Regaining Confidence after Stroke (RCAS): a feasibility randomised controlled trial (RCT)

Background: The Regaining Confidence after Stroke Course (RCAS) was designed to facilitate adjustment for people with stroke discharged from rehabilitation. The aim of the trial was to evaluate the feasibility of conducting a randomised trial to compare a RCAS course with usual care. The rates feasibility of screening and recruitment, rates of consent and retention, acceptability of outcome measures and the acceptability and fidelity of the intervention, were evaluated. Methods: Participants with stroke were recruited from hospital databases and community services and randomly assigned to the Regaining Confidence after Stroke (RCAS) course or usual care. The course comprised 11 weekly 2 hour sessions with 6-8 participants, delivered by two rehabilitation assistants. Carers were invited to attend three of the sessions. Sessions were video recorded. A six item checklist was developed from the manual content. Each item was rated as met, partially met, or not met. Fidelity was assumed if >75% of the criteria were met. Outcomes were assessed 3 and 6 months after randomisation. Semi-structured interviews, were conducted using open ended questions to assess the acceptability of the intervention. Results: Of 47 participants (mean age 66.9 years [SD 14.9]; 26 men) 22 were randomly allocated to the intervention and 25 to usual care. Participants attended a mean of 8.2 out of 11 sessions [SD 2.6]. Fidelity outcomes suggested that the content corresponded to the manual but further training of the therapist was needed. Interview findings indicated the intervention was acceptable and considered beneficial. At three months, 35 (78%) participants returned questionnaires and 30 (67%) at 6 months, but only 38(42 %) were fully completed. Conclusion: The results support the feasibility of conducting a randomised trial to evaluate the effectiveness of a RCAS course compared to usual care

The purpose of mess in action research: building rigour though a messy turn

Mess and rigour might appear to be strange bedfellows. This paper argues that the purpose of mess is to facilitate a turn towards new constructions of knowing that lead to transformation in practice (an action turn). Engaging in action research - research that can disturb both individual and communally held notions of knowledge for practice - will be messy. Investigations into the 'messy area', the interface between the known and the nearly known, between knowledge in use and tacit knowledge as yet to be useful, reveal the 'messy area' as a vital element for seeing, disrupting, analysing, learning, knowing and changing. It is the place where long-held views shaped by professional knowledge, practical judgement, experience and intuition are seen through other lenses. It is here that reframing takes place and new knowing, which has both theoretical and practical significance, arises: a 'messy turn' takes place

Binary-Induced Gravitational Collapse: A Trivial Example

We present a simple model illustrating how a highly relativistic, compact object which is stable in isolation can be driven dynamically unstable by the tidal field of a binary companion. Our compact object consists of a test-particle in a relativistic orbit about a black hole; the binary companion is a distant point mass. Our example is presented in light of mounting theoretical opposition to the possibility that sufficiently massive, binary neutron stars inspiraling from large distance can collapse to form black holes prior to merger. Our strong-field model suggests that first order post-Newtonian treatments of binaries, and stability analyses of binary equilibria based on orbit-averaged, mean gravitational fields, may not be adequate to rule out this possibility.Comment: 7 pages, 5 figures, RevTeX, to appear in Phys. Rev. D, Jan 15 199

Exome sequencing identifies nonsegregating nonsense ATM and PALB2 variants in familial pancreatic cancer.

We sequenced 11 germline exomes from five families with familial pancreatic cancer (FPC). One proband had a germline nonsense variant in ATM with somatic loss of the variant allele. Another proband had a nonsense variant in PALB2 with somatic loss of the variant allele. Both variants were absent in a relative with FPC. These findings question the causal mechanisms of ATM and PALB2 in these families and highlight challenges in identifying the causes of familial cancer syndromes using exome sequencing

