Whole home exercise intervention for depression in older care home residents (the OPERA study) : a process evaluation

Background: The ‘Older People’s Exercise intervention in Residential and nursing Accommodation’ (OPERA) cluster randomised trial evaluated the impact of training for care home staff together with twice-weekly, physiotherapist-led exercise classes on depressive symptoms in care home residents, but found no effect. We report a process evaluation exploring potential explanations for the lack of effect. Methods: The OPERA trial included over 1,000 residents in 78 care homes in the UK. We used a mixed methods approach including quantitative data collected from all homes. In eight case study homes, we carried out repeated periods of observation and interviews with residents, care staff and managers. At the end of the intervention, we held focus groups with OPERA research staff. We reported our first findings before the trial outcome was known. Results: Homes showed large variations in activity at baseline and throughout the trial. Overall attendance rate at the group exercise sessions was low (50%). We considered two issues that might explain the negative outcome: whether the intervention changed the culture of the homes, and whether the residents engaged with the intervention. We found low levels of staff training, few home champions for the intervention and a culture that prioritised protecting residents from harm over encouraging activity. The trial team delivered 3,191 exercise groups but only 36% of participants attended at least 1 group per week and depressed residents attended significantly fewer groups than those who were not depressed. Residents were very frail and therefore most groups only included seated exercises. Conclusions: The intervention did not change the culture of the homes and, in the case study homes, activity levels did not change outside the exercise groups. Residents did not engage in the exercise groups at a sufficient level, and this was particularly true for those with depressive symptoms at baseline. The physical and mental frailty of care home residents may make it impossible to deliver a sufficiently intense exercise intervention to impact on depressive symptoms

Symmetries of Holographic Minimal Models

It was recently proposed that a large N limit of a family of minimal model CFTs is dual to a certain higher spin gravity theory in AdS_3, where the 't Hooft coupling constant of the CFT is related to a deformation parameter of the higher spin algebra. We identify the asymptotic symmetry algebra of the higher spin theory for generic 't Hooft parameter, and show that it coincides with a family of W-algebras previously discovered in the context of the KP hierarchy. We furthermore demonstrate that this family of W-algebras controls the representation theory of the minimal model CFTs in the 't Hooft limit. This provides a non-trivial consistency check of the proposal and explains part of the underlying mechanism.Comment: 25 pages; references added and minor corrections (published version

Charged particle-like branes in ABJM

We study the effect of adding lower dimensional brane charges to the 't Hooft monopole, di-baryon and baryon vertex configurations in $AdS_4 \times \mathbb{P}^3$. We show that these configurations capture the background fluxes in a way that depends on the induced charges, and therefore, require additional fundamental strings in order to cancel the worldvolume tadpoles. The study of the dynamics reveals that the charges must lie inside some interval in order to find well defined configurations, a situation familiar from the baryon vertex in $AdS_5 \times S^5$ with charges. For the baryon vertex and the di-baryon the number of fundamental strings must also lie inside an allowed interval. Our configurations are sensitive to the flat $B$-field recently suggested in the literature. We make some comments on its possible role. We also discuss how these configurations are modified in the presence of a non-zero Romans mass.Comment: 31 pages, 14 figures, discussion of charges improved, published versio

Optimising Vine Weevil, Otiorhynchus sulcatus F. (Coleoptera: Curculionidae), Monitoring Tool Design.

Vine weevil, Otiorhynchus sulcatus F. (Coleoptera: Curculionidae), is an economically important insect pest of horticultural crops. To identify an effective and reliable monitoring system for adult vine weevil, this study investigated the influence of colour, height and entrance position on the efficacy of a model monitoring tool using modified paper cups as refuges. Vine weevil preferences were determined by the number of individuals recorded within a refuge. When provided with a binary choice between black or white refuges, vine weevil adults showed a preference for black refuges. Vine weevils provided with a range of coloured refuges (blue, green, red and yellow) in addition to black and white refuges showed a preference for black and blue over the other colours and white refuges in group choice experiments. Refuge height and entrance position also influenced vine weevil behaviour with individuals exhibiting a preference for taller refuges and those with entrance openings around the refuge base. These results provide insights into refuge selection by adult vine weevils, which can be exploited to improve monitoring tool design. The importance of developing an effective monitoring tool for vine weevil adults as part of an integrated pest management programme is discussed

Prevalence and determinants of the use of self-tests by members of the public: a mixed methods study

Background Self-tests can be used by members of the public to diagnose conditions without involving a doctor, nurse or other health professional. As technologies to design and manufacture diagnostic tests have developed, a range of self-tests have become available to the public to buy over-the-counter and via the Internet. This study aims to describe how many people have used self-tests and identify factors associated with their use. Methods A postal questionnaire will elicit basic information, including sociodemographic characteristics, and whether the person has used or would use specified self-tests. Consent will be sought to recontact people who want to participate further in the study, and interviews and focus groups will be used to develop hypotheses about factors associated with self-test use. These hypotheses will be tested in a case-control study. An in-depth questionnaire will be developed incorporating the identified factors. This will be sent to: people who have used a self-test (cases); people who have not used a self-test but would use one in the future (controls); and people who have not used and would not use a self-test (controls). Logistic regression analysis will be used to establish which factors are associated with self-test use. Discussion Self-tests do have potential benefits, for example privacy and convenience, but also potential harms, for example delay seeking treatment after a true negative result when the symptoms are actually due to another condition. It is anticipated that the outcomes from this study will include recommendations about how to improve the appropriate use of self-tests and existing health services, as well as information to prepare health professionals for patients who have used self-tests

Why Physicians Who Treat Hypertension Should Know More About Air Pollution

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75525/1/j.1524-6175.2007.07187.x.pd

ABJM Baryon Stability and Myers effect

We consider magnetically charged baryon vertex like configurations in AdS^4 X CP^3 with a reduced number of quarks l. We show that these configurations are solutions to the classical equations of motion and are stable beyond a critical value of l. Given that the magnetic flux dissolves D0-brane charge it is possible to give a microscopical description in terms of D0-branes expanding into fuzzy CP^n spaces by Myers dielectric effect. Using this description we are able to explore the region of finite 't Hooft coupling.Comment: 29 pages, Latex; minor changes; version to appear in JHE

A soliton menagerie in AdS

We explore the behaviour of charged scalar solitons in asymptotically global AdS4 spacetimes. This is motivated in part by attempting to identify under what circumstances such objects can become large relative to the AdS length scale. We demonstrate that such solitons generically do get large and in fact in the planar limit smoothly connect up with the zero temperature limit of planar scalar hair black holes. In particular, for given Lagrangian parameters we encounter multiple branches of solitons: some which are perturbatively connected to the AdS vacuum and surprisingly, some which are not. We explore the phase space of solutions by tuning the charge of the scalar field and changing scalar boundary conditions at AdS asymptopia, finding intriguing critical behaviour as a function of these parameters. We demonstrate these features not only for phenomenologically motivated gravitational Abelian-Higgs models, but also for models that can be consistently embedded into eleven dimensional supergravity.Comment: 62 pages, 21 figures. v2: added refs and comments and updated appendice