Community based trial of home blood pressure monitoring with nurse-led telephone support in patients with stroke or transient ischaemic attack recently discharged from hospital.

BACKGROUND: High blood pressure in patients with stroke increases the risk of recurrence but management in the community is often inadequate. Home blood pressure monitoring may increase patients' involvement in their care, increase compliance, and reduce the need for patients to attend their General Practitioner if blood pressure is adequately controlled. However the value of home monitoring to improve blood pressure control is unclear. In particular its use has not been evaluated in stroke patients in whom neurological and cognitive ability may present unique challenges. DESIGN: Community based randomised trial with follow up after 12 months. PARTICIPANTS: 360 patients admitted to three South London Stroke units with stroke or transient ischaemic attack within the past 9 months will be recruited from the wards or outpatients and randomly allocated into two groups. All patients will be visited by the specialist nurse at home at baseline when she will measure their blood pressure and administer a questionnaire. These procedures will be repeated at 12 months follow up by another researcher blind as to whether the patient is in intervention or control group. INTERVENTION: INTERVENTION patients will be given a validated home blood pressure monitor and support from the specialist nurse. Control patients will continue with usual care (blood pressure monitoring by their practice). Main outcome measures in both groups after 12 months: 1. Change in systolic blood pressure.2. Cost effectiveness: Incremental cost of the intervention to the National Health Service and incremental cost per quality adjusted life year gained

Phase--coherence Effects in Antidot Lattices: A Semiclassical Approach to Bulk Conductivity

We derive semiclassical expressions for the Kubo conductivity tensor. Within our approach the oscillatory parts of the diagonal and Hall conductivity are given as sums over contributions from classical periodic orbits in close relation to Gutzwiller's trace formula for the density of states. Taking into account the effects of weak disorder and temperature we reproduce recently observed anomalous phase coherence oscillations in the conductivity of large antidot arrays.Comment: 11 pages, 2 figures available under request, RevTe

‘Test n Treat (TnT)’– Rapid testing and same-day, on-site treatment to reduce rates of chlamydia in sexually active further education college students: study protocol for a cluster randomised feasibility trial

Background Sexually active young people attending London further education (FE) colleges have high rates of chlamydia, but screening rates are low. We will conduct a cluster randomised feasibility trial of frequent, rapid, on-site chlamydia testing and same-day treatment (Test and Treat (TnT)) in six FE colleges (with parallel qualitative and economic assessments) to assess the feasibility of conducting a future trial to investigate if TnT reduces chlamydia rates. Methods We will recruit 80 sexually active students aged 16–24 years from public areas at each of six colleges. All participants (total n = 480) will be asked to provide samples (urine for males, self-taken vaginal swabs for females) and complete questionnaires on sexual lifestyle and healthcare use at baseline and after 7 months. Participants will be informed that baseline samples will not be tested for 7 months and be advised to get screened separately. Colleges will be randomly allocated to the intervention (TnT) or the control group (no TnT). One and 4 months after recruitment, participants at each intervention college (n = 3) will be texted and invited for on-site chlamydia tests using the 90-min Cepheid GeneXpert system. Students with positive results will be asked to see a visiting nurse health adviser for same-day treatment and partner notification, (backed by genitourinary medicine follow-up). Participants in control colleges (n = 3) will receive ‘thank you’ texts 1 and 4 months after recruitment. Seven months after recruitment, participants from both groups will be invited to complete questionnaires and provide samples for TnT. All samples will be tested, and same-day treatment offered to students with positive results. Acceptability of TnT will be assessed by qualitative interviews of purposively sampled students (n = 30) and college staff (n = 12). We will collect data on costs of TnT and usual healthcare. Discussion Findings will provide key values to inform feasibility, sample size and timescales of a future definitive trial of TnT in FE colleges, including: Recruitment rates TnT uptake rates Follow-up rates Prevalence of chlamydia in participants at baseline and 7 months Acceptability of TnT to students and college staff Estimate of the cost per person screened/treated in TnT versus usual care Trial registration International Standard Randomised Controlled Trials Registry, ID: ISRCTN58038795, Registered on 31 August 2016

