1,477 research outputs found
`In pursuit of the Nazi mind?' the deployment of psychoanalysis in the allied struggle against Germany
This paper discusses how psychoanalytic ideas were brought to bear in the Allied struggle against the Third Reich and explores some of the claims that were made about this endeavour. It shows how a variety of studies of Fascist psychopathology, centred on the concept of superego, were mobilized in military intelligence, post-war planning and policy recommendations for âdenazificationâ. Freud's ideas were sometimes championed by particular army doctors and government planners; at other times they were combined with, or displaced by, competing, psychiatric and psychological forms of treatment and diverse studies of the Fascist âpersonalityâ. This is illustrated through a discussion of the treatment and interpretation of the deputy leader of the Nazi Party, Rudolf Hess, after his arrival in Britain in 1941
Inequalities in living well with dementia â the impact of deprivation on wellbeing, quality of life and life satisfaction: results from the Improving the experience of Dementia and Enhancing Active Life study
The Eccentricity-Mass Distribution of Exoplanets: Signatures of Different Formation Mechanisms?
We examine the distributions of eccentricity and host star metallicity of
exoplanets as a function of their mass. Planets with M sin i >~ 4 M_J have an
eccentricity distribution consistent with that of binary stars, while planets
with M sin i <~ 4 M_J are less eccentric than binary stars and more massive
planets. In addition, host star metallicities decrease with planet mass. The
statistical significance of both of these trends is only marginal with the
present sample of exoplanets. To account for these trends, we hypothesize that
there are two populations of gaseous planets: the low-mass population forms by
gas accretion onto a rock-ice core in a circumstellar disk and is more abundant
at high metalliticities, and the high-mass population forms directly by
fragmentation of a pre-stellar cloud. Planets of the first population form in
initially circular orbits and grow their eccentricities later, and may have a
mass upper limit from the total mass of the disk that can be accreted by the
core. The second population may have a mass lower limit resulting from
opacity-limited fragmentation. This would roughly divide the two populations in
mass, although they would likely overlap over some mass range. If most objects
in the second population form before the pre-stellar cloud becomes highly
opaque, they would have to be initially located in orbits larger than ~30 AU,
and would need to migrate to the much smaller orbits in which they are
observed. The higher mean orbital eccentricity of the second population might
be caused by the larger required intervals of radial migration, and the brown
dwarf desert might be due to the inability of high-mass brown dwarfs to migrate
inwards sufficiently in radius.Comment: 7 pages, 4 figures. Version with expanded discussion section.
Accepted for publication in A&
HST/NICMOS Observations of NGC 1333: The Ratio of Stars to Sub-Stellar Objects
We present an analysis of NICMOS photometry and low-resolution grism
spectroscopy of low-mass stars and sub-stellar objects in the young
star-forming region NGC 1333. Our goal is to constrain the ratio of low-mass
stars to sub- stellar objects down to 20 Mjup in the cluster as well as
constrain the cluster IMF down to 30 Mjup in combination with a previous survey
of NGC 1333 by Wilking et al. Our survey covers 4 fields of 51.2" x 51.2",
centered on brown dwarf candidates previously identified in Wilking et al. We
extend previous work based on the use of a water vapor index for spectral
typing to wavelengths accessible with NICMOS on the HST. Spectral types were
derived for the 14 brightest objects in our fields, ranging from <M0 - M8,
which at the age of the cluster (0.3 Myr) corresponds to a range in mass of
>0.25 - 0.02 Msun. In addition to the spectra, we present an analysis of the
color-magnitude diagram using pre-main sequence evolutionary models of D'Antona
& Mazzitelli. Using an extinction-limited sample, we derive the ratio of
low-mass stars to brown dwarfs. Comparisons of the observed ratio to that
expected from the field IMF of Chabrier indicate that the two results are
consistent. We combine our data with that of Wilking et al. to compute the
ratio of intermediate-mass stars (0.1 - 1.0 Msun) to low-mass objects (0.03 -
0.1 Msun) in the cluster. We also report the discovery of a faint companion to
the previously confirmed brown dwarf ASR 28, as well as a possible outflow
surrounding ASR 16. If the faint companion is confirmed as a cluster member, it
