Efficiency of using community organisations as catalysts for recruitment to continence promotion trials

This article is available open access through the publisher’s website from the link below. Copyright @ 2012 The Authors.Background - A major challenge for determining the effectiveness of community-based continence promotion campaigns is recruitment of a representative sample of incontinent participants who have not previously sought care. Purpose - To evaluate the efficiency of engaging community organisations as catalysts for recruitment of community-dwelling older women with incontinence to the ‘Continence across Continents’ randomised controlled trial. Methods - Seniors’ and women’s community-based organisations throughout the United Kingdom were solicited by telephone or email to assist recruitment for an open-label cluster randomised controlled trial testing three experimental continence promotion interventions and a control intervention for incontinent older women. Women aged 60 years and older who experienced at least weekly urinary incontinence and who had never sought treatment were eligible to participate. The response rate of the organisations and enrolment rate of eligible participants attending the continence promotion workshops were recorded. Differences in recruitment efficiency by intervention group were ascertained using analysis of variance statistics. Results - We contacted 408 community organisations over a 1-year period. Seventy organisations (17%) agreed to host a workshop, 249 (61%) did not provide a response, and 89 (22%) refused. Workshops were administered in a group format to 61 organisations (15%); 667 women attended, 583 (87%) submitted the screening questionnaire, and 437 (66%) met eligibility criteria for inclusion. A total of 192 women consented to participate in the trial, yielding a 44% recruitment efficiency among workshop attendees known to be eligible, with no significant difference in enrolment rates between groups. However, the mean participant recruitment rate per number of attendees at each workshop was only 29%, varying substantially between groups from 19% to 37%, with the lowest rate observed for the control group. The mean annual recruitment rate expressed as the number of enrolled participants per community organisation contacted was 0.5. Limitations - Reasons for women’s non-response were not collected. The findings may be country specific. Conclusions - The recruitment rate for a continence promotion trial among older women known to be eligible and attending workshops hosted by local community organisations was high (44%). Strategies are needed to bolster community organisations’ involvement in health promotion trials in general and for continence issues in particular

Long Gamma-Ray Burst Progenitors: Boundary Conditions and Binary Models

The observed association of Long Gamma-Ray Bursts (LGRBs) with peculiar Type Ic supernovae gives support to Woosley`s collapsar/hypernova model, in which the GRB is produced by the collapse of the rapidly rotating core of a massive star to a black hole. The association of LGRBs with small star-forming galaxies suggests low-metallicity to be a condition for a massive star to evolve to the collapsar stage. Both completely-mixed single star models and binary star models are possible. In binary models the progenitor of the GRB is a massive helium star with a close companion. We find that tidal synchronization during core-helium burning is reached on a short timescale (less than a few millennia). However, the strong core-envelope coupling in the subsequent evolutionary stages is likely to rule out helium stars with main-sequence companions as progenitors of hypernovae/GRBs. On the other hand, helium stars in close binaries with a neutron-star or black-hole companion can, despite the strong core-envelope coupling in the post-helium burning phase, retain sufficient core angular momentum to produce a hypernova/GRB.Comment: 8 pp., 2 figs, Proceedings of 5th Stromlo Symposiu

Effectiveness of continence promotion for older women via community organisations: A cluster randomised trial

