Development and feasibility testing of an education program to improve knowledge and self-care among Aboriginal and Torres Strait Islander patients with heart failure

INTRODUCTION: There is a 70% higher age-adjusted incidence of heart failure (HF) among Aboriginal and Torres Strait Islander people, three times more hospitalisations and twice as many deaths as among non-Aboriginal people. There is a need to develop holistic yet individualised approaches in accord with the values of Aboriginal community health care to support patient education and self-care. The aim of this study was to re-design an existing HF educational resource (Fluid Watchers-Pacific Rim) to be culturally safe for Aboriginal and Torres Strait Islander peoples, working in collaboration with the local community, and to conduct feasibility testing.  METHODS: This study was conducted in two phases and utilised a mixed-methods approach (qualitative and quantitative). Phase 1 used action research methods to develop a culturally safe electronic resource to be provided to Aboriginal HF patients via a tablet computer. An HF expert panel adapted the existing resource to ensure it was evidence-based and contained appropriate language and images that reflects Aboriginal culture. A stakeholder group (which included Aboriginal workers and HF patients, as well as researchers and clinicians) then reviewed the resources, and changes were made accordingly. In Phase 2, the new resource was tested on a sample of Aboriginal HF patients to assess feasibility and acceptability. Patient knowledge, satisfaction and self-care behaviours were measured using a before and after design with validated questionnaires. As this was a pilot test to determine feasibility, no statistical comparisons were made.  RESULTS: Phase 1: Throughout the process of resource development, two main themes emerged from the stakeholder consultation. These were the importance of identity, meaning that it was important to ensure that the resource accurately reflected the local community, with the appropriate clothing, skin tone and voice. The resource was adapted to reflect this, and members of the local community voiced the recordings for the resource. The other theme was comprehension; images were important and all text was converted to the first person and used plain language. Phase 2: Five Aboriginal participants, mean age 61.6±10.0 years, with NYHA Class III and IV heart failure were enrolled. Participants reported a high level of satisfaction with the resource (83.0%). HF knowledge (percentage of correct responses) increased from 48.0±6.7% to 58.0±9.7%, a 20.8% increase, and results of the self-care index indicated that the biggest change was in patient confidence for self-care, with a 95% increase in confidence score (46.7±16.0 to 91.1±11.5). Changes in management and maintenance scores varied between patients.  CONCLUSIONS: By working in collaboration with HF experts, Aboriginal researchers and patients, a culturally safe HF resource has been developed for Aboriginal and Torres Strait Islander patients. Engaging Aboriginal researchers, capacity-building, and being responsive to local systems and structures enabled this pilot study to be successfully completed with the Aboriginal community and positive participant feedback demonstrated that the methodology used in this study was appropriate and acceptable; participants were able to engage with willingness and confidence

Differential impact of two risk communications on antipsychotic prescribing to people with dementia in Scotland: segmented regression time series analysis 2001-2011

The two risk communications were associated with reductions in antipsychotic use, in ways which were compatible with marked differences in their content and dissemination. Further research is needed to ensure that the content and dissemination of regulatory risk communications is optimal, and to track their impact on intended and unintended outcomes. Although rates are falling, antipsychotic prescribing in dementia in Scotland remains unacceptably hig

The VLT-FLAMES Tarantula survey XX. The nature of the X-ray bright emission-line star VFTS 399

Context. The stellar population of the 30 Doradus star-forming region in the Large Magellanic Cloud contains a subset of apparently single, rapidly rotating O-type stars. The physical processes leading to the formation of this cohort are currently uncertain. Aims. One member of this group, the late O-type star VFTS 399, is found to be unexpectedly X-ray bright for its bolometric luminosity − in this study we aim to determine its physical nature and the cause of this behaviour. Methods. To accomplish this we performed a time-resolved analysis of optical, infrared and X-ray observations. Results. We found VFTS 399 to be an aperiodic photometric variable with an apparent near-IR excess. Its optical spectrum demonstrates complex emission profiles in the lower Balmer series and select He i lines − taken together these suggest an OeBe classification. The highly variable X-ray luminosity is too great to be produced by a single star, while the hard, non-thermal nature suggests the presence of an accreting relativistic companion. Finally, the detection of periodic modulation of the X-ray lightcurve is most naturally explained under the assumption that the accretor is a neutron star. Conclusions. VFTS 399 appears to be the first high-mass X-ray binary identified within 30 Dor, sharing many observational characteristics with classical Be X-ray binaries. Comparison of the current properties of VFTS 399 to binary-evolution models suggests a progenitor mass ≳25 M⊙ for the putative neutron star, which may host a magnetic field comparable in strength to those of magnetars. VFTS 399 is now the second member of the cohort of rapidly rotating “single” O-type stars in 30 Dor to show evidence of binary interaction resulting in spin-up, suggesting that this may be a viable evolutionary pathway for the formation of a subset of this stellar population

