Abstract
We report results from continued timing observations of PSR J0740+6620, a high-mass, 2.8 ms radio pulsar in orbit with a likely ultracool white dwarf companion. Our data set consists of ...combined pulse arrival-time measurements made with the 100 m Green Bank Telescope and the Canadian Hydrogen Intensity Mapping Experiment telescope. We explore the significance of timing-based phenomena arising from general relativistic dynamics and variations in pulse dispersion. When using various statistical methods, we find that combining ∼1.5 yr of additional, high-cadence timing data with previous measurements confirms and improves on previous estimates of relativistic effects within the PSR J0740+6620 system, with the pulsar mass
m
p
=
2.08
−
0.07
+
0.07
M
⊙
(68.3% credibility) determined by the relativistic Shapiro time delay. For the first time, we measure secular variation in the orbital period and argue that this effect arises from apparent acceleration due to significant transverse motion. After incorporating contributions from Galactic differential rotation and off-plane acceleration in the Galactic potential, we obtain a model-dependent distance of
d
=
1.14
−
0.15
+
0.17
kpc (68.3% credibility). This improved distance confirms the ultracool nature of the white dwarf companion determined from recent optical observations. We discuss the prospects for future observations with next-generation facilities, which will likely improve the precision on
m
p
for J0740+6620 by an order of magnitude within the next few years.
Purpose
Quality of life (QOL) is an important concept in the field of health and medicine. QOL is a complex concept that is interpreted and defined differently within and between disciplines, ...including the fields of health and medicine. The aims of this study were to systematically review the literature on QOL in medicine and health research and to describe the country of origin, target groups, instruments, design, and conceptual issues.
Methods
A systematic review was conducted to identify research studies on QOL and health-related quality of life (HRQOL). The databases Scopus, which includes Embase and MEDLINE, CINAHL, and PsycINFO were searched for articles published during one random week in November 2016. The ten predefined criteria of Gill and Feinstein were used to evaluate the conceptual and methodological rigor.
Results
QOL research is international and involves a variety of target groups, research designs, and QOL measures. According to the criteria of Gill and Feinstein, the results show that only 13% provided a definition of QOL, 6% distinguished QOL from HRQOL. The most frequently fulfilled criteria were: (i) stating the domains of QOL to be measured; (ii) giving a reason for choosing the instruments used; and (iii) aggregating the results from multiple items.
Conclusion
QOL is an important endpoint in medical and health research, and QOL research involves a variety of patient groups and different research designs. Based on the current evaluation of the methodological and conceptual clarity of QOL research, we conclude that the majority QOL studies in health and medicine have conceptual and methodological challenges.
Abstract
In this work, we present polarization profiles for 23 millisecond pulsars observed at 820 and 1500 MHz with the Green Bank Telescope as part of the NANOGrav pulsar timing array. We calibrate ...the data using Mueller matrix solutions calculated from observations of PSRs B1929+10 and J1022+1001. We discuss the polarization profiles, which can be used to constrain pulsar emission geometry, and present both the first published radio polarization profiles for nine pulsars and the discovery of very low-intensity average profile components (“microcomponents”) in four pulsars. We obtain the Faraday rotation measures for each pulsar and use them to calculate the Galactic magnetic field parallel to the line of sight for different lines of sight through the interstellar medium. We fit for linear and sinusoidal trends in time in the dispersion measure and Galactic magnetic field and detect magnetic field variations with a period of 1 yr in some pulsars, but overall find that the variations in these parameters are more consistent with a stochastic origin.
Abstract
Aims
To perform the first psychometric analysis of the Norwegian version of the eHLQ using confirmative factor analysis (CFA) procedures in a population of patients admitted to hospital ...using a cross-sectional design. The eHLQ consists of 35 items capturing the 7-dimensional eHealth Literacy Framework (eHLF) which describes users' attributes, user's interaction with technologies and user's experience with digital health systems.
Methods
The 7 independent scales of the eHLQ was translated from Danish and culturally adapted into the Norwegian language following a standardised protocol. Assessment of construct validity of the eHLQ was undertaken using data from a cross-sectional survey of 260 patients hospitalized at a Norwegian University Hospital in the Oslo area during a two-week period in June 2021. The analysis included using correlation analysis (Pearsons R), internal consistency (Cronbach’s alpha) and confirmatory factor analysis (CFA).
