CME-HSS Interaction and Characteristics Tracked from Sun to Earth.

In a thorough study, we investigate the origin of a remarkable plasma and magnetic field configuration observed in situ on June 22, 2011, near L1, which appears to be a magnetic ejecta (ME) and a shock signature engulfed by a solar wind high-speed stream (HSS). We identify the signatures as an Earth-directed coronal mass ejection (CME), associated with a C7.7 flare on June 21, 2011, and its interaction with a HSS, which emanates from a coronal hole (CH) close to the launch site of the CME. The results indicate that the major interaction between the CME and the HSS starts at a height of 1.3 R ⊙ up to 3 R ⊙ . Over that distance range, the CME undergoes a strong north-eastward deflection of at least 30 ∘ due to the open magnetic field configuration of the CH. We perform a comprehensive analysis for the CME-HSS event using multi-viewpoint data (from the Solar TErrestrial RElations Observatories, the Solar and Heliospheric Observatory and the Solar Dynamics Observatory), and combined modeling efforts (nonlinear force-free field modeling, Graduated Cylindrical Shell CME modeling, and the Forecasting a CME's Altered Trajectory - ForeCAT model). We aim at better understanding its early evolution and interaction process as well as its interplanetary propagation and related in situ signatures, and finally the resulting impact on the Earth's magnetosphere.

Demographic Study of Hip Fractures in the Maltese Islands.

INTRODUCTION: Despite hip fractures being a great public health burden, only few studies have analyzed the relationship between hip fracture incidence and socioeconomic status. Many studies found an association; however, results are in part conflicting. OBJECTIVE: To analyze the impact of regional-level socioeconomic status on the incidence of hip fractures in the Maltese Islands. METHOD: All individuals older than 50 years who presented to the acute care hospitals in Malta and Gozo with low-energy hip fractures between December 1, 2015, and November 30, 2016, were selected. Data on individual demographics, hip fracture type, surgical intervention, and hospital stay were collected. The percentage of hip fracture and socioeconomic status of each region in the Maltese Islands were calculated. These were then analyzed for any statistical association. RESULTS: A moderate negative correlation (r = -0.5987, N = 454, P < .05) was found between the socioeconomic status and the incidence of hip fracture in each region. There was 5.9% (n = 27) mortality rate posed by these hip fractures. The average duration of hospital stay was 14 days, with an average delay to surgical intervention of 2 days. CONCLUSION: Despite the Maltese Islands having a small population (429 344 people) and a free universal national health service, our results show that districts with low socioeconomic status had a higher incidence of hip fracture. Further studies using individual socioeconomic data and longer duration are required.

Earth's magnetosphere and outer radiation belt under sub-Alfvénic solar wind.

The interaction between Earth's magnetic field and the solar wind results in the formation of a collisionless bow shock 60,000-100,000 km upstream of our planet, as long as the solar wind fast magnetosonic Mach (hereafter Mach) number exceeds unity. Here, we present one of those extremely rare instances, when the solar wind Mach number reached steady values <1 for several hours on 17 January 2013. Simultaneous measurements by more than ten spacecraft in the near-Earth environment reveal the evanescence of the bow shock, the sunward motion of the magnetopause and the extremely rapid and intense loss of electrons in the outer radiation belt. This study allows us to directly observe the state of the inner magnetosphere, including the radiation belts during a type of solar wind-magnetosphere coupling which is unusual for planets in our solar system but may be common for close-in extrasolar planets.

Strong coronal channelling and interplanetary evolution of a solar storm up to Earth and Mars.

