A Study of Community Interaction

This study analyses selected aspects of the community impact of the Kitsap Community Action Program projects entitled \u27\u27The Public Awareness of Kitsap (PACK). PACK was initiated as a response to a downsizing of Department of Defense activities in Kitsap County. With PACK, the Kitsap Community Action Program (KCAP) joined hands with the Washington Service Corps in an effort funded by the Defense Conversion Assistance program to revitalize the local Bremerton and Kitsap County economies

A randomised controlled feasibility trial of the Graded Repetitive Arm Strengthening Programme delivered to survivors of stroke at home

BACKGROUND/AIMS: This randomised controlled feasibility trial evaluated the recruitment, engagement and effect of the Graded Repetitive Arm Strengthening Programme in a community rehabilitation setting in London, UK. METHODS: A parallel design was used to ascertain the effect of the Graded Repetitive Arm Strengthening Programme plus standard care compared to standard care only over four weeks. Eleven participants were randomised using permuted blocks randomisation following discharge, with six participants allocated to the Graded Repetitive Arm Strengthening Programme (study) group and five to the standard care (control) group. The primary outcome was the Wolf Motor Function Test. Secondary outcomes were the Motor Activity Log and grip strength. RESULTS: A total of five participants in each group were analysed as one person withdrew from the study group. Participants in the study group gave more time to supplementing their exercise time independently (160% more vs 42% more). Most Wolf Motor Function Test tasks' time and function data showed a small difference in favour of the Graded Repetitive Arm Strengthening Programme. Results were re-examined using a Bayesian structural equation model to quantify changes in the underlying impairment. This showed significant differences: 40% faster task completion (P<0.001, 95% confidence level [CI] 30–49%), mean improvement of 0.54 on the five-point functional ability score (P<0.001, 95% CI 0.39–0.68), odds ratio of 0.05 for non-completion of task (P<0.001, 95% CI 0.02–0.14). CONCLUSIONS: This study has shown that implementing the Graded Repetitive Arm Strengthening Programme is feasible and may have a greater effect on outcomes when delivered as part of care in a community rehabilitation setting. The analysis of the Wolf Motor Function Test was also critiqued

Liquid crystal dimers and the twist-bend nematic phase: on the role of spacers and terminal alkyl chains.

The synthesis and characterisation of four series of liquid crystal dimers based on benzylideneaniline mesogenic units, and in which the lengths of terminal alkyloxy chains are varied are reported. The series differ in terms of their flexible spacers, namely, heptamethylene, nonamethylene, hexyloxy, and oxypentyloxy chains. The heptamethylene- and nonamethylene-linked dimers both show conventional nematic, N, and twist-bend nematic, NTB, phases with short terminal chains, and smectic behaviour emerges on increasing terminal chain length. This is attributed to increased molecular inhomogeneity driving microphase separation. The dimers containing the shorter heptamethylene spacer show a smectic A phase whereas those with the longer nonamethylene spacer exhibit an anticlinic smectic C phase. Smectic behaviour is not observed for the dimers containing either a hexyloxy spacer which exhibit nematic and twist-bend nematic phases, or with an oxypentyloxy spacer which show only a conventional nematic phase. A general observation is that TNTBN and TNI alternate in the same sense in a homologous series on varying the length of the terminal alkyl chains suggesting that the spatial uniformity of the molecular curvature is an important factor in stabilising the NTB phase. The transitional properties of the four corresponding dimers possessing nitrile terminal substituents are also described. These show enantiotropic nematic phases, and in addition, for those containing either polymethylene or hexyloxy spacers, a twist-bend nematic phase is observed. Differences in the thermal behaviour of the dimers may be attributed largely to changes in molecular shape arising from the nature of the link between the spacer and mesogenic units

Disclosure of Maternal HIV Status to Children: To Tell or Not To Tell . . . That Is the Question

HIV-infected mothers face the challenging decision of whether to disclose their serostatus to their children. From the perspective of both mother and child, we explored the process of disclosure, providing descriptive information and examining the relationships among disclosure, demographic variables, and child adjustment. Participants were 23 mothers and one of their noninfected children (9 to 16 years of age). Sixty-one percent of mothers disclosed. Consistent with previous research, disclosure was not related to child functioning. However, children sworn to secrecy demonstrated lower social competence and more externalizing problems. Differential disclosure, which occurred in one-third of the families, was associated with higher levels of depressive and anxiety symptoms. Finally, knowing more than mothers had themselves disclosed was related to child maladjustment across multiple domains. Clinical implications and the need for future research are considered

Probing for proof, plausibility, principle and possibility: a new approach to assessing evidence in a systematic evidence review

