“It gave me something big in my life to wonder and think about which took over the space … and not MS”: Managing well-being in multiple sclerosis through art-making

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ 2014 Informa UK Ltd.Background and aim: Individuals living with Multiple Sclerosis (MS) often face progressive loss of function, uncertainty and disruption to self-image and valued roles. Previous studies show that creative self-expression is valued by some people living with long-term illness, yet its meaning for people living with MS is unclear. This research study explored the meanings of leisure-based visual art-making for people living with MS. Method: This qualitative study followed guidelines for Interpretative Phenomenological Analysis (IPA). Single semi-structured interviews were conducted with five adults (2 males; 3 females; 40–65 years), recruited from MS Ireland. Findings: Participants valued art-making for contributing to a more satisfying way of life; for filling occupational voids and using time well. Deep immersion offered respite from worry about illness. Creative classes offered social camaraderie and opportunities for learning and development. Art-making processes and products were highly affirmative, increasing emotional well-being and promoting self-worth. Most felt that they expressed valued aspects of self through their art. Art-making appeared to assist with identity maintenance, accommodating functional losses associated with MS whilst opening “new doors”. Conclusion: Art-making offered a multi-faceted means of supporting identity and increasing fulfilment in lives that were restricted in many ways by MS

An X-ray and Radio Study of the Varying Expansion Velocities in Tycho's Supernova Remnant

We present newly obtained X-ray and radio observations of Tycho's supernova remnant using {\it Chandra} and the Karl G. Jansky Very Large Array in 2015 and 2013/14, respectively. When combined with earlier epoch observations by these instruments, we now have time baselines for expansion measurements of the remnant of 12-15 year in the X-rays and 30 year in the radio. The remnant's large angular size allows for proper motion measurements at many locations around the periphery of the blast wave. We find, consistent with earlier measurements, a clear gradient in the expansion velocity of the remnant, despite its round shape. The proper motions on the western and southwestern sides of the remnant are about a factor of two higher than those in the east and northeast. We showed in an earlier work that this is related to an offset of the explosion site from the geometric center of the remnant due to a density gradient in the ISM, and using our refined measurements reported here, we find that this offset is $\sim 23"$ towards the northeast. An explosion center offset in such a circular remnant has implications for searches for progenitor companions in other remnants.Comment: Accepted for publication in ApJ Letter

Highlighting the hidden dangers of a ‘weak’ opioid:Deaths following use of dihydrocodeine in England (2001–2020)

BackgroundDihydrocodeine (DHC) is considered a ‘weak’ opioid, but there is evidence of its increasing misuse in overdose deaths. This research aims to analyse trends in DHC-related deaths in England relevant to source and dose of DHC, and decedent demographics.MethodsCases from England reported to the National Programme on Substance Abuse Deaths (NPSAD) where DHC was identified at post-mortem and/or implicated in death between 2001 and 2020 were extracted for analysis.Results2071 DHC-related deaths were identified. The greatest number of deaths involved illicitly obtained DHC and a significant increase in these deaths was recorded over time (r = 0.5, p = 0.03). However, there was a concurrent decline in the implication rate of DHC in causing death (r = −0.6, p &lt; 0.01). Fatalities were primarily due to accidental overdose (64.8%) and misuse was highly prevalent in combination with additional central nervous system depressants (95.3%), namely illicit heroin/morphine and diazepam. In contrast, when DHC was obtained over-the-counter (OTC) suicide mortality accounted for almost half of the deaths (42.5%). Differences in polysubstance use were also identified, with less heroin/morphine and benzodiazepine co-detection, but increased OTC codeine co-detection.ConclusionsDHC misuse in England is increasing. The pharmacological consideration of DHC as a ‘weak’ opioid may be misinterpreted by users, leading to accidental overdosing. There is an urgent need to understand increasing polypharmacy in overdose deaths. Additionally, suicides involving DHC is a potential cause for concern and a review of OTC opioid-paracetamol preparations is necessary to determine whether the benefits of these medications continue to outweigh the risks of intentional overdose.</p