would have a mass of ~ 5 Mjup (mass ratio 0.15) at a projected distance of 350
AU, similar to 2MASS 1207-3923 B.Comment: 33 pages, 6 figures, accepted for publication by A
Microwave background anisotropies due to non-linear structures in open and Lambda universes
A new method arising from a gauge-theoretic approach to general relativity is
applied to the formation of clusters in an expanding universe. The three
cosmological models (Omega_0=1, Omega_Lambda=0), (Omega_0=0.3,
Omega_Lambda=0.7), (Omega_0=0.3, Omega_Lambda=0) are considered, which extends
our previous application (Lasenby et al. 1999
-"http://xxx.soton.ac.uk/abs/astro-ph/9810123"-, Dabrowski et al. 1999
-"http://xxx.soton.ac.uk/abs/astro-ph/9810149"-). A simple initial velocity and
density perturbation of finite extent is imposed at the epoch z=1000 and we
investigate the subsequent evolution of the density and velocity fields for
clusters observed at redshifts z=1, z=2 and z=3. Photon geodesics and redshifts
are also calculated so that the Cosmic Microwave Background (CMB) anisotropies
due to collapsing clusters can be estimated. We find that the central CMB
temperature decrement is slightly stronger and extends to larger angular scales
in the non-zero Omega_Lambda case. This effect is strongly enhanced in the open
case. Gravitational lensing effects are also considered and we apply our model
to the reported microwave decrement observed towards the quasar pair PC
1643+4631 A & B.Comment: 9 pages, 9 figures. Submitted to Monthly Notices of the Royal
Astronomical Society (MNRAS
Reviewing research evidence and the case of participation in sport and physical recreation by black and minority ethnic communities
The paper addresses the implications of using the process of systematic review in the many areas of leisure where there is a dearth of material that would be admitted into conventional Cochrane Reviews. This raises important questions about what constitutes legitimate knowledge, questions that are of critical import not just to leisure scholars, but to the formulation of policy. The search for certainty in an area that lacks conceptual consensus results in an epistemological imperialism that takes a geocentric form. While clearly, there is a need for good research design whatever the style of research, we contend that the wholesale rejection of insightful research is profligate and foolhardy. A mechanism has to be found to capitalise on good quality research of whatever form. In that search, we draw upon our experience of conducting a review of the material available on participation in sport and physical recreation by people from Black and minority ethnic groups. The paper concludes with a proposal for a more productive review process that makes better use of the full panoply of good quality research available. © 2012 © 2012 Taylor & Francis
Qualitative study of the impact of an authentic electronic portfolio in undergraduate medical education
Background
Portfolios are increasingly used in undergraduate and postgraduate medical education. Four medical schools have collaborated with an established NHS electronic portfolio provider to develop and implement an authentic professional electronic portfolio for undergraduate students. We hypothesized that using an authentic portfolio would have significant advantages for students, particularly in familiarizing them with the tool many will continue to use for years after graduation. This paper describes the early evaluation of this undergraduate portfolio at two participating medical schools.
Methods
To gather data, a questionnaire survey with extensive free text comments was used at School 1, and three focus groups were held at School 2. This paper reports thematic analysis of studentsâ opinions expressed in the free text comments and focus groups.
Results
Five main themes, common across both schools were identified. These concerned the purpose, use and acceptability of the portfolio, advantages of and barriers to the use of the portfolio, and the impacts on both learning and professional identity.
Conclusions
An authentic portfolio mitigated some of the negative aspects of using a portfolio, and had a positive effect on studentsâ perception of themselves as becoming past of the profession. However, significant barriers to portfolio use remained, including a lack of understanding of the purpose of a portfolio and a perceived damaging effect on feedback
The balance of power: accretion and feedback in stellar mass black holes
In this review we discuss the population of stellar-mass black holes in our
galaxy and beyond, which are the extreme endpoints of massive star evolution.
