise awareness of Long Covid and help inform management of Long Covid and how wider social systems and networks may inform better healthcare service access and experiences

Enhanced motivational interviewing for reducing weight and increasing physical activity in adults with high cardiovascular risk: the MOVE IT three-arm RCT.

BACKGROUND: Motivational interviewing (MI) enhanced with behaviour change techniques (BCTs) and deployed by health trainers targeting multiple risk factors for cardiovascular disease (CVD) may be more effective than interventions targeting a single risk factor. OBJECTIVES: The clinical effectiveness and cost-effectiveness of an enhanced lifestyle motivational interviewing intervention for patients at high risk of CVD in group settings versus individual settings and usual care (UC) in reducing weight and increasing physical activity (PA) were tested. DESIGN: This was a three-arm, single-blind, parallel randomised controlled trial. SETTING: A total of 135 general practices across all 12 South London Clinical Commissioning Groups were recruited. PARTICIPANTS: A total of 1742 participants aged 40-74 years with a ≥ 20.0% risk of a CVD event in the following 10 years were randomised. INTERVENTIONS: The intervention was designed to integrate MI and cognitive-behavioural therapy (CBT), delivered by trained healthy lifestyle facilitators in 10 sessions over 1 year, in group or individual format. The control group received UC. RANDOMISATION: Simple randomisation was used with computer-generated randomisation blocks. In each block, 10 participants were randomised to the group, individual or UC arm in a 4 : 3 : 3 ratio. Researchers were blind to the allocation. MAIN OUTCOME MEASURES: The primary outcomes are change in weight (kg) from baseline and change in PA (average number of steps per day over 1 week) from baseline at the 24-month follow-up, with an interim follow-up at 12 months. An economic evaluation estimates the relative cost-effectiveness of each intervention. Secondary outcomes include changes in low-density lipoprotein cholesterol and CVD risk score. RESULTS: The mean age of participants was 69.75 years (standard deviation 4.11 years), 85.5% were male and 89.4% were white. At the 24-month follow-up, the group and individual intervention arms were not more effective than UC in increasing PA [mean 70.05 steps, 95% confidence interval (CI) -288 to 147.9 steps, and mean 7.24 steps, 95% CI -224.01 to 238.5 steps, respectively] or in reducing weight (mean -0.03 kg, 95% CI -0.49 to 0.44 kg, and mean -0.42 kg, 95% CI -0.93 to 0.09 kg, respectively). At the 12-month follow-up, the group and individual intervention arms were not more effective than UC in increasing PA (mean 131.1 steps, 95% CI -85.28 to 347.48 steps, and mean 210.22 steps, 95% CI -19.46 to 439.91 steps, respectively), but there were reductions in weight for the group and individual intervention arms compared with UC (mean -0.52 kg, 95% CI -0.90 to -0.13 kg, and mean -0.55 kg, 95% CI -0.95 to -0.14 kg, respectively). The group intervention arm was not more effective than the individual intervention arm in improving outcomes at either follow-up point. The group and individual interventions were not cost-effective. CONCLUSIONS: Enhanced MI, in group or individual formats, targeted at members of the general population with high CVD risk is not effective in reducing weight or increasing PA compared with UC. Future work should focus on ensuring objective evidence of high competency in BCTs, identifying those with modifiable factors for CVD risk and improving engagement of patients and primary care. TRIAL REGISTRATION: Current Controlled Trials ISRCTN84864870. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 69. See the NIHR Journals Library website for further project information. This research was part-funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London

