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

Sharks of the order Carcharhiniformes from the British Coniacian, Santonian and Campanian (Upper Cretaceous).

Bulk sampling of phosphate-rich horizons within the British Coniacian to Campanian (Upper Cretaceous) yielded very large samples of shark and ray teeth. All of these samples yielded teeth of diverse members of the Carcharhiniformes, which commonly dominate the fauna. The following species are recorded and described: Pseudoscyliorhinus reussi (Herman, 1977) comb. nov., Crassescyliorhinus germanicus (Herman, 1982) gen. nov., Scyliorhinus elongatus (Davis, 1887), Scyliorhinus brumarivulensis sp. nov., ? Palaeoscyllium sp., Prohaploblepharus riegrafi (Müller, 1989) gen. nov., ? Cretascyliorhinus sp., Scyliorhinidae inc. sedis 1, Scyliorhinidae inc. sedis 2, Pteroscyllium hermani sp. nov., Protoscyliorhinus sp., Leptocharias cretaceus sp. nov., Palaeogaleus havreensis Herman, 1977, Paratriakis subserratus sp. nov., Paratriakis tenuis sp. nov., Paratriakis sp. indet. and ? Loxodon sp. Taxa belonging to the families ?Proscylliidae, Leptochariidae, and Carcharhinidae are described from the Cretaceous for the first time. The evolutionary and palaeoecological implications of these newly recognised faunas are discussed

Regular Conjugacy Classes in the Weyl Group and Integrable Hierarchies

Generalized KdV hierarchies associated by Drinfeld-Sokolov reduction to grade one regular semisimple elements from non-equivalent Heisenberg subalgebras of a loop algebra \G\otimes{\bf C}[\lambda,\lambda^{-1}] are studied. The graded Heisenberg subalgebras containing such elements are labelled by the regular conjugacy classes in the Weyl group {\bf W}(\G) of the simple Lie algebra \G. A representative w\in {\bf W}(\G) of a regular conjugacy class can be lifted to an inner automorphism of \G given by $\hat w=\exp\left(2i\pi {\rm ad I_0}/m\right)$, where $I_0$ is the defining vector of an $sl_2$ subalgebra of \G.The grading is then defined by the operator $d_{m,I_0}=m\lambda {d\over d\lambda} + {\rm ad} I_0$ and any grade one regular element $\Lambda$ from the Heisenberg subalgebra associated to $[w]$ takes the form $\Lambda = (C_+ +\lambda C_-)$, where $[I_0, C_-]=-(m-1) C_-$ and $C_+$ is included in an $sl_2$ subalgebra containing $I_0$. The largest eigenvalue of ${\rm ad}I_0$ is $(m-1)$ except for some cases in $F_4$, $E_{6,7,8}$. We explain how these Lie algebraic results follow from known results and apply them to construct integrable systems.If the largest ${\rm ad} I_0$ eigenvalue is $(m-1)$, then using any grade one regular element from the Heisenberg subalgebra associated to $[w]$ we can construct a KdV system possessing the standard \W-algebra defined by $I_0$ as its second Poisson bracket algebra. For \G a classical Lie algebra, we derive pseudo-differential Lax operators for those non-principal KdV systems that can be obtained as discrete reductions of KdV systems related to $gl_n$. Non-abelian Toda systems are also considered.Comment: 44 pages, ENSLAPP-L-493/94, substantial revision, SWAT-95-77. (use OLATEX (preferred) or LATEX

Visual saliency and semantic incongruency influence eye movements when inspecting pictures

Models of low-level saliency predict that when we first look at a photograph our first few eye movements should be made towards visually conspicuous objects. Two experiments investigated this prediction by recording eye fixations while viewers inspected pictures of room interiors that contained objects with known saliency characteristics. Highly salient objects did attract fixations earlier than less conspicuous objects, but only in a task requiring general encoding of the whole picture. When participants were required to detect the presence of a small target, then the visual saliency of nontarget objects did not influence fixations. These results support modifications of the model that take the cognitive override of saliency into account by allowing task demands to reduce the saliency weights of task-irrelevant objects. The pictures sometimes contained incongruent objects that were taken from other rooms. These objects were used to test the hypothesis that previous reports of the early fixation of congruent objects have not been consistent because the effect depends upon the visual conspicuity of the incongruent object. There was an effect of incongruency in both experiments, with earlier fixation of objects that violated the gist of the scene, but the effect was only apparent for inconspicuous objects, which argues against the hypothesis

Dynamical Fine Tuning in Brane Inflation

We investigate a novel mechanism of dynamical tuning of a flat potential in the open string landscape within the context of warped brane-antibrane inflation in type IIB string theory. Because of competing effects between interactions with the moduli stabilizing D7-branes in the warped throat and anti-D3-branes at the tip, a stack of branes gives rise to a local minimum of the potential, holding the branes high up in the throat. As branes successively tunnel out of the local minimum to the bottom of the throat the potential barrier becomes lower and is eventually replaced by a flat inflection point, around which the remaining branes easily inflate. This dynamical flattening of the inflaton potential reduces the need to fine tune the potential by hand, and also leads to successful inflation for a larger range of inflaton initial conditions, due to trapping in the local minimum.Comment: 23 pages, 9 figures. v2: Updated D3-dependence in potential, small changes to numerical result

Learning and interaction in groups with computers: when do ability and gender matter?

In the research reported in this paper, we attempt to identify the background and process factors influencing the effectiveness of groupwork with computers in terms of mathematics learning. The research used a multi-site case study design in six schools and involved eight groups of six mixed-sex, mixed-ability pupils (aged 9-12) undertaking three research tasks – two using Logo and one a database. Our findings suggest that, contrary to other recent research, the pupil characteristics of gender and ability have no direct influence on progress in group tasks with computers. However, status effects – pupils' perceptions of gender and ability – do have an effect on the functioning of the group, which in turn can impede progress for all pupils concerned

Superficial versus deep lymph node dissection in early stage vulvar carcinoma

Our primary objective was to evaluate the difference in overall survival, recurrence rate, and post-operative morbidity related to superficial versus deep inguinal lymphadenectomy in squamous cell carcinoma of the vulva