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Recovery Colleges are opening internationally. The evaluation focus has been on outcomes for Recovery College students who use mental health services. However, benefits may also arise for: staff who attend or co-deliver courses; the mental health and social care service hosting the Recovery College; and wider society. A theory-based change model characterising how Recovery Colleges impact at these higher levels is needed for formal evaluation of their impact, and to inform future Recovery College development. The aim of this study was to develop a stratified theory identifying candidate mechanisms of action and outcomes (impact) for Recovery Colleges at staff, services and societal levels.
Methods
Inductive thematic analysis of 44 publications identified in a systematised review was supplemented by collaborative analysis involving a lived experience advisory panel to develop a preliminary theoretical framework. This was refined through semi-structured interviews with 33 Recovery College stakeholders (service user students, peer/non-peer trainers, managers, community partners, clinicians) in three sites in England.
Results
Candidate mechanisms of action and outcomes were identified at staff, services and societal levels. At the staff level, experiencing new relationships may change attitudes and associated professional practice. Identified outcomes for staff included: experiencing and valuing co-production; changed perceptions of service users; and increased passion and job motivation. At the services level, Recovery Colleges often develop somewhat separately from their host system, reducing the reach of the college into the host organisation but allowing development of an alternative culture giving experiential learning opportunities to staff around co-production and the role of a peer workforce. At the societal level, partnering with community-based agencies gave other members of the public opportunities for learning alongside people with mental health problems and enabled community agencies to work with people they might not have otherwise. Recovery Colleges also gave opportunities to beneficially impact on community attitudes.
Conclusions
This study is the first to characterise the mechanisms of action and impact of Recovery Colleges on mental health staff, mental health and social care services, and wider society. The findings suggest that a certain distance is needed in the relationship between the Recovery College and its host organisation if a genuine cultural alternative is to be created. Different strategies are needed depending on what level of impact is intended, and this study can inform decision-making about mechanisms to prioritise. Future research into Recovery Colleges should include contextual evaluation of these higher level impacts, and investigate effectiveness and harms.
. NGC 300 X-1 and IC 10 X-1 are currently the only two robust extragalactic candidates for being Wolf-Rayet/black hole X-ray binaries, the Galactic analogue being Cyg X-3. These systems are believed to be a late product of high-mass X-ray binary evolution and direct progenitors of black hole mergers. From the analysis of Swift data, the orbital period of NGC 300 X-1 was found to be 32.8 h. We here merge the full set of existing data of NGC 300 X-1, using XMM-Newton, Chandra and Swift observations to derive a more precise value of the orbital period of 32.7932 ± 0.0029 h above a confidence level of 99.99%. This allows us to phase connect the X-ray light curve of the source with radial velocity measurements of He II lines performed in 2010. We show that, as for IC 10 X-1 and Cyg X-3, the X-ray eclipse corresponds to maximum of the blueshift of the He II lines, instead of the expected zero velocity. This indicates that for NGC 300 X-1 as well, the wind of the WR star is completely ionised by the black hole radiation and that the emission lines come from the region of the WR star that is in the shadow. We also present for the first time the light curve of two recent very long XMM-Newton observations of the source, performed on the 16th to 20th of December 2016.
Anti-retroviral therapy (ART) regimes for HIV are associated with raised levels of circulating triglycerides (TGs) in western populations. However, there are limited data on the impact of ART on cardiometabolic risk in sub-Saharan African (SSA) populations.
Methods
Pooled analyses of 14 studies comprising 21 023 individuals, on whom relevant cardiometabolic risk factors (including TG), HIV and ART status were assessed between 2003 and 2014, in SSA. The association between ART and raised TG (>2.3 mmol/L) was analysed using regression models.
Findings
Among 10 615 individuals, ART was associated with a two-fold higher probability of raised TG (RR 2.05, 95% CI 1.51–2.77, I2 = 45.2%). The associations between ART and raised blood pressure, glucose, HbA1c, and other lipids were inconsistent across studies.
Interpretation
Evidence from this study confirms the association of ART with raised TG in SSA populations. Given the possible causal effect of raised TG on cardiovascular disease (CVD), the evidence highlights the need for prospective studies to clarify the impact of long term ART on CVD outcomes in SSA.
The upper mass limit of stars remains an open question in astrophysics. Here we discuss observations of the most massive stars (greater than 100 solar masses) in the local universe and how the observations fit in with theoretical predictions. In particular, the Large Magellanic Cloud plays host to numerous very massive stars, making it an ideal template to study the roles that environment, metallicity, and multiplicity play in the formation and evolution of the most massive stars. We will discuss the work that is instrumental in laying the groundwork for interpreting future observations by James Webb of starburst regions in the high redshift universe.
