Long-term Periodicities in the Flux from Low Mass X-ray Binaries

Using data from the All Sky Monitor (ASM) on the Rossi X-ray Timing Explorer (RXTE) we have searched for long term periodicities in the X-ray flux of GX 1+4, Sco X-2 (GX 349+2), and GX 339-4. For GX 1+4 we also used data from BATSE and Galactic Centre scans performed by RXTE. We find no evidence for X-ray modulations at the suggested ~304 d orbital period of GX 1+4. However, we find tentative evidence for a periodicity at 420 d to 460 d. An upper limit of 15% peak-to-peak is set on any sinusoidal modulation in the 1.5 - 3.0 keV flux of Sco X-2 for periods in the 30 to 100 d range. For GX 339-4 we confirm the Low State modulation and report the detection of significant low-frequency modulations in both the High State and Very High State. We fail to detect this modulation in the Off State. We show that if the reported orbital period of GX 339-4 lies in the range 0.5 - 1.7 d, then it is not present in the RXTE ASM light curve.Comment: 7 pages, 8 figures. Accepted for publication in Advanced in Space Research, 16th of March 200

Low-Frequency Oscillations in Global Simulations of Black Hole Accretion

We have identified the presence of large-scale, low-frequency dynamo cycles in a long-duration, global, magnetohydrodynamic (MHD) simulation of black hole accretion. Such cycles had been seen previously in local shearing box simulations, but we discuss their evolution over 1,500 inner disk orbits of a global pi/4 disk wedge spanning two orders of magnitude in radius and seven scale heights in elevation above/below the disk midplane. The observed cycles manifest themselves as oscillations in azimuthal magnetic field occupying a region that extends into a low-density corona several scale heights above the disk. The cycle frequencies are ten to twenty times lower than the local orbital frequency, making them potentially interesting sources of low-frequency variability when scaled to real astrophysical systems. Furthermore, power spectra derived from the full time series reveal that the cycles manifest themselves at discrete, narrow-band frequencies that often share power across broad radial ranges. We explore possible connections between these simulated cycles and observed low-frequency quasi-periodic oscillations (LFQPOs) in galactic black hole binary systems, finding that dynamo cycles have the appropriate frequencies and are located in a spatial region associated with X-ray emission in real systems. Derived observational proxies, however, fail to feature peaks with RMS amplitudes comparable to LFQPO observations, suggesting that further theoretical work and more sophisticated simulations will be required to form a complete theory of dynamo-driven LFQPOs. Nonetheless, this work clearly illustrates that global MHD dynamos exhibit quasi-periodic behavior on timescales much longer than those derived from test particle considerations.Comment: Version accepted to The Astrophysical Journal, 8 pages, 7 figure

Disparate Ontologies? Revisiting Descola’s Ontological Schema among Northern Societies

Disparate Ontologies? Takes a critical look at Philippe Descola’s four-field anthropological model for ontologies among hunter-gatherer societies. Descola’s model juxtaposes animism, totemism, analogism, and naturalism as reflecting different expressions of interiority and physicality and queries those four ontological concepts as comparative units of analysis. While Descola’s Beyond Nature and Culture (2013) was a ground-breaking exploration of ontological ethnology and anthropological theory, the present work questions whether animism and totemism should be considered as comparable units in cross-cultural anthropological studies. Disparate Ontologies? focuses on the interpretive suitability of the concepts of animism and totemism as comparable variables in comparative analysis by investigating a sample of traditional indigenous societies from the northernmost Northern Hemisphere. The work focuses on ethnographic examples of animism and totemism, as well as cyclical rebirth eschatology and forms of perspectivism in an attempt to provide insights into the similarities and differences of ontological reckonings among diverse peoples across the North