Results
All factor loadings were high to acceptable (i.e. > 0.6), except for five items which had somewhat lower loadings. Regarding internal consistency, alpha ranged from 0.73 to 0.90. For optimal CFA fit for the different scale models, correlated residuals were required for five of the seven scales. Overall our analysis shows an intermediate fit of the orginal construct. Scale intercorrelations were all below 0.8, indicating an overall acceptable discriminant validity between the 7 dimensions.
Conclusions
The results from the CFA analysis indicate that for almost all 7 eHLQ scales, an acceptable model fit was achieved. The 260 hospitalized patients included in this study represented a variety of diagnoses, recruited from a geographically limited area. Further studies on psychometric properties of the Norwegian version of eHLQ in larger samples, diverse settings and by using more comprehensive approaches are warranted.
Summary
Background
Health literacy (HL) – the ability to seek, understand and utilize health information – is important for good health. Suboptimal HL has been associated with poorer health outcomes ...in other chronic conditions, although this has not previously been studied in patients with psoriasis.
Objectives
To investigate the HL strengths and weaknesses of a cohort of patients with moderate‐to‐severe psoriasis. Another aim was to examine possible associations between patients’ quality of life, their demographic, clinical and self‐management characteristics, and dimensions of HL.
Methods
A cross‐sectional study was conducted. Data were collected from a cohort of patients with psoriasis who had received climate helio therapy from 2011 to 2016 (n = 825). HL was assessed by the Health Literacy Questionnaire (HLQ). The association between HL domains, demographic, clinical and self‐management variables were analysed using bivariate correlation and a four‐step linear multiple regression model.
Results
The scores on all HLQ dimensions indicated lower health literacy than other populations. The linear regression models showed a significant association between HL, quality of life and self‐management variables, with higher HL predicting higher quality of life, self‐efficacy and psoriasis knowledge. Sex, educational attainment, age and disease severity had less influence on health literacy.
Conclusions
Improving HL may be a useful strategy for reducing disparities in self‐management skills for patients with psoriasis. Interventions that aim to reduce disease severity and increase psoriasis knowledge, self‐efficacy and quality of life may positively increase HL.
What's already known about this topic?
Health literacy (HL) has increasingly been acknowledged as an essential component of an individual's resources and competency to self‐manage chronic conditions such as psoriasis.
HL negatively affects healthcare utilization.
HL has not yet been investigated in patients with psoriasis.
What does this study add?
This is the first comprehensive HL assessment of psoriasis.
Patients with psoriasis who have received climate helio therapy have lower HL scores than people with other chronic conditions.
Factors associated with lower HL in people with psoriasis include lower educational attainment, lower psoriasis severity, lack of knowledge, lower self‐efficacy, fewer comorbidities, shorter disease duration and lower quality of life.
Assessing HL in psoriasis may help tailor self‐management support interventions.
Linked Comment: Rowlands. Br J Dermatol 2019; 180:1299–1300.
Plain language summary available online
Respond to this article
Objective
The objective of this study was to determine the efficacy of hydroxychloroquine (HCQ) in the primary thrombosis prevention of antiphospholipid antibody (aPL)-positive patients with no other ...systemic autoimmune diseases.
Methods
Under the auspices of Antiphospholipid Syndrome Alliance for Clinical Trials and International Networking, a multicenter, international, randomized controlled trial (RCT) was initiated, in which persistently aPL-positive but thrombosis-free patients without systemic autoimmune diseases were randomized to receive HCQ or no treatment in addition to their standard regimen. The primary objective was the efficacy of HCQ in preventing the first thrombosis. The secondary objectives were the thrombosis incidence rate, and the effects of HCQ on aPL profile and mortality rate. Patients were risk-stratified based on antiplatelet agent use. The goal was to follow patients every 6 months for 5 years.