Africa is experiencing a rapid increase in adult obesity and associated cardiometabolic diseases (CMDs). The H3Africa AWI-Gen Collaborative Centre was established to examine genomic and environmental factors that influence body composition, body fat distribution and CMD risk, with the aim to provide insights towards effective treatment and intervention strategies. It provides a research platform of over 10 500 participants, 40–60 years old, from Burkina Faso, Ghana, Kenya and South Africa. Following a process that involved community engagement, training of project staff and participant informed consent, participants were administered detailed questionnaires, anthropometric measurements were taken and biospecimens collected. This generated a wealth of demographic, health history, environmental, behavioural and biomarker data. The H3Africa SNP array will be used for genome-wide association studies. AWI-Gen is building capacity to perform large epidemiological, genomic and epigenomic studies across several African counties and strives to become a valuable resource for research collaborations in Africa.
The Westerlund 1 Galactic cluster hosts an eclectic mix of coeval massive stars. At a modest distance of 4–5 kpc, it offers a unique opportunity to study the resolved stellar content of a young (~5 Myr) high mass (5·104M⊙) star cluster. With the aim of testing single-star evolutionary predictions, and revealing any signatures of binary evolution, we discuss on-going analyses of NTT/SOFI near-IR spectroscopy of Wolf-Rayet stars in Westerlund 1. We find that late WN stars are H-poor compared to their counterparts in the Milky Way field, and nearly all are less luminous than predicted by single-star Geneva isochrones at the age of Westerlund 1.
The development of infrared observational facilities has revealed a number of massive stars in obscured environments throughout the Milky Way and beyond. The determination of their stellar and wind properties from infrared diagnostics is thus required to take full advantage of the wealth of observations available in the near and mid infrared. However, the task is challenging. This session addressed some of the problems encountered and showed the limitations and successes of infrared studies of massive stars.
Recent studies have claimed the existence of very massive stars (VMS) up to 300 M⊙ in the local Universe. As this finding may represent a paradigm shift for the canonical stellar upper-mass limit of 150 M⊙, it is timely to discuss the status of the data, as well as the far-reaching implications of such objects. We held a Joint Discussion at the General Assembly in Beijing to discuss (i) the determination of the current masses of the most massive stars, (ii) the formation of VMS, (iii) their mass loss, and (iv) their evolution and final fate. The prime aim was to reach broad consensus between observers and theorists on how to identify and quantify the dominant physical processes.
Wolf-Rayet (WR) stars are the evolved descendants of massive O-type stars and are considered to be progenitor candidates for Type Ib/c core-collapse supernovae (SNe). Recent results of our HST/WFC3 survey of Wolf-Rayet stars in M101 are summarised based on the detection efficiency of narrow-band optical imaging compared to broad-band methods. We show that on average 42% of WR stars, increasing to ~85% in central regions, are only detected in the narrow-band imaging. Hence, the non-detection of a WR star at the location of ~10 Type Ib/c SNe in broad-band imaging is no longer strong evidence for a non-WR progenitor channel.
Fluidic flight controls enable forces and moments for flight vehicle trim and manoeuvre to be produced without use of conventional moving surface controls. This paper introduces a methodology for the design of Circulation Control (CC) and Fluidic Thrust Vectoring (FTV) as fluidic controls for roll and pitch. Work was undertaken as part of the multidisciplinary FLAVIIR project, with the goal of providing full authority fluidic flight controls sufficient for a fully flapless flight of an 80kg class demonstrator aircraft known as DEMON. The design methodology considers drag, mass, volume and pneumatic power requirements as part of the overall design cost function. It is shown that the fundamental flow physics of both CC and FTV are similar, and hence there are strong similarities to the design approach of each. Flight ready CC and FTV hardware has been designed, manufactured and ground tested. The CC system was successfully wind tunnel demonstrated on an 85% scale half model of the DEMON. The design condition of a control ΔCL of 0·1 was achieved with a blowing coefficient of 0·01, giving a useable control gain of 10. The FTV system was static tested using a micro gas turbine source. The control characteristic was ‘N’ shaped, consisting of an initial high gain response in a negative sense (gain = −30) followed by a low gain response in a positive sense (gain = +3) at higher blowing rate. CC and FTV control hardware directly contributes to around 6% to the overall mass of the flight vehicle, however provision of pneumatic power carries a significant mass penalty unless generated as part of an integrated engine bleed system.
Investigations using a liquid-phase blocking sandwich enzyme-linked immunosorbent assay (ELISA) for the measurement of antibodies against foot-and-mouth disease virus (FMDV) in sera from sheep and from cattle are reported, and results compared with those obtained by virus neutralization (VN) tests.
Serum antibody titres in sheep after primary vaccination and in cattle challenged with a natural aerosol after vaccination were similar by ELISA and VN. However, the antibody levels detected in sera of cattle during early infection and of vaccinated cattle after intradermolingual challenge were clearly greater by ELISA than by VN.
The ELISA titres in cattle sera following synthetic peptide vaccination indicated some relationship to protection and were clearly different from those recorded by VN. On the other hand, the antibody levels following conventional vaccination showed that ELISA and VN titres in cattle sera were related to protection. Although there was a good agreement between the ELISA antibody titre and protection for the four vaccines used, by VN the titre which afforded protection varied depending on the vaccine used.
The ELISA was considered therefore to be more reliable than the VN and may prove useful for evaluating the immunological response of animals following infection and following vaccination.
The Tarantula Survey is an ambitious ESO Large Programme that has obtained multi-epoch spectroscopy of over 1000 massive stars in the 30 Doradus region in the Large Magellanic Cloud. Here, we introduce the scientific motivations of the survey and give an overview of the observational sample. Ultimately, quantitative analysis of every star, paying particular attention to the effects of rotational mixing and binarity, will be used to address fundamental questions in both stellar and cluster evolution.
A solid-phase enzyme-linked immunosorbent assay was developed to measure both African swine fever virus (ASFV) antigen and antibody. Experiments showed it to be reproducible and able to detect limiting antigen concentrations of 50–500 HAD50/ml. The assay was more sensitive than those used at present to detect ASFV antibody and it is suggested that it might be of great diagnostic use in countries where African swine fever has recently appeared.
A solid phase radioimmunoassay (RIA) has been successfully developed to measure both African swine fever virus (ASFV) antigen and antibody. Studies show that the assay is reproducible and will detect limiting antigen concentrations equivalent to 50–500 HAD50/ml. Both direct and indirect antibody RIA have been developed and have proved to be approximately 100 times more sensitive than the complement fixation test at present available and 1000 times more sensitive than the immuno-electro-osmophoresis test for the detection of ASFV antibody.
Our Working Group studies massive, luminous stars, with historical focus on early-type (OB) stars, but extending in recent years to include massive red supergiants that evolve from hot stars. There is also emphasis on the role of massive stars in other branches of astrophysics, particularly regarding starburst galaxies, the first stars, core-collapse gamma-ray bursts, and formation of massive stars.
Observed properties of Wolf–Rayet (WR) stars at high metallicity are reviewed. Wolf–Rayet stars are more common at higher metallicity, as a result of stronger mass-loss during earlier evolutionary phases with late-WC-subtypes signatures of Solar metallicity or higher. Similar numbers of early (WC4–7) and late (WC8–9) stars are observed in the Solar neighbourhood, whilst late subtypes dominate at higher metallicities, such as Westerlund 1 in the inner Milky Way and in M83. The observed trend to later WC subtype within metal-rich environments is intimately linked to a metallicity dependence of WR stars, in the sense that strong winds preferentially favour late subtypes. This has relevance to (a) the upper mass limit in metal-rich galaxies such as NGC 3049, due to softer ionizing fluxes from WR stars at high metallicity; and (b) the fact that evolutionary models including a WR metallicity dependence provide a better match to the observed N(WC)/N(WN) ratio. The latter conclusion partially rests upon the assumption of constant line luminosities for WR stars, yet observations and theoretical atmospheric models reveal higher line fluxes at high metallicity.
The federally funded Cities Readiness Initiative (CRI) requires seamless federal, state, and local public health coordination to provide antibiotics to an entire city population within 48 hours of an aerosolized release of anthrax. We document practical lessons learned from the development and implementation of the Boston CRI plan. Key themes center on heightened emphasis on security, a new mass protection model of dispensing, neighborhood-centric clinic site selection, online training of Medical Reserve Corps volunteers, and the testing of operations through drills and exercises. Sharing such lessons can build national preparedness. (Disaster Med Public Health Preparedness. 2008;2:40–49)
We have obtained new optical spectra with the ESO/VLT of the final helium flash star, V605 Aql. These spectra indicate that V605 Aql has evolved significantly in only 80 years. It now has a T$_{\rm eff}\sim$95,000 K and has abundances similar to those seen in [WC] central stars but not to those of a typical RCB star.
We discuss the determination of fundamental parameters of
"normal" hot, massive OB-type stars, namely
temperatures, luminosities, masses, gravities and surface abundances.
We also present methods used to derive properties of stellar winds
- mass-loss rates and wind velocities from early-type stars.
We discuss the various post-main sequence phases of massive stars,
focusing on Wolf-Rayet stars, Luminous Blue Variables, plus connections
with other early-type and late-type supergiants.
End states for massive stars are
also investigated, emphasising connections between Supernovae originating from
core-collapse massive stars and Gamma Ray Bursts.