Acute hospital dementia care: results from a national audit

Background: Admission to an acute hospital can be distressing and disorientating for a person with dementia, and is associated with decline in cognitive and functional ability. The objective of this audit was to assess the quality of dementia care in acute hospitals in the Republic of Ireland. Methods: Across all 35 acute public hospitals, data was collected on care from admission through discharge using a retrospective chart review (n = 660), hospital organisation interview with senior management (n = 35), and ward level organisation interview with ward managers (n = 76). Inclusion criteria included a diagnosis of dementia, and a length of stay greater than 5 days. Results: Most patients received physical assessments, including mobility (89 %), continence (84 %) and pressure sore risk (87 %); however assessment of pain (75 %), and particularly functioning (36 %) was poor. Assessment for cognition (43 %) and delirium (30 %) was inadequate. Most wards have access at least 5 days per week to Liaison Psychiatry (93 %), Geriatric Medicine (84 %), Occupational Therapy (79 %), Speech & Language (81 %), Physiotherapy (99 %), and Palliative Care (89 %) Access to Psychology (9 %), Social Work (53 %), and Continence services (34 %) is limited. Dementia awareness training is provided on induction in only 2 hospitals, and almost half of hospitals did not offer dementia training to doctors (45 %) or nurses (48 %) in the previous 12 months. Staff cover could not be provided on 62 % of wards for attending dementia training. Most wards (84 %) had no dementia champion to guide best practice in care. Discharge planning was not initiated within 24 h of admission in 72 % of cases, less than 40 % had a single plan for discharge recorded, and 33 % of carers received no needs assessment prior to discharge. Length of stay was significantly greater for new discharges to residential care (p < .001). Conclusion: Dementia care relating to assessment, access to certain specialist services, staffing levels, training and support, and discharge planning is sub-optimal, which may increase the risk of adverse patient outcomes and the cost of acute care. Areas of good practice are also highlighted

Development and measurement properties of the AxEL (attitude toward education and advice for low-back-pain) questionnaire

Introduction: Clinician time and resources may be underutilised if the treatment they offer does not match patient expectations and attitudes. We developed a questionnaire (AxEL-Q) to guide clinicians toward elements of first-line care that are pertinent to their patients with low back pain. Methods: We used guidance from the COSMIN consortium to develop the questionnaire and evaluated it in a sample of people with low back pain of any duration. Participants were recruited from the community, were over 18 years and fluent in English. Statements that represented first-line care were identified. Semantic scales were used to measure attitude towards these statements. These items were combined to develop the questionnaire draft. Construct validity was evaluated with exploratory factor analysis and hypotheses testing, comparing to the Back Beliefs Questionnaire and modified Pain Self-Efficacy Questionnaire. Reliability was evaluated and floor and ceiling effects calculated. Results: We recruited 345 participants, and had complete data for analysis for 313 participants. The questionnaire draft was reduced to a 3-Factor questionnaire through exploratory factor analysis. Factor 1 comprised 9 items and evaluated Attitude toward staying active, Factor 2 comprised 4 items and evaluated Attitude toward low back pain being rarely caused by a serious health problem, Factor 3 comprised 4 items and evaluated Attitude toward not needing to know the cause of back pain to manage it effectively. There was a strong inverse association between each factor and the Back Beliefs Questionnaire and a moderate positive association with the modified Pain Self-Efficacy Questionnaire. Each independent factor demonstrated acceptable internal consistency; Cronbach α Factor 1 = 0.92, Factor 2 = 0.91, Factor 3 = 0.90 and adequate interclass correlation coefficients; Factor 1 = 0.71, Factor 2 = 0.73, Factor 3 = 0.79. Conclusion: This study demonstrates acceptable construct validity and reliability of the AxEL-Q, providing clinicians with an insight into the likelihood of patients following first-line care at the outset

A multi-analysis approach for estimating regional health impacts from the 2017 Northern California wildfires

Smoke impacts from large wildfires are mounting, and the projection is for more such events in the future as the one experienced October 2017 in Northern California, and subsequently in 2018 and 2020. Further, the evidence is growing about the health impacts from these events which are also difficult to simulate. Therefore, we simulated air quality conditions using a suite of remotely-sensed data, surface observational data, chemical transport modeling with WRF-CMAQ, one data fusion, and three machine learning methods to arrive at datasets useful to air quality and health impact analyses. To demonstrate these analyses, we estimated the health impacts from smoke impacts during wildfires in October 8–20, 2017, in Northern California, when over 7 million people were exposed to Unhealthy to Very Unhealthy air quality conditions. We investigated using the 5-min available GOES-16 fire detection data to simulate timing of fire activity to allocate emissions hourly for the WRF-CMAQ system. Interestingly, this approach did not necessarily improve overall results, however it was key to simulating the initial 12-hr explosive fire activity and smoke impacts. To improve these results, we applied one data fusion and three machine learning algorithms. We also had a unique opportunity to evaluate results with temporary monitors deployed specifically for wildfires, and performance was markedly different. For example, at the permanent monitoring locations, the WRF-CMAQ simulations had a Pearson correlation of 0.65, and the data fusion approach improved this (Pearson correlation = 0.95), while at the temporary monitor locations across all cases, the best Pearson correlation was 0.5. Overall, WRF-CMAQ simulations were biased high and the geostatistical methods were biased low. Finally, we applied the optimized PM2.5 exposure estimate in an exposure-response function. Estimated mortality attributable to PM2.5 exposure during the smoke episode was 83 (95% CI: 0, 196) with 47% attributable to wildland fire smoke. Implications: Large wildfires in the United States and in particular California are becoming increasingly common. Associated with these large wildfires are air quality and health impact to millions of people from the smoke. We simulated air quality conditions using a suite of remotely-sensed data, surface observational data, chemical transport modeling, one data fusion, and three machine learning methods to arrive at datasets useful to air quality and health impact analyses from the October 2017 Northern California wildfires. Temporary monitors deployed for the wildfires provided an important model evaluation dataset. Total estimated regional mortality attributable to PM2.5 exposure during the smoke episode was 83 (95% confidence interval: 0, 196) with 47% of these deaths attributable to the wildland fire smoke. This illustrates the profound effect that even a 12-day exposure to wildland fire smoke can have on human health

