bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validating the Support Needs Approach for Patients (SNAP) tool in primary care: a person-centred approach for patients with advanced chronic obstructive pulmonary disease (COPD)
Authors: Gardner Carole , Ewing Gail , Farquhar Morag 
Published: June 2018

BackgroundPrimary care is at the forefront of COPD management. A person-centred approach is advocated, yet patients have difficulty in articulating their needs to health care professionals (HCPs). The Support Needs Approach for Patients (SNAP) tool aims to enable patients to identify and express their support needs but its validity is unknown.AimTo establish the face, content and criterion validity of the SNAP tool in advanced COPD.MethodTwo-stage mixed method primary care study involving patients with advanced COPD, and their carers. Stage 1: Face and content validity assessed though focus groups involving patients and carers (n = 12), considering the appropriateness, relevance and completeness of the SNAP tool. Data analysed using thematic analysis within a Framework Approach. Stage 2: Content and criteria validity assessed in a postal survey through patient self-completion of the SNAP tool and disease impact measures (Chronic Respiratory Questionnaire, COPD Assessment Test, and Hospital Anxiety and Depression Scale). Content validity assessed using summary statistics; criterion validity via correlations between tool items and impact measures.ResultsThe SNAP tool has good face, content and criterion validity. Patients and carers found the tool patient-friendly and potentially useful. No items on the tool were redundant, and clear correlations were found between tool items and the majority of items/sub-scales of the impact measures.ConclusionThe SNAP tool has good face validity; content and criteria validity will be reported. It has the potential to facilitate person-centred care by enabling patients to express their support needs to HCPs. Future work will pilot SNAP in clinical practice.
Practice funding and socioeconomic deprivation in English general practices: a longitudinal study 2013–2017
Authors: Levene Louis S , Baker Richard , Bankart John , Walker Nicola , Williams Christopher , Wilson Andrew 
Published: June 2018

BackgroundThe NHS general practice payment formula has no specific measures of socio-economic deprivation, an important health determinant. Variables related to population health needs are poor predictors of cross-sectional variations in practice payments. Additional years of payments data allow longitudinal analyses.AimDo deprivation scores predict variations in the slope over time of NHS practice payments, after adjusting for organisational and population factors?MethodThe sample was 6898 English practices with more than 500 patients, studied over 4 financial years, 2013–2014 to 2016–2017. The dependent variable was total NHS payments per registered patient (after deductions). The independent variable was the Index of Multiple Deprivation (IMD) 2015 score for each practice (range: 3.2 to 66.5). 17 Confounders were selected for conceptual plausibility and data availability at practice level, and included organisational variables and population variables A random intercepts and random slopes model was fitted to adjust for clustering of measurements within practices. The linear effects of independent variables on payments over time were modelled by fitting interaction terms (product of variable with year). Descriptive statistics and univariable analyses were undertaken.ResultsPractice IMD scores were very weak predictors of longitudinal variations in total payments’ slopes (4.9p/patient/1 unit increase in IMD). We also found that our confounders had very small predictive effects, and payments and IMD were not correlated in any year (Spearman correlation coefficients ranging from 0.01 to 0.06). The median of payments increased from £102.77 (2013–2014) to £115.43 (2016–2017).ConclusionTotal payments increased very slightly more in practices with higher deprivation scores. This suggests that the NHS general practice payment formula may not adequately compensate practices whose populations have greater health needs.
Research activity and quality indicators in primary care - An explorative qualitative interview study
Authors: Riding Helen , Haining S , Robinson L 
Published: June 2018

BackgroundEmerging evidence suggests that research activity improves healthcare performance in secondary care. Staff who contribute and participate in research studies, tend to have a greater understanding, and use, of current evidence and guidelines. The engagement in research in primary care and correlation with quality indicators (QIs) is unclear.AimThe aim of this study is exploring the link between research activity and quality indicators in primary care.Method4 GPs and 4 practice managers consented and participated in semi-structured interviews conducted in spring 2017. A purposive sampling strategy was adopted until data saturation was achieved. The interviews were digitally recorded, transcribed verbatim and analysed using thematic framework analysis.ResultsPractices with a GP research champion were more likely to undertake research. Staff directly participating in the recruitment and follow-up and the research teams adopting a participatory and active research methodology is more likely to lead to improvement in quality. Including research as Enhanced Service may influence increased participation. The QOF is most likely to reflect improvement related to research, but opinions were mixed.ConclusionClinical Commissioning Groups and NHS England should be encouraged to develop QIs for research. As the landscape changes with the creation of Accountable Care Systems, there is an opportunity address the inclusion of research into practice contracts. This paper is the first to explore this topic in primary care and the findings will contribute towards developing quantitative research to expand the findings of this exploratory study.
Gestational diabetes mellitus: are mothers being followed-up? A retrospective study
Authors: Ward Rebecca , Hanna Fahmy W , Shelley-Hitchen Ann , Hodgson Ellen , Heald Adrian , Fryer Anthony A , Duff Christopher J 
Published: June 2018

