195 research outputs found
The Fight Against the Threat of Witchcraft and Paganism in Anglo-Saxon England
Unlike the general assumption that England was completely Christianized after Augustine’s mission to the island, witchcraft and paganism thrived all throughout the Christian period of Anglo-Saxon history. Sources condemning witchcraft and paganism increased during the Danish raids in the mid-ninth century and beyond due to an increased sense of a perceived threat of paganism. King Alfred himself reacted to this threat by doing everything he could to strengthen his people in their Christian beliefs through education reform and his law code. The Church battled against the perceived threat through penitentials–which they used to discourage pagan practices. Lay-people fought against paganism sometimes by the simple act of confessing to their priests, and sometimes by taking protection from the perceived threat into their own hands like in the case of the anonymous widow from Ailsworth. While witchcraft prevailed throughout the entire pre-Alfred Anglo-Saxon period (ca 600-870), the Anglo-Saxons’ perception of the threat of paganism–especially during the Danish raids in the mid-ninth century–caused nearly all aspects of Anglo-Saxon Christendom to fight against paganism and witchcraft in their respective ways
Peer support and reminiscence therapy for people with dementia and their family carers: a factorial pragmatic randomised trial
Objective The objective of this study was to evaluate peer support and reminiscence therapy, separately and together, in comparison with usual care for people with dementia and their family carers.
Design Factorial pragmatic randomised trial, analysed by treatment allocated, was used for this study.
Setting The trial ran in Community settings in England.
Participants People with dementia and their family carers were the participants.
Interventions Treatment as usual (TAU) plus one of the following: one-to-one peer support to family carers from experienced carers (Carer Supporter Programme; CSP), group reminiscence therapy (Remembering Yesterday, Caring Today; RYCT) for people with dementia and carers, both or neither.
Main outcome measures Primary outcomes included health-related quality of life (SF-12) for carers and quality of life (QoL-AD) for people with dementia; secondary outcomes included quality of relationship for carers and people with dementia; both were collected by blinded assessors at baseline, 5 and 12 months (primary end point).
Results Of 291 pairs recruited, we randomised 145 (50%) to CSP (71% uptake) and 194 (67%) to RYCT (61% uptake). CSP and RYCT, separately or together, were not effective in improving primary outcomes or most secondary outcomes. For CSP versus ‘no CSP’, adjusted difference in means was 0.52 points on the SF-12 (95% CI −1.28 to 2.32) and −0.08 points on the QoL-AD (95% CI −1.70 to 1.56). For RYCT versus ‘no RYCT’, the difference was 0.10 points on the SF-12 (95% CI −1.72 to 1.93) and 0.51 points on the QoL-AD (95% CI −1.17 to 2.08). However, carers reported better relationships with the people with dementia (difference 1.11, 95% CI 0.00 to 2.21, p=0.05). Comparison of combined intervention with TAU, and of intervention received, suggested differential impacts for carers and persons with dementia.
Conclusions There is no evidence from the trial that either peer support or reminiscence is effective in improving the quality of life.
Trial registration number ISRCTN37956201
Support at Home: Interventions to Enhance Life in Dementia (SHIELD) – evidence, development and evaluation of complex interventions
Background: Dementia is a national priority and this research addresses the Prime Minister’s commitment
to dementia research as demonstrated by his 2020 challenge and the new UK Dementia Research Institute.
In the UK > 800,000 older people have dementia. It has a major impact on the lives of people with
dementia themselves, on the lives of their family carers and on services, and costs the nation £26B per
year. Pharmacological cures for dementias such as Alzheimer’s disease are not expected before 2025. If no
cure can be found, the ageing demographic will result in 2 million people living with dementia by 2050.
People with dementia lose much more than just their memory and their daily living skills; they can also lose
their independence, their dignity and status, their confidence and morale, and their roles both within the
family and beyond. They can be seen as a burden by society, by their families and even by themselves, and
may feel unable to contribute to society. This programme of research aims to find useful interventions to
improve the quality of life of people with dementia and their carers, and to better understand how people
with dementia can be supported at home and avoid being admitted to hospital.
Objectives: (1) To develop and evaluate the maintenance cognitive stimulation therapy (MCST) for people
with dementia; (2) to develop the Carer Supporter Programme (CSP), and to evaluate the CSP and
Remembering Yesterday, Caring Today (RYCT) for people with dementia both separately and together in
comparison with usual care; and (3) to develop a home treatment package (HTP) for dementia, to field test
the HTP in practice and to conduct an exploratory trial.
