An evaluation of the 'Living with Cancer' project: Using neuro-linguistic programming techniques to maximise the coping strategies of carers and patients living with cancer in Ellesmere Port

The 'Living with cancer' project aimed to improve communication, relationship, and coping skills of health professionals, cancer patients and their carers in Ellesmere Port. The project delivered NLP Diploma training to 55 health professionals between April 2001-March 2004.Commissioned by Chester and Halton NHS Trust and funded through the New Opportunities Fund

On the origin of the O and B-type stars with high velocities II Runaway stars and pulsars ejected from the nearby young stellar groups

We use milli-arcsecond accuracy astrometry (proper motions and parallaxes) from Hipparcos and from radio observations to retrace the orbits of 56 runaway stars and nine compact objects with distances less than 700 pc, to identify the parent stellar group. It is possible to deduce the specific formation scenario with near certainty for two cases. (i) We find that the runaway star zeta Ophiuchi and the pulsar PSR J1932+1059 originated about 1 Myr ago in a supernova explosion in a binary in the Upper Scorpius subgroup of the Sco OB2 association. The pulsar received a kick velocity of about 350 km/s in this event, which dissociated the binary, and gave zeta Oph its large space velocity. (ii) Blaauw & Morgan and Gies & Bolton already postulated a common origin for the runaway-pair AE Aur and mu Col, possibly involving the massive highly-eccentric binary iota Ori, based on their equal and opposite velocities. We demonstrate that these three objects indeed occupied a very small volume \sim 2.5Myr ago, and show that they were ejected from the nascent Trapezium cluster. We identify the parent group for two more pulsars: both likely originate in the 50 Myr old association Per OB3, which contains the open cluster alpha Persei. At least 21 of the 56 runaway stars in our sample can be linked to the nearby associations and young open clusters. These include the classical runaways 53 Arietis (Ori OB1), xi Persei (Per OB2), and lambda Cephei (Cep OB3), and fifteen new identifications, amongst which a pair of stars running away in opposite directions from the region containing the lambda Ori cluster. Other currently nearby runaways and pulsars originated beyond 700 pc, where our knowledge of the parent groups is very incomplete.Comment: Accepted for publication in the A&A. 29 pages, 19 figure

Impact of case management (Evercare) on frail elderly patients: Controlled before and after analysis of quantitative outcome data

Objectives: To determine the impact on outcomes in patients of the Evercare approach to case management of elderly people. Design: Practice level before and after analysis of hospital admissions data with control group. Setting: Nine primary care trusts in England that, in 2003-5, piloted case management of elderly people selected as being at high risk of emergency admission. Main outcome measures: Rates of emergency admission, emergency bed days, and mortality from April 2001 to March 2005 in 62 Evercare practices and 6960-7695 control practices in England (depending on the analysis being carried out). Results: The intervention had no significant effect on rates of emergency admission (increase 16.5%, (95% confidence interval –5.7% to 38.7%), emergency bed days (increase 19.0%, –5.3% to 43.2%), and mortality (increase 34.4%, –1.7% to 70.3%) for a high risk population aged >65 with a history of two or more emergency admissions in the preceding 13 months. For the general population aged 65 effects on the rates of emergency admission (increase 2.5%, –2.1% to 7.0%), emergency bed days (decrease –4.9%, –10.8% to 1.0%), and mortality (increase 5.5%, –3.5% to 14.5%) were also non-significant. Conclusions: Case management of frail elderly people introduced an additional range of services into primary care without an associated reduction in hospital admissions. This may have been because of identification of additional cases. Employment of community matrons is now a key feature of case management policy in the NHS in England. Without more radical system redesign this policy is unlikely to reduce hospital admissions