BackgroundWomen with gestational diabetes (GDM) have an elevated risk of developing type 2 diabetes (T2DM). NICE Guidance recommends women who develop GDM are screened 6 weeks post-partum and annually thereafter.AimTo evaluate conformity to guidance of screening in women with GDM by 6-week post-partum fasting plasma glucose (FPG) and annual FPG and determine time between delivery and development of T2DM.MethodRecords at a tertiary referral centre were used to identify women (n = 54) diagnosed with GDM by antenatal oral glucose tolerance test between July 1999 and January 2007. Data from laboratory records were used to collect investigations of glycaemic status during the follow-up period (median follow-up 12.4 years, range 9.5–17.1 years).ResultsOf 252 women, 102 (40.2%) did not have a FPG at 6 weeks (+/−2 weeks). Of these, median time to first test was 1.2 years (range 0.04–10.8 years), with only 43.1% followed-up within 1 year. In those who had a 6-week FPG, 17 (11.3%) women had no further tests. A total of 84 (33% of those with gestational diabetes in the index pregnancy) women were diagnosed with T2DM; median time from delivery to diagnosis was 5.2 years (range 0.35–15.95). We found the only significant factor for a follow-up test at 1-year post-partum was the use of insulin.ConclusionOur data suggest an alternative approach is needed for monitoring women with a history of GDM. This needs to be appropriate for a generally healthy group in which traditional screening mechanisms may not be adequate or sufficient.
Near-infrared Polarimetry of the Outflow Source AFGL 6366S: Detection of Circular Polarization
Authors: Kwon Jungmi , Nakagawa Takao , Tamura Motohide , Hough James H. , Kandori Ryo , Choi Minho , Kang Miju , Cho Jungyeon , Nakajima Yasushi , Nagata Tetsuya 
Published: June 2018

Abstract
We have carried out near-infrared circular and linear imaging polarimetry of the AFGL 6366S region. There is one large infrared reflection nebula associated with the AFGL 6366S cluster and one small infrared reflection nebula associated with AFGL 6366S NE. Prominent and extended polarized nebulosities over the AFGL 6366S cluster field are found to be composed of several components and local nebula peaks, and those nebulosities are illuminated by at least three sources, which is roughly consistent with a previous study. However, the detailed linear polarization patterns and their degrees differ from the earlier study. The brightest regions of the nebulae are illuminated by the IRAS/WISE source. In addition, we report the first detection of circular polarization (CP) in the reflection nebula associated with AFGL 6366S. The CP is as large as approximately 4% in the K

s
band, and the maximum CP extent is approximately 0.45 pc, which is comparable to that for the largest CP regions known to date, such as Orion and Mon R2, although the CP degrees are much smaller. The CP pattern is mostly quadrupolar, and its morphology resembles the shape of the C18O dense core. Therefore, the CP region is probably illuminated by the IRAS/WISE source and its polarization is amplified by the dichroic absorption of the dense core associated with the cluster. This is the ninth source whose degrees of CPs are measured to be greater than 3%, suggesting that large and extended infrared CP regions are common among mid- to high-mass young stellar objects.
The Magnetic Response of the Solar Atmosphere to Umbral Flashes
Authors: Houston S. J. , Jess D. B. , Ramos A. Asensio , Grant S. D. T. , Beck C. , Norton A. A. , Prasad S. Krishna 
Published: June 2018

