A Puzzle Involving Galactic Bulge Microlensing Events

We study a sample of 16 microlensed Galactic bulge main sequence turnoff region stars for which high dispersion spectra have been obtained with detailed abundance analyses. We demonstrate that there is a very strong and highly statistically significant correlation between the maximum magnification of the microlensed bulge star and the value of the [Fe/H] deduced from the high resolution spectrum of each object. Physics demands that this correlation, assuming it to be real, be the result of some sample bias. We suggest several possible explanations, but are forced to reject them all,and are left puzzled. To obtain a reliable metallicity distribution in the Galactic bulge based on microlensed dwarf stars it will be necessary to resolve this issue through the course of additional observations.Comment: Submitted to ApJL, table 2 (quite long) will only appear in the on-line version of ApJ

Integration of family planning services into HIV care clinics: Results one year after a cluster randomized controlled trial in Kenya.

OBJECTIVES:To determine if integration of family planning (FP) and HIV services led to increased use of more effective contraception (i.e. hormonal and permanent methods, and intrauterine devices) and decreased pregnancy rates. DESIGN:Cohort analysis following cluster randomized trial, when the Kenya Ministry of Health led integration of the remaining control (delayed integration) sites and oversaw integrated services at the original intervention (early integration) sites. SETTING:Eighteen health facilities in Kenya. SUBJECTS:Women aged 18-45 receiving care: 5682 encounters at baseline, and 11628 encounters during the fourth quarter of year 2. INTERVENTION:"One-stop shop" approach to integrating FP and HIV services. MAIN OUTCOME MEASURES:Use of more effective contraceptive methods and incident pregnancy across two years of follow-up. RESULTS:Following integration of FP and HIV services at the six delayed integration clinics, use of more effective contraception increased from 31.7% to 44.2% of encounters (+12.5%; Prevalence ratio (PR) = 1.39 (1.19-1.63). Among the twelve early integration sites, the proportion of encounters at which women used more effective contraceptive methods was sustained from the end of the first to the second year of follow-up (37.5% vs. 37.0%). Pregnancy incidence including all 18 integrated sites in year two declined in comparison to the control arm in year one (rate ratio: 0.72; 95% CI 0.60-0.87). CONCLUSIONS:Integration of FP services into HIV clinics led to a sustained increase in the use of more effective contraceptives and decrease in pregnancy incidence 24 months following implementation of the integrated service model. TRIAL REGISTRATION:ClinicalTrials.gov NCT01001507

Estimating forest aboveground biomass by low density lidar data in mixed broad-leaved forests in the Italian Pre-Alps

Background: Estimation of forest biomass on the regional and global scale is of great importance. Many studies have demonstrated that lidar is an accurate tool for estimating forest aboveground biomass. However, results vary with forest types, terrain conditions and the quality of the lidar data. Methods: In this study, we investigated the utility of low density lidar data (<2 points∙m−2) for estimating forest aboveground biomass in the mountainous forests of northern Italy. As a study site we selected a 4 km2 area in the Valsassina mountains in Lombardy Region. The site is characterized by mixed and broad-leaved forests with variable stand densities and tree species compositions, being representative for the entire Pre-Alps region in terms of type of forest and geomorphology. We measured and determined tree height, DBH and tree species for 27 randomly located circular plots (radius =10 m) in May 2008. We used allometric equations to calculate total aboveground tree biomass and subsequently plot-level aboveground biomass (mg∙ha−1). Lidar data were collected in June 2004. Results: Our results indicate that low density lidar data can be used to estimate forest aboveground biomass with acceptable accuracies. The best height results show a R2 = 0.87 from final model and the root mean square error (RMSE) 1.02 m (8.3% of the mean). The best biomass model explained 59% of the variance in the field biomass. Leave-one-out cross validation yielded an RMSE of 30.6 mg∙ha−1 (20.9% of the mean). Conclusions: Low-density lidar data can be used to develop a forest aboveground biomass model from plot-level lidar height measurements with acceptable accuracies. In order to monitoring the National Forest Inventory, and respond to Kyoto protocol requirements, this analysis might be applied to a larger area. Keywords: LiDAR; Allometric equations; Plant height; Mixed fores

A powerful intervention: general practitioners' use of sickness certification in depression

