School-related subjective well-being promotes subsequent adaptability, achievement, and positive behavioural conduct.

BACKGROUND: Previous studies have shown that subjective well-being and adaptability are linked to adaptive educational outcomes, including higher achievement and lower anxiety. It is not presently clear, however, how school-related subjective well-being and adaptability are related, or predict behavioural outcomes such as student conduct. AIM: The aim of the present study was to test a bidirectional model of school-related subjective well-being and adaptability, and how they relate to achievement and behavioural conduct. METHOD: Data were collected from 539 Year 12 students over four waves. Achievement and behavioural conduct were measured in the first wave of data collection (T1 ), school-related subjective well-being and adaptability at the second and third waves (T2 and T3 ), and achievement and behavioural conduct again in the fourth wave of data collection (T4 ). RESULTS: A structural equation model showed that T2 school-related subjective well-being predicted higher T3 adaptability, but not vice versa. T3 school-related subjective well-being predicted greater T4 achievement and positive behavioural conduct, and T3 adaptability predicted greater T4 positive behavioural conduct. CONCLUSION: School-related subjective well-being promotes adaptability, achievement, and positive behavioural conduct, and adaptability is also related to positive behavioural conduct. Attempts to foster well-being and adaptability could show educational gains for students

The combined diabetes and renal control trial (C-DIRECT) - a feasibility randomised controlled trial to evaluate outcomes in multi-morbid patients with diabetes and on dialysis using a mixed methods approach

Background: This cluster randomised controlled trial set out to investigate the feasibility and acceptability of the “Combined Diabetes and Renal Control Trial” (C-DIRECT) intervention, a nurse-led intervention based on motivational interviewing and self-management in patients with coexisting end stage renal diseases and diabetes mellitus (DM ESRD). Its efficacy to improve glycaemic control, as well as psychosocial and self-care outcomes were also evaluated as secondary outcomes. Methods: An assessor-blinded, clustered randomised-controlled trial was conducted with 44 haemodialysis patients with DM ESRD and ≥ 8% glycated haemoglobin (HbA1c), in dialysis centres across Singapore. Patients were randomised according to dialysis shifts. 20 patients were assigned to intervention and 24 were in usual care. The C-DIRECT intervention consisted of three weekly chair-side sessions delivered by diabetes specialist nurses. Data on recruitment, randomisation, and retention, and secondary outcomes such as clinical endpoints, emotional distress, adherence, and self-management skills measures were obtained at baseline and at 12 weeks follow-up. A qualitative evaluation using interviews was conducted at the end of the trial. Results: Of the 44 recruited at baseline, 42 patients were evaluated at follow-up. One patient died, and one discontinued the study due to deteriorating health. Recruitment, retention, and acceptability rates of C-DIRECT were generally satisfactory HbA1c levels decreased in both groups, but C-DIRECT had more participants with HbA1c < 8% at follow up compared to usual care. Significant improvements in role limitations due to physical health were noted for C-DIRECT whereas levels remained stable in usual care. No statistically significant differences between groups were observed for other clinical markers and other patient-reported outcomes. There were no adverse effects. Conclusions: The trial demonstrated satisfactory feasibility. A brief intervention delivered on bedside as part of routine dialysis care showed some benefits in glycaemic control and on QOL domain compared with usual care, although no effect was observed in other secondary outcomes. Further research is needed to design and assess interventions to promote diabetes self-management in socially vulnerable patients

Effect of Systemic Hypertension With Versus Without Left Ventricular Hypertrophy on the Progression of Atrial Fibrillation (from the Euro Heart Survey).

Hypertension is a risk factor for both progression of atrial fibrillation (AF) and development of AF-related complications, that is major adverse cardiac and cerebrovascular events (MACCE). It is unknown whether left ventricular hypertrophy (LVH) as a consequence of hypertension is also a risk factor for both these end points. We aimed to assess this in low-risk AF patients, also assessing gender-related differences. We included 799 patients from the Euro Heart Survey with nonvalvular AF and a baseline echocardiogram. Patients with and without hypertension were included. End points after 1 year were occurrence of AF progression, that is paroxysmal AF becoming persistent and/or permanent AF, and MACCE. Echocardiographic LVH was present in 33% of 379 hypertensive patients. AF progression after 1 year occurred in 10.2% of 373 patients with rhythm follow-up. In hypertensive patients with LVH, AF progression occurred more frequently as compared with hypertensive patients without LVH (23.3% vs 8.8%, p = 0.011). In hypertensive AF patients, LVH was the most important multivariably adjusted determinant of AF progression on multivariable logistic regression (odds ratio 4.84, 95% confidence interval 1.70 to 13.78, p = 0.003). This effect was only seen in male patients (27.5% vs 5.8%, p = 0.002), while in female hypertensive patients, no differences were found in AF progression rates regarding the presence or absence of LVH (15.2% vs 15.0%, p = 0.999). No differences were seen in MACCE for hypertensive patients with and without LVH. In conclusion, in men with hypertension, LVH is associated with AF progression. This association seems to be absent in hypertensive women

Environmental Noise in Advanced LIGO Detectors

The sensitivity of the Advanced LIGO detectors to gravitational waves can be affected by environmental disturbances external to the detectors themselves. Since the transition from the former initial LIGO phase, many improvements have been made to the equipment and techniques used to investigate these environmental effects. These methods have aided in tracking down and mitigating noise sources throughout the first three observing runs of the advanced detector era, keeping the ambient contribution of environmental noise below the background noise levels of the detectors. In this paper we describe the methods used and how they have led to the mitigation of noise sources, the role that environmental monitoring has played in the validation of gravitational wave events, and plans for future observing runs