Extreme Fermi surface smearing in a maximally disordered concentrated solid solution

We show that the Fermi surface can survive the presence of extreme compositional disorder in the equiatomic alloy Ni0.25Fe0.25Co0.25Cr0.25. Our high-resolution Compton scattering experiments reveal a Fermi surface which is smeared across a significant fraction of the Brillouin zone (up to 40% of 2π/a). The extent of this smearing and its variation on and between different sheets of the Fermi surface have been determined, and estimates of the electron mean free path and residual resistivity have been made by connecting this smearing with the coherence length of the quasiparticle states

The ethics of biobanking: key issues and controversies

The ethics of biobanking is one of the most controversial issues in current bioethics and public health debates. For some, biobanks offer the possibility of unprecedented advances which will revolutionise research and improve the health of future generations. For others they are worrying repositories of personal information and tissue which will be used without sufficient respect for those from whom they came. Wherever one stands on this spectrum, from an ethics perspective biobanks are revolutionary. Traditional ethical safeguards of informed consent and confidentiality, for example, simply don’t work for the governance of biobanks and as a result new ethical structures are required. Thus it is not too great a claim to say that biobanks require a rethinking of our ethical assumptions and frameworks which we have applied generally to other issues in ethics. This paper maps the key challenges and controversies of biobanking ethics; it considers; informed consent (its problems in biobanking and possibilities of participants’ withdrawal), broad consent, the problems of confidentiality, ownership, property and comercialisation issues, feedback to participants and the ethics of re-contact

Postural stability in older adults with a distal radial fracture

BACKGROUND: The physical risk factors leading to distal radial fractures are poorly understood. The goal of this study was to compare postural stability between older adults with and without a prior distal radial fragility fracture. METHODS: This case-control evaluation was performed at a single tertiary institution. The fracture cohort comprised 23 patients treated for a low-energy distal radial fracture within 6 to 24 months prior to this study. Twenty-three age and sex-matched control participants, without a prior fragility fracture, were selected from an outpatient clinic population. All participants completed a balance assessment with a computerized balance platform device. Dynamic motion analysis (DMA) scores ranging from 0 to 1,440 points are produced, with lower scores indicating better postural stability. Participants also completed validated questionnaires for general health quality (EuroQol-5D-3L [EQ-5D-3L]) and physical activity (Physical Activity Scale for the Elderly [PASE]) and comprehensive health and demographic information including treatment for compromised balance or osteoporosis. Statistical analysis compared data between cases and controls using either the Student t test or the Mann-Whitney U test. RESULTS: There were no significant differences (p > 0.05) in age, sex, body mass index, physical activity score, or EQ-5D-3L general health visual analog scale score between participants with or without prior distal radial fracture. The fracture cohort demonstrated poorer balance, with higher DMA scores at 933 points compared with 790 points for the control cohort (p = 0.008). Nineteen patients (83%) in the fracture cohort reported having dual x-ray absorptiometry (DXA) scans within 5 years prior to this study, but only 2 patients (9%) had ever been referred for balance training with physical therapy. CONCLUSIONS: Older adults who sustain low-energy distal radial fractures demonstrate impaired postural stability compared with individuals of a similar age who have not sustained such fractures. Following a distal radial fracture, these patients may benefit from interventions to improve postural stability. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence