Targets and self monitoring in hypertension: randomised controlled trial and cost effectiveness analysis

Objectives: To assess whether blood pressure control in primary care could be improved with the use of patient held targets and self monitoring in a practice setting, and to assess the impact of these on health behaviours, anxiety, prescribed antihypertensive drugs, patients’ preferences, and costs. \ud Design: Randomised controlled trial. \ud Setting: Eight general practices in south Birmingham. \ud Participants: 441 people receiving treatment in primary care for hypertension but not controlled below the target of < 140/85 mm Hg. \ud Interventions: Patients in the intervention group received treatment targets along with facilities to measure their own blood pressure at their general practice; they were also asked to visit their general practitioner or practice nurse if their blood pressure was repeatedly above the target level. Patients in the control group received usual care (blood pressure monitoring by their practice). \ud Main outcome measures: Primary outcome: change in systolic blood pressure at six months and one year in both intervention and control groups. Secondary outcomes: change in health behaviours, anxiety, prescribed antihypertensive drugs, patients’ preferences of method of blood pressure monitoring, and costs. \ud Results: 400 (91%) patients attended follow up at one year. Systolic blood pressure in the intervention group had significantly reduced after six months (mean difference 4.3 mm Hg (95% confidence interval 0.8 mm Hg to 7.9 mm Hg)) but not after one year (mean difference 2.7 mm Hg (-1.2 mm Hg to 6.6 mm Hg)). No overall difference was found in diastolic blood pressure, anxiety, health behaviours, or number of prescribed drugs. Patients who self monitored lost more weight than controls (as evidenced by a drop in body mass index), rated self monitoring above monitoring by a doctor or nurse, and consulted less often. Overall, self monitoring did not cost significantly more than usual care (£251 ($437; 364 euros) (95% confidence interval £233 to £275) versus £240 (£217 to £263). \ud Conclusions: Practice based self monitoring resulted in small but significant improvements of blood pressure at six months, which were not sustained after a year. Self monitoring was well received by patients, anxiety did not increase, and there was no appreciable additional cost. Practice based self monitoring is feasible and results in blood pressure control that is similar to that in usual care. \u

On the pion-nucleon coupling constant

In view of persisting misunderstanding about the determination of the pion-nucleon coupling constants in the Nijmegen multienergy partial-wave analyses of pp, np, and pbar-p scattering data, we present additional information which may clarify several points of discussion. We comment on several recent papers addressing the issue of the pion-nucleon coupling constant and criticizing the Nijmegen analyses.Comment: 19 pages, Nijmegen preprint THEF-NYM-92-0

Dark matter annihilation and non-thermal Sunyaev-Zel'dovich effect: II. dwarf spheroidal galaxy

We calculate the CMB temperature distortion due to the energetic electrons and positrons produced by dark matter annihilation (Sunyaev-Zel'dovich effect), in dwarf spheroidal galaxies (dSphs). In the calculation we have included two important effects which were previously ignored. First we show that the electron-positron pairs with energy less than GeV, which were neglected in previous calculation, could contribute a significant fraction of the total signal. Secondly we also consider the full effects of diffusion loss, which could significantly reduce the density of electron-positron pairs at the center of cuspy halos. For neutralinos, we confirm that detecting such kind of SZ effect is beyond the capability of the current or even the next generation experiments. In the case of light dark matter (LDM) the signal is much larger, but even in this case it is only marginally detectable with the next generation of experiment such as ALMA. We conclude that similar to the case of galaxy clusters, in the dwarf galaxies the SZ_2DM} effect is not a strong probe of DM annihilations.Comment: 22 pages, 9 figures, version accepted by JCA

Interactions between Octet Baryons in the SU_6 Quark model

The baryon-baryon interactions for the complete baryon octet (B_8) are investigated in a unified framework of the resonating-group method, in which the spin-flavor SU_6 quark-model wave functions are employed. Model parameters are determined to reproduce properties of the nucleon-nucleon system and the low-energy cross section data for the hyperon-nucleon interaction. We then proceed to explore B_8 B_8 interactions in the strangeness S=-2, -3 and -4 sectors. The S-wave phase-shift behavior and total cross sections are systematically understood by 1) the spin-flavor SU_6 symmetry, 2) the special role of the pion exchange, and 3) the flavor symmetry breaking.Comment: 11 pages, 6 figures, submitted to Phys. Rev. C (Rapid Communication

