Exploring the impact of depressive symptoms and medication beliefs on medication adherence in hypertension-A primary care study

Objective: This Study aimed to assess the levels of adherence in a sample of hypertensive patients being cared for in primary care in Northern Ireland and to explore the impact of depressive symptoms and medication beliefs on medication adherence.

Optimal glycaemic control, pre-eclampsia and gestational hypertension in women with type 1 diabetes in the Diabetes and Pre-Eclampsia Intervention Trial

OBJECTIVE
To assess the relationship between glycemic control, pre-eclampsia, and gestational hypertension in women with type 1 diabetes.

RESEARCH DESIGN AND METHODS
Pregnancy outcome (pre-eclampsia or gestational hypertension) was assessed prospectively in 749 women from the randomized controlled Diabetes and Pre-eclampsia Intervention Trial (DAPIT). HbA1c (A1C) values were available up to 6 months before pregnancy (n = 542), at the first antenatal visit (median 9 weeks) (n = 721), at 26 weeks’ gestation (n = 592), and at 34 weeks’ gestation (n = 519) and were categorized as optimal (<6.1%: referent), good (6.1–6.9%), moderate (7.0–7.9%), and poor (=8.0%) glycemic control, respectively.

RESULTS
Pre-eclampsia and gestational hypertension developed in 17 and 11% of pregnancies, respectively. Women who developed pre-eclampsia had significantly higher A1C values before and during pregnancy compared with women who did not develop pre-eclampsia (P < 0.05, respectively). In early pregnancy, A1C =8.0% was associated with a significantly increased risk of pre-eclampsia (odds ratio 3.68 [95% CI 1.17–11.6]) compared with optimal control. At 26 weeks’ gestation, A1C values =6.1% (good: 2.09 [1.03–4.21]; moderate: 3.20 [1.47–7.00]; and poor: 3.81 [1.30–11.1]) and at 34 weeks’ gestation A1C values =7.0% (moderate: 3.27 [1.31–8.20] and poor: 8.01 [2.04–31.5]) significantly increased the risk of pre-eclampsia compared with optimal control. The adjusted odds ratios for pre-eclampsia for each 1% decrement in A1C before pregnancy, at the first antenatal visit, at 26 weeks’ gestation, and at 34 weeks’ gestation were 0.88 (0.75–1.03), 0.75 (0.64–0.88), 0.57 (0.42–0.78), and 0.47 (0.31–0.70), respectively. Glycemic control was not significantly associated with gestational hypertension.

CONCLUSIONS
Women who developed pre-eclampsia had significantly higher A1C values before and during pregnancy. These data suggest that optimal glycemic control both early and throughout pregnancy may reduce the risk of pre-eclampsia in women with type 1 diabetes.

A puzzling periodicity in the pulsating DA white dwarf G 117-B15A

We present time-resolved optical spectrophotometry of the pulsating hydrogen atmosphere (DA) white dwarf G 117-B15A. We find three periodicities in the pulsation spectrum (215 s, 272 s, and 304 s) all of which have been found in earlier studies. By comparing the fractional wavelength dependence of the pulsation amplitudes ( chromatic amplitudes) with models, we confirm a previous report that the strongest mode, at 215 s, has l = 1. The chromatic amplitude for the 272 s mode is very puzzling, showing an increase in fractional amplitude with wavelength that cannot be reproduced by the models for any ` at optical wavelengths. Based on archival HST data, we show that while the behaviour of the 215 s mode at ultra-violet wavelengths is as expected from models, the weird behaviour of the 272 s periodicity is not restricted to optical wavelengths in that it fails to show the expected increase in fractional amplitude towards shorter wavelengths. We discuss possible causes for the discrepancies found for the 272 s variation, but find that all are lacking, and conclude that the nature of this periodicity remains unclear.

