Living a healthy life : an evaluation of a self-management for chronic conditions course, Arthritis New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science (Health Psychology) at Massey University

Chronic disease management is a major challenge for health care systems in the developed world. Self-management has the ability to help improve health status, health behaviours and reduce health care utilisation for people with chronic disease. In this exploratory before-after cohort study, questionnaires were distributed to people with chronic disease attending a self-management course offered by Arthritis New Zealand. Ninety-four people at baseline, and at six months, 67 people, completed eight health status, four health behaviour, one self-efficacy, and six health care utilisation measures. The 67 participants at six months also completed seven course evaluation measures in addition to course delivery, social support, course barrier and course attendance measures. The relationship at onset between self-efficacy and health status was analysed using a stepwise regression. Self-efficacy, which accounted for 27% of variance, was significantly related to health distress and to the energy levels of participants. To determine the relationship between self-efficacy and self-management behaviours at baseline, standard multiple regressions were run. Self-efficacy was unrelated to the self- management behaviours of the participants at the course onset. To analyse the mediation effect of self-efficacy on health status a stepwise regression was run, while holding self-efficacy constant. Self-efficacy at six months explained 42% of the variance in baseline self-efficacy, after controlling for baseline self-efficacy in the second model, self-efficacy at six months was significantly related to perceived illness intrusiveness and accounted for an additional 58% of the variance. Two hierarchical stepwise-regressions assessed the mediation effect of self-efficacy on self-management behaviours. Self-efficacy at six months accounted for no additional variance in the participants' self-management skills. Paired t-tests and Wilcoxon matched-pairs signed ranks measured changes in health status, self-efficacy, health behaviours and health care utilisation. No significant improvements occurred in health status. Significant improvements occurred in four health outcomes. Independent t-tests and the Mann- Whitney tests identified significant differences between gender, age and location with health status, health behaviour and health care utilisation outcomes at baseline and at six months. The process evaluation of the course showed general satisfaction. Explanations for the results are offered, limitations of the study are highlighted, and suggestions for future chronic disease self-management research are proposed

The space density of magnetic and non-magnetic cataclysmic variables, and implications for CV evolution

We present constraints on the space densities of both non-magnetic and magnetic cataclysmic variables, and discuss some implications for models of the evolution of CVs. The high predicted non-magnetic CV space density is only consistent with observations if the majority of these systems are extremely faint in X-rays. The data are consistent with the very simple model where long-period IPs evolve into polars and account for the whole short-period polar population. The fraction of WDs that are strongly magnetic is not significantly higher for CV primaries than for isolated WDs. Finally, the space density of IPs is sufficiently high to explain the bright, hard X-ray Galactic Centre source population.Comment: Proceedings of the conferencs "The Golden Age of Cataclysmic Variables and Related Objects II", Palermo, 9-14 September 2013. Accepted for publication in Acta Polytechnica. 6 pages, 4 figure

Superkicks in ultrarelativistic encounters of spinning black holes

We study ultrarelativistic encounters of two spinning, equal-mass black holes through simulations in full numerical relativity. Two initial data sequences are studied in detail: one that leads to scattering and one that leads to a grazing collision and merger. In all cases, the initial black hole spins lie in the orbital plane, a configuration that leads to the so-called "superkicks". In astrophysical, quasicircular inspirals, such kicks can be as large as ~3,000 km/s; here, we find configurations that exceed ~15,000 km/s. We find that the maximum recoil is to a good approximation proportional to the total amount of energy radiated in gravitational waves, but largely independent of whether a merger occurs or not. This shows that the mechanism predominantly responsible for the superkick is not related to merger dynamics. Rather, a consistent explanation is that the "bobbing" motion of the orbit causes an asymmetric beaming of the radiation produced by the in-plane orbital motion of the binary, and the net asymmetry is balanced by a recoil. We use our results to formulate some conjectures on the ultimate kick achievable in any black hole encounter.Comment: 10 pages, 6 figures, 2 table

The social origins of failure: morphogenesis of educational agency in the Cape Colony

This study is an investigation into the failure of dominant social agents to achieve social objectives through control over the educational sphere. The Morphogenetic Approach, developed by British sociologist Margaret Archer, is utilized to explore the educational agency of dominant groups in the Cape Colony over the period from 1652 to approximately 1860. The general objective is to gain greater insight into the complex relations between, on the one hand, structural and ideological factors, and on the other hand, features of social agents as collectivities who hold particular ideas and institutional positions in relation to the education service provided. This information is, then, utilized to explore the morphogenetic origins of failure, i.e. as emerging from the complex interaction between parts of the social system. This study makes a contribution by applying the morphogenetic perspective in a new context; utilizing the pre-colonial and other subsequent historical context to explore the pre-conditioning effect of past interaction on later interaction; revisiting well-known material to arrive at new conclusions from the morphogenetic perspective and introducing the morphogenesis / transformation of agency as source of failure; and it considers the implied strategic considerations for successful agency. The methodology of the study was determined by the nature of the morphogenetic perspective. In the way utilized here, the morphogenetic approach was a method for analyzing the relationships between components of a social system. The study contains two major divisions: Section A contains the development of the theoretical equipment for the application on the Cape Colony in Section B. The theoretical work involves separate consideration being given to the role of overall social features, institutional structure, ideational features and features of agent in the success/failure of agency. Particular attention is given to the changes that occur among the above and how it serves to explain the failure of agency. The general conclusion arrived at is that failure of agency is inevitable, if by success is meant the complete victory of one agent over others in terms of the achievement of the objectives set by such an agent at the outset of the interaction between the groups involved. Morphogenetic processes are responsible for modifications in both the context and the groups, and even the most powerful dominant agent cannot prevent the unintended outcome of interaction over a prolonged period of time

Final State of Gregory-Laflamme Instability

We describe the behavior of a perturbed 5-dimensional black string subject to the Gregory-Laflamme instability. We show that the horizon evolves in a self-similar manner, where at any moment in the late-time development of the instability the horizon can be described as a sequence of 3-dimensional spherical black holes of varying size, joined by black string segments of similar radius. As with the initial black string, each local string segment is itself unstable, and this fuels the self-similar cascade to (classically) arbitrarily small scales; in the process the horizon develops a fractal structure. In finite asymptotic time, the remaining string segments shrink to zero-size, yielding a naked singularity. Since no fine-tuning is required to excite the instability, this constitutes a generic violation of cosmic censorship. We further discuss how this behavior is related to satellite formation in low-viscosity fluid streams subject to the Rayleigh-Plateau instability, and estimate the fractal dimension of the horizon prior to formation of the naked singularity.Comment: 27 pages, 6 Figures. Chapter of the book `Black Holes in Higher Dimensions' to be published by Cambridge University Press (editor: G. Horowitz