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

Added Value Report: University of Westminster Transformation in Students Project

One of the core aims that all Higher Education institutions share is to enhance graduate employability, and develop a workforce that is ready for the constantly changing labour market. While the concept of employability is shifting and variable (e.g. students as ‘customers’ and/or ‘partners’ (Skea, 2017), it is necessary to develop inclusive measures of employability that can extend beyond generic skills, and include values and identity-driven attributes. The literature recognises that graduate attributes are a set of desirable skills, qualities and understandings that both the University and students deem as important for employment and for shaping identities within the labour market (O’Leary, 2016; Bridgstock, 2009; Tomlinson, 2007). Thus, focus groups and interviews were carried out with undergraduates, postgraduates and alumni to explore their experiences at the University of Westminster, and to elicit the values and qualities that they consider important and personally valuable to their success in the future. This report presents qualitative findings on students’ experiences of gaining “added value” from their time at Westminster. Subsequently, we will use the results to create a robust survey that gives a scientific measurement of students’ attribute development throughout their studies at University

Supported Decision-Making: The Expectations Held by People With Experience of Mental Illness

Supported decision-making (SDM) is a principle guiding mental health service provision, which aims to improve people’s ability to make informed decisions about their care. Understanding diverse individual needs is vital to its success. Based on 29 narrative interviews with people diagnosed with mental illness in Australia, we examine how participants reflected on their own experiences of SDM. We find that participants’ conceptualization of mental health expertise, their own lived experiences and sense of agency, and their varying needs for dependence and independence influenced their relations with mental health practitioners. These factors in turn shaped their expectations about SDM. Four narrative positions emerged: the ‘Inward Expert’, the ‘Outward Entrustor’, the ‘Self-Aware Observer’ and the ‘Social Integrator’. These positionings influenced the type or style of support that participants expected and considered most useful. Our findings are relevant to developing effective approaches to SDM that take into account service users’ needs and preferences

Cross Validation of a Figure Skating Blade Instrumented to Measure Figure Skating Impact

Please refer to the pdf version of the abstract located adjacent to the title

Repeated century-scale droughts over the past 13,000 yr near the Hudson River watershed, USA

Author Posting. © The Author(s), 2009. This is the author's version of the work. It is posted here by permission of Elsevier B.V. for personal use, not for redistribution. The definitive version was published in Quaternary Research 75 (2011): 523-530, doi:10.1016/j.yqres.2011.01.006.Sediment and ground-penetrating radar data from Davis Pond near the Hudson River valley reveal past droughts in a historically humid region that presently supplies water to millions of people in and around New York City. A minimum of eleven sandy paleoshoreline deposits in the lake date from 13.4-0.6 cal ka BP. The deposits span 1500 to 200 years between bracketing radiocarbon dates, and intrude into lacustrine silts up to 9.0 m below the modern lake surface in a transect of six cores. Three lowstands, ca. 13.4-10.9, 9.2 and 8.2 cal ka BP indicate low regional moisture balance when low temperatures affected the North Atlantic region. Consistent with insolation trends, water levels rose from ca. 8.0 cal ka BP to present, but five low stands interrupted the rise and are likely associated with ocean-atmosphere interactions. Similar to evidence from other studies, the data from Davis Pond indicate repeated multi-century periods of prolonged or frequent droughts super-imposed on long-term regional trends toward high water levels. The patterns indicate that water supplies in this heavily populated region have continuously varied at multiple time scales, and confirm that humid regions such as the northeastern USA are more prone to severe drought than historically expected.We thank The Ocean and Climate Change Institute at Woods Hole Oceanographic Institution and NSF Earth System History program grants (EAR-0602380 to J. Donnelly and EAR-0602408 to B. Shuman) for supporting this research

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

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