Family support for stroke: one year follow up of a randomised controlled trial

Background: There is evidence that family support can benefit carers of stroke patients, but not the patients themselves. Objective: To extend the follow up of a single blind randomised controlled trial of family support for stroke patients and carers to one year to ascertain whether there were any late effects of the intervention. Methods: The study was a randomised controlled trial. Patients admitted to hospital with acute stroke who had a close carer were assigned to receive family support or normal care. Families were visited at home by a researcher 12 months after the stroke, and a series of questionnaires was administered to patient and carer. Results: The benefits to carers mostly persisted, though they were no longer statistically significant because some patients were lost to follow up. There was no evidence of any effects on patients. Conclusion: Family support is effective for carers, but different approaches need to be considered to alleviate the psychosocial problems of stroke patients. Abbreviations: FSO, family support organiser; SF-36, short form 36 item health assessment questionnaire Keywords: caregiver; family support; stroke In recognition of the impact that stroke has on carers as well as patients,1 services such as Stroke Association family support have been developed in the United Kingdom which provide information, emotional support, and liaison with other services. The service maintains contact through a combination of home and hospital visits and telephone calls. In the Oxford family support trial, we found that this service was associated with significantly improved quality of life of carers at follow up six months after the stroke, but had no effects on patients.2 Other randomised controlled trials of the service in other areas have also found no evidence of benefit to patients with follow up varying from four to nine months after recruitment.3,4 The lack of benefit to patients may be attributable to the short duration of follow up in these trials. The service usually maintains contact with a family for a year, and some patients spend a significant proportion of the first six months in hospital, during which time family support might be anticipated to have less impact. We carried out a second follow up of participants in the Oxford trial to investigate the effects of family support on patients and carers one year after the stroke

Magnetic Field Generation in Stars

Enormous progress has been made on observing stellar magnetism in stars from the main sequence through to compact objects. Recent data have thrown into sharper relief the vexed question of the origin of stellar magnetic fields, which remains one of the main unanswered questions in astrophysics. In this chapter we review recent work in this area of research. In particular, we look at the fossil field hypothesis which links magnetism in compact stars to magnetism in main sequence and pre-main sequence stars and we consider why its feasibility has now been questioned particularly in the context of highly magnetic white dwarfs. We also review the fossil versus dynamo debate in the context of neutron stars and the roles played by key physical processes such as buoyancy, helicity, and superfluid turbulence,in the generation and stability of neutron star fields. Independent information on the internal magnetic field of neutron stars will come from future gravitational wave detections. Thus we maybe at the dawn of a new era of exciting discoveries in compact star magnetism driven by the opening of a new, non-electromagnetic observational window. We also review recent advances in the theory and computation of magnetohydrodynamic turbulence as it applies to stellar magnetism and dynamo theory. These advances offer insight into the action of stellar dynamos as well as processes whichcontrol the diffusive magnetic flux transport in stars.Comment: 41 pages, 7 figures. Invited review chapter on on magnetic field generation in stars to appear in Space Science Reviews, Springe

Managing further rehabilitation in longer-term stroke patients in the community: A new approach

Stroke is becoming a major public health issue in our country due to the fact that there is an increasing life span of our population. Due to advancement of acute management of stroke, three out of four people will survive beyond the acute phase of stroke. Stroke care providers are still debating regarding the exact period of the terminology ‘longer-term stroke’; however many agreed that long-term of stroke refers to the period of one year and thereafter as this period is the determinant for longer-term survival. Management beyond the first year of stroke is complex, encompasses all aspects of patient’s life; physical, psychological and integration into community. Rehabilitation being the cornerstone of longer-term stroke management should now focused on more evidence-based approach as to be effective and relevant to the stroke patient

Marine nematode taxonomy in the DNA age: the present and future of molecular tools to access their biodiversity