Time-resolved optical spectroscopy of the pulsating DA white dwarf HS0507+0434B - New constraints on mode identification and pulsation properties

We present a detailed analysis of time-resolved optical spectra of the ZZ Ceti white dwarf, HS 0507+0434B. Using the wavelength dependence of observed mode amplitudes, we deduce the spherical degree, l, of the modes, most of which have l = 1. The presence of a large number of combination frequencies (linear sums or differences of the real modes) enabled us not only to test theoretical predictions but also to indirectly infer spherical and azimuthal degrees of real modes that had no observed splittings. In addition to the above, we measure line-of-sight velocities from our spectra. We find only marginal evidence for periodic modulation associated with the pulsation modes: at the frequency of the strongest mode in the lightcurve, we measure an amplitude of 2.6 +/- 1.0 kms(-1), which has a probability of 2% of being due to chance; for the other modes, we find lower values. Our velocity amplitudes and upper limits are smaller by a factor of two compared to the amplitudes found in ZZ Psc. We find that this is consistent with expectations based on the position of HS 0507+0434B in the instability strip. Combining all the available information from data such as ours is a first step towards constraining atmospheric properties in a convectionally unstable environment from an observational perspective.

Forensic examination of multilayer white paint by lateral scanning Raman spectroscopy

Multilayer samples of white architectural paint potentially have very high evidential value in forensic casework, because the probability that two unrelated samples will have the same sequence of layers is extremely low. However, discrimination between the different layers using optical microscopy is often difficult or impossible. Here, lateral scanning Raman spectroscopy has been used to chemically map the cross-sections of multilayer white paint chips. It was found that the spectra did allow the different layers to be delineated on the basis of their spectral features. The boundaries between different layers were not as sharp as expected, with transitions occurring over length scales of > 20 µm, even with laser spot diameters <4 µm. However, the blurring of the boundaries was not so large as to prevent recording and identification of spectra from each of the layers in the samples. This method clearly provides excellent discrimination between different multilayer white paint samples and can readily be incorporated into existing procedures for examination of paint transfer evidence.

Platelet Redox Balance in Diabetic Patients with Hypertension improved by n-3 fatty acids

OBJECTIVE:
Patients with type 2 diabetes mellitus (T2DM) are at increased risk of developing cardiovascular disease, largely as a result of defective production of cardioprotective nitric oxide and a concomitant rise in oxidative stress. Dietary interventions that could reverse this trend would be extremely beneficial. Here we investigated whether dietary n-3 polyunsaturated fatty acid (n-3 PUFA) supplementation positively affected platelet nitroso-redox imbalance.
RESEARCH DESIGN AND METHODS:
We randomized hypertensive T2DM patients (T2DM HT; n = 22) and age-and-sex matched hypertensive study participants without diabetes (HT alone; n = 23) in a double-blind, crossover fashion to receive 8 weeks of n-3 PUFAs (1.8 g eicosapentaenoic acid and 1.5 g docosahexaenoic acid) or identical olive oil capsules (placebo), with an intervening 8-week washout period. Platelet nitrite and superoxide were measured and compared before and after treatment; 8-isoprostane was determined by ELISA and subcellular compartmentalization of the NAD(P)H oxidase subunit p47-phox examined by Western blotting.
RESULTS:
The n-3 PUFA supplementation reduced 8-isoprostane and superoxide levels in platelets from T2DM HT, but not HT alone, participants, without effect on nitrite production. This coincided with a significant decrease in p47-phox membrane localization and a similar reduction in superoxide to that achieved with apocynin. At baseline, a subcohort of T2DM HT and HT alone participants showed evidence of nitric oxide synthase (NOS)-derived superoxide production, indicating defective enzymatic activity. This was reversed significantly in T2DM HT participants after treatment, demonstrating improved NOS function.
CONCLUSIONS:
Our finding that n-3 PUFAs diminish platelet superoxide production in T2DM HT patients in vivo suggests a therapeutic role for these agents in reducing the vascular-derived oxidative stress associated with diabetes.

