Efficacy of a self-help manual in increasing resilience in carers of adults with depression in Thailand

Caring for a person with a mental illness can have adverse effects on caregivers; however, little is known about how best to help such caregivers. The aim of the present study was to examine the efficacy of a cognitive behaviour therapy-guided self-help manual in increasing resilience in caregivers of individuals with depression, in comparison to caregivers who receive routine support only. A randomized, controlled trial was conducted, following CONSORT guidelines, with 54 caregivers allocated to parallel intervention (self-help manual) (n = 27) or control (standard support) (n = 27) groups. Resilience was assessed at baseline, post-test (week 8), and follow up (week 12). Intention-to-treat analyses were undertaken. Repeated-measures ANOVA indicated a significant difference in resilience scores between the three time points, showing a large effect. Pairwise comparisons between intervention and control groups indicated resilience to be significantly different between baseline and post-test, and between baseline and follow up, but not between post-test and follow up. Overall, the intervention group showed a slightly greater increase in resilience over time than the control group; however, the time–group interaction was not significant. Guided self-help is helpful in improving caregivers’ resilience and could be used as an adjunct to the limited support provided to carers by mental health nurses and other clinicians

DNA bending by photolyase in specific and non-specific complexes studied by atomic force microscopy

Specific and non-specific complexes of DNA and photolyase are visualised by atomic force microscopy. As a substrate for photolyase a 1150 bp DNA restriction fragment was UV-irradiated to produce damaged sites at random positions. Comparison with a 735 bp undamaged DNA fragment made it possible to separate populations of specific and non-specific photolyase complexes on the 1150 bp fragment, relieving the need for highly defined substrates. Thus it was possible to compare DNA bending for specific and non-specific interactions. Non-specific complexes show no significant bending but increased rigidity compared to naked DNA, whereas specific complexes show DNA bending of on average 36°and higher flexibility. A model obtained by docking shows that photolyase can accommodate a 36°bent DNA in the vicinity of the active site

The IR-Completion of Gravity: What happens at Hubble Scales?

We have recently proposed an "Ultra-Strong" version of the Equivalence Principle (EP) that is not satisfied by standard semiclassical gravity. In the theory that we are conjecturing, the vacuum expectation value of the (bare) energy momentum tensor is exactly the same as in flat space: quartically divergent with the cut-off and with no spacetime dependent (subleading) ter ms. The presence of such terms seems in fact related to some known difficulties, such as the black hole information loss and the cosmological constant problem. Since the terms that we want to get rid of are subleading in the high-momentum expansion, we attempt to explore the conjectured theory by "IR-completing" GR. We consider a scalar field in a flat FRW Universe and isolate the first IR-correction to its Fourier modes operators that kills the quadratic (next to leading) time dependent divergence of the stress energy tensor VEV. Analogously to other modifications of field operators that have been proposed in the literature (typically in the UV), the present approach seems to suggest a breakdown (here, in the IR, at large distances) of the metric manifold description. We show that corrections to GR are in fact very tiny, become effective at distances comparable to the inverse curvature and do not contain any adjustable parameter. Finally, we derive some cosmological implications. By studying the consistency of the canonical commutation relations, we infer a correction to the distance between two comoving observers, which grows as the scale factor only when small compared to the Hubble length, but gets relevant corrections otherwise. The corrections to cosmological distance measures are also calculable and, for a spatially flat matter dominated Universe, go in the direction of an effective positive acceleration.Comment: 27 pages, 2 figures. Final version, references adde

Gravitational lensing in the strong field limit

We provide an analytic method to discriminate among different types of black holes on the ground of their strong field gravitational lensing properties. We expand the deflection angle of the photon in the neighbourhood of complete capture, defining a strong field limit, in opposition to the standard weak field limit. This expansion is worked out for a completely generic spherically symmetric spacetime, without any reference to the field equations and just assuming that the light ray follows the geodesics equation. We prove that the deflection angle always diverges logarithmically when the minimum impact parameter is reached. We apply this general formalism to Schwarzschild, Reissner-Nordstrom and Janis-Newman-Winicour black holes. We then compare the coefficients characterizing these metrics and find that different collapsed objects are characterized by different strong field limits. The strong field limit coefficients are directly connected to the observables, such as the position and the magnification of the relativistic images. As a concrete example, we consider the black hole at the centre of our galaxy and estimate the optical resolution needed to investigate its strong field behaviour through its relativistic images.Comment: 10 pages, 5 figures, in press on Physical Review

On static spherically symmetric solutions of the vacuum Brans-Dicke theory

It is shown that among the four classes of the static spherically symmetric solution of the vacuum Brans-Dicke theory of gravity only two are really independent. Further by matching exterior and interior (due to physically reasonable spherically symmetric matter source) scalar fields it is found that only Brans class I solution with certain restriction on solution parameters may represent exterior metric for a nonsingular massive object. The physical viability of the black hole nature of the solution is investigated. It is concluded that no physical black hole solution different from the Schwarzschild black hole is available in the Brans-Dicke theory.Comment: 15 pages, To be published in Gen. Rel. and Grav, typos in references correcte

The Dynamical Instability of Static, Spherically Symmetric Solutions in Nonsymmetric Gravitational Theories

We consider the dynamical stability of a class of static, spherically-symmetric solutions of the nonsymmetric gravitational theory. We numerically reproduce the Wyman solution and generate new solutions for the case where the theory has a nontrivial fundamental length scale \mu^{-1}. By considering spherically symmetric perturbations of these solutions we show that the Wyman solutions are generically unstable.Comment: 13 pages, uses amslatex, graphicx and subfigure package

Caval-Aortic Access to Allow Transcatheter Aortic Valve Replacement in Otherwise Ineligible Patients Initial Human Experience

ObjectivesThis study describes the first use of caval-aortic access and closure to enable transcatheter aortic valve replacement (TAVR) in patients who lacked other access options. Caval-aortic access refers to percutaneous entry into the abdominal aorta from the femoral vein through the adjoining inferior vena cava.BackgroundTAVR is attractive in high-risk or inoperable patients with severe aortic stenosis. Available transcatheter valves require large introducer sheaths, which are a risk for major vascular complications or preclude TAVR altogether. Caval-aortic access has been successful in animals.MethodsWe performed a single-center retrospective review of procedural and 30-day outcomes of prohibitive-risk patients who underwent TAVR via caval-aortic access.ResultsBetween July 2013 and January 2014, 19 patients underwent TAVR via caval-aortic access; 79% were women. Caval-aortic access and tract closure were successful in all 19 patients; TAVR was successful in 17 patients. Six patients experienced modified VARC-2 major vascular complications, 2 (11%) of whom required intervention. Most (79%) required blood transfusion. There were no deaths attributable to caval-aortic access. Throughout the 111 (range 39 to 229) days of follow up, there were no post-discharge complications related to tract creation or closure. All patients had persistent aorto-caval flow immediately post-procedure. Of the 16 patients who underwent repeat imaging after the first week, 15 (94%) had complete closure of the residual aorto-caval tract.ConclusionsPercutaneous transcaval venous access to the aorta allows TAVR in otherwise ineligible patients, and may offer a new access strategy for other applications requiring large transcatheter implants