Molecular taxonomy is one of the most promising yet challenging fields of biology. Molecular markers such as nuclear and mitochondrial genes are being used in a variety of studies surveying marine nematode taxa. Sequences from more than 600 species have been deposited to date in online databases. These barcode sequences are assigned to 150 nominal species from 104 genera. There are 41 species assigned to Enoplea and 109 species to Chromadorea. Morphology-based surveys are greatly limited by processing speed, while barcoding approaches for nematodes are hampered by difficulties in matching sequence data with morphology-based taxonomy. DNA barcoding is a promising approach because some genes contain variable regions that are useful to discriminate species boundaries, discover cryptic species, quantify biodiversity and analyse phylogeny. We advocate a combination of several approaches in studies of molecular taxonomy, DNA barcoding and conventional taxonomy as a necessary step to enhance the knowledge of biodiversity of marine nematodes

Publications of the Space Physiology and Countermeasures Program, Cardiopulmonary Discipline: 1980-1990

A 10-year cumulative bibliography of publications resulting from research supported by the Cardiopulmonary Discipline of the Space Physiology and Countermeasures Program of NASA's Life Sciences Division is provided. Primary subjects included in this bibliography are Fluid Shifts, Cardiovascular Fitness, Cardiovascular Physiology, and Pulmonary Physiology. General physiology references are also included. Principal investigators whose research tasks resulted in publication are identified. Publications are identified by a record number corresponding with their entry in the Life Sciences Bibliographic Database, maintained at the George Washington University

An acute case of expressive aphasia following ischaemic stroke

Mr. D.C. is a 75-year old gentleman brought to casualty after a neighbour found him unable to speak. Since he was severely aphasic, he was unable to give a proper history. The patient was able to understand commands, making this a pure expressive aphasia. He was also noted to have right hemiparesis and right facial weakness. On examination, Mr D.C. was found to have 0/5 power on the right half of his body and 3/5 power on the left side of his body using the MRC muscle power assessment scale. He was noted to have right facial weakness in an upper motor neurone lesion pattern. He was urgently admitted to a medical ward and a CT scan was requested. The scan confirmed a left middle cerebral artery (MCA) ischaemic infarct affecting the basal ganglia and Broca’s Area in the inferior frontal lobe.peer-reviewe

57 second oscillations in Nova Centauri 1986 (V842 Cen)

High speed photometry in 2008 shows that the light curve of V842 Cen possesses a coherent modulation at 56.825 s, with sidebands at 56.598 s and 57.054 s. These have appeared since this nova remnant was observed in 2000 and 2002. We deduce that the dominant signal is the rotation period of the white dwarf primary and the sidebands are caused by reprocessing from a surface moving with an orbital period of 3.94 h. Thus V842 Cen is an intermediate polar (IP) of the DQ Herculis subclass, is the fastest rotating white dwarf among the IPs and is the third fastest known in a cataclysmic variable. As in other IPs we see no dwarf nova oscillations, but there are often quasi-periodic oscillations in the range 350 - 1500 s. There is a strong brightness modulation with a period of 3.78 h, which we attribute to negative superhumps, and there is an even stronger signal at 2.886 h which is of unknown origin but is probably a further example of that seen in GW Lib and some other systems. We used the Swift satellite to observe V842 Cen in the ultra-violet and in X-rays, although no periodic modulation was detected in the short observations. The X-ray luminosity of this object appears to be much lower than that of other IPs in which the accretion region is directly visible.Comment: 6 pages, 10 figures, accepted for publication in MNRA

Magnetic White Dwarfs

In this paper we review the current status of research on the observational and theoretical characteristics of isolated and binary magnetic white dwarfs (MWDs). Magnetic fields of isolated MWDs are observed to lie in the range 10^3-10^9G. While the upper limit cutoff appears to be real, the lower limit is more difficult to investigate. The incidence of magnetism below a few 10^3G still needs to be established by sensitive spectropolarimetric surveys conducted on 8m class telescopes. Highly magnetic WDs tend to exhibit a complex and non-dipolar field structure with some objects showing the presence of higher order multipoles. There is no evidence that fields of highly magnetic WDs decay over time, which is consistent with the estimated Ohmic decay times scales of ~10^11 yrs. MWDs, as a class, also appear to be more massive than their weakly or non-magnetic counterparts. MWDs are also found in binary systems where they accrete matter from a low-mass donor star. These binaries, called magnetic Cataclysmic Variables (MCVs) and comