The TrueBlue study : is practice nurse-led collaborative care effective in the management of depression for patients with heart disease or diabetes?

Background: In the presence of type 2 diabetes (T2DM) or coronary heart disease (CHD), depression is under diagnosed and under treated despite being associated with worse clinical outcomes. Our earlier pilot study demonstrated that it was feasible, acceptable and affordable for practice nurses to extend their role to include screening for and monitoring of depression alongside biological and lifestyle risk factors. The current study will compare the clinical outcomes of our model of practice nurse-led collaborative care with usual care for patients with depression and T2DM or CHD.Methods: This is a cluster-randomised intervention trial. Eighteen general practices from regional and metropolitan areas agreed to join this study, and were allocated randomly to an intervention or control group. We aim to recruit 50 patients with co-morbid depression and diabetes or heart disease from each of these practices. In the intervention group, practice nurses (PNs) will be trained for their enhanced roles in this nurse-led collaborative care study. Patients will be invited to attend a practice nurse consultation every 3 months prior to seeing their usual general practitioner. The PN will assess psychological, physiological and lifestyle parameters then work with the patient to set management goals. The outcome of this assessment will form the basis of a GP Management Plan document. In the control group, the patients will continue to receive their usual care for the first six months of the study before the PNs undergo the training and switch to the intervention protocol. The primary clinical outcome will be a reduction in the depression score. The study will also measure the impact on physiological measures, quality of life and on patient attitude to health care delivered by practice nurses.Conclusion: The strength of this programme is that it provides a sustainable model of chronic disease management with monitoring and self-management assistance for physiological, lifestyle and psychological risk factors for high-risk patients with co-morbid depression, diabetes or heart disease. The study will demonstrate whether nurse-led collaborative care achieves better outcomes than usual care.<br /

Detection of Water and/or Hydroxyl on Asteroid (16) Psyche

In order to search for evidence of hydration on M-type asteroid (16) Psyche, we observed this object in the 3 micron spectral region using the long-wavelength cross-dispersed (LXD: 1.9-4.2 micron) mode of the SpeX spectrograph/imager at the NASA Infrared Telescope Facility (IRTF). Our observations show that Psyche exhibits a 3 micron absorption feature, attributed to water or hydroxyl. The 3 micron absorption feature is consistent with the hydration features found on the surfaces of water-rich asteroids, attributed to OH- and/or H2O-bearing phases (phyllosilicates). The detection of a 3 micron hydration absorption band on Psyche suggests that this asteroid may not be metallic core, or it could be a metallic core that has been impacted by carbonaceous material over the past 4.5 Gyr. Our results also indicate rotational spectral variations, which we suggest reflect heterogeneity in the metal/silicate ratio on the surface of Psyche.Comment: 13 pages, 9 figures in Astronomical Journal, 201

Final Report Sediment Nutrient and Metal, and Water Column Heavy Metal Characterization in the Genesee River

This Study was conducted in cooperation with New York State Department of Environmental Conservation (Albany, New York) and the International Joint Commission for the Great Lakes (Windsor, Ontario, Canada)

Constraining the neutron-matter equation of state with gravitational waves

We show how observations of gravitational waves from binary neutron star (BNS) mergers over the next few years can be combined with insights from nuclear physics to obtain useful constraints on the equation of state (EoS) of dense matter, in particular, constraining the neutron-matter EoS to within 20% between one and two times the nuclear saturation density $n_0\approx 0.16\ {\text{fm}^{-3}}$. Using Fisher information methods, we combine observational constraints from simulated BNS merger events drawn from various population models with independent measurements of the neutron star radii expected from x-ray astronomy (the Neutron Star Interior Composition Explorer (NICER) observations in particular) to directly constrain nuclear physics parameters. To parameterize the nuclear EoS, we use a different approach, expanding from pure nuclear matter rather than from symmetric nuclear matter to make use of recent quantum Monte Carlo (QMC) calculations. This method eschews the need to invoke the so-called parabolic approximation to extrapolate from symmetric nuclear matter, allowing us to directly constrain the neutron-matter EoS. Using a principal component analysis, we identify the combination of parameters most tightly constrained by observational data. We discuss sensitivity to various effects such as different component masses through population-model sensitivity, phase transitions in the core EoS, and large deviations from the central parameter values.Comment: 13 pages, 9 figures + supplement 11 page

The Number of Edges in Maximal 2-Planar Graphs

A graph is 2-planar if it has local crossing number two, that is, it can be drawn in the plane such that every edge has at most two crossings. A graph is maximal 2-planar if no edge can be added such that the resulting graph remains 2-planar. A 2-planar graph on n vertices has at most 5n-10 edges, and some (maximal) 2-planar graphs - referred to as optimal 2-planar - achieve this bound. However, in strong contrast to maximal planar graphs, a maximal 2-planar graph may have fewer than the maximum possible number of edges. In this paper, we determine the minimum edge density of maximal 2-planar graphs by proving that every maximal 2-planar graph on n ? 5 vertices has at least 2n edges. We also show that this bound is tight, up to an additive constant. The lower bound is based on an analysis of the degree distribution in specific classes of drawings of the graph. The upper bound construction is verified by carefully exploring the space of admissible drawings using computer support

Kaon Condensation in a Nambu--Jona-Lasinio (NJL) Model at High Density

We demonstrate a fully self-consistent microscopic realization of a kaon-condensed colour-flavour locked state (CFLK0) within the context of a mean-field NJL model at high density. The properties of this state are shown to be consistent with the QCD low-energy effective theory once the proper gauge neutrality conditions are satisfied, and a simple matching procedure is used to compute the pion decay constant, which agrees with the perturbative QCD result. The NJL model is used to compare the energies of the CFLK0 state to the parity even CFL state, and to determine locations of the metal/insulator transition to a phase with gapless fermionic excitations in the presence of a non-zero hypercharge chemical potential and a non-zero strange quark mass. The transition points are compared with results derived previously via effective theories and with partially self-consistent NJL calculations. We find that the qualitative physics does not change, but that the transitions are slightly lower.Comment: 21 pages, ReVTeX4. Clarified discussion and minor change