768 research outputs found

    A pilot randomized controlled trial of a self-management group intervention for people with early-stage dementia (The SMART study)

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    BACKGROUND: Self-management equips people to manage the symptoms and lifestyle changes that occur in long-term health conditions; however, there is limited evidence about its effectiveness for people with early-stage dementia. This pilot randomized controlled trial (RCT) explored the feasibility of a self-management intervention for people with early-stage dementia. METHODS: The participants were people with early-stage dementia (n = 24) and for each participant a caregiver also took part. Participants were randomly allocated to either an eight-week self-management group intervention or treatment as usual (TAU). Assessments were conducted at baseline, three months and six months post-randomization by a researcher blind to group allocation. The primary outcome measure was self-efficacy score at three months. RESULTS: Thirteen people with dementia were randomized to the intervention and 11 to TAU. Two groups were run, the first consisting of six people with dementia and the second of seven people with dementia. There was a small positive effect on self-efficacy with the intervention group showing gains in self-efficacy compared to the TAU group at three months (d = 0.35), and this was maintained at six months (d = 0.23). In terms of intervention acceptability, attrition was minimal, adherence was good, and satisfaction ratings were high. Feedback from participants was analyzed with content analysis. The findings suggest the positive aspects of the intervention were that it fostered independence and reciprocity, promoted social support, offered information, and provided clinician support. CONCLUSIONS: This study has provided preliminary evidence that self-management may be beneficial for people with early-stage dementia.Welsh National Institute for Social Care and Health Research Health Award 201

    Phase coexistence of gradient Gibbs states

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    We consider the (scalar) gradient fields η=(ηb)\eta=(\eta_b)--with bb denoting the nearest-neighbor edges in Z2\Z^2--that are distributed according to the Gibbs measure proportional to \texte^{-\beta H(\eta)}\nu(\textd\eta). Here H=bV(ηb)H=\sum_bV(\eta_b) is the Hamiltonian, VV is a symmetric potential, β>0\beta>0 is the inverse temperature, and ν\nu is the Lebesgue measure on the linear space defined by imposing the loop condition ηb1+ηb2=ηb3+ηb4\eta_{b_1}+\eta_{b_2}=\eta_{b_3}+\eta_{b_4} for each plaquette (b1,b2,b3,b4)(b_1,b_2,b_3,b_4) in Z2\Z^2. For convex VV, Funaki and Spohn have shown that ergodic infinite-volume Gibbs measures are characterized by their tilt. We describe a mechanism by which the gradient Gibbs measures with non-convex VV undergo a structural, order-disorder phase transition at some intermediate value of inverse temperature β\beta. At the transition point, there are at least two distinct gradient measures with zero tilt, i.e., Eηb=0E \eta_b=0.Comment: 3 figs, PTRF style files include

    Localized f electrons in CexLa1-xRhIn5: dHvA Measurements

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    Measurements of the de Haas-van Alphen effect in CexLa1-xRhIn5 reveal that the Ce 4f electrons remain localized for all x, with the mass enhancement and progressive loss of one spin from the de Haas-van Alphen signal resulting from spin fluctuation effects. This behavior may be typical of antiferromagnetic heavy fermion compounds, inspite of the fact that the 4f electron localization in CeRhIn5 is driven, in part, by a spin-density wave instability.Comment: 4 pages, 4 figures, submitted to PR

    Effective interaction between helical bio-molecules

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    The effective interaction between two parallel strands of helical bio-molecules, such as deoxyribose nucleic acids (DNA), is calculated using computer simulations of the "primitive" model of electrolytes. In particular we study a simple model for B-DNA incorporating explicitly its charge pattern as a double-helix structure. The effective force and the effective torque exerted onto the molecules depend on the central distance and on the relative orientation. The contributions of nonlinear screening by monovalent counterions to these forces and torques are analyzed and calculated for different salt concentrations. As a result, we find that the sign of the force depends sensitively on the relative orientation. For intermolecular distances smaller than 6A˚6\AA it can be both attractive and repulsive. Furthermore we report a nonmonotonic behaviour of the effective force for increasing salt concentration. Both features cannot be described within linear screening theories. For large distances, on the other hand, the results agree with linear screening theories provided the charge of the bio-molecules is suitably renormalized.Comment: 18 pages, 18 figures included in text, 100 bibliog

    Using the past to constrain the future: how the palaeorecord can improve estimates of global warming

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    Climate sensitivity is defined as the change in global mean equilibrium temperature after a doubling of atmospheric CO2 concentration and provides a simple measure of global warming. An early estimate of climate sensitivity, 1.5-4.5{\deg}C, has changed little subsequently, including the latest assessment by the Intergovernmental Panel on Climate Change. The persistence of such large uncertainties in this simple measure casts doubt on our understanding of the mechanisms of climate change and our ability to predict the response of the climate system to future perturbations. This has motivated continued attempts to constrain the range with climate data, alone or in conjunction with models. The majority of studies use data from the instrumental period (post-1850) but recent work has made use of information about the large climate changes experienced in the geological past. In this review, we first outline approaches that estimate climate sensitivity using instrumental climate observations and then summarise attempts to use the record of climate change on geological timescales. We examine the limitations of these studies and suggest ways in which the power of the palaeoclimate record could be better used to reduce uncertainties in our predictions of climate sensitivity.Comment: The final, definitive version of this paper has been published in Progress in Physical Geography, 31(5), 2007 by SAGE Publications Ltd, All rights reserved. \c{opyright} 2007 Edwards, Crucifix and Harriso

    Adsorption of mono- and multivalent cat- and anions on DNA molecules

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    Adsorption of monovalent and multivalent cat- and anions on a deoxyribose nucleic acid (DNA) molecule from a salt solution is investigated by computer simulation. The ions are modelled as charged hard spheres, the DNA molecule as a point charge pattern following the double-helical phosphate strands. The geometrical shape of the DNA molecules is modelled on different levels ranging from a simple cylindrical shape to structured models which include the major and minor grooves between the phosphate strands. The densities of the ions adsorbed on the phosphate strands, in the major and in the minor grooves are calculated. First, we find that the adsorption pattern on the DNA surface depends strongly on its geometrical shape: counterions adsorb preferentially along the phosphate strands for a cylindrical model shape, but in the minor groove for a geometrically structured model. Second, we find that an addition of monovalent salt ions results in an increase of the charge density in the minor groove while the total charge density of ions adsorbed in the major groove stays unchanged. The adsorbed ion densities are highly structured along the minor groove while they are almost smeared along the major groove. Furthermore, for a fixed amount of added salt, the major groove cationic charge is independent on the counterion valency. For increasing salt concentration the major groove is neutralized while the total charge adsorbed in the minor groove is constant. DNA overcharging is detected for multivalent salt. Simulations for a larger ion radii, which mimic the effect of the ion hydration, indicate an increased adsorbtion of cations in the major groove.Comment: 34 pages with 14 figure
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