Blood pressure control by home monitoring : meta-analysis of randomised trials

Objective To determine the effect of home blood pressure monitoring on blood pressure levels and proportion of people with essential hypertension achieving targets. Design Meta-analysis of 18 randomised controlled trials. Participants 1359 people with essential hypertension allocated to home blood pressure monitoring and 1355 allocated to the "control" group seen in the healthcare system for 2-36 months. Main outcome measures Differences in systolic (13 studies), diastolic (16 studies), or mean (3 studies) blood pressures, and proportion of patients achieving targets (6 studies), between intervention and control groups. Results Systolic blood pressure was lower in people with hypertension who had home blood pressure monitoring than in those who had standard blood pressure monitoring in the healthcare system (standardised mean difference 4.2 (95% confidence interval 1.5 to 6.9) mm Hg), diastolic blood pressure was lower by 2.4 (1.2 to 3.5) mm Hg, and mean blood pressure was lower by 4.4 (2.0 to 6.8) mm Hg. The relative risk of blood pressure above predetermined targets was lower in people with home blood pressure monitoring (risk ratio 0.90, 0.80 to 1.00). When publication bias was allowed for, the differences were attenuated: 2.2 ( − 0.9 to 5.3) mm Hg for systolic blood pressure and 1.9 (0.6 to 3.2) mm Hg for diastolic blood pressure. Conclusions Blood pressure control in people with hypertension (assessed in the clinic) and the proportion achieving targets are increased when home blood pressure monitoring is used rather than standard blood pressure monitoring in the healthcare system. The reasons for this are not clear. The difference in blood pressure control between the two methods is small but likely to contribute to an important reduction in vascular complications in the hypertensive population

Creating personas for political and social consciousness in HCI design

Personas have become an important tool for Human-Computer Interaction professionals. However, they are not immune to limitations and critique, including stereotyping. We suggest that while some of the criticisms to personas are important, the use of personas is open to them in part because of an unquestioned focus on explicating user needs and goals in traditional persona research and creation. This focus, while helping designers, obscures some other potentially relevant aspects. In particular, when the goal of the product or software being designed is associated with social and political goals rather than with bringing a product to the market, it may be relevant to focus personas on political aspirations, social values and the will or capacity of personas to take action. We argue that it is possible when producing personas (and associated scenarios) to partially move away from representing needs and embrace personas which more explicitly represent political or social beliefs and values. We also suggest that a phenomenographic approach to user data analysis is one way to achieve this. We provide empirical evidence for our position from two large-scale European projects, the first one in the area of Social Innovation and the second in the area of eParticipation

Moving Toward Assured Access to Treatment in Microbicide Trials

Anna Forbes discusses the Global Campaign for Microbicides' consensus statement on access to treatment and standards of care in microbicide trials

Criminal Laws on Sex Work and HIV Transmission: Mapping the Laws, Considering the Consequences

Lawmakers historically justify the mobilization of criminal laws on prostitution and HIV as a means of controlling the spread of disease. Over time, however, public health research has conclusively demonstrated that criminal laws on prostitution and HIV significantly impede the ability of sex workers to access services and to live without the stigma and blame associated with being a transmitter of HIV. In turn, mainstream public health approaches to sex work and HIV emphasize decriminalization as a way to improve the lives of sex workers in need of care, treatment, and services. Our current legal system, which criminalizes both prostitution and HIV transmission and exposure, is not in keeping with this decriminalization frame and instead compounds criminal penalties on people charged with prostitution related crimes and undermines HIV efforts. This Article presents a public health law mapping of U.S. states that mandate HIV testing and criminalize HIV positive sex workers. The mapping demonstrates that laws on HIV transmission and exposure interact with laws on sex work to compound criminal penalties on people charged with prostitution related crimes. In keeping with public health evidence, this Article argues that decriminalization of sex work and HIV transmission and exposure is integral to effectively address the HIV epidemic. The Article seeks to contribute to a growing literature on the necessity of decriminalizing sex work by uncovering how these laws interact to undermine the HIV response