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/Objectives: The primary objective of this cluster randomised controlled trial was to compare the effectiveness of the three experimental continence promotion interventions against a control intervention on urinary symptom improvement in older women with untreated incontinence recruited from community organisations. A second objective was to determine whether changes in incontinence-related knowledge and new uptake of risk-modifying behaviours explain these improvements. Setting: 71 community organisations across the UK. Participants: 259 women aged 60 years and older with untreated incontinence entered the trial; 88% completed the 3-month follow-up. Interventions: The three active interventions consisted of a single 60 min group workshop on (1) continence education (20 clusters, 64 women); (2) evidence-based self-management (17 clusters, 70 women); or (3) combined continence education and self-management (17 clusters, 61 women). The control intervention was a single 60 min educational group workshop on memory loss, polypharmacy and osteoporosis (17 clusters, 64 women). Primary and secondary outcome measures: The primary outcome was self-reported improvement in incontinence 3 months postintervention at the level of the individual. The secondary outcome was change in the International Consultation on Incontinence Questionnaire (ICIQ) from baseline to 3-month follow-up. Changes in incontinence-related knowledge and behaviours were also assessed. Results: The highest rate of urinary symptom improvement occurred in the combined intervention group (66% vs 11% of the control group, prevalence difference 55%, 95% CI 43% to 67%, intracluster correlation 0). 30% versus 6% of participants reported significant improvement respectively (prevalence difference 23%, 95% CI 10% to 36%, intracluster correlation 0). The number-needed-to-treat was 2 to achieve any improvement in incontinence symptoms, and 5 to attain significant improvement. Compared to controls, participants in the combined intervention reported an adjusted mean 2.05 point (95% CI 0.87 to 3.24) greater improvement on the ICIQ from baseline to 3-month follow-up. Changes in knowledge and self-reported risk-reduction behaviours paralleled rates of improvement in all intervention arms. Conclusions: Continence education combined with evidence-based self-management improves symptoms of incontinence among untreated older women. Community organisations represent an untapped vector for delivering effective continence promotion interventions.Canadian Institutes of Health Research – Institute on Aging and the Economic and Social Research Council (UK

Enzymatic synthesis of vanillin

Due to increasing interest in natural vanillin, two enzymatic routes for the synthesis of vanillin were developed. The flavoprotein vanillyl alcohol oxidase (VAO) acts on a wide range of phenolic compounds and converts both creosol and vanillylamine to vanillin with high yield. The VAO-mediated conversion of creosol proceeds via a two-step process in which the initially formed vanillyl alcohol is further oxidized to vanillin. Catalysis is limited by the formation of an abortive complex between enzyme-bound flavin and creosol. Moreover, in the second step of the process, the conversion of vanillyl alcohol is inhibited by the competitive binding of creosol. The VAO-catalyzed conversion Of vanillylamine proceeds efficiently at alkaline pH values. Vanillylamine is initially converted to a vanillylimine intermediate product, which is hydrolyzed nonenzymatically to vanillin. This route to vanillin has biotechnological potential as the widely available principle of red pepper, capsaicin, can be hydrolyzed enzymatically to vanillylamine

The bottom magnetic field and magnetosphere evolution of neutron star in low mass X-ray binary

The accretion induced neutron star magnetic field evolution is studied through considering the accretion flow to drag the field lines aside and dilute the polar field strength, and as a result the equatorial field strength increases and is buried inside the crust. The main conclusions of model are as follows: (i) the polar field decays with increasing the accreted mass; (ii) The bottom magnetic field strength of about $10^8$ G can occur when neutron star magnetosphere radius approaches the star radius, which depends on the accretion rate as \mdot^{1/2}; (iii) The neutron star magnetosphere radius decreases with accretion until it reaches the star radius, and its evolution is little influenced by the initial field and the accretion rate after accreting \sim 0.01 \ms, which implies that the magnetosphere radii of neutron stars in LMXBs would be homogeneous for Z sources and Atoll sources if they accreted the comparable masses. As an extension, the physics effects of the possible strong magnetic zone in the X-ray neutron stars and recycled pulsars are discussed. Moreover, The strong magnetic fields in the binary pulsars PSR 1831-00 and PSR 1718-19 after accreting about half solar mass in the binary accretion phase, $8.7\times10^{10}$ G and $1.28\times10^{12}$ G, respectively, can be explained through considering the incomplete frozen flow in the polar zone. As a model's expectation, the existence of the low magnetic field ($\sim 3\times 10^{7}$ G) neutron stars or millisecond pulsars is suggested.Comment: 8 pages, 4 figs, accepted by MNRAS, 200