A Bubbling Nearby Molecular Cloud: COMPLETE Shells in Perseus

We present a study on the shells (and bubbles) in the Perseus molecular cloud using the COMPLETE survey large-scale 12CO(1-0) and 13CO(1-0) maps. The twelve shells reported here are spread throughout most of the Perseus cloud and have circular or arc-like morphologies with a range in radius of about 0.1 to 3 pc. Most of them have not been detected before most likely as maps of the region lacked the coverage and resolution needed to distinguish them. The majority of the shells are coincident with infrared nebulosity of similar shape and have a candidate powering source near the center. We suggest they are formed by the interaction of spherical or very wide-angle winds powered by young stars inside or near the Perseus molecular cloud -a cloud that is commonly considered to be mostly forming low-mass stars. Two of the twelve shells are powered by high-mass stars close to the cloud, while the others appear to be powered by low or intermediate mass stars in the cloud. We argue that winds with a mass loss rate of about 10^-8 to 10^-6 M_sun/yr are required to produce the observed shells. Our estimates indicate that the energy input rate from these stellar winds is similar to the turbulence dissipation rate. We conclude that in Perseus the total energy input from both collimated protostellar outflows and powerful spherical winds from young stars is sufficient to maintain the turbulence in the molecular cloud. Large scale molecular line and IR continuum maps of a sample of clouds will help determine the frequency of this phenomenon in other star forming regions.Comment: 48 pages in total: 16 pages of text and references; 2 pages of tables; 30 figures (one page per figure). Accepted for publication in the Astrophysical Journa

Depression at work, authenticity in question: Experiencing, concealing and revealing

Australia and the United Kingdom have introduced policies to protect employees who experience mental illness, including depression. However, a better understanding of the experiential issues workers face (e.g. sense of moral failure) is needed for the provision of appropriate and beneficial support. We analysed 73 interviews from the United Kingdom and Australia where narratives of depression and work intersected. Participants encountered difficulties in being (and performing as if) 'authentic' at work, with depression contributing to confusions about the self. The diffuse post-1960s imperative to 'be yourself' is experienced in conflicting ways: while some participants sought support from managers and colleagues (e.g. sick leave, back-to-work plans), many others put on a façade in an attempt to perform the 'well' and 'authentic' employee. We outline the contradictory forces at play for participants when authenticity and visibility are expected, yet, moral imperatives to be good (healthy) employees are normative

Depression at Work, Authenticity in Question: Experiencing, Concealing and Revealing

Australia and the UK have both introduced policies to protect employees who experience mental illness, including depression. However, a better understanding of the issues workers face (e.g. sense of moral failure) is needed for the provision of appropriate and beneficial support. We analysed 73 interviews from the UK and Australia where narratives of depression and work intersected. Participants encountered difficulties in being (and performing as if) ‘authentic’ at work, with depression contributing to confusions about the self. The diffuse post-1960s imperative to ‘be yourself’ is experienced in conflicting ways: While some participants sought support from managers and colleagues (e.g. sick leave, back to work plans), many others put on a façade in an attempt to perform the ‘well’ and ‘authentic’ employee. We outline the contradictory forces at play for participants when authenticity and visibility are expected, yet moral imperatives to be good (healthy) employees are normative

Sustaining the Digital Humanities in the UK

The Sustaining Digital Humanities in the UK report is timely for the UK Digital Humanities (DH) landscape. The establishment of UK Research and Innovation (UKRI) has created an opportune moment for the strategic planning of research infrastructure between and across all the research areas. Led by Giles Bergel and Pip Willcox, this report is based on the findings of a workshop held at the University of Oxford’s e-Research Centre (OeRC) on 21 June 2018 and sponsored by the Software Sustainability Institute. The workshop was led by an advisory board of Digital Humanities practitioners, representing a range of career stages, roles, and disciplines. The workshop’s organisers and advisory board are the joint authors of this report, with contributions from workshop participants. The mission of the Software Sustainability Institute (SSI) is to cultivate better, more sustainable, research software to enable world-class research. Currently celebrating its 10th year, the SSI has achieved broadening engagement across academic communities including humanities – for example as a longstanding supporter of the Digital Humanities at Oxford Summer School (DHOxSS), and with SSI Fellows in the arts and humanities areas. This report was commissioned by the SSI with the aim of advancing its mission within the humanities. Digital Humanities, a broad intersection of models, methods, tools, materials, career paths and affiliations, in both established and novel disciplines was identified as the area within the humanities that most closely aligns with the SSI’s role