'The show must go on': Event dramaturgy as consolidation of community

Event dramaturgy and cultural performance have not been examined in the literature from a strategic standpoint of fostering the social value of events. Thus, the purpose of this study was to explore the case of the Water Carnival, a celebratory event in a rural community of Southwest Texas, demonstrating the essence of this event as a symbolic social space, wherein event participants instantiate a shared and valued sense of community. A hermeneutical approach was employed, interpreting the event and its symbolisms as a text, combined with findings from ethnographic fieldwork, including participant observation, in-depth interviews and analysis of archival documents. The study examines the ways that dramaturgy in the Water Carnival helps frame the ongoing public discourse for community improvement and enhances social capital. The implications of the study for social leverage of events are discussed. It is suggested that a foundation for strategic social planning is the understanding of events as symbolic social spaces and their embeddedness in community development, which can be accomplished when events are pertinent to public discourse, address community issues, represent an inclusive range of stakeholders, and promote cooperation

VLBA Imaging of the OH Maser in IIIZw35

We present a parsec-scale image of the OH maser in the nucleus of the active galaxy IIIZw35, made using the Very Long Baseline Array at a wavelength of 18 cm. We detected two distinct components, with a projected separation of 50 pc (for D=110 Mpc) and a separation in Doppler velocity of 70 km/s, which contain 50% of the total maser flux. Velocity gradients within these components could indicate rotation of clouds with binding mass densities of ~7000 solar masses per cubic parsec, or total masses of more than 500,000 solar masses. Emission in the 1665-MHz OH line is roughly coincident in position with that in the 1667-MHz line, although the lines peak at different Doppler velocities. We detected no 18 cm continuum emission; our upper limit implies a peak apparent optical depth greater than 3.4, assuming the maser is an unsaturated amplifier of continuum radiation.Comment: 10 pages, 3 figure

A Binary Millisecond Pulsar in Globular Cluster NGC6544

We report the detection of a new 3.06 ms binary pulsar in the globular cluster NGC6544 using a Fourier-domain ``acceleration'' search. With an implied companion mass of ~0.01 solar masses and an orbital period of only P_b~1.7 hours, it displays very similar orbital properties to many pulsars which are eclipsed by their companion winds. The orbital period is the second shortest of known binary pulsars after 47 Tuc R. The measured flux density of 1.3 +/- 0.4 mJy at 1332 MHz indicates that the pulsar is almost certainly the known steep-spectrum point source near the core of NGC6544.Comment: Accepted by ApJ Letters on 11 October 2000, 5 page

On Estimation of the Post-Newtonian Parameters in the Gravitational-Wave Emission of a Coalescing Binary

The effect of the recently obtained 2nd post-Newtonian corrections on the accuracy of estimation of parameters of the gravitational-wave signal from a coalescing binary is investigated. It is shown that addition of this correction degrades considerably the accuracy of determination of individual masses of the members of the binary. However the chirp mass and the time parameter in the signal is still determined to a very good accuracy. The possibility of estimation of effects of other theories of gravity is investigated. The performance of the Newtonian filter is investigated and it is compared with performance of post-Newtonian search templates introduced recently. It is shown that both search templates can extract accurately useful information about the binary.Comment: 34 pages, 118Kb, LATEX format, submitted to Phys. Rev.

The stigmatisation of people with chronic back pain

This study responded to the need for better theoretical understanding of experiences that shape the beliefs, attitudes and needs of chronic back patients attending pain clinics. The aim was explore and conceptualise the experiences of people of working age who seek help from pain clinics for chronic back pain. Methods. This was a qualitative study, based on an interpretative phenomenological approach (IPA). During in-depth interviews in their homes, participants were invited to 'tell their story' from the time their pain began. Participants were twelve male and six female patients, aged between 28 and 62 years, diagnosed as having chronic benign back pain. All had recently attended one of two pain clinics as new referrals. The interview transcripts were analysed thematically. Findings. Stigmatisation emerged as a key theme from the narrative accounts of participants. The findings expose subtle as well as overt stigmatising responses by family, friends, health professionals and the general public which appeared to have a profound effect on the perceptions, self esteem and behaviours of those interviewed. Conclusions. The findings suggest that patients with chronic back pain feel stigmatised by the time they attend pain clinics and this may affect their attitudes and behaviours towards those offering professional help. Theories of chronic pain need to accommodate these responses, while pain management programmes need to address the realities and practicalities of dealing with stigma in everyday life