&lt;b&gt;Background&lt;/b&gt; Depression is frequently cited as the reason for sickness absence, and it is estimated that sickness certificates are issued in one third of consultations for depression. Previous research has considered GP views of sickness certification but not specifically in relation to depression. This study aimed to explore GPs views of sickness certification in relation to depression.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Methods&lt;/b&gt; A purposive sample of GP practices across Scotland was selected to reflect variations in levels of incapacity claimants and antidepressant prescribing. Qualitative interviews were carried out between 2008 and 2009.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Results&lt;/b&gt; A total of 30 GPs were interviewed. A number of common themes emerged including the perceived importance of GP advocacy on behalf of their patients, the tensions between stakeholders involved in the sickness certification system, the need to respond flexibly to patients who present with depression and the therapeutic nature of time away from work as well as the benefits of work. GPs reported that most patients with depression returned to work after a short period of absence and that it was often difficult to predict which patients would struggle to return to work.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Conclusions&lt;/b&gt; GPs reported that dealing with sickness certification and depression presents distinct challenges. Sickness certificates are often viewed as powerful interventions, the effectiveness of time away from work for those with depression should be subject to robust enquiry

Acceptance, well-being, and goals in adolescents with chronic illness : a daily process analysis

Objective: The main aim of this study was to investigate the relationship between acceptance and well-being in adolescents with chronic illness from a daily process perspective. Furthermore, we explored the role of daily experienced interference and facilitation of life goals by treatment goals as mediating mechanisms. Methods: Thirty-eight adolescents with cystic fibrosis (CF) or diabetes completed questionnaires assessing acceptance, negative life events and goal-related self-efficacy. Furthermore, an online diary assessing daily mood, daily experienced interference and facilitation of life goals by treatment goals was completed during three consecutive weeks. Results: Acceptance of illness was positively related to daily well-being, but unrelated to daily goal interference and facilitation. Furthermore, daily goal interference and facilitation were unrelated to same-day and next-day well-being. Conclusion: This study suggests that acceptance of illness plays an important role in the daily mood of adolescents with CF and diabetes. This relationship, however, was not mediated by daily experienced interference and facilitation of life goals by treatment goals. Further research is needed to determine whether interventions promoting acceptance are beneficial for adolescents with CF and diabetes

Wearable activity technology and action-planning (WATAAP) to promote physical activity in cancer survivors: Randomised controlled trial protocol

FUNDAMENTOS/OBJETIVO: Los sobrevivientes de cáncer colorrectal y ginecológico corren riesgo cardiovascular debido a las comorbilidades y al comportamiento sedentario, lo que justifica una intervención factible para aumentar la actividad física. El Enfoque del Proceso de Acción Sanitaria (HAPA) es un marco teórico prometedor para el cambio de comportamiento en materia de salud, y los rastreadores de actividad física que se pueden llevar puestos ofrecen un medio novedoso de autocontrol de la actividad física para los supervivientes de cáncer. MÉTODO: Sesenta y ocho sobrevivientes de cáncer colorrectal y ginecológico serán asignados al azar a grupos de intervención y control de 12 semanas. Los participantes del grupo de intervención recibirán: un Fitbit AltaTM para monitorear la actividad física, sesiones de grupo basadas en HAPA, un folleto y una llamada telefónica de apoyo. Los participantes del grupo de control sólo recibirán el folleto basado en HAPA. La actividad física (utilizando acelerómetros), la presión sanguínea, el IMC y las construcciones HAPA se evaluarán en la línea de base, a las 12 semanas (después de la intervención) y a las 24 semanas (seguimiento). El análisis de los datos utilizará la interacción Grupo x Tiempo de un análisis de Modelo Mixto Lineal General. CONCLUSIONES: Las intervenciones de actividad física que son aceptables y que tienen sólidos fundamentos teóricos son prometedoras para mejorar la salud de los sobrevivientes de cáncer.BACKGROUND/OBJECTIVE: Colorectal and gynecologic cancer survivors are at cardiovascular risk due to comorbidities and sedentary behaviour, warranting a feasible intervention to increase physical activity. The Health Action Process Approach (HAPA) is a promising theoretical framework for health behaviour change, and wearable physical activity trackers offer a novel means of self-monitoring physical activity for cancer survivors. METHOD: Sixty-eight survivors of colorectal and gynecologic cancer will be randomised into 12-week intervention and control groups. Intervention group participants will receive: a Fitbit AltaTM to monitor physical activity, HAPA-based group sessions, booklet, and support phonecall. Participants in the control group will only receive the HAPA-based booklet. Physical activity (using accelerometers), blood pressure, BMI, and HAPA constructs will be assessed at baseline, 12-weeks (post-intervention) and 24-weeks (follow-up). Data analysis will use the Group x Time interaction from a General Linear Mixed Model analysis. CONCLUSIONS: Physical activity interventions that are acceptable and have robust theoretical underpinnings show promise for improving the health of cancer survivors.• The Tonkinson Colorectal Cancer Research. Subvención 57838 • St. John of God Gynecologic Oncology Research Group (Western Australia). AyudapeerReviewe