The identification of the optical/IR counterpart of the 15.8-s transient X-ray pulsar XTE J1946+274

We report on the discovery of the optical/IR counterpart of the 15.8s transient X-ray pulsar XTE J1946+274. We re-analysed archival BeppoSAX observations of XTE J1946+274, obtaining a new refined position (a circle with 22" radius at 90% confidence level). Based on this new position we carried out optical and infra-red (IR) follow-up observations. Within the new error circle we found a relatively optical faint (B=18.6) IR bright (H=12.1) early type reddened star (V--R=1.6). The optical spectra show strong H-alpha and H-beta emission lines. The IR photometric observations of the field confirm the presence of an IR excess for the H-alpha--emitting star (K=11.6, J--H=0.6) which is likely surrounded by a circumstellar envelope. Spectroscopic and photometric data indicate a B0--1V--IVe spectral-type star located at a distance of 8--10kpc and confirm the Be-star/X-ray binary nature of XTE J1946+274.Comment: Accepted for publication on A&A (7 pages and 4 figures

XMM-Newton observations of IGRJ18410-0535: The ingestion of a clump by a supergiant fast X-ray transient

IGRJ18410-0535 is a supergiant fast X-ray transients. This subclass of supergiant X-ray binaries typically undergoes few- hour-long outbursts reaching luminosities of 10^(36)-10^(37) erg/s, the occurrence of which has been ascribed to the combined effect of the intense magnetic field and rotation of the compact object hosted in them and/or the presence of dense structures ("clumps") in the wind of their supergiant companion. IGR J18410-0535 was observed for 45 ks by XMM-Newton as part of a program designed to study the quiescent emission of supergiant fast X-ray transients and clarify the origin of their peculiar X-ray variability. We carried out an in-depth spectral and timing analysis of these XMM-Newton data. IGR J18410-0535 underwent a bright X-ray flare that started about 5 ks after the beginning of the observation and lasted for \sim15 ks. Thanks to the capabilities of the instruments on-board XMM-Newton, the whole event could be followed in great detail. The results of our analysis provide strong convincing evidence that the flare was produced by the accretion of matter from a massive clump onto the compact object hosted in this system. By assuming that the clump is spherical and moves at the same velocity as the homogeneous stellar wind, we estimate a mass and radius of Mcl \simeq1.4\times10^(22) g and Rcl \simeq8\times10^(11) cm. These are in qualitative agreement with values expected from theoretical calculations. We found no evidence of pulsations at \sim4.7 s after investigating coherent modulations in the range 3.5 ms-100 s. A reanalysis of the archival ASCA and Swift data of IGR J18410-0535, for which these pulsations were previously detected, revealed that they were likely to be due to a statistical fluctuation and an instrumental effect, respectively.Comment: Accepted for publication on A&A. V2: Inserted correct version of Fig.1

The Be/X-ray transient 4U 0115+63/V635 Cassiopeiae. III. Quasi-cyclic variability

4u 0115+63 is one of the most active and best studied Be/X-ray transients. Previous studies of 4u0115+63 have led to the suggestion that it undergoes relatively fast quasi-cyclic activity. However, due to the lack of good coverage of the observations, the variability time scales are uncertain. Our objective is to investigate the long-term behaviour of 4u 0115+63 to confirm its quasi-cyclic nature and to explain its correlated optical/IR and X-ray variability. We have performed optical/IR photometric observations and optical spectroscopic observations of 4u 0115+63 over the last decade with unprecedented coverage. We have focused on the Halpha line variability and the long-term changes of the photometric magnitudes and colours and investigated these changes in correlation with the X-ray activity of the source. results The optical and infrared emission is characterised by cyclic changes with a period of ~ 5 years. This long-term variability is attributed to the state of the circumstellar disc around the Be star companion. Each cycle involves a low state when the disc is very weak or absent and the associated low amplitude variability is orbitally modulated and a high state when a perturbed disc precesses, giving rise to fast and large amplitude photometric changes. X-ray outbursts in 4u 0115+63 come in pairs, i.e., two in every cycle. However, sometimes the second outburst is missing. Our results can be explained within the framework of the decretion disc model. The neutron star acts as the perturbing body, truncating and distorting the disc. The first outburst would occur before the disc is strongly perturbed. The second outburst leads to the dispersal of the disc and marks the end of the perturbed phase.Comment: 10 pages, 6 figures, Tables 2 and 3 in electronic form onl