The severe geomagnetic effects of solar storms or coronal mass ejections (CMEs) are to a large degree determined by their propagation direction with respect to Earth. There is a lack of understanding of the processes that determine their non-radial propagation. Here we present a synthesis of data from seven different space missions of a fast CME, which originated in an active region near the disk centre and, hence, a significant geomagnetic impact was forecasted. However, the CME is demonstrated to be channelled during eruption into a direction +37±10° (longitude) away from its source region, leading only to minimal geomagnetic effects. In situ observations near Earth and Mars confirm the channelled CME motion, and are consistent with an ellipse shape of the CME-driven shock provided by the new Ellipse Evolution model, presented here. The results enhance our understanding of CME propagation and shape, which can help to improve space weather forecasts.

Observations of an extreme storm in interplanetary space caused by successive coronal mass ejections.

Space weather refers to dynamic conditions on the Sun and in the space environment of the Earth, which are often driven by solar eruptions and their subsequent interplanetary disturbances. It has been unclear how an extreme space weather storm forms and how severe it can be. Here we report and investigate an extreme event with multi-point remote-sensing and in situ observations. The formation of the extreme storm showed striking novel features. We suggest that the in-transit interaction between two closely launched coronal mass ejections resulted in the extreme enhancement of the ejecta magnetic field observed near 1 AU at STEREO A. The fast transit to STEREO A (in only 18.6 h), or the unusually weak deceleration of the event, was caused by the preconditioning of the upstream solar wind by an earlier solar eruption. These results provide a new view crucial to solar physics and space weather as to how an extreme space weather event can arise from a combination of solar eruptions.

Psychometric analysis of the Brisbane Practice Environment Measure (B-PEM).

PURPOSE: To undertake rigorous psychometric testing of the newly developed contemporary work environment measure (the Brisbane Practice Environment Measure [B-PEM]) using exploratory factor analysis and confirmatory factor analysis. METHODS: Content validity of the 33-item measure was established by a panel of experts. Initial testing involved 195 nursing staff using principal component factor analysis with varimax rotation (orthogonal) and Cronbach's alpha coefficients. Confirmatory factor analysis was conducted using data from a further 983 nursing staff. RESULTS: Principal component factor analysis yielded a four-factor solution with eigenvalues greater than 1 that explained 52.53% of the variance. These factors were then verified using confirmatory factor analysis. Goodness-of-fit indices showed an acceptable fit overall with the full model, explaining 21% to 73% of the variance. Deletion of items took place throughout the evolution of the instrument, resulting in a 26-item, four-factor measure called the Brisbane Practice Environment Measure-Tested. CONCLUSIONS: The B-PEM has undergone rigorous psychometric testing, providing evidence of internal consistency and goodness-of-fit indices within acceptable ranges. The measure can be utilised as a subscale or total score reflective of a contemporary nursing work environment. CLINICAL RELEVANCE: An up-to-date instrument to measure practice environment may be useful for nursing leaders to monitor the workplace and to assist in identifying areas for improvement, facilitating greater job satisfaction and retention.

Coronal mass ejection (CME) activity of low mass M stars as an important factor for the habitability of terrestrial exoplanets. I. CME impact on expected magnetospheres of Earth-like exoplanets in close-in habitable zones.

Low mass M- and K-type stars are much more numerous in the solar neighborhood than solar-like G-type stars. Therefore, some of them may appear as interesting candidates for the target star lists of terrestrial exoplanet (i.e., planets with mass, radius, and internal parameters identical to Earth) search programs like Darwin (ESA) or the Terrestrial Planet Finder Coronagraph/Inferometer (NASA). The higher level of stellar activity of low mass M stars, as compared to solar-like G stars, as well as the closer orbital distances of their habitable zones (HZs), means that terrestrial-type exoplanets within HZs of these stars are more influenced by stellar activity than one would expect for a planet in an HZ of a solar-like star. Here we examine the influences of stellar coronal mass ejection (CME) activity on planetary environments and the role CMEs may play in the definition of habitability criterion for the terrestrial type exoplanets near M stars. We pay attention to the fact that exoplanets within HZs that are in close proximity to low mass M stars may become tidally locked, which, in turn, can result in relatively weak intrinsic planetary magnetic moments. Taking into account existing observational data and models that involve the Sun and related hypothetical parameters of extrasolar CMEs (density, velocity, size, and occurrence rate), we show that Earth-like exoplanets within close-in HZs should experience a continuous CME exposure over long periods of time. This fact, together with small magnetic moments of tidally locked exoplanets, may result in little or no magnetospheric protection of planetary atmospheres from a dense flow of CME plasma. Magnetospheric standoff distances of weakly magnetized Earth-like exoplanets at orbital distances

