Twelve month follow-up on a randomised controlled trial of relaxation training for post-stroke anxiety

© The Author(s) 2016. Objective: To follow up participants in a randomised controlled trial of relaxation training for anxiety after stroke at 12 months. Design: Twelve month follow-up to a randomised controlled trial, in which the control group also received treatment. Setting: Community. Participants: Fifteen of twenty one original participants with post-stroke anxiety participated in a one year follow-up study. Interventions: A self-help autogenic relaxation CD listened to five times a week for one month, immediately in the intervention group and after three months in the control group. Main measures: Hospital Anxiety and Depression Scale-Anxiety subscale and the Telephone Interview of Cognitive Status for inclusion. Hospital Anxiety and Depression Scale-Anxiety subscale for outcome. All measures were administered by phone. Results: Anxiety ratings reduced significantly between pre and post-intervention, and between pre-intervention and one year follow-up (‡2(2) = 22.29, p < 0.001). Conclusions: Reductions in anxiety in stroke survivors who received a self-help autogenic relaxation CD appear to be maintained after one year

A pilot randomized controlled trial of self-help relaxation to reduce post-stroke depression

© 2017, © The Author(s) 2017. Objective: To consider the potential of self-help relaxation training to treat depression after stroke. Design: Randomized controlled trial with cross-over at three months. Setting: Community. Participants: In total, 21 people with stroke, aged 49–82 years. Intervention: Autogenic relaxation CD. Main measure: Hospital Anxiety and Depression Scale–Depression (HADS-D) subscale. Results: No difference in depression change scores was identified between the treatment and control groups; however, on two follow-ups, significant positive differences relative to screening were found for the treatment group (at 2 months Z = −2.55, P =.011 and 12 months Z = −2.44, P =.015). A partial η2 =.07 was identified. Conclusion: Self-help relaxation holds promise as a self-help treatment for depression after stroke. Findings from this trial, considered with others of relaxation for depression, suggest that a study including a total of 80 participants would likely be sufficient to establish efficacy of the treatment, relative to controls, in those with stroke

Determinants In HIV Counselling And Testing In Couples In North Rift Kenya

Background: Voluntary HIV counselling and testing (VCT) has been shown to be an acceptable and effective tool in the fight against HIV/AIDS. Couple HIV Counselling and Testing (CHCT) however, is a relatively new concept whose acceptance and efficacy is yet to be determined.Objective: To describe factors that motivate couples to attend VCT as a couple. Design: A cross sectional qualitative study.Setting: Moi Teaching and Referral Hospital and Moi University, School of Medicine, Eldoret, KenyaSubjects: Seventy one individuals were interviewed during KII (9) and dyad interviews (31 couples). Ten FGDs involving a total of 109 individuals were held. Results: Cultural practices, lack of CHCT awareness, stigma and fear of results deter CHCT utilisation. Location of centre where it is unlikely to be associated with HIV testing, qualified professional staff and minimal waiting times would enhance CHCT utilisation.Conclusions: CHCT as a tool in the fight against HIV/AIDS in this region of Kenya is feasible as the factors that would deter couples are not insurmountable

Stakeholders perception of HIV sero-discordant couples in western Kenya

Objective: To describe the perceptions of key stakeholders regarding the counselling needs of HI V sero-discordant couples as part of preparation for a clinical trial involving HIV sero-discordant couples. Design: Qualitative study using key informant and couple interviews. Setting: Moi Teaching and Referral Hospital (MTRH). Subjects: A purposive sample of nine key informants and 31 couple interviews totaling 71 participants. The couple interviews consisted of HI V untested, HI V concordant (positive and negative) and discordant couples. Results: Seventy one individuals participated in nine key informant and 31 couple interviews. The responses identified the following as key issues in counselling HIV discordant couples: The need for education on the meaning of HI V sero-discordancy including potential sources of infection; assistance in disclosing HIV test results to one\'s partner; discussion of the stigma surrounding formula feeding. Overall, the participants supported safer sexual practices in discordant partnerships. Conclusions: Psychosocial support of HI V sero-discordant couples should include messages about the meaning, mechanisms and implications of sero-discordancy. Culturally appropriate HI Vdisclosure and safer sex messages are also needed to support these partnerships. East African Medical Journal Vol. 85 (7) 2008: pp. 326-33

Finite to infinite steady state solutions, bifurcations of an integro-differential equation

We consider a bistable integral equation which governs the stationary solutions of a convolution model of solid--solid phase transitions on a circle. We study the bifurcations of the set of the stationary solutions as the diffusion coefficient is varied to examine the transition from an infinite number of steady states to three for the continuum limit of the semi--discretised system. We show how the symmetry of the problem is responsible for the generation and stabilisation of equilibria and comment on the puzzling connection between continuity and stability that exists in this problem

Dynamical mechanism of atrial fibrillation: a topological approach

While spiral wave breakup has been implicated in the emergence of atrial fibrillation, its role in maintaining this complex type of cardiac arrhythmia is less clear. We used the Karma model of cardiac excitation to investigate the dynamical mechanisms that sustain atrial fibrillation once it has been established. The results of our numerical study show that spatiotemporally chaotic dynamics in this regime can be described as a dynamical equilibrium between topologically distinct types of transitions that increase or decrease the number of wavelets, in general agreement with the multiple wavelets hypothesis. Surprisingly, we found that the process of continuous excitation waves breaking up into discontinuous pieces plays no role whatsoever in maintaining spatiotemporal complexity. Instead this complexity is maintained as a dynamical balance between wave coalescence -- a unique, previously unidentified, topological process that increases the number of wavelets -- and wave collapse -- a different topological process that decreases their number.Comment: 15 pages, 14 figure

On a Conjecture of Goriely for the Speed of Fronts of the Reaction--Diffusion Equation

In a recent paper Goriely considers the one--dimensional scalar reaction--diffusion equation $u_t = u_{xx} + f(u)$ with a polynomial reaction term $f(u)$ and conjectures the existence of a relation between a global resonance of the hamiltonian system $u_{xx} + f(u) = 0$ and the asymptotic speed of propagation of fronts of the reaction diffusion equation. Based on this conjecture an explicit expression for the speed of the front is given. We give a counterexample to this conjecture and conclude that additional restrictions should be placed on the reaction terms for which it may hold.Comment: 9 pages Revtex plus 4 postcript figure

Bilateral Vestibular Dysfunction Associated With Chronic Exposure to Military Jet Propellant Type-Eight Jet Fuel.

We describe three patients diagnosed with bilateral vestibular dysfunction associated with the jet propellant type-eight (JP-8) fuel exposure. Chronic exposure to aromatic and aliphatic hydrocarbons, which are the main constituents of JP-8 military aircraft jet fuel, occurred over 3-5 years\u27 duration while working on or near the flight line. Exposure to toxic hydrocarbons was substantiated by the presence of JP-8 metabolit