On the Stellar Kinematics and Mass of the Virgo Ultra-Diffuse Galaxy VCC 1287

Here, we present a kinematical analysis of the Virgo cluster ultra-diffuse galaxy (UDG) VCC 1287 based on data taken with the Keck Cosmic Web Imager (KCWI). We confirm VCC 1287's association both with the Virgo cluster and its globular cluster (GC) system, measuring a recessional velocity of $1116 \pm 2\ \mathrm{km\ s^{-1}}$. We measure a stellar velocity dispersion ($19 \pm 6\ \mathrm{km\ s^{-1}}$) and infer both a dynamical mass ($1.11^{+0.81}_{-0.81} \times 10^{9} \ \mathrm{M_{\odot}}$) and mass to light ratio ($13^{+11}_{-11}$) within the half light radius (4.4 kpc). This places VCC 1287 slightly above the well established relation for normal galaxies, with a higher mass to light ratio for its dynamical mass than normal galaxies. We use our dynamical mass, and an estimate of GC system richness, to place VCC 1287 on the GC number -- dynamical mass relation, finding good agreement with a sample of normal galaxies. Based on a total halo mass derived from GC counts, we then infer that VCC 1287 likely resides in a cored or low concentration dark matter halo. Based on the comparison of our measurements to predictions from simulations, we find that strong stellar feedback and/or tidal effects are plausibly the dominant mechanisms in the formation of VCC 1287. Finally, we compare our measurement of the dynamical mass with those for other UDGs. These dynamical mass estimates suggest relatively massive halos and a failed galaxy origin for at least some UDGs.Comment: 13 pages, 10 figures with an additional 5 pages and 5 figures in appendices. Accepted for publication in MNRAS. v2: with small updates from publication formatting and a minor plotting fix for Fig. 1

Variation in photosynthetic efficiency of spring barley (Hordeum vulgare ssp. vulgare) landraces

Crop yields are coming under pressure to continue to grow in the face of climate change, competition, disease and pressure to reduce inputs. Photosynthetic efficiency is being targeted for improvement to increase yields. This study examined the variation in parameters of photosynthetic efficiency including canopy structure (leaf length, canopy angle, and chlorophyll content and growth rate) and gas exchange (photosynthetic rate, stomatal density and chlorophyll fluorescence) in Spring Barley (Hordeum vulgare ssp vulgare). These were first established for modern cultivars representing the most widely grown lines in the last 60 years. As cultivars are developed from a small pool of parents they may have limited genetic variation available for breeding. Landraces have been suggested as sources of variation. Using field and growth cabinet based studies the photosynthetic efficiencies of canopy structure and gas exchange were established for a range of European landraces under high and low nutrient inputs. This study demonstrated that in modern cultivars the leaf length increased with year of release from 23.2 to 29.6 cm and the chlorophyll content decreased from 46.9 to 34.8 SPAD units. Once the ear had emerged no difference was seen in canopy structure or photosynthetic rate. There was variation in landrace canopy establishment rate, leaf angle and number of leaves present within the canopy. The landraces from Northern European latitudes pushed though booting and reached full canopy establishment up to 8 days sooner than those from Southern Europe. This may be a response to a shorter growth season at Northern latitudes requiring the canopy to be established quickly. The landraces held the leaves within their canopy in a more horizontal position than the Southern European lines with leaf angle ranging from 18-45 degrees at GS39 and 31-84 degrees at GS59. This regressed negatively with temperature so it may be that a vertical canopy structure is beneficial in areas with higher temperatures. The photosynthetic rate of the landraces showed no variation but when chlorophyll fluorescence examined the efficiency of photosystem II (PSII) there was a positive regression of Fv/Fm ratio with latitude. This suggested that lines from Southern Europe were experiencing a greater stress with a ratio of up to 0.822 compared to those lines from the North with ratios from 0.767. The stomatal density of the landraces showed a large difference in ranges from 22-41 stomata between the lines. When high and low nutrient inputs were compared reductions from a ratio of 0.48 to 0.47 in Harvest Index and from 55g to 52g in 1000 grain weight were seen. The chlorophyll content of the lines was also reduced from 41.7 to 39.2 SPAD units at GS39 and from 44.9 to 39.8 SPAD units at GS59 by the reduction in nutrient inputs which may be a result of less N available for the production of chlorophyll. In conclusion there is variation present in canopy structure in European landraces that may be useful for future breeding or in identifying landrace collections which could be targeted for traits of interest in photosynthetic efficiency. These landraces may provide traits which could be used to develop cultivars which are locally adapted to climate and environmental conditions

The assembly history of the nearest S0 galaxy NGC 3115 from its kinematics out to six half-light radii