Methods: (1) The MCST programme was developed for people with dementia based on evidence and
qualitative work. A randomised controlled trial (RCT) [with a pilot study of MCST plus acetylcholinesterase
inhibitors (AChEIs)] compared MCST with cognitive stimulation therapy (CST) only. The MCST implementation
study conducted a trial of outreach compared with usual care, and assessed implementation in practice.
(2) The CSP was developed based on existing evidence and the engagement of carers of people with dementia. The RCT (with internal pilot) compared the CSP and reminiscence (RYCT), both separately and
in combination, with usual care. (3) A HTP for dementia, including the most promising interventions and
components, was developed by systematically reviewing the literature and qualitative studies including
consensus approaches. The HTP for dementia was evaluated in practice by conducting in-depth field testing.
Results: (1) Continuing MCST improved quality of life and improved cognition for those taking AChEIs.
It was also cost-effective. The CST implementation studies indicated that many staff will run CST groups
following a 1-day training course, but that outreach support helps staff go on to run maintenance groups
and may also improve staff sense of competence in dementia care. The study of CST in practice found no
change in cognition or quality of life at 8-month follow-up. (2) The CSP/RYCT study found no benefits for
family carers but improved quality of life for people with dementia. RYCT appeared beneficial for the
quality of life of people with dementia but at an excessively high cost. (3) Case management for people
with dementia reduces admissions to long-term care and reduces behavioural problems. In terms of
managing crises, staff suggested more costly interventions, carers liked education and support, and people
with dementia wanted family support, home adaptations and technology. The easy-to-use home treatment
manual was feasible in practice to help staff working in crisis teams to prevent hospital admissions for
people with dementia.
Limitations: Given constraints on time and funding, we were unable to compete the exploratory trial of
the HTP package or to conduct an economic evaluation.
Future research: To improve the care of people with dementia experiencing crises, a large-scale clinical
trial of the home treatment manual is needed.
Conclusion: There is an urgent need for effective psychosocial interventions for dementia. MCST improved
quality of life and was cost-effective, with benefits to cognition for those on AChEIs. MCST was feasible in
practice. Both CSP and RYCT improved the quality of life of people with dementia, but the overall costs
may be too high. The HTP was useful in practice but requires evaluation in a full trial. Dementia care
research may improve the lives of millions of people across the world.
Trial registrations: Current Controlled Trials ISRCTN26286067 (MCST), ISRCTN28793457 (MCST
implementation) and ISRCTN37956201 (CSP/RYCT).
Funding: This project was funded by the National Institute for Health Research (NIHR) Programme Grants
for Applied Research programme and will be published in full in Programme Grants for Applied Research;
Vol. 5, No. 5. See the NIHR Journals Library website for further project information
Role of Surface Energy and Nano-Roughness in the Removal Efficiency of Bacterial Contamination by Nonwoven Wipes from Frequently Touched Surfaces
Healthcare associated infections (HCAIs) are responsible for substantial patient morbidity, mortality and economic cost. Infection control strategies for reducing rates of transmission include the use of nonwoven wipes to remove pathogenic bacteria from frequently touched surfaces. Wiping is a dynamic process that involves physicochemical mechanisms to detach and transfer bacteria to fibre surfaces within the wipe. The purpose of this study was to determine the extent to which systematic changes in fibre surface energy and nano-roughness influence removal of bacteria from an abiotic polymer surface in dry wiping conditions, without liquid detergents or disinfectants. Nonwoven wipe substrates composed of two commonly used fibre types, lyocell (cellulosic) and polypropylene, with different surface energies and nano-roughnesses, were manufactured using pilot-scale nonwoven facilities to produce samples of comparable structure and dimensional properties. The surface energy and nano-roughness of some lyocell substrates were further adjusted by either oxygen (O2) or hexafluoroethane (C2F6) gas plasma treatment. Static adpression wiping of an inoculated surface under dry conditions produced removal efficiencies of between 9.4% and 15.7%, with no significant difference (p < 0.05) in the relative removal efficiencies of Escherichia coli, Staphylococcus aureus or Enterococcus faecalis. However, dynamic wiping markedly increased peak wiping efficiencies to over 50%, with a minimum increase in removal efficiency of 12.5% and a maximum increase in removal efficiency of 37.9% (all significant at p < 0.05) compared with static wiping, depending on fibre type and bacterium. In dry, dynamic wiping conditions, nonwoven wipe substrates with a surface energy closest to that of the contaminated surface produced the highest E. coli removal efficiency, while the associated increase in fibre nano-roughness abrogated this trend with S. aureus and E. faecalis.