Abstract
Chromospheric observations of sunspot umbrae offer an exceptional view of magnetoacoustic shock phenomena and the impact they have on the surrounding magnetically dominated plasma. We employ simultaneous slit-based spectro-polarimetry and spectral imaging observations of the chromospheric He i 10830 Å and Ca ii 8542 Å lines to examine fluctuations in the umbral magnetic field caused by the steepening of magnetoacoustic waves into umbral flashes. Following the application of modern inversion routines, we find evidence to support the scenario that umbral shock events cause expansion of the embedded magnetic field lines due to the increased adiabatic pressure. The large number statistics employed allow us to calculate the adiabatic index, γ = 1.12 ± 0.01, for chromospheric umbral locations. Examination of the vector magnetic field fluctuations perpendicular to the solar normal revealed changes up to ∼200 G at the locations of umbral flashes. Such transversal magnetic field fluctuations have not been described before. Through comparisons with nonlinear force-free field extrapolations, we find that the perturbations of the transverse field components are oriented in the same direction as the quiescent field geometries. This implies that magnetic field enhancements produced by umbral flashes are directed along the motion path of the developing shock, hence producing relatively small changes, up to a maximum of ∼8°, in the inclination and/or azimuthal directions of the magnetic field. Importantly, this work highlights that umbral flashes are able to modify the full vector magnetic field, with the detection of the weaker transverse magnetic field components made possible by high-resolution data combined with modern inversion routines.
Torsional Alfvén Wave Embedded ICME Magnetic Cloud and Corresponding Geomagnetic Storm
Authors: Raghav Anil N. , Kule Ankita , Bhaskar Ankush , Mishra Wageesh , Vichare Geeta , Surve Shobha 
Published: June 2018

Abstract
Energy transfer during the interaction of large-scale solar wind structure and the Earth’s magnetosphere is a chronic issue in space-weather studies. To understand this, researchers widely studied the geomagnetic storm and substorm phenomena. The present understanding suggests that the long duration of the southward interplanetary magnetic field component is the most important parameter for the geomagnetic storm. Such a long duration strong southward magnetic field is often associated with ICMEs, torsional Alfvén fluctuations superposed corotating interacting regions (CIRs), and fast solar wind streams. Torsional Alfvén fluctuations embedded CIRs have been known of for a long time; however, magnetic clouds embedded with such fluctuations are rarely observed. The presence of Alfvén waves in the ICME/MC and the influence of these waves on the storm evolution remains an interesting topic of study. The present work confirms the torsional Alfvén waves in a magnetic cloud associated with a CME launched on 2011 February 15, which impacted the Earth’s magnetosphere on 2011 February 18. Furthermore, observations indicate that these waves inject energy into the magnetosphere during the storm and contribute to the long recovery time of geomagnetic storms. Our study suggests that the presence of torsional Alfvén waves significantly controls the storm dynamics.
A Thorough View of the Nuclear Region of NGC 253: Combined Herschel, SOFIA, and APEX Data Set
Authors: Pérez-Beaupuits J. P. , Güsten R. , Harris A. , Requena-Torres M. A. , Menten K. M. , Weiß A. , Polehampton E. , van der Wiel M. H. D. 
Published: June 2018

Abstract
We present a large set of spectral lines detected in the 40″ central region of the starburst galaxy NGC 253. Observations were obtained with the three instruments SPIRE, PACS, and HIFI on board the Herschel Space Observatory, upGREAT on board the SOFIA airborne observatory, and the ground-based Atacama Pathfinder EXperiment telescope. Combining the spectral and photometry products of SPIRE and PACS, we model the dust continuum spectral energy distribution (SED) and the most complete 12CO line SED reported so far toward the nuclear region of NGC 253. The properties and excitation of the molecular gas were derived from a three-component non-LTE radiative transfer model, using the SPIRE 13CO lines and ground-based observations of the lower-J
13CO and HCN lines, to constrain the model parameters. Three dust temperatures were identified from the continuum emission, and three components are needed to fit the full CO line SED. Only the third CO component (fitting mostly the HCN and PACS 12CO lines) is consistent with a shock-/mechanical-heating scenario. A hot core chemistry is also argued as a plausible scenario to explain the high-J
12CO lines detected with PACS. The effect of enhanced cosmic-ray ionization rates, however, cannot be ruled out and is expected to play a significant role in the diffuse and dense gas chemistry. This is supported by the detection of ionic species like OH+ and H2O+, as well as the enhanced fluxes of the OH lines with respect to those of H2O lines detected in both PACS and SPIRE spectra.
Formation of Silicate and Titanium Clouds on Hot Jupiters
Authors: Powell Diana , Zhang Xi , Gao Peter , Parmentier Vivien 
Published: June 2018

