The Glasgow outcome at discharge scale: an inpatient assessment of disability after brain injury

This study assesses the validity and reliability of the Glasgow Outcome at Discharge Scale (GODS), which is a tool that is designed to assess disability after brain injury in an inpatient setting. It is derived from the Glasgow Outcome Scale-Extended (GOS-E), which assesses disability in the community after brain injury. Inter-rater reliability on the GODS is high (quadratic-weighted kappa 0.982; 95% confidence interval [CI] 0.968, 0.996) as is concurrent validity with the Disability Rating Scale (DRS) (Spearman correlation −0.728; 95% CI −0.819, −0.601). The GODS is significantly associated with physical and fatigue subscales of the short form (SF)-36 in hospital. In terms of predictive validity the GODS is highly associated with the GOS-E after discharge (Spearman correlation 0.512; 95% CI 0.281, 0.687), with the DRS, and with physical, fatigue, and social subscales of the SF-36. The GODS is recommended as an assessment tool for disability after brain injury pre-discharge and can be used in conjunction with the GOS-E to monitor disability between hospital and the community

Discovery of Seven Companions To Intermediate-Mass Stars With Extreme Mass Ratios in the Scorpius-Centaurus Association

We report the detection of seven low-mass companions to intermediate-mass stars (SpT B/A/F; M similar to 1.5-4.5M(circle dot)) in the Scorpius-Centaurus (Sco-Cen) Association using nonredundant aperture masking interferometry. Our newly detected objects have contrasts Delta L' approximate to 4-6, corresponding to masses as low as similar to 20 M-Jup and mass ratios of q approximate to 0.01-0.08, depending on the assumed age of the target stars. With projected separations rho approximate to 10-30 AU, our aperture masking detections sample an orbital region previously unprobed by conventional adaptive optics imaging of intermediate-mass Sco-Cen stars covering much larger orbital radii (similar to 30-3000 AU). At such orbital separations, these objects resemble higher-mass versions of the directly imaged planetary mass companions to the 10-30 Myr, intermediate-mass stars HR 8799, beta Pictoris, and HD 95086. These newly discovered companions span the brown dwarf desert, and their masses and orbital radii provide a new constraint on models of the Formation of low-mass stellar and substellar companions to intermediate-mass stars.NASA through the Sagan Fellowship ProgramNSF Astronomy and Astrophysics Postdoctoral Fellowship AST-1203023Clay FellowshipNASA through Hubble Fellowship 51257.01AURA, Inc., for NASA NAS 5-26555W. M. Keck FoundationAstronom

A close halo of large transparent grains around extreme red giant stars

Intermediate-mass stars end their lives by ejecting the bulk of their envelope via a slow dense wind back into the interstellar medium, to form the next generation of stars and planets. Stellar pulsations are thought to elevate gas to an altitude cool enough for the condensation of dust, which is then accelerated by radiation pressure from starlight, entraining the gas and driving the wind. However accounting for the mass loss has been a problem due to the difficulty in observing tenuous gas and dust tens of milliarcseconds from the star, and there is accordingly no consensus on the way sufficient momentum is transferred from the starlight to the outflow. Here, we present spatially-resolved, multi-wavelength observations of circumstellar dust shells of three stars on the asymptotic giant branch of the HR diagram. When imaged in scattered light, dust shells were found at remarkably small radii (<~ 2 stellar radii) and with unexpectedly large grains (~300 nm radius). This proximity to the photosphere argues for dust species that are transparent to starlight and therefore resistant to sublimation by the intense radiation field. While transparency usually implies insufficient radiative pressure to drive a wind, the radiation field can accelerate these large grains via photon scattering rather than absorption - a plausible mass-loss mechanism for lower-amplitude pulsating stars.Comment: 13 pages, 1 table, 6 figure

Mid-infrared size survey of Young Stellar Objects: Description of Keck segment-tilting experiment and basic results

The mid-infrared properties of pre-planetary disks are sensitive to the temperature and flaring profiles of disks for the regions where planet formation is expected to occur. In order to constrain theories of planet formation, we have carried out a mid-infrared (wavelength 10.7 microns) size survey of young stellar objects using the segmented Keck telescope in a novel configuration. We introduced a customized pattern of tilts to individual mirror segments to allow efficient sparse-aperture interferometry, allowing full aperture synthesis imaging with higher calibration precision than traditional imaging. In contrast to previous surveys on smaller telescopes and with poorer calibration precision, we find most objects in our sample are partially resolved. Here we present the main observational results of our survey of 5 embedded massive protostars, 25 Herbig Ae/Be stars, 3 T Tauri stars, 1 FU Ori system, and 5 emission-line objects of uncertain classification. The observed mid-infrared sizes do not obey the size-luminosity relation found at near-infrared wavelengths and a companion paper will provide further modelling analysis of this sample. In addition, we report imaging results for a few of the most resolved objects, including complex emission around embedded massive protostars, the photoevaporating circumbinary disk around MWC 361A, and the subarcsecond binaries T Tau, FU Ori and MWC 1080.Comment: Accepted by Astrophysical Journal. 38 pages. 9 figure

Dignity and respect during pregnancy and childbirth: a survey of the experience of disabled women

Background: Despite the increasing number of women with disability globally becoming pregnant, there is currently limited research about their experiences. A national survey of women’s experience of dignity and respect during pregnancy and childbirth raised concerns about the possibility of women with disability having unequal care with overall less choice and control. To address this further we conducted a study to explore the experiences of dignity and respect in childbirth of women with disability. Methods: The study involved a self-selecting, convenience sample of 37 women who had given birth in the United Kingdom and Ireland and had completed an internet-based survey. Women were identified through online networks and groups of and for disabled parents and for people with specific medical conditions. Data were collected using an online survey tool. Survey data were analysed using descriptive statistics. Thematic analysis was used for open questions. Results: Despite generally positive responses, just over half of the group of women expressed dissatisfaction with care provision. Only 19% thought that reasonable adjustments or accommodations had been made for them (7/37). When reasonable adjustments were not in place, participants’ independence and dignity were undermined. More than a quarter of women felt they were treated less favourably because of their disability (10/37, 27%). At all points in the pregnancy continuum more than a quarter of women felt their rights were either poorly or very poorly respected; however this was greatest in the postnatal period (11/35, 31%). In addition, more than half of the women (20/36, 56%) felt that maternity care providers did not have appropriate awareness of or attitudes to disability. Conclusions: Women’s experiences of dignity and respect in childbirth revealed that a significant proportion of women felt their rights were poorly respected and that they were treated less favourably because of their disability. This suggests that there is a need to look more closely at individualised care. It was also evident that more consideration is required to improve attitudes of maternity care providers to disability and services need to adapt to provide reasonable adjustments to accommodate disability, including improving continuity of carer