Results
We recruited 20 persistently aPL-positive patients (female: 19, mean age: 46.6 ± 9.9 years, and baseline antiplatelet medication: 14); 9/20 were randomized to HCQ. During the mean follow-up of 1.7 years, no patients developed thrombosis or a serious adverse event. The study was terminated early due to the low recruitment rate, exacerbated by the prolonged manufacturing shortage and significant price increase of HCQ in the United States.
Conclusion
Given that a small number of patients with a relatively short follow-up were enrolled in our RCT, and no patients developed thrombosis, we cannot accurately assess the effectiveness of HCQ for primary thrombosis prevention in persistently aPL-positive patients with no other systemic autoimmune diseases. Our experience suggests that conducting an international RCT, especially without pharmaceutical support, is an extremely challenging undertaking.
ABSTRACT
PSR J1757−1854 is one of the most relativistic double neutron star binary systems known in our Galaxy, with an orbital period of $P_\text{b}=4.4\, \text{h}$ and an orbital eccentricity of ...e = 0.61. As such, it has promised to be an outstanding laboratory for conducting tests of relativistic gravity. We present the results of a 6-yr campaign with the 100-m Green Bank and 64-m Parkes radio telescopes, designed to capitalize on this potential. We identify secular changes in the profile morphology and polarization of PSR J1757−1854, confirming the presence of geodetic precession and allowing the constraint of viewing geometry solutions consistent with General Relativity. We also update PSR J1757−1854’s timing, including new constraints of the pulsar’s proper motion, post-Keplerian parameters, and component masses. We conclude that the radiative test of gravity provided by PSR J1757−1854 is fundamentally limited to a precision of 0.3 per cent due to the pulsar’s unknown distance. A search for pulsations from the companion neutron star is also described, with negative results. We provide an updated evaluation of the system’s evolutionary history, finding strong support for a large kick velocity of $w\ge 280\, \rm{km\,s}^{-1}$ following the second progenitor supernova. Finally, we reassess PSR J1757−1854’s potential to provide new relativistic tests of gravity. We conclude that a 3-σ constraint of the change in the projected semimajor axis ($\dot{x}$) associated with Lense–Thirring precession is expected no earlier than 2031. Meanwhile, we anticipate a 3-σ measurement of the relativistic orbital deformation parameter δθ as soon as 2026.
Summary
Background
Psoriasis is a common skin disease with extensive comorbidity risks, which may affect multiple aspects of life. Self‐management is essential for skin treatment and lifestyle ...choices, but few disease‐specific tailored self‐management and educational programmes appear to be available.
Objectives
To evaluate the effects of a 3‐month individual motivational interviewing intervention in patients with psoriasis (with a total follow‐up of 6 months) after climate therapy/heliotherapy (CHT).
Methods
A randomized controlled trial with 169 patients with psoriasis was conducted in the context of CHT at Gran Canaria, Spain. The main outcome measures were Self‐Administered Psoriasis Area and Severity Index (SAPASI) and Health Education Impact Questionnaire (heiQ), and the secondary outcomes were illness perception, psoriasis knowledge and lifestyle change assessments. Outcomes were measured at baseline, after 3 weeks of CHT, and 3 months and 6 months later.
Results
There were significant overall treatment effects in the study group in terms of the SAPASI score, three self‐management domains of heiQ and the self‐efficacy scores (P < 0∙05). The lifestyle change parameters were significantly better in the study group. Illness perception differed between the groups at 3 months (P = 0∙014), and psoriasis knowledge was significantly better in the study group at 6 months (P = 0∙017).
Conclusions
A 3‐month motivational interviewing intervention following CHT had positive overall effects on disease severity, self‐efficacy, psoriasis knowledge and health behaviour change. This approach has the potential to be an important complement to medical management, self‐management and education in patients with psoriasis.
What's already known about this topic?
Psoriasis requires extensive self‐management with respect to skin treatment and lifestyle choices.
Motivational interviewing is a form of patient‐centred counselling that aims to facilitate change and increase self‐efficacy.
What does this study add?
The first evaluation of motivational interviewing in patients with psoriasis.
Motivational interviewing could be an important self‐management support method in psoriasis, leading to reduced disease severity, increased self‐efficacy and psoriasis knowledge, and better lifestyle patterns.
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