Optical and X-ray Outbursts of Be/X-ray binary system SAX J2103.5+4545

We present the relations between Halpha equivalent width, optical brightness and X-ray flux of Be/X-ray binary system SAX J2103.5+4545, by analyzing the optical photometric and spectroscopic observations together with the X-ray observations. In the photometric observations PSF photometry were applied using MIDAS and its DAOPHOT package. The reduction and analysis of spectra were done by using MIDAS and its suitable packages. The X-ray outburst of the system occurred just after the optical outburst. The nearly symmetric Halpha emission line profiles observed during the beginning of optical outburst turn into asymmetric profiles with increased EW values during the dissipation of Be disc. Halpha lines changed from emission to absorption during the observation period. The observed double peaked HeI emission lines might come from the accretion disc of neutron star which is temporarily formed at the time of X-ray outburst.Comment: to be pubished at Astronomy and Astrophysics on June 200

Integrating team science into interdisciplinary graduate education: an exploration of the SESYNC Graduate Pursuit

Complex socio-environmental challenges require interdisciplinary, team-based research capacity. Graduate students are fundamental to building such capacity, yet formal opportunities for graduate students to develop these capacities and skills are uncommon. This paper presents an assessment of the Graduate Pursuit (GP) program, a formal interdisciplinary team science graduate research and training program administered by the National Socio-Environmental Synthesis Center (SESYNC). Quantitative and qualitative assessment of the program’s first cohort revealed that participants became significantly more comfortable with interdisciplinary research and team science approaches, increased their capacity to work across disciplines, and were enabled to produce tangible research outcomes. Qualitative analysis of four themes—(1) discipline, specialization, and shared purpose, (2) interpersonal skills and personality, (3) communication and teamwork, and (4) perceived costs and benefits—encompass participants’ positive and negative experiences and support findings from past assessments. The findings also identify challenges and benefits related to individual personality traits and team personality orientation, the importance of perceiving a sense of autonomy and independence, and the benefit of graduate training programs independent of the university and graduate program environment

VarGoats project: a dataset of 1159 whole-genome sequences to dissect Capra hircus global diversity

Background: Since their domestication 10,500 years ago, goat populations with distinctive genetic backgrounds have adapted to a broad variety of environments and breeding conditions. The VarGoats project is an international 1000-genome resequencing program designed to understand the consequences of domestication and breeding on the genetic diversity of domestic goats and to elucidate how speciation and hybridization have modeled the genomes of a set of species representative of the genus Capra. Findings: A dataset comprising 652 sequenced goats and 507 public goat sequences, including 35 animals representing eight wild species, has been collected worldwide. We identified 74,274,427 single nucleotide polymorphisms (SNPs) and 13,607,850 insertion-deletions (InDels) by aligning these sequences to the latest version of the goat reference genome (ARS1). A Neighbor-joining tree based on Reynolds genetic distances showed that goats from Africa, Asia and Europe tend to group into independent clusters. Because goat breeds from Oceania and Caribbean (Creole) all derive from imported animals, they are distributed along the tree according to their ancestral geographic origin. Conclusions: We report on an unprecedented international effort to characterize the genome-wide diversity of domestic goats. This large range of sequenced individuals represents a unique opportunity to ascertain how the demographic and selection processes associated with post-domestication history have shaped the diversity of this species. Data generated for the project will also be extremely useful to identify deleterious mutations and polymorphisms with causal effects on complex traits, and thus will contribute to new knowledge that could be used in genomic prediction and genome-wide association studies

Phenomenology of the Lense-Thirring effect in the Solar System

Recent years have seen increasing efforts to directly measure some aspects of the general relativistic gravitomagnetic interaction in several astronomical scenarios in the solar system. After briefly overviewing the concept of gravitomagnetism from a theoretical point of view, we review the performed or proposed attempts to detect the Lense-Thirring effect affecting the orbital motions of natural and artificial bodies in the gravitational fields of the Sun, Earth, Mars and Jupiter. In particular, we will focus on the evaluation of the impact of several sources of systematic uncertainties of dynamical origin to realistically elucidate the present and future perspectives in directly measuring such an elusive relativistic effect.Comment: LaTex, 51 pages, 14 figures, 22 tables. Invited review, to appear in Astrophysics and Space Science (ApSS). Some uncited references in the text now correctly quoted. One reference added. A footnote adde