What was the impact of the first wave of COVID-19 on the delivery of care to children and adults with congenital heart disease? A qualitative study using online forums

OBJECTIVES: Globally, healthcare systems have been stretched to the limit by the COVID-19 pandemic. Significant changes have had to be made to the way in which non-COVID-19-related care has been delivered. Our objective was to understand, from the perspective of patients with a chronic, life-long condition (congenital heart disease, CHD) and their parents/carers, the impact of COVID-19 on the delivery of care, how changes were communicated and whether healthcare providers should do anything differently in a subsequent wave of COVID-19 infections. DESIGN AND SETTING: Qualitative study involving a series of asynchronous discussion forums set up and moderated by three patient charities via their Facebook pages. PARTICIPANTS: Patients with CHD and parents/carers of patients with CHD. MAIN OUTCOME MEASURES: Qualitative responses to questions posted on the discussion forums. RESULTS: The forums ran over a 6-week period and involved 109 participants. Following thematic analysis, we identified three themes and 10 subthemes related to individual condition-related factors, patient-related factors and health professional/centre factors that may have influenced how patients and parents/carers experienced changes to service delivery as a result of COVID-19. Specifically, respondents reported high levels of disruption to the delivery of care, inconsistent advice and messaging and variable communication from health professionals, with examples of both excellent and very poor experiences of care reported. Uncertainty about follow-up and factors related to the complexity and stability of their condition contributed to anxiety and stress. CONCLUSIONS: The importance of clear, consistent communication cannot be over-estimated. Our findings, while collected in relation to patients with CHD, are not necessarily specific to this population and we believe that they reflect the experiences of many thousands of people with life-long conditions in the UK. Recommendations related to communication, service delivery and support during the pandemic may improve patients' experience of care and, potentially, their outcomes

Acid Alteration at Mawrth Vallis between the older Fe/Mg-rich Clays and the younger Al/Si-rich Clays

Spectral doublet at 2.21-2.23 and 2.26-2.28 µm attributed to acidic alteration of Fe/Mg-smectite at Mawrth Vallis

Radiative association and inverse predissociation of oxygen atoms

The formation of \mbox{O}_2 by radiative association and by inverse predissociation of ground state oxygen atoms is studied using quantum-mechanical methods. Cross sections, emission spectra, and rate coefficients are presented and compared with prior experimental and theoretical results. At temperatures below 1000~K radiative association occurs by approach along the $1\,{}^3\Pi_u$ state of \mbox{O}_2 and above 1000~K inverse predissociation through the \mbox{B}\,{}^3\Sigma_u^- state is the dominant mechanism. This conclusion is supported by a quantitative comparison between the calculations and data obtained from hot oxygen plasma spectroscopy.Comment: submitted to Phys. Rev. A (Sept. 7., 1994), 19 pages, 4 figures, latex (revtex3.0 and epsf.sty

Nuclear Magnetic Resonance and Hyperfine Structure

Contains research objectives and reports onAlfred P. Sloan Foundatio

Coccydynia

Coccydynia is a term that refers to pain in the region of the coccyx. Most cases are associated with abnormal mobility of the coccyx which may trigger a chronic inflammatory process leading to degeneration of this structure. In some patients this instability may be detected on dynamic radiographs. Nonsurgical management remains the gold standard treatment for coccydynia, consisting of decreased sitting, seat cushioning, coccygeal massage, stretching, manipulation, local injection of steroids or anesthetics, and postural adjustments. Those patients who fail these conservative modalities may potentially benefit from coccygectomy. However, surgical intervention is typically reserved for patients with evidence of advanced coccygeal instability (e.g., subluxation or hypermobility) or spicule formation, as this population appears to exhibit the greatest improvement postoperatively

Testing the role of circadian genes in conferring risk for psychiatric disorders

Disturbed sleep and disrupted circadian rhythms are a common feature of psychiatric disorders, and many groups have postulated an association between genetic variants in circadian clock genes and psychiatric disorders. Using summary data from the association analyses of the Psychiatric Genomics Consortia (PGC) for schizophrenia, bipolar disorder and major depressive disorder, we evaluated the evidence that common SNPs in genes encoding components of the molecular clock influence risk to psychiatric disorders. Initially, gene-based and SNP P-values were analyzed for 21 core circadian genes. Subsequently, an expanded list of genes linked to control of circadian rhythms was analyzed. After correcting for multiple comparisons, none of the circadian genes were significantly associated with any of the three disorders. Several genes previously implicated in the etiology of psychiatric disorders harbored no SNPs significant at the nominal level of

Heavily electron-doped electronic structure and isotropic superconducting gap in AxFe2Se2 (A=K,Cs)

The low energy band structure and Fermi surface of the newly discovered superconductor, AxFe2Se2 (A=K,Cs), have been studied by angle-resolved photoemission spectroscopy. Compared with iron pnictide superconductors, AxFe2Se2 (A=K,Cs) is the most heavily electron-doped with Tc~30 K. Only electron pockets are observed with an almost isotropic superconducting gap of ~10.3 meV, while there is no hole Fermi surface near the zone center, which indicates the inter-pocket hopping or Fermi surface nesting is not a necessary ingredient for the unconventional superconductivity in iron-based superconductors. Thus, the sign changed s$_\pm$ pairing symmetry, a leading candidate proposed for iron-based superconductors, becomes conceptually irrelevant in describing the superconducting state here. A more conventional s-wave pairing is a better description.Comment: 4 pages, 4 figures, published online in Nature Materials 201

Passive-solar design manual for the United States Navy

A passive solar design manual for single-family detached residences and dormitory-type buildings is being developed. The design procedure employed in the manual is a simplification of the original monthly solar load ratio (SLR) method. The new SLR correlations involve a single constant for each system. The correlation constant appears as a scale factor permitting the use of a universal performance curve for all passive systems. Furthermore, by providing location-dependent correlations between the annual solar heating fraction (SHF)* and the minimum monthly SHF, we have eliminated the need to perform an SLR calculation for each month of the heating season