Illness perceptions and coping in physical health conditions: A meta-analysis

Objective: There is a considerable body of research linking elements of Leventhal’s Common Sense Model (CSM) to emotional well-being/distress outcomes among people with physical illness. The present study aims to consolidate this literature and examine the evidence for the role of coping strategies within this literature. Methods: A systematic review was conducted where the outcomes of interest were: depression, anxiety and quality of life. A total of 1050 articles were identified and 31 articles were considered eligible to be included in the review. Results: Across a range of illnesses, perceptions of consequences of the illness and emotional representations were consistently the illness perceptions with the strongest relationship with the outcomes. Coping variables tend to be stronger predictors of outcomes than the illness perception variables. The evidence for the mediating effect of coping was inconsistent. Conclusions: Illness perceptions and coping have an important role to play in the explanation of distress outcomes across a range of physical health conditions. However, some clarity about the theoretical position of coping in relation to illness perceptions, and further longitudinal work is needed if we are to apply this information to the design of interventions for the improvement of psychological health among people with physical health conditions.<br/

Determinants of hospital death in haematological cancers: findings from a qualitative study

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. Objectives: Current UK health policy promotes enabling people to die in a place they choose, which for most is home. Despite this, patients with haematological malignancies (leukaemias, lymphomas and myeloma) are more likely to die in hospital than those with other cancers, and this is often considered a reflection of poor quality end-of-life care. This study aimed to explore the experiences of clinicians and relatives to determine why hospital deaths predominate in these diseases.Methods: The study was set within the Haematological Malignancy Research Network (HMRN-www.hmrn.org), an ongoing population-based cohort that provides infrastructure for evidence-based research. Qualitative interviews were conducted with clinical staff in haematology, palliative care and general practice (n=45) and relatives of deceased HMRN patients (n=10). Data were analysed for thematic content and coding and classification was inductive. Interpretation involved seeking meaning, salience and connections within the data. Results: Five themes were identified relating to: the characteristics and trajectory of haematological cancers, a mismatch between the expectations and reality of home death, preference for hospital death, barriers to home/hospice death and suggested changes to practice to support non-hospital death, when preferred. Conclusions: Hospital deaths were largely determined by the characteristics of haematological malignancies, which included uncertain trajectories, indistinct transitions and difficulties predicting prognosis and identifying if or when to withdraw treatment. Advance planning (where possible) and better communication between primary and secondary care may facilitate non-hospital death

Molecular cytogenetic differentiation of paralogs of Hox paralogs in duplicated and re-diploidized genome of the North American paddlefish (Polyodon spathula).

BackgroundAcipenseriformes is a basal lineage of ray-finned fishes and comprise 27 extant species of sturgeons and paddlefishes. They are characterized by several specific genomic features as broad ploidy variation, high chromosome numbers, presence of numerous microchromosomes and propensity to interspecific hybridization. The presumed palaeotetraploidy of the American paddlefish was recently validated by molecular phylogeny and Hox genes analyses. A whole genome duplication in the paddlefish lineage was estimated at approximately 42 Mya and was found to be independent from several genome duplications evidenced in its sister lineage, i.e. sturgeons. We tested the ploidy status of available chromosomal markers after the expected rediploidization. Further we tested, whether paralogs of Hox gene clusters originated from this paddlefish specific genome duplication are cytogenetically distinguishable.ResultsWe found that both paralogs HoxA alpha and beta were distinguishable without any overlapping of the hybridization signal - each on one pair of large metacentric chromosomes. Of the HoxD, only the beta paralog was unequivocally identified, whereas the alpha paralog did not work and yielded only an inconclusive diffuse signal. Chromosomal markers on three diverse ploidy levels reflecting different stages of rediploidization were identified: quadruplets retaining their ancestral tetraploid condition, semi-quadruplets still reflecting the ancestral tetraploidy with clear signs of advanced rediploidization, doublets were diploidized with ancestral tetraploidy already blurred. Also some of the available microsatellite data exhibited diploid allelic band patterns at their loci whereas another locus showed more than two alleles.ConclusionsOur exhaustive staining of paddlefish chromosomes combined with cytogenetic mapping of ribosomal genes and Hox paralogs and with microsatellite data, brings a closer look at results of the process of rediploidization in the course of paddlefish genome evolution. We show a partial rediploidization represented by a complex mosaic structure comparable with segmental paleotetraploidy revealed in sturgeons (Acipenseridae). Sturgeons and paddlefishes with their high propensity for whole genome duplication thus offer suitable animal model systems to further explore evolutionary processes that were shaping the early evolution of all vertebrates