The Optical Polarization and Warm Absorber in IRAS 17020+4544

We report the detection of ionized absorption in the ASCA spectrum of the narrow-line Seyfert 1 galaxy IRAS 17020+4544. Subsequent optical spectropolarimetry revealed high polarization increasing from 3% in the red to 5% in the blue, indicating electron or dust scattering as a likely origin. The broad emission line H$\alpha$ is somewhat less polarized than the continuum, supporting a location of the polarizing material within the AGN. The Balmer line decrement and reddened optical spectrum support the presence of a dusty warm absorber in this object. We compared the broad band optical polarization and ionized X-ray absorption of a collection of Seyfert 1 and 1.5 galaxies, excluding classes of objects that are likely to have significant neutral X-ray absorption. Warm absorber objects are generally more likely to have high optical polarization than objects with no detected ionized absorption. This result lends additional support to the idea that the warm absorber is associated with dust and implies either that dust transmission is responsible for at least part of the polarization or that the polarization is revealed because of the dimming of the optical spectrum. Spectropolarimetry of Seyfert 1s generally locates the scattering material inside the narrow-line region and often close to or within the broad line region, consistent with estimates of the location of the dusty warm absorber.Comment: 11 pages using (AASTeX) aaspp4.sty and 3 Postscript figures. Accepted for publication in Astrophysical Journal Letter

Weak Reprocessed Features in the Broad Line Radio Galaxy 3C382

We present a detailed X-ray study of the Broad Line Radio Galaxy 3C382, observed with the BeppoSAX satellite in a very bright state. The continuum emission is well modeled with a power law that steepens at high energies, with an e-folding energy of about 120 keV. At soft energies a clear excess of emission is detected, which can not be explained solely by the extended thermal halo seen in a ROSAT HRI image. A second, more intense soft X-ray component, possibly related to an accretion disk, is required by the data. Both a reflection component (R=0.3) and an iron line (EW \sim 50) are detected, at levels much weaker than in Seyfert galaxies, suggesting a common origin. Combining our measurements with results from the literature we find that the iron line has remained approximately constant over 9 years while the continuum varied by a factor of 5. Thus the fluorescent gas does not respond promptly to the variations of the X-ray primary source, suggesting that the reprocessing site is located away, likely at parsec distances. While the continuum shape indicates that X-rays derive from a thermal Comptonization process, the weakness of other spectral features implies that either the upper layers of the optically thick accretion disk are completely ionized or the corona above the disk is outflowing with mildly relativistic velocity.Comment: 11 pages, 4 figures. Accepted for publication in the Astrophysical Journa

An X-Ray View of the Jet-Cycle in the Radio Loud AGN 3C120

We present a study of the central engine in the broad-line radio galaxy 3C120 using a multi-epoch analysis of a deep XMM-Newton observation and two deep Suzaku pointings (in 2012). In order to place our spectral data into the context of the disk-disruption/jet-ejection cycles displayed by this object, we monitor the source in the UV/X-ray bands, and in the radio band. We find three statistically acceptable spectral models, a disk-reflection model, a jet-model and a jet+disk model. Despite being good descriptions of the data, the disk-reflection model violates the radio constraints on the inclination, and the jet-model has a fine-tuning problem, requiring a jet contribution exceeding that expected. Thus, we argue for a composite jet+disk model. Within the context of this model, we verify the basic predictions of the jet-cycle paradigm, finding a truncated/refilling disk during the Suzaku observations and a complete disk extending down to the innermost stable circular orbit (ISCO) during the XMM-Newton observation. The idea of a refilling disk is further supported by the detection of the ejection of a new jet knot approximately one month after the Suzaku pointings. We also discover a step-like event in one of the Suzaku pointings in which the soft band lags the hard band. We suggest that we are witnessing the propagation of a disturbance from the disk into the jet on a timescale set by the magnetic field.Comment: 14 pages, 10 figures, accepted for publication in Ap

“What if There's Something Wrong with Her?”‐How Biomedical Technologies Contribute to Epistemic Injustice in Healthcare

While there is a steadily growing literature on epistemic injustice in healthcare, there are few discussions of the role that biomedical technologies play in harming patients in their capacity as knowers. Through an analysis of newborn and pediatric genetic and genomic sequencing technologies (GSTs), I argue that biomedical technologies can lead to epistemic injustice through two primary pathways: epistemic capture and value partitioning. I close by discussing the larger ethical and political context of critical analyses of GSTs and their broader implications for just and equitable healthcare delivery