In particular we focus on how we can attempt to balance the available accretion
energy with feedback to the environment via radiation, jets and winds,
considering also possible contributions to the energy balance from black hole
spin and advection. We review quantitatively the methods which are used to
estimate these quantities, regardless of the details of the astrophysics close
to the black hole. Once these methods have been outlined, we work through an
outburst of a black hole X-ray binary system, estimating the flow of mass and
energy through the different accretion rates and states. While we focus on
feedback from stellar mass black holes in X-ray binary systems, we also
consider the applicability of what we have learned to supermassive black holes
in active galactic nuclei. As an important control sample we also review the
coupling between accretion and feedback in neutron stars, and show that it is
very similar to that observed in black holes, which strongly constrains how
much of the astrophysics of feedback can be unique to black holes.Comment: To be published in Haardt et al. Astrophysical Black Holes. Lecture
Notes in Physics. Springer 201
Effectiveness and Safety of Adalimumab Biosimilar SB5 in IBD:Outcomes in Originator to SB5 Switch, Double Biosimilar Switch and Bio-Naieve SB5 Observational Cohorts
BACKGROUND AND AIMS: Multiple adalimumab [ADA] biosimilars are now approved for use in inflammatory bowel disease [IBD]; however, effectiveness and safety data remain scarce. We aimed to investigate long-term outcomes of the ADA biosimilar SB5 in IBD patients following a switch from the ADA originator [SB5-switch cohort] or after start of SB5 [SB5-start cohort]. METHODS: We performed an observational cohort study in a tertiary IBD referral centre. All IBD patients treated with Humira underwent an elective switch to SB5. We identified all these patients in a biological prescription database that prospectively registered all ADA start and stop dates including brand names. Data on IBD phenotype, C-reactive protein [CRP], drug persistence, ADA drug and antibody levels, and faecal calprotectin were collected. RESULTS: In total, 481 patients were treated with SB5, 256 in the SB5-switch cohort (median follow-up: 13.7 months [IQR 8.6â15.2]) and 225 in the SB5-start cohort [median follow-up: 8.3 months [4.2â12.8]). Of the SB5-switch cohort, 70.8% remained on SB5 beyond 1 year; 90/256 discontinued SB5, mainly due to adverse events [46/90] or secondary loss of response [37/90]. In the SB5-start cohort, 81/225 discontinued SB5, resulting in SB5-drug persistence of 60.3% beyond 1 year. No differences in clinical remission [p = 0.53], CRP [p = 0.80], faecal calprotectin [p = 0.40] and ADA trough levels [p = 0.55] were found between baseline, week 26 and week 52 following switch. Injection site pain was the most frequently reported adverse event. CONCLUSION: Switching from ADA originator to SB5 appeared effective and safe in this study with over 12 months of follow-up
Quality of medication use in primary care - mapping the problem, working to a solution: a systematic review of the literature
Background: The UK, USA and the World Health Organization have identified improved patient safety in healthcare as a priority. Medication error has been identified as one of the most frequent forms of medical error and is associated with significant medical harm. Errors are the result of the systems that produce them. In industrial settings, a range of systematic techniques have been designed to reduce error and waste. The first stage of these processes is to map out the whole system and its reliability at each stage. However, to date, studies of medication error and solutions have concentrated on individual parts of the whole system. In this paper we wished to conduct a systematic review of the literature, in order to map out the medication system with its associated errors and failures in quality, to assess the strength of the evidence and to use approaches from quality management to identify ways in which the system could be made safer.
Methods: We mapped out the medicines management system in primary care in the UK. We conducted a systematic literature review in order to refine our map of the system and to establish the quality of the research and reliability of the system.
Results: The map demonstrated that the proportion of errors in the management system for medicines in primary care is very high. Several stages of the process had error rates of 50% or more: repeat prescribing reviews, interface prescribing and communication and patient adherence. When including the efficacy of the medicine in the system, the available evidence suggested that only between 4% and 21% of patients achieved the optimum benefit from their medication. Whilst there were some limitations in the evidence base, including the error rate measurement and the sampling strategies employed, there was sufficient information to indicate the ways in which the system could be improved, using management approaches. The first step to improving the overall quality would be routine monitoring of adherence, clinical effectiveness and hospital admissions.
Conclusion: By adopting the whole system approach from a management perspective we have found where failures in quality occur in medication use in primary care in the UK, and where weaknesses occur in the associated evidence base. Quality management approaches have allowed us to develop a coherent change and research agenda in order to tackle these, so far, fairly intractable problems
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