Kepler Observations of V447 Lyr: An Eclipsing U Gem Cataclysmic Variable

We present the results of an analysis of data covering 1.5 years of the dwarf nova V447 Lyr. We detect eclipses of the accretion disk by the mass donating secondary star every 3.74 hrs which is the binary orbital period. V447 Lyr is therefore the first dwarf nova in the Kepler field to show eclipses. We also detect five long outbursts and six short outbursts showing V447 Lyr is a U Gem type dwarf nova. We show that the orbital phase of the mid-eclipse occurs earlier during outbursts compared to quiescence and that the width of the eclipse is greater during outburst. This suggests that the bright spot is more prominent during quiescence and that the disk is larger during outburst than quiescence. This is consistent with an expansion of the outer disk radius due to the presence of high viscosity material associated with the outburst, followed by a contraction in quiescence due to the accretion of low angular momentum material. We note that the long outbursts appear to be triggered by a short outburst, which is also observed in the super-outbursts of SU UMa dwarf novae as observed using Kepler.Comment: Accepted by MNRA

KIC 9406652: An Unusual Cataclysmic Variable in the Kepler Field of View

KIC 9406652 is a remarkable variable star in the Kepler field of view that shows both very rapid oscillations and long term outbursts in its light curve. We present an analysis of the light curve over quarters 1 to 15 and new spectroscopy that indicates that the object is a cataclysmic variable with an orbital period of 6.108 hours. However, an even stronger signal appears in the light curve periodogram for a shorter period of 5.753 hours, and we argue that this corresponds to the modulation of flux from the hot spot region in a tilted, precessing disk surrounding the white dwarf star. We present a preliminary orbital solution from radial velocity measurements of features from the accretion disk and the photosphere of the companion. We use a Doppler tomography algorithm to reconstruct the disk and companion spectra, and we also consider how these components contribute to the object's spectral energy distribution from ultraviolet to infrared wavelengths. This target offers us a remarkable opportunity to investigate disk processes during the high mass transfer stage of evolution in cataclysmic variables.Comment: 31 pages, 13 figures, accepted for Ap

Targeted, structured text messaging to improve dietary and lifestyle behaviours for people on maintenance haemodialysis (KIDNEYTEXT): Study protocol for a randomised controlled trial

Introduction Managing nutrition is critical for reducing morbidity and mortality in patients on haemodialysis but adherence to the complex dietary restrictions remains problematic. Innovative interventions to enhance the delivery of nutritional care are needed. The aim of this phase II trial is to evaluate the feasibility and effectiveness of a targeted mobile phone text messaging system to improve dietary and lifestyle behaviours in patients on long-term haemodialysis. Methods and analysis Single-blinded randomised controlled trial with 6 months of follow-up in 130 patients on haemodialysis who will be randomised to either standard care or KIDNEYTEXT. The KIDNEYTEXT intervention group will receive three text messages per week for 6 months. The text messages provide customised dietary information and advice based on renal dietary guidelines and general healthy eating dietary guidelines, and motivation and support to improve behaviours. The primary outcome is feasibility including recruitment rate, drop-out rate, adherence to renal dietary recommendations, participant satisfaction and a process evaluation using semistructured interviews with a subset of purposively sampled participants. Secondary and exploratory outcomes include a range of clinical and behavioural outcomes and a healthcare utilisation cost analysis will be undertaken. Ethics and dissemination The study has been approved by the Western Sydney Local Health District Human Research Ethics Committee-Westmead. Results will be presented at scientific meetings and published in peer-reviewed publications. Trial registration number ACTRN12617001084370; Pre-results

GALEX and Optical Light Curves of WX LMi, SDSSJ103100.5+202832.2 and SDSSJ121209.31+013627.7

{\it GALEX} near ultraviolet (NUV) and far-ultraviolet (FUV) light curves of three extremely low accretion rate polars show distinct modulations in their UV light curves. While these three systems have a range of magnetic fields from 13 to 70 MG, and of late type secondaries (including a likely brown dwarf in SDSSJ121209.31+013627.7), the accretion rates are similar, and the UV observations imply some mechanism is operating to create enhanced emission zones on the white dwarf. The UV variations match in phase to the two magnetic poles viewed in the optical in WX LMi and to the single poles evident in the optical in SDSSJ1212109.31+013627.7 and SDSSJ103100.55+202832.2. Simple spot models of the UV light curves show that if hot spots are responsible for the UV variations, the temperatures are on the order of 10,000-14,000K. For the single pole systems, the size of the FUV spot must be smaller than the NUV and in all cases, the geometry is likely more complicated than a simple circular spot.Comment: 29 pages, 4 tables, 10 figures, Astrophysical Journal, accepte