Rickettsia parkeri in Amblyomma americanum Ticks, Tennessee and Georgia, USA

To determine the geographic distribution of the newly recognized human pathogen Rickettsia parkeri, we looked for this organism in ticks from Tennessee and Georgia, USA. Using PCR and sequence analysis, we identified R. parkeri in 2 Amblyomma americanum ticks. This rickettsiosis may be underdiagnosed in the eastern United States

Complexity of multi-dimensional spontaneous EEG decreases during propofol induced general anaesthesia

Emerging neural theories of consciousness suggest a correlation between a specific type of neural dynamical complexity and the level of consciousness: When awake and aware, causal interactions between brain regions are both integrated (all regions are to a certain extent connected) and differentiated (there is inhomogeneity and variety in the interactions). In support of this, recent work by Casali et al (2013) has shown that Lempel-Ziv complexity correlates strongly with conscious level, when computed on the EEG response to transcranial magnetic stimulation. Here we investigated complexity of spontaneous high-density EEG data during propofol-induced general anaesthesia. We consider three distinct measures: (i) Lempel-Ziv complexity, which is derived from how compressible the data are; (ii) amplitude coalition entropy, which measures the variability in the constitution of the set of active channels; and (iii) the novel synchrony coalition entropy (SCE), which measures the variability in the constitution of the set of synchronous channels. After some simulations on Kuramoto oscillator models which demonstrate that these measures capture distinct ‘flavours’ of complexity, we show that there is a robustly measurable decrease in the complexity of spontaneous EEG during general anaesthesia

Medication administration errors for older people in long-term residential care

Background Older people in long-term residential care are at increased risk of medication errors. The purpose of this study was to evaluate a computerised barcode medication management system designed to improve drug administrations in residential and nursing homes, including comparison of error rates and staff awareness in both settings. Methods All medication administrations were recorded prospectively for 345 older residents in thirteen care homes during a 3-month period using the computerised system. Staff were surveyed to identify their awareness of administration errors prior to system introduction. Overall, 188,249 attempts to administer medication were analysed to determine the prevalence of potential medication administration errors (MAEs). Error classifications included attempts to administer medication at the wrong time, to the wrong person or discontinued medication. Analysis compared data at residential and nursing home level and care and nursing staff groups. Results Typically each resident was exposed to 206 medication administration episodes every month and received nine different drugs. Administration episodes were more numerous (p < 0.01) in nursing homes (226.7 per resident) than in residential homes (198.7). Prior to technology introduction, only 12% of staff administering drugs reported they were aware of administration errors being averted in their care home. Following technology introduction, 2,289 potential MAEs were recorded over three months. The most common MAE was attempting to give medication at the wrong time. On average each resident was exposed to 6.6 potential errors. In total, 90% of residents were exposed to at least one MAE with over half (52%) exposed to serious errors such as attempts to give medication to the wrong resident. MAEs rates were significantly lower (p < 0.01) in residential homes than nursing homes. The level of non-compliance with system alerts was low in both settings (0.075% of administrations) demonstrating virtually complete error avoidance. Conclusion Potentially inappropriate administration of medication is a serious problem in long-term residential care. A computerised barcode system can accurately and automatically detect inappropriate attempts to administer drugs to residents. This tool can reliably be used by care staff as well as nurses to improve quality of care and patient safety