Life events and acute cardiovascular reactions to mental stress: a cohort study

Objective: This study addressed the issue of whether frequent exposure to life events is associated with aggravation or blunting of cardiovascular reactions to acute mental stress. Methods: In a substantial cohort of 585 healthy young adults, systolic and diastolic blood pressure and pulse rate were recorded at rest and in response to a mental arithmetic stress task. Participants indicated, from a list of 50 events, those they had experienced in the last year. Results: There was an overall association between life events and blunted cardiovascular reactivity that was driven by variations in the frequency of exposure to desirable events. The total number of events and the number of personal events were negatively associated with systolic blood pressure and pulse rate reactions to acute stress, whereas the number of work-related events was negatively associated with diastolic blood pressure and pulse rate reactivity. The negative association between total events and systolic blood pressure reactivity was stronger for women than men, whereas men exposed to frequent undesirable events showed enhanced diastolic blood pressure reactivity. The blunting of pulse rate reactivity associated with frequent personal life events was evident particularly for those who had a relatively large number of close friends. Conclusions: The nature and extent of the association between life events exposure and stress reactivity in young adults depends on the valence of the events together with the sex of the individual and their social network size

A Novel Method for Achieving SAR Imaging with a Pair of Micro-Satellites by Means of a Bi-Static Configuration

There is increasing interest in the potential capabilities and applications of micro -satellites in the field of Earth-observation (EO). Passive optical imaging is now well established on such platforms, however, an active imaging payload - a synthetic aperture radar (SAR) - would appear to be insupportable, due to its size, complexity and high -power requirements. A major driver of these requirements is that traditional SAR systems use backscatter - which is necessarily weak from most terrain types. If the forward scattered energy could be gathered, then the transmit-power requirements could drop significantly. We therefore propose a novel method by which two micro-satellites fly in formation to accomplish a SAR mission bi-statically. The transmitting satellite will be the “master”, with the receiver satellite “slaved” off it by means of a synchronization signal. The satellites image a swath of 30 km, at a ground resolution of 30 m from 700 km altitude. Our constellation geometry can image anywhere in a pre-selected latitude band, and requires minimal orbit-control resources. The viewing configuration resolves the left-right ambiguity that occurs in near nadir pointing bi-static radar. Applications to a polar ice-monitoring mission are discussed, although with minor changes any location on Earth can be viewed

Patient reactions to a web-based cardiovascular risk calculator in type 2 diabetes: a qualitative study in primary care.

Use of risk calculators for specific diseases is increasing, with an underlying assumption that they promote risk reduction as users become better informed and motivated to take preventive action. Empirical data to support this are, however, sparse and contradictory

Are the scientific foundations of temperate marine reserves too warm and hard?

The scientific literature (including some of the most high-profile papers) on the ecological and fisheries effects of permanent no-take marine reserves is dominated by examples from hard tropical and warm temperate ecosystems. It appears to have been tacitly assumed that inference from these studies can directly inform expectations of marine reserve effects in cooler temperate and cold temperate waters. Trends in peer-reviewed studies indicate that the empirical basis for this assumption is tenuous because of a relative lack of research effort in cooler seas, and differences between tropical and temperate regions in ecology, seasonality, the nature of fisheries and prevailing governance regimes. © Copyright Foundation for Environmental Conservation 2012

Patterns of initiation in the poetry of Ted Hughes from 1970 to 1980

This study seeks to give a close reading of the poems in the major sequences by Ted Hughes published since 1970. The consideration of the poems centres upon the influence of initiatory religious patterns and their mythologies upon the poet's work. A key to such initiatory patterns is the primitive religious phenomenon known as shamanism. The first chapter of the thesis charts evidence of Hughes's fascination with shamanic practice and shows its pervasive and central influence from early poems such as 'Jaguar' right up to the pivotal work of Caudate. In chapters on each of the three volumes preceding Gaudete Hughes is shown as being preoccupied with shamanic questions rather than with the answers that a fully initiated shaman is able to give. Crow takes its protagonist to the very threshold of initiation, as does Prometheus on his Crag, but the need for the contextualization of the abstract experiences in the poems becomes very clear. Cave Birds is an attempt to introduce a coda of the realities of common human experience, but it is not until Gaudete that the strong mythological element in Hughes's work is disciplined into a greater, though flawed, whole. More and more Hughes seeks to transform the profane experience of our present life into a perception of the sacred. In Gaudete Lumb fails to do this with the rituals of his personal fertility cult and those around him are killed or emotionally damaged. But he himself is radically changed. The Epilogue Poems of Gaudete reflect this change and point the way away from a poetic reliance on the mechanisms of mythology to a living out of ritual in the poetry itself. Both 'Moortown' and Remains of Elmet exemplify this development in their perception of the sacredness of Nature. By Adam and the Sacred Nine the mythological element can now be presented yoked in a balanced way to the sensitivity of the poetry

Variations in hypoxia impairs muscle oxygenation and performance during simulated team-sport running

Purpose: To quantify the effect of acute hypoxia on muscle oxygenation and power during simulated team-sport running. Methods: Seven individuals performed repeated and single sprint efforts, embedded in a simulated team-sport running protocol, on a non-motorized treadmill in normoxia (sea-level), and acute normobaric hypoxia (simulated altitudes of 2,000 and 3,000 m). Mean and peak power was quantified during all sprints and repeated sprints. Mean total work, heart rate, blood oxygen saturation, and quadriceps muscle deoxyhaemoglobin concentration (assessed via near-infrared spectroscopy) were measured over the entire protocol. A linear mixed model was used to estimate performance and physiological effects across each half of the protocol. Changes were expressed in standardized units for assessment of magnitude. Uncertainty in the changes was expressed as a 90% confidence interval and interpreted via non-clinical magnitude-based inference. Results: Mean total work was reduced at 2,000 m (−10%, 90% confidence limits ±6%) and 3,000 m (−15%, ±5%) compared with sea-level. Mean heart rate was reduced at 3,000 m compared with 2,000 m (−3, ±3 min(−1)) and sea-level (−3, ±3 min(−1)). Blood oxygen saturation was lower at 2,000 m (−8, ±3%) and 3,000 m (−15, ±2%) compared with sea-level. Sprint mean power across the entire protocol was reduced at 3,000 m compared with 2,000 m (−12%, ±3%) and sea-level (−14%, ±4%). In the second half of the protocol, sprint mean power was reduced at 3,000 m compared to 2,000 m (−6%, ±4%). Sprint mean peak power across the entire protocol was lowered at 2,000 m (−10%, ±6%) and 3,000 m (−16%, ±6%) compared with sea-level. During repeated sprints, mean peak power was lower at 2,000 m (−8%, ±7%) and 3,000 m (−8%, ±7%) compared with sea-level. In the second half of the protocol, repeated sprint mean power was reduced at 3,000 m compared to 2,000 m (−7%, ±5%) and sea-level (−9%, ±5%). Quadriceps muscle deoxyhaemoglobin concentration was lowered at 3,000 m compared to 2,000 m (−10, ±12%) and sea-level (−11, ±12%). Conclusions: Simulated team-sport running is impaired at 3,000 m compared to 2,000 m and sea-level, likely due to a higher muscle deoxygenation

Assessing regional patterns of juvenile salmon growth in the Salish Sea

Early marine juvenile growth in Pacific salmon is generally positively correlated with overall survival to reproductive age. In this study, regional patterns of juvenile salmon growth are being analyzed over a two-year period (2012-2013) in the Salish Sea and surrounding waters to better assess juvenile productivity, via growth, in the Salish Sea and surrounding waters to provide us insight into possible mechanisms regulating survival. Insulin-like growth factor-1 (IGF-1), a hormone used to assess instantaneous growth in fishes, including juvenile salmon, was measured in late June and early July of 2012 and 2013 in the Strait of Georgia, Johnstone Strait, Queen Charlotte Strait, and Puget Sound. Juvenile sockeye (Oncorhynchus nerka) and pink salmon (O. gorbuscha) were collected in 2012, whereas juvenile coho (O. kisutch), Chinook (O. tshawytscha), and chum salmon (O. keta) where obtained in both years. In 2012 IGF-1 levels were highest in pink salmon from the Gulf Islands and Puget Sound; this was a unique pattern among the 5 species of juvenile salmon sampled. Coho salmon IGF-1 levels were highest in samples from the Northern Strait of Georgia. Chinook salmon IGF-1 levels were significantly higher in the Strait of Georgia than Puget Sound. The only regions where IGF-1 values were consistently low for three of the four species were Queen Charlotte Strait and Johnstone Strait. Analyses of 2013 IGF-1 levels (juvenile coho, Chinook, chum and a low number of sockeye) are underway and scheduled plans to obtain samples in late June to early July of 2014 are in place

Changes in the socio-demographic patterning of late adolescent health risk behaviours during the 1990s: analysis of two West of Scotland cohort studies

Background: Substance use and sexual risk behaviour affect young people's current and future health and wellbeing in many high-income countries. Our understanding of time-trends in adolescent health-risk behaviour is largely based on routinely collected survey data in school-aged adolescents (aged 15 years or less). Less is known about changes in these behaviours among older adolescents. Methods: We compared two cohorts from the same geographical area (West of Scotland), surveyed in 1990 and 2003, to: describe time-trends in measures of smoking, drinking, illicit drug use, early sexual initiation, number of opposite sex sexual partners and experience of pregnancy at age 18-19 years, both overall and stratified by gender and socioeconomic status (SES); and examine the effect of time-trends on the patterning of behaviours by gender and SES. Our analyses adjust for slight between-cohort age differences since age was positively associated with illicit drug use and pregnancy. Results: Rates of drinking, illicit drug use, early sexual initiation and experience of greater numbers of sexual partners all increased significantly between 1990 and 2003, especially among females, leading to attenuation and, for early sexual initiation, elimination, of gender differences. Most rates increased to a similar extent regardless of SES. However, rates of current smoking decreased only among those from higher SES groups. In addition, increases in 'cannabis-only' were greater among higher SES groups while use of illicit drugs other than cannabis increased more in lower SES groups. Conclusion: Marked increases in female substance use and sexual risk behaviours have implications for the long-term health and wellbeing of young women. More effective preventive measures are needed to reduce risk behaviour uptake throughout adolescence and into early adulthood. Public health strategies should reflect both the widespread prevalence of risk behaviour in young people as well as the particular vulnerability to certain risk behaviours among those from lower SES groups

Modelling the impact of changes to abdominal aortic aneurysm screening and treatment services in England during the COVID-19 pandemic.

BackgroundThe National Health Service (NHS) abdominal aortic aneurysm (AAA) screening programme (NAAASP) in England screens 65-year-old men. The programme monitors those with an aneurysm, and early intervention for large aneurysms reduces ruptures and AAA-related mortality. AAA screening services have been disrupted following COVID-19 but it is not known how this may impact AAA-related mortality, or where efforts should be focussed as services resume.MethodsWe repurposed a previously validated discrete event simulation model to investigate the impact of COVID-19-related service disruption on key outcomes. This model was used to explore the impact of delayed invitation and reduced attendance in men invited to screening. Additionally, we investigated the impact of temporarily suspending scans, increasing the threshold for elective surgery to 7cm and increasing drop-out in the AAA cohort under surveillance, using data from NAAASP to inform the population.FindingsDelaying invitation to primary screening up to two years had little impact on key outcomes whereas a 10% reduction in attendance could lead to a 2% lifetime increase in AAA-related deaths. In surveillance patients, a 1-year suspension of surveillance or increase in the elective threshold resulted in a 0.4% increase in excess AAA-related deaths (8% in those 5-5.4cm at the start). Longer suspensions or a doubling of drop-out from surveillance would have a pronounced impact on outcomes.InterpretationEfforts should be directed towards encouraging men to attend AAA screening service appointments post-COVID-19. Those with AAAs on surveillance should be prioritised as the screening programme resumes, as changes to these services beyond one year are likely to have a larger impact on surgical burden and AAA-related mortality

Negative pressure wound therapy for treating foot wounds in people with diabetes mellitus (Review)

Diabetes mellitus is a common condition that leads to high blood glucose concentrations, with around 2.8 million people affected in the UK (approximately 4.3% of the population). Some people with diabetes can develop ulcers on their feet. These wounds can take a long time to heal, be painful and become infected. Ulceration of the foot in people with diabetes can also lead to a higher risk of amputation of parts of the foot or leg. Generally, people with diabetes are at a higher risk of lower-limb amputation than people without diabetes. Negative pressure wound therapy is a wound treatment which involves applying suction to a wound; it is used increasingly around the world but it is not clear how effective it is. It also expensive compared with treatments such as dressings. We found five randomised controlled trials that compared negative pressure wound therapy with other treatments. We found some preliminary evidence that negative pressure wound therapy increases the healing of foot wounds on people with diabetes compared with other treatments. However, the findings are not conclusive and more, better quality randomised controlled trials are required