Using new and archival data, we study the kinematic properties of the nearest field S0 galaxy, NGC 3115, out to $\sim6.5$ half-light radii ($R_\mathrm{e}$) from its stars (integrated starlight), globular clusters (GCs) and planetary nebulae (PNe). We find evidence of three kinematic regions with an inner transition at $\sim0.2\ R_\mathrm{e}$ from a dispersion-dominated bulge ($V_\mathrm{rot}/\sigma <1$) to a fast-rotating disk ($V_\mathrm{rot}/\sigma >1$), and then an additional transition from the disk to a slowly rotating spheroid at $\sim2-2.5\, R_\mathrm{e}$, as traced by the red GCs and PNe (and possibly by the blue GCs beyond $\sim5\, R_\mathrm{e}$). From comparison with simulations, we propose an assembly history in which the original progenitor spiral galaxy undergoes a gas-rich minor merger that results in the embedded kinematically cold disk that we see today in NGC 3115. At a later stage, dwarf galaxies, in mini mergers (mass-ratio $<$ 1:10), were accreted building-up the outer slowly rotating spheroid, with the central disk kinematics largely unaltered. Additionally, we report new spectroscopic observations of a sample of ultra-compact dwarfs (UCDs) around NGC 3115 with the Keck/KCWI instrument. We find that five UCDs are inconsistent with the general rotation field of the GCs, suggesting an \textit{ex-situ} origin for these objects, i.e. perhaps the remnants of tidally stripped dwarfs. A further seven UCDs follow the GC rotation pattern, suggesting an \textit{in-situ} origin and, possibly a GC-like nature.Comment: 22 pages (including 3 pages of Appendix material), 14 figures, published in MNRA

The Future of Offshore Financial Centres. A Case Study of Bermuda

The future of offshore financial centres has been a major topic of legal and political debate in recent years. Whilst offshore centres around the globe have reaped substantial rewards in the past two decades, it is debateable whether this can and should be sustained. As one of the most prosperous offshore financial centres, the study of Bermuda can be interpreted and applied to other offshore financial centres in the Caribbean. The analysis of international businesses and their employees is the central concept in this study in order to analyse the future of international business, and in particular the financial industry. A review of international expansion into foreign markets and the external factors associated with this will be analysed, followed by an analysis of ten interview subjects that have been chosen as representatives of the banking, insurance, and accounting industries on the island. The opinions of both expatriate and Bermudian citizens will be the main focus of my thesis due to the fact that the future of international business in Bermuda is highly dependent on skilled professionals remaining on the island. Their interpretation of the future is therefore the most important element

An Imaging Study of the Globular Cluster Systems of NGC 1407 and NGC 1400

We present wide-field Keck telescope imaging of the globular cluster (GC) systems around NGC 1407 and NGC 1400 in the Eridanus galaxy cloud. This is complemented by Hubble Space Telescope images from the Advanced Camera for Surveys of NGC 1407 and Wide Field and Planetary Camera 2 images of NGC 1400. We clearly detect bimodality in the GC colour distribution of NGC 1407. The blue GC subpopulation has a mean colour of B-I = 1.61 and a relative contribution of around 40%, whereas the red subpopulation with B-I = 2.06 contributes 60% to the overall GC system. Assuming old ages, this corresponds to [Fe/H] = -1.45 and -0.19. Both subpopulations are intrinsically broad in colour (indicating a range in ages and/or metallicities), with the red subpopulation being broader than the blue. The GC colour distribution for NGC 1400 is less clear cut than for NGC 1407, however, we also find evidence for a bimodal distribution. We find the NGC 1407 red GCs to be 20% smaller in size than the blue ones. We find both GC systems to possess a GC surface density distribution which is largely constant in these inner galaxy regions. We fit isothermal-like profiles and derive GC system core radii of 9.4 kpc for NGC 1407 and 5.8 kpc for NGC 1400. For NGC 1407 we are able to separate the surface density distribution into blue and red subpopulations, giving 17.8 and 7.6 kpc respectively. Outside this central region, the radial profile of the GC surface density is similar to that of the galaxy light for NGC 1407 but it is flatter for NGC 1400. A fit to the GC luminosity function gives a distance modulus of 31.6, which is in good agreement with distances based on the Faber-Jackson relation and the Virgo infall corrected velocity.Comment: 13 pages, 20 figures, 1 table, 4 tables in the appendix (available from first author). Accepted for publication in MNRAS. Updated SBF distance valu