Emotion recognition/understanding ability in hearing or vision-impaired children: do sounds, sights, or words make the difference?

BACKGROUND: This study was designed to assess whether children with a sensory disability have consistent delays in acquiring emotion recognition and emotion understanding abilities. METHOD: Younger (6-11 years) and older (12-18 years) hearing-impaired children (HI; n = 49), vision-impaired children (VI; n = 42), and children with no sensory impairment (NSI; n = 72) were assessed with the Emotion Recognition Scales (ERS), which include two tests of the ability to recognize vocal expressions of emotion, two tests of the ability to recognize facial expressions of emotion, and three tests of emotion understanding. RESULTS: Results indicate that when compared with age-peers, HI children and adolescents have significant delays or deficits on all ERS, but VI children and adolescents are delayed only on emotion recognition tasks. When compared with children group-matched for verbal ability (Wechsler verbal scales), the achievement of HI children on ERS equals or exceeds that of controls; VI children underachieve on an emotion recognition task and overachieve on an emotion vocabulary task compared to verbal ability matched peers. CONCLUSIONS: We conclude that VI children have a specific emotion recognition deficit, but among HI children, performance on emotion recognition and emotion understanding tasks reflects delayed acquisition of a broad range of language-mediated abilities.

Nurses' attitudes towards clients who self-harm.

BACKGROUND: Deliberate self-harm is frequently encountered by emergency department (ED) nurses. However, clients are often dissatisfied with the care provided and clinicians feel ambivalent, helpless or frustrated when working with clients who self-harm. AIM: The aim of the study was to develop and test a scale to identify relevant dimensions of ED nurses' attitudes to clients who present with self-injury. METHODS: Items on Attitudes Towards Deliberate Self-Harm Questionnaire (ADSHQ) were drawn from a literature review and focus group discussions with ED nurses. The tool was piloted with 20 ED nurses not working in the target agencies. A survey of nurses working within 23 major public and 14 major private EDs in Queensland, Australia (n = 1008) was then undertaken. RESULTS: A total of 352 questionnaires were returned (35% response). Analysis revealed four factors that reflected nurses' attitudes toward these clients. The factors related to nurses' perceived confidence in their assessment and referral skills; ability to deal effectively with clients, empathic approach; and ability to cope effectively with legal and hospital regulations that guide practice. There was a generally negative attitude towards clients who self-harm. Correlations were found between years of ED experience and total score on the ADSHQ, and years of ED experience and an empathic approach towards clients who deliberately self-harm. CONCLUSION: There is a need for continuing professional development activities to address negative attitudes and provide practical strategies to inform practice and clinical protocols.

Study of Queensland emergency department nurses' actions and formal and informal procedures for clients who self-harm.

Emergency department nurses are often required to assess and manage the needs of people who self-harm. A survey of 352 nurses working within 23 major public and 14 major private emergency departments in Queensland, Australia, investigated the extent to which formal and informal procedures are available and the extent to which these procedures guide how nurses respond to clients who present with deliberate self-harm. The Risk Assessment Questionnaire was developed and found that nurses are frequently called to respond to clients presenting because of deliberate self-harm, but most have no formal training in this area. In some services there is a lack of formal and comprehensive procedures for assessment and treatment. Where procedures do exist, significant therapeutic areas related to assessment are not explored with clients. These findings have implications for continuing professional development activities, nursing education programs and clinical practice procedures.