Developing young people's sense of self and place through sport

Previous research has recognized positive health implications, both physical and mental, as an outcome of participation in leisure pursuits. They provide opportunities for self-expression and stress reduction, as well as an environment in which people can socialize. Leisure activities, specifically sport activities, can play a significant role in young people's identity development. This paper explores the leisure activities in which young people in Adelaide, Australia participate. It examines the role of leisure activities in terms of young people's identity and feelings towards their hometown. This study consisted of semi-structured focus groups conducted with 24 senior high school students, followed by a survey resulting in 226 useable responses. Respondents were aged between 16 and 18 years of age. From the range of activities identified and explored, the results revealed sports activities to have the greatest impact on young people's lives. The results demonstrated that frequency of participation has a significant effect on young people's involvement levels and how they identify with the activity

Growth of free-standing bulk wurtzite AlxGa1−xN layers by molecular beam epitaxy using a highly efficient RF plasma source

The recent development of group III nitrides allows researchers world-wide to consider AlGaN based light emitting diodes as a possible new alternative deep ultra–violet light source for surface decontamination and water purification. In this paper we will describe our recent results on plasma-assisted molecular beam epitaxy (PA-MBE) growth of free-standing wurtzite AlxGa1−xN bulk crystals using the latest model of Riber's highly efficient nitrogen RF plasma source. We have achieved AlGaN growth rates up to 3 µm/h. Wurtzite AlxGa1−xN layers with thicknesses up to 100 μm were successfully grown by PA-MBE on 2-inch and 3-inch GaAs (111)B substrates. After growth the GaAs was subsequently removed using a chemical etch to achieve free-standing AlxGa1−xN wafers. Free-standing bulk AlxGa1−xN wafers with thicknesses in the range 30–100 μm may be used as substrates for further growth of AlxGa1−xN-based structures and devices. High Resolution Scanning Transmission Electron Microscopy (HR-STEM) and Convergent Beam Electron Diffraction (CBED) were employed for detailed structural analysis of AlGaN/GaAs (111)B interface and allowed us to determine the N-polarity of AlGaN layers grown on GaAs (111)B substrates. The novel, high efficiency RF plasma source allowed us to achieve free-standing AlxGa1−xN layers in a single day's growth, making this a commercially viable process

Simulation techniques for cosmological simulations

Modern cosmological observations allow us to study in great detail the evolution and history of the large scale structure hierarchy. The fundamental problem of accurate constraints on the cosmological parameters, within a given cosmological model, requires precise modelling of the observed structure. In this paper we briefly review the current most effective techniques of large scale structure simulations, emphasising both their advantages and shortcomings. Starting with basics of the direct N-body simulations appropriate to modelling cold dark matter evolution, we then discuss the direct-sum technique GRAPE, particle-mesh (PM) and hybrid methods, combining the PM and the tree algorithms. Simulations of baryonic matter in the Universe often use hydrodynamic codes based on both particle methods that discretise mass, and grid-based methods. We briefly describe Eulerian grid methods, and also some variants of Lagrangian smoothed particle hydrodynamics (SPH) methods.Comment: 42 pages, 16 figures, accepted for publication in Space Science Reviews, special issue "Clusters of galaxies: beyond the thermal view", Editor J.S. Kaastra, Chapter 12; work done by an international team at the International Space Science Institute (ISSI), Bern, organised by J.S. Kaastra, A.M. Bykov, S. Schindler & J.A.M. Bleeke

Baryons: What, When and Where?

We review the current state of empirical knowledge of the total budget of baryonic matter in the Universe as observed since the epoch of reionization. Our summary examines on three milestone redshifts since the reionization of H in the IGM, z = 3, 1, and 0, with emphasis on the endpoints. We review the observational techniques used to discover and characterize the phases of baryons. In the spirit of the meeting, the level is aimed at a diverse and non-expert audience and additional attention is given to describe how space missions expected to launch within the next decade will impact this scientific field.Comment: Proceedings Review for "Astrophysics in the Next Decade: JWST and Concurrent Facilities", ed. X. Tielens, 38 pages, 10 color figures. Revised to address comments from the communit