Plasma modification of the nano-roughness and surface energy of fibres in nonwoven wipes was found to influence the relative removal efficiencies of common bacterial pathogens from model healthcare surfaces under dynamic wiping conditions
High-Resolution Near-Infrared Polarimetry of a Circumstellar Disk around UX Tau A
We present H-band polarimetric imagery of UX Tau A taken with HiCIAO/AO188 on
the Subaru Telescope. UX Tau A has been classified as a pre-transitional disk
object, with a gap structure separating its inner and outer disks. Our imagery
taken with the 0.15 (21 AU) radius coronagraphic mask has revealed a strongly
polarized circumstellar disk surrounding UX Tau A which extends to 120 AU, at a
spatial resolution of 0.1 (14 AU). It is inclined by 46 \pm 2 degree as the
west side is nearest. Although SED modeling and sub-millimeter imagery
suggested the presence of a gap in the disk, with the inner edge of the outer
disk estimated to be located at 25 - 30 AU, we detect no evidence of a gap at
the limit of our inner working angle (23 AU) at the near-infrared wavelength.
We attribute the observed strong polarization (up to 66 %) to light scattering
by dust grains in the disk. However, neither polarization models of the
circumstellar disk based on Rayleigh scattering nor Mie scattering
approximations were consistent with the observed azimuthal profile of the
polarization degrees of the disk. Instead, a geometric optics model of the disk
with nonspherical grains with the radii of 30 micron meter is consistent with
the observed profile. We suggest that the dust grains have experienced frequent
collisional coagulations and have grown in the circumstellar disk of UX Tau A.Comment: 20 pages, 8 figures, and 1 table. accepted to PAS
Discovery of Small-Scale Spiral Structures in the Disk of SAO 206462 (HD 135344B): Implications for the Physical State of the Disk from Spiral Density Wave Theory
We present high-resolution, H-band, imaging observations, collected with
Subaru/HiCIAO, of the scattered light from the transitional disk around SAO
206462 (HD 135344B). Although previous sub-mm imagery suggested the existence
of the dust-depleted cavity at r~46AU, our observations reveal the presence of
scattered light components as close as 0.2" (~28AU) from the star. Moreover, we
have discovered two small-scale spiral structures lying within 0.5" (~70AU). We
present models for the spiral structures using the spiral density wave theory,
and derive a disk aspect ratio of h~0.1, which is consistent with previous
sub-mm observations. This model can potentially give estimates of the
temperature and rotation profiles of the disk based on dynamical processes,
independently from sub-mm observations. It also predicts the evolution of the
spiral structures, which can be observable on timescales of 10-20 years,
providing conclusive tests of the model. While we cannot uniquely identify the
origin of these spirals, planets embedded in the disk may be capable of
exciting the observed morphology. Assuming that this is the case, we can make
predictions on the locations and, possibly, the masses of the unseen planets.
Such planets may be detected by future multi-wavelengths observations.Comment: 8 pages, 5 figures, ApJL in press, typo correcte
High-Contrast NIR Polarization Imaging of MWC480
One of the key predictions of modeling from the IR excess of Herbig Ae stars
is that for protoplanetary disks, where significant grain growth and settling
has occurred, the dust disk has flattened to the point that it can be partially
or largely shadowed by the innermost material at or near the dust sublimation
radius. When the self-shadowing has already started, the outer disk is expected
to be detected in scattered light only in the exceptional cases that the scale
height of the dust disk at the sublimation radius is smaller than usual.