Weak-Localization and Integrability in Ballistic Cavities

We demonstrate the existence of an interference contribution to the average magnetoconductance, G(B), of ballistic cavities and use it to test the semiclassical theory of quantum billiards. G(B) is qualitatively different for chaotic and regular cavities, an effect explained semiclassically by the differing classical distribution of areas. The magnitude of G(B) is poorly explained by the semiclassical theory of coherent backscattering (elastic enhancement factor)-- correlations beyond time-reversed pairs of trajectories must be included-- but is in agreement with random matrix theory.Comment: 12 pages + 3 figures, revtex, hub-92-w

Parkfield earthquakes of June 27-29, 1966, Monterey and San Luis Obispo Counties, California—Preliminary report

Two earthquakes, M = 5.3 and 5.5, shook the Parkfield area in southern Monterey County, California, at 0409:56.5 and 0426:13.8 GMT, 28 June 1966. They were preceded by foreshocks on the same day at 0100 and 0115. A third shock, M = 5.0, occurred in the same area at 1953:26.2 on 29 June. The earthquakes were followed by a heavy sequence of aftershocks with epicenters along the San Andreas fault zone extending for about 15 miles southward beyond Cholame in San Luis Obispo County. A P-wave first-motion fault plane solution shows strike of vertical fault plane is N 33°W, coinciding with a surface zone of en echelon fault fractures in the pattern characteristic of right-lateral, strike-slip movement. The motion appears to have an upward component on the west side, at about 20° from pure strike slip. Extensive instrumentation within a few miles of the epicentral district gave unusually complete records from foreshock to aftershock sequence. A strong-motion instrument in the fault zone near Cholame recorded the unusually high horizontal acceleration of 0.5 g. The epicentral region of the earthquakes is on a known active segment of the San Andreas fault. Earthquakes in 1901, 1922, and 1934 in this region were also accompanied by surface faulting. On the published State geologic map, scale 1:250,000, the San Andreas fault zone shows a braided pattern of several branching en echelon major faults. Topographic forms, typical of the features of rift valleys, testify to the recency of fault movements. Small right-lateral surficial displacements had been recognized prior to the late June earthquakes in at least three places on the Parkfield-Cholame trace of the fault. Similar creep, or slippage, has continued since the earthquakes. Extensive nets of survey markers installed by 30 June across the active fault trace had recorded slippage as great as 0.1 inch per day by 12 July. The fault trace associated with the earthquakes is principally in alluvium of unknown depth in Cholame Valley, apparently a faulted graben within the San Andreas fault zone. Under a blanket of Tertiary and Quaternary sedimentary rocks in this part of the southern Coast Ranges, the great fault separates Jurassic-Cretaceous granitic and metamorphic rocks in the western block from Late Jurassic eugeosynclinal sedimentary and volcanic rocks of the Franciscan Formation in the eastern block. In spite of the large horizontal acceleration recorded near the fault, very little building damage occurred in this sparsely populated region. Small concrete and steel bridges in, and adjacent to the fault trace, did not have their structural strength impaired

Mesoscopic Transport Through Ballistic Cavities: A Random S-Matrix Theory Approach

We deduce the effects of quantum interference on the conductance of chaotic cavities by using a statistical ansatz for the S matrix. Assuming that the circular ensembles describe the S matrix of a chaotic cavity, we find that the conductance fluctuation and weak-localization magnitudes are universal: they are independent of the size and shape of the cavity if the number of incoming modes, N, is large. The limit of small N is more relevant experimentally; here we calculate the full distribution of the conductance and find striking differences as N changes or a magnetic field is applied.Comment: 4 pages revtex 3.0 (2-column) plus 2 postscript figures (appended), hub.pam.94.