Abstract
We present the first application of a bin-scheme microphysical and vertical transport model to determine the size distribution of titanium and silicate cloud particles in the atmospheres of hot Jupiters. We predict particle size distributions from first principles for a grid of planets at four representative equatorial longitudes, and investigate how observed cloud properties depend on the atmospheric thermal structure and vertical mixing. The predicted size distributions are frequently bimodal and irregular in shape. There is a negative correlation between the total cloud mass and equilibrium temperature as well as a positive correlation between the total cloud mass and atmospheric mixing. The cloud properties on the east and west limbs show distinct differences that increase with increasing equilibrium temperature. Cloud opacities are roughly constant across a broad wavelength range, with the exception of features in the mid-infrared. Forward-scattering is found to be important across the same wavelength range. Using the fully resolved size distribution of cloud particles as opposed to a mean particle size has a distinct impact on the resultant cloud opacities. The particle size that contributes the most to the cloud opacity depends strongly on the cloud particle size distribution. We predict that it is unlikely that silicate or titanium clouds are responsible for the optical Rayleigh scattering slope seen in many hot Jupiters. We suggest that cloud opacities in emission may serve as sensitive tracers of the thermal state of a planet’s deep interior through the existence or lack of a cold trap in the deep atmosphere.
The Magnetic Binary GJ 65: A Test of Magnetic Diffusivity Effects
Authors: MacDonald James , Mullan D. J. , Dieterich Sergio 
Published: June 2018

Abstract
GJ 65 is an M dwarf binary system consisting of the two flare stars BL Cet (GJ 65A) and UV Cet (GJ 65B). Two teams of investigators have recently reported total magnetic fluxes corresponding to fields of 4.5 and 5.2 kG for GJ 65A and 5.8 and 6.7 kG for GJ 65B: for each component, the magnetic results obtained by the two teams agree with each other to within 1σ. For the first time, we can directly compare the predictions of our magneto-convective models, based on fitting observed stellar parameters, with measured field strengths. We find that our models agree with the observed field strengths, provided the effects of finite conductivity are accounted for. Thus, GJ 65 provides us with an opportunity to use observations of field strengths to distinguish between the predictions of our models that assume perfect electrical conductivity and those that allow for finite conductivity.
Influence of Earth-directed Coronal Mass Ejections on the Sun’s Shadow Observed by the Tibet-III Air Shower Array
Authors: Amenomori M. , Bi X. J. , Chen D. , Chen T. L. , Chen W. Y. , Cui S. W. , Danzengluobu  , Ding L. K. , Feng C. F. , Feng Zhaoyang , Feng Z. Y. , Gou Q. B. , Guo Y. Q. , He H. H. , He Z. T. , Hibino K. , Hotta N. , Hu Haibing , Hu H. B. , Huang J. , Jia H. Y. , Jiang L. , Kajino F. , Kasahara K. , Katayose Y. , Kato C. , Kawata K. , Kozai M. , Labaciren  , Le G. M. , Li A. F. , Li H. J. , Li W. J. , Liu C. , Liu J. S. , Liu M. Y. , Lu H. , Meng X. R. , Miyazaki T. , Munakata K. , Nakajima T. , Nakamura Y. , Nanjo H. , Nishizawa M. , Niwa T. , Ohnishi M. , Ohta I. , Ozawa S. , Qian X. L. , Qu X. B. , Saito T. , Saito T. Y. , Sakata M. , Sako T. K. , Shao J. , Shibata M. , Shiomi A. , Shirai T. , Sugimoto H. , Takita M. , Tan Y. H. , Tateyama N. , Torii S. , Tsuchiya H. , Udo S. , Wang H. , Wu H. R. , Xue L. , Yamamoto Y. , Yamauchi K. , Yang Z. , Yuan A. F. , Zhai L. M. , Zhang H. M. , Zhang J. L. , Zhang X. Y. , Zhang Y. , Zhang Yi , Zhang Ying , Zhaxisangzhu  , Zhou X. X. ,   (The Tibet ASγ Collaboration)
Published: June 2018