High-contrast imaging combined with the IR spectral energy distribution allow
us to measure the degree of flattening of the disk, as well as to determine the
properties of the outer disk. We present polarimetric differential imaging in
band obtained with Subaru/HiCIAO of one such system, MWC 480. The HiCIAO
data were obtained at a historic minimum of the NIR excess. The disk is
detected in scattered light from 0\farcs2-1\farcs0 (27.4-137AU). Together with
the marginal detection of the disk from 1998 February 24 by HST/NICMOS, our
data constrain the opening half angle for the disk to lie between
1.3. When compared with similar measures in CO for
the gas disk from the literature, the dust disk subtends only 30% of the
gas disk scale height (H/R0.03). Such a dust disk is a factor of 5-7
flatter than transitional disks, which have structural signatures that giant
planets have formed.Comment: 21 pages, 6 figures, 1 table, ApJ accepted 2012-05-0
Galaxy Clustering in Early SDSS Redshift Data
We present the first measurements of clustering in the Sloan Digital Sky
Survey (SDSS) galaxy redshift survey. Our sample consists of 29,300 galaxies
with redshifts 5,700 km/s < cz < 39,000 km/s, distributed in several long but
narrow (2.5-5 degree) segments, covering 690 square degrees. For the full,
flux-limited sample, the redshift-space correlation length is approximately 8
Mpc/h. The two-dimensional correlation function \xi(r_p,\pi) shows clear
signatures of both the small-scale, ``fingers-of-God'' distortion caused by
velocity dispersions in collapsed objects and the large-scale compression
caused by coherent flows, though the latter cannot be measured with high
precision in the present sample. The inferred real-space correlation function
is well described by a power law, \xi(r)=(r/6.1+/-0.2 Mpc/h)^{-1.75+/-0.03},
for 0.1 Mpc/h < r < 16 Mpc/h. The galaxy pairwise velocity dispersion is
\sigma_{12} ~ 600+/-100 km/s for projected separations 0.15 Mpc/h < r_p < 5
Mpc/h. When we divide the sample by color, the red galaxies exhibit a stronger
and steeper real-space correlation function and a higher pairwise velocity
dispersion than do the blue galaxies. The relative behavior of subsamples
defined by high/low profile concentration or high/low surface brightness is
qualitatively similar to that of the red/blue subsamples. Our most striking
result is a clear measurement of scale-independent luminosity bias at r < 10
Mpc/h: subsamples with absolute magnitude ranges centered on M_*-1.5, M_*, and
M_*+1.5 have real-space correlation functions that are parallel power laws of
slope ~ -1.8 with correlation lengths of approximately 7.4 Mpc/h, 6.3 Mpc/h,
and 4.7 Mpc/h, respectively.Comment: 51 pages, 18 figures. Replaced to match accepted ApJ versio
The impact of individual Cognitive Stimulation Therapy (iCST) on cognition, quality of life, caregiver health, and family relationships in dementia: a randomized controlled trial
Background: Cognitive Stimulation Therapy (CST) is a well-established group psychosocial intervention for people with dementia. There is evidence that homebased programmes of cognitive stimulation delivered by family caregivers may benefit both the person and the caregiver. However, no previous studies have evaluated caregiver-delivered CST. This study aimed to evaluate the effectiveness of a home-based, caregiver-led individual Cognitive Stimulation Therapy (iCST) program in (i) improving cognition and quality of life (QoL) for the person with dementia and (ii) mental and physical health (wellbeing) for the caregiver.
Methods and Findings: A single-blind, pragmatic randomized trial (RCT) at eight study sites across the UK. The intervention and blinded assessment of outcomes were conducted in participants’ homes. 356 people with mild to moderate dementia and their caregivers recruited from memory services, and community mental health teams. Participants were randomly assigned to iCST (75, 30 minute sessions) or treatment as usual (TAU) control over 25 weeks. iCST sessions consisted of themed activities designed to be mentally stimulating and enjoyable. Caregivers delivering iCST received training and support from an unblind researcher. Primary outcomes were cognition (Alzheimer’s Disease Assessment Scale cognitive [ADAS-Cog]) and self-reported quality of life (QoL) (Quality of Life Alzheimer’s Disease [QoL-AD]) for the person with dementia, and general health status (Short Form-12 [SF-12]) for the caregiver. Secondary outcomes included: quality of the caregiving relationship from the perspectives of the person and of the caregiver (Quality of the Carer Patient Relationships Scale), and health-related QoL (EQ5D) for the caregiver. Intention to treat (ITT) analyses were conducted. At the post-test (26 weeks), there were no differences between the iCST and TAU groups in the outcomes of cognition (MD = -0·55, 95% CI -2·00 to 0·90; p=0·45), and self-reported quality of life (QoL) (MD = -0·02, 95% CI -1·22 to 0·82; p= 0·97) for people with dementia, or caregivers’ general health status (MD=0·13, 95% CI -1·65 to 1·91; p=0·89). However, people with dementia receiving iCST rated the relationship with their caregiver more positively (MD = 1·77, 95% CI 0·26 to 3·28; p=0·02) and iCST improved QoL for caregivers (EQ-5D, MD = 0·06, 95% CI 0·02 to 0·10; p=0·01). Forty percent (72/180) of dyads allocated to iCST completed at least two sessions per week, with 22% (39/180) completing no sessions at all. Study limitations include low adherence to the intervention.
Conclusions: There was no evidence that iCST has an effect on cognition or QoL for people with dementia. However, participating in iCST appeared to enhance the quality of the caregiving relationship and caregivers’ QoL
- …