Distant Type Ia and II supernovae (SNe) can serve as valuable probes of the history of the cosmic expansion and star formation, and provide important information on their progenitor models. At present, however, there are few observational constraints on the abundance of SNe at high redshifts. A major science driver for the Next Generation Space Telescope is the study of such very distant SNe. In this paper we discuss strategies for finding and counting distant SNe by using repeat imaging of supercritical intermediate redshift clusters whose mass distributions are well constrained via modelling of strongly lensed features. For a variety of different models for the star formation history and supernova progenitors, we estimate the likelihood of detecting lensed SNe as a function of their redshift. In the case of a survey conducted with Hubble Space Telescope (HST), we predict a high probability of seeing a supernova in a single return visit with either Wide Field Planetary Camera 2 or Advanced Camera for Surveys, and a much higher probability of detecting examples with z > 1 in the lensed case. Most events would represent magnified SNe II at z ≃ 1, and a fraction will be more distant examples. We discuss various ways to classify such events using ground-based infrared photometry. We demonstrate an application of the method using the HST archival data and discuss the case of a possible event found in the rich cluster AC 114 (z = 0.31).

We present a measurement of the volumetric rate of "calcium-rich" optical transients in the local universe, using a sample of three events from the Palomar Transient Factory (PTF). This measurement builds on a detailed study of the PTF transient detection efficiencies and uses a Monte Carlo simulation of the PTF survey. We measure the volumetric rate of calcium-rich transients to be higher than previous estimates: - 1.21+0.39 1.13 10-5 events yr-1Mpc-3. This is equivalent to 33%-94% of the local volumetric Type Ia supernova rate. This calcium-rich transient rate is sufficient to reproduce the observed calcium abundances in galaxy clusters, assuming an asymptotic calcium yield per calcium-rich event of .0.05 M. We also study the PTF detection efficiency of these transients as a function of position within their candidate host galaxies. We confirm as a real physical effect previous results that suggest that calcium-rich transients prefer large physical offsets from their host galaxies.

Anxiety and depression have significant and widespread effects on daily function and symptoms of patients with coronary artery disease over a 5-year period. This may partially explain why results of treadmill stress testing and angiography poorly predict the daily functioning of patients with coronary artery disease.

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Pain complaints are commonly reported symptoms among postmenopausal women and can have significant effects on health-related quality of life. We sought to identify medical and psychosocial factors that predict changes in pain and overall physical functioning over a 3-year period among postmenopausal women with recurrent pain conditions. We examined data from postmenopausal women age 50 to 79 with recurrent pain conditions (low back pain, neck pain, headache or migraines, or joint pain or stiffness) over a 3-year period using the Women's Health Initiative Observational Study Cohort (N = 67,963). Multinomial logistic regression models controlling for demographic and clinical characteristics were used to identify baseline predictors of change in the SF-36 subscales for pain and physical functioning between baseline and 3-year follow-up. Body mass index (BMI) was associated with worsening of pain (OR [95% CI] 1.54 [1.45-1.63] for BMI ≥30) and physical functioning (1.83 [1.71-1.95] for BMI ≥30). A higher reported number of nonpain symptoms, higher medical comorbidity, and a positive screen for depression (1.13 [1.05-1.22] for worsened pain) were also associated with worsening of pain and physical functioning. Baseline prescription opioid use was also associated with lack of improvement in pain (OR .42, 95% CI .36-.49) and with worsened physical functioning (1.25 [1.04-1.51]).

Perspective

This study presents prospective data on change in pain and physical functioning in postmenopausal women over a 3-year period. Our results suggest depression, nonpain physical symptoms, obesity, and possibly opioid treatment are associated with worse long-term pain outcomes in this population.

Purpose

Although coronary disease is the second most common cause of work and functional disability, little is known about the relative contributions of biomedical and psychosocial factors to this disability. This study was conducted to determine the associations of depression and anxiety with self-reported physical function and activity interference in patients with coronary artery disease.

Methods

This was a 1-year prospective cohort study of 198 HMO members who had elective cardiac catheterization for coronary artery disease in 1992. Measures included: severity of coronary artery stenosis from cardiac catheterization reports; anxiety and depression severity using interviewer-administered Hamilton Anxiety and Depression Rating Scales; and self-reported physical function and activity interference.

Results

At the time of catheterization, patients' self-reported physical function differed significantly by number of main coronary vessels stenosed >70% (P <0.03), by anxiety quartiles (P = 0.001), and by depression quartiles (P = 0.001). At 1 year, physical function was no longer associated with the number of main coronary vessels stenosed at baseline, but still was significantly associated with baseline anxiety (P <0.001) and depression quartiles (P = 0.01). Moreover, change in physical function scores from baseline to 12 months was associated with baseline anxiety (P <0.001) or depression (P <0.001) quartiles, but not with baseline number of occluded coronaries. Results for activity interference were similar to those for physical function. These associations were largely unchanged when corrected for age, sex, education, social class, medical versus surgical management of CAD, and degree of medical comorbidity.

Conclusion

Anxiety and depression have a significant and persistent effect on physical function in patients with coronary artery disease. Although current treatment methods appear to neutralize the influence of coronary stenosis on physical function during the year following catheterization, this is not true for anxiety and depression.

Objective

We examine prospectively the role of specific forms of self-efficacy in the physical and role function for patients with coronary heart disease after controlling for the effects of anxiety and depression.

Methods

A 6-month prospective cohort study was conducted after cardiac catheterization of 198 HMO members, demonstrating clinically significant coronary disease. Coronary disease severity was assessed through cardiac catheterization; physical function, role function, anxiety, depression, and self-efficacy were assessed through questionnaires.

Results

The Cardiac Self-Efficacy Scale had two factors (maintain function and control symptoms) with high internal consistency and good convergent and discriminant validity. In multiple regression models, the self-efficacy scales significantly predicted physical function, social function, and family function after controlling for baseline function, baseline anxiety, and other significant correlates.

Conclusions

Self-efficacy to maintain function and to control symptoms helps predict the physical function and role function, after accounting for coronary disease severity, anxiety, and depression in patients with clinically significant coronary disease. Interventions to improve self-efficacy may have a broader applicability in the heart disease population than previously appreciated.

Abstract: A rare subclass of Type Ia supernovae (SNe Ia) shows evidence of strong interaction with a hydrogen-rich circumstellar medium (CSM); these objects are referred to as SNe Ia-CSM. PTF11kx began life as a SN Ia, but after a month it began to show indications of significant interaction with its CSM. This well-studied object solidified the connection between SNe Ia-CSM and more typical SNe Ia, despite their spectral similarity to Type IIn SNe (which likely come from massive star progenitors, as opposed to the white dwarf progenitors for the SNe Ia-CSM). The spectra of all ~20 known SNe Ia-CSM are dominated by Hα emission (with widths of ~2000 km s−1) and exhibit large Hα/Hβ intensity ratios; moreover, they have an almost complete lack of He I emission (see left panel of Figure 1). They also show possible evidence of dust formation through a decrease in the red wing of Hα 75–100 days past maximum brightness. The absolute magnitudes of SNe Ia-CSM are found to be -21.3 mag ≤ MR ≤ −19 mag (see right panel of Figure 1), and they also show ultraviolet emission at early times and strong infrared emission at late times (but no detected radio or X-ray emission). Finally, the host galaxies of SNe Ia-CSM imply that these objects come from a relatively young stellar population.

OBJECTIVE:Depression has been reported to increase cardiac event rates and functional impairment in patients with coronary disease. This article describes the impact of depression on subsequent healthcare utilization for such patients. METHODS:One hundred ninety-eight health maintenance organization patients with stable coronary disease were interviewed after elective angiography using a structured psychiatric diagnostic scale. Cardiac events, hospitalizations, procedures, and costs were monitored for the next 5 years through automated data. Subjects were classified at the time of angiography by modified DSM-IV criteria into those with major, minor, and no depression. RESULTS:In univariate analyses, the no depression group (N = 136) was most likely to receive coronary artery bypass grafting (CABG) (61% vs. 36% in the major depression group vs. 27% in the minor depression group, p =.001), and the major depression group (N = 25) was most likely to receive percutaneous transluminal coronary angioplasty (PTCA) (44% vs. 14% in the minor depression group vs. 24% in the no depression group). The minor depression group (N = 37) was least likely to be hospitalized for cardiac reasons during follow-up (54% vs. 80% in the major depression group vs. 80% in the no depression group, p =.005). Five-year rates of myocardial infarction and death did not differ significantly between groups. Proportional hazard models showed that those in the depression groups differed in time from catheterization to CABG (chi2(2) = 11.9, p =.003) and time to PCTA (chi2(2) = 7.74, p =.02) after controlling for relevant covariates. Median regression showed that patients with no depression had higher costs during the first year but tended to have lower costs in years 2 through 5 than patients with minor or major depression. CONCLUSIONS:Depression status at angiography is associated with the need for revascularization and total healthcare costs for the following year.

Objectives

The purpose of this study was to define how the relation between depression and self-reported physical health in patients with coronary disease is modified by other patient-centered factors.

Methods

We conducted a prospective cohort study of 111 patients (members of a health maintenance organization) with angiographically documented coronary disease, examining factors (physical symptoms, psychological states and traits, and spousal support) modifying the relation between depression and patient-reported physical health 5 years later using multiple hierarchical regression models.

Results

Five regression models (all including demographic and disease severity covariates) were constructed to predict physical health from depression only (R2 = 0.22); depression plus angina and fatigue (R2 = 0.53); depression plus positive affect and novelty seeking and their interaction (R2 = 0.48); depression plus spousal support (R2 = 0.27); and depression, angina, fatigue, positive affect, and novelty seeking (overall model) (R2 = 0.65). Depression remained significant in each model, but the proportion of variance it predicted was diminished in the presence of the other variables (bivariate r = 0.39, partial r = 0.37-0.13).

Conclusions

The effect of depression on self-reported physical health is significantly mediated by physical symptoms (angina and fatigue), personality states and traits (positive affect and novelty seeking), and spousal support. Positive affect and novelty seeking had more marked effects on physical health in the presence of more depression. Thus, a broad range of factors beyond the severity of coronary disease itself affect the perceived physical health of patients with coronary heart disease.

OBJECTIVES: Effective communication skills are essential for optimally managing chronic pain and opioids. This exploratory, sequential mixed methods study tested the effect of a novel framework designed to improve pain-related communication and outcomes. METHODS: Study 1 developed a novel 5-step framework for helping primary care clinicians discuss chronic pain and opioids with patients. Study 2 pilot tested an intervention for teaching this framework using standardized patient instructors-actors trained to portray patients and provide immediate clinician feedback-deployed during regular clinic hours. Primary care physicians were randomized to receive either the intervention or pain management recommendations from the Centers for Disease Control and Prevention. Primary outcomes were pain-related interference at 2 months and clinician use of targeted communication skills (coded from transcripts of audio-recorded visits); secondary outcomes were pain intensity at 2 months, clinician self-efficacy for communicating about chronic pain, patient experience, and clinician-reported visit difficulty. RESULTS: We enrolled 47 primary care physicians from 2 academic teaching clinics and recorded visits with 48 patients taking opioids for chronic pain who had an appointment scheduled with an enrolled physician. The intervention was not associated with significant changes in primary or secondary outcomes other than clinician self-efficacy, which was significantly greater in the intervention group. DISCUSSION: This study developed a novel framework and intervention for teaching clinician pain-related communications skills. Although the intervention showed promise, more intensive or multicomponent interventions may be needed to have a significant impact on clinicians pain-related communication and pain outcomes.