Abstract
We examine the possible influence of Earth-directed coronal mass ejections (ECMEs) on the Sun’s shadow in the 3 TeV cosmic-ray intensity observed by the Tibet-III air shower (AS) array. We confirm a clear solar-cycle variation of the intensity deficit in the Sun’s shadow during ten years between 2000 and 2009. This solar-cycle variation is overall reproduced by our Monte Carlo (MC) simulations of the Sun’s shadow based on the potential field model of the solar magnetic field averaged over each solar rotation period. We find, however, that the magnitude of the observed intensity deficit in the Sun’s shadow is significantly less than that predicted by MC simulations, particularly during the period around solar maximum when a significant number of ECMEs is recorded. The χ
2 tests of the agreement between the observations and the MC simulations show that the difference is larger during the periods when the ECMEs occur, and the difference is reduced if the periods of ECMEs are excluded from the analysis. This suggests the first experimental evidence of the ECMEs affecting the Sun’s shadow observed in the 3 TeV cosmic-ray intensity.
Are Elias 2-27's Spiral Arms Driven by Self-gravity, or by a Companion? A Comparative Spiral Morphology Study
Authors: Forgan Duncan H. , Ilee John D. , Meru Farzana 
Published: June 2018

Abstract
The spiral waves detected in the protostellar disk surrounding Elias 2-27 have been suggested as evidence of the disk being gravitationally unstable. However, previous work has shown that a massive, stable disk undergoing an encounter with a massive companion are also consistent with the observations. We compare the spiral morphology of smoothed particle hydrodynamic simulations modeling both cases. The gravitationally unstable disk produces symmetric, tightly wound spiral arms with constant pitch angle, as predicted by the literature. The companion disk’s arms are asymmetric, with pitch angles that increase with radius. However, these arms are not well-fitted by standard analytic expressions, due to the high disk mass and relatively low companion mass. We note that differences (or indeed similarities) in morphology between pairs of spirals is a crucial discriminant between scenarios for Elias 2-27, and hence future studies must fit spiral arms individually. If Elias 2-27 continues to show symmetric tightly wound spiral arms in future observations, then we posit that it is the first observed example of a gravitationally unstable protostellar disk.
Possibilities and Pitfalls with Establishing a National Data Store for Natural Science Collections
Authors: Daly Brenda , Roberts Reuben 
Published: June 2018

The South African National Biodiversity Institute (SANBI) has initiated the development of the National Biodiversity Information System to provide access to integrated South African biodiversity information. The aim of the project is to centrally manage all biodiversity information to support researchers, conservationists, policy and decision-makers in achieving their goals, support planners in making sensible decisions, and help SANBI understand the anthropogenic impact on biodiversity. The project is set to deliver a centralised web-based infrastructure to capture, aggregate, manage, discover, analyse and visualise biodiversity data and associated information through a suite of tools and spatial layers. The infrastructure is a Microsoft technology stack with microservices component architecture (http://microservices.io/patterns/microservices.html), which is vital to building an application out of small collaborating services, stemming from integrating the enterprise system.
SANBI conducted a review of the data holdings of the individual herbaria and museums in South Africa. The intention is to have a federated approach to data management, exposing what is available as a collection but ensuring that each individual natural science collection has full ownership and management control over their data within a defined framework and governed by internationally accepted data policies and standards. The presentation highlights the opportunities and unexpected difficulties with developing a national botanical and zoological collections data management service in South Africa.
Être psychologue et immigrant : les enjeux de la clinique
Authors: Tissières Nathalie , Krymko-Bleton Irène 
Published: June 2018

Bien que nombreux au Québec, les psychologues immigrants vivent une réalité professionnelle peu connue. Cet article explore les enjeux cliniques qui leur sont spécifiques. Lors de deux entrevues, quatre psychologues immigrants ont commenté des dessins d’enfants et abordé leur pratique clinique. Les données ont été analysées selon l’approche psychodynamique. Les résultats se déclinent en trois thématiques : le rôle de l’identité culturelle des psychologues dans leurs interprétations des dessins, leur relation avec leurs patients immigrants et l’impact d’expériences de discrimination sur leur identité professionnelle. Leur position d’immigrants leur donne des atouts de taille, mais il y a également un revers à la médaille : des difficultés à faire reconnaître leurs compétences, la discrimination et des conflits identitaires. Ces défis constituent des expériences de vie très précieuses pour la clinique, si les enjeux narcissiques qu’ils soulèvent sont élaborés.