This article proposes a new approach to assessing evidence during a systematic evidence review aiming to inform international development policy. Drawing lessons from a number of social science systematic evidence reviews, the paper identifies how the method’s limiting perspective on evidence (including the exclusive focus on ‘golden standard’ empirical information) has serious disadvantages for the usability of evidence reviews for policy. This article aims to provide an alternative framework that allows for a less exclusionary, yet policy-practical way of assessing evidence. We propose four perspectives on evidence, appropriate for different stages in the policy process: principle when setting or prioritising broad policy goals, plausibility when assessing specific future policies, proof when evaluating past policies and possibility when striving for innovation and allowing exchange of ideas

The Democratic Biopolitics of PrEP

PrEP (Pre-Exposure Prophylaxis) is a relatively new drug-based HIV prevention technique and an important means to lower the HIV risk of gay men who are especially vulnerable to HIV. From the perspective of biopolitics, PrEP inscribes itself in a larger trend of medicalization and the rise of pharmapower. This article reconstructs and evaluates contemporary literature on biopolitical theory as it applies to PrEP, by bringing it in a dialogue with a mapping of the political debate on PrEP. As PrEP changes sexual norms and subjectification, for example condom use and its meaning for gay subjectivity, it is highly contested. The article shows that the debate on PrEP can be best described with the concepts ‘sexual-somatic ethics’ and ‘democratic biopolitics’, which I develop based on the biopolitical approach of Nikolas Rose and Paul Rabinow. In contrast, interpretations of PrEP which are following governmentality studies or Italian Theory amount to either farfetched or trivial positions on PrEP, when seen in light of the political debate. Furthermore, the article is a contribution to the scholarship on gay subjectivity, highlighting how homophobia and homonormativity haunts gay sex even in liberal environments, and how PrEP can serve as an entry point for the destigmatization of gay sexuality and transformation of gay subjectivity. ‘Biopolitical democratization’ entails making explicit how medical technology and health care relates to sexual subjectification and ethics, to strengthen the voice of (potential) PrEP users in health politics, and to renegotiate the profit and power of Big Pharma

A scoping study of interventions to increase the uptake of physical activity (PA) amongst individuals with mild-to-moderate depression (MMD)

Background - Depression is the largest contributor to disease burden globally. The evidence favouring physical activity as a treatment for mild-to-moderate depression is extensive and relatively uncontested. It is unclear, however, how to increase an uptake of physical activity amongst individuals experiencing mild-to-moderate depression. This leaves professionals with no guidance on how to help people experiencing mild-to-moderate depression to take up physical activity. The purpose of this study was to scope the evidence on interventions to increase the uptake of physical activity amongst individuals experiencing mild-to-moderate depression, and to develop a model of the mechanisms by which they are hypothesised to work. Methods - A scoping study was designed to include a review of primary studies, grey literature and six consultation exercises; two with individuals with experience of depression, two pre-project consultations with physical activity, mental health and literature review experts, one with public health experts, and one with community engagement experts. Results - Ten papers met the inclusion criteria and were included in the review. Consultation exercises provided insights into the mechanisms of an uptake of physical activity amongst individuals experiencing mild-to-moderate depression; evidence concerning those mechanisms is (a) fragmented in terms of design and purpose; (b) of varied quality; (c) rarely explicit about the mechanisms through which the interventions are thought to work. Physical, environmental and social factors that may represent mediating variables in the uptake of physical activity amongst people experiencing mild-to-moderate depression are largely absent from studies. Conclusions - An explanatory model was developed. This represents mild-to-moderate depression as interfering with (a) the motivation to take part in physical activity and (b) the volition that it is required to take part in physical activity. Therefore, both motivational and volitional elements are important in any intervention to increase physical activity in people with mild-to-moderate depression. Furthermore, mild-to-moderate depression-specific factors need to be tackled in any physical activity initiative, via psychological treatments such as Cognitive Behavioural Therapy. We argu

Writing in Britain and Ireland, c. 400 to c. 800

No abstract available

First narrow-band search for continuous gravitational waves from known pulsars in advanced detector data

Spinning neutron stars asymmetric with respect to their rotation axis are potential sources of continuous gravitational waves for ground-based interferometric detectors. In the case of known pulsars a fully coherent search, based on matched filtering, which uses the position and rotational parameters obtained from electromagnetic observations, can be carried out. Matched filtering maximizes the signalto- noise (SNR) ratio, but a large sensitivity loss is expected in case of even a very small mismatch between the assumed and the true signal parameters. For this reason, narrow-band analysis methods have been developed, allowing a fully coherent search for gravitational waves from known pulsars over a fraction of a hertz and several spin-down values. In this paper we describe a narrow-band search of 11 pulsars using data from Advanced LIGO’s first observing run. Although we have found several initial outliers, further studies show no significant evidence for the presence of a gravitational wave signal. Finally, we have placed upper limits on the signal strain amplitude lower than the spin-down limit for 5 of the 11 targets over the bands searched; in the case of J1813-1749 the spin-down limit has been beaten for the first time. For an additional 3 targets, the median upper limit across the search bands is below the spin-down limit. This is the most sensitive narrow-band search for continuous gravitational waves carried out so far