First record of greater white-toothed shrew Crocidura russula in Ireland

1. Skeletal remains of greater white-toothed shrew Crocidura russula were recovered from barn owl Tyto alba and kestrel Falco tinnunculus pellets collected at 15 locations in Counties Tipperary and Limerick in Ireland in September 2007 and March 2008. Seven greater white-toothed shrews were trapped at four locations in Tipperary in March 2008. This is the first Irish record of C. russula and compelling evidence that the species is established in Ireland.

Infrared spectrum of an extremely cool white-dwarf star

White dwarfs are the remnant cores of stars that initially had masses of less than 8 solar masses. They cool gradually over billions of years, and have been suggested(1,2) to make up much of the 'dark matter' in the halo of the Milky way. But extremely cool white dwarfs have proved difficult to detect, owing to both their faintness and their anticipated similarity in colour to other classes of dwarf stars. Recent improved models(3-5) indicate that white dwarfs are much more blue than previously supposed, suggesting that the earlier searches may have been looking for the wrong kinds of objects. Here we report an infrared spectrum of an extremely cool white dwarf that is consistent with the new models. We determine the star's temperature to be 3,500 +/- 200 K, making it the coolest known white dwarf. The kinematics of this star indicate that it is in the halo of the Milky Way, and the density of such objects implied by the serendipitous discovery of this star is consistent with white dwarfs dominating the dark matter in the halo.

On the parallax of WD 0346+246: a halo white dwarf candidate

We present a parallax measurement for the very cool degenerate WD 0346+246, the serendipitous discovery of which was reported by Hambly et al, We find an absolute parallax of 36 +/- 5 mas, yielding a distance estimate of 28 +/- 4pc. The resulting absolute visual magnitude of the object is M-V = 16.8 +/- 0.3, making it the second-lowest luminosity white dwarf currently known. We use the distance estimate and measured proper motion to show that the object has kinematics consistent with membership of the Galactic halo. WD 0346+246 is therefore by far the coolest and least luminous of only a handful of plausible halo white dwarf candidates. As such, the object has relevance to the ongoing debate concerning the results of microlensing experiments and the nature of any baryonic dark matter component to the Galactic halo residing in stellar remnants.

The 'Unhomely' White Women of Antillean Writing

While the field known as ‘Whiteness Studies’ has been thriving in Anglophone criticism and theory for over 25 years, it is almost unknown in France. This is partly due to epistemological and political differences, but also to demographic factors — in contrast with the post-plantation culture of the US, for example, whites in Martinique and Guadeloupe are a tiny minority of small island populations. Yet ‘whiteness’ remains a phantasized and a fetishized state in the Antillean imaginary, and is strongly inflected by gender. This article sketches the emergence of ‘white’ femininity during slavery, then examines its representation in the work of a number of major Antillean writers (Condé, Placoly, Confiant, Chamoiseau). In their work, a cluster of recurring images and leitmotifs convey the idealization or, more commonly, the pathologization, of the white woman; these images resonate strongly with Bhabha’s ‘unhomely’, and convey the disturbing imbrication of sex and race in Antillean history.

Workplace social capital and risk of chronic and severe hypertension: a cohort study

Objective: The association between workplace factors and the development of hypertension remains uncertain. We examined the risk of hypertension as a function of workplace social capital, that is, social cohesion, trust and reciprocity in the workplace.

White matter fractional anisotrophy predicts balance performance in older adults

Aging is characterized by brain structural changes that may compromise motor functions. In the context of postural control, white matter integrity is crucial for the efficient transfer of visual, proprioceptive and vestibular feedback in the brain. To determine the role of age-related white matter decline as a function of the sensory feedback necessary to correct posture, we acquired diffusion weighted images in young and old subjects. A force platform was used to measure changes in body posture under conditions of compromised proprioceptive and/or visual feedback. In the young group, no significant brain structure-balance relations were found. In the elderly however, the integrity of a cluster in the frontal forceps explained 21% of the variance in postural control when proprioceptive information was compromised. Additionally, when only the vestibular system supplied reliable information, the occipital forceps was the best predictor of balance performance (42%). Age-related white matter decline may thus be predictive of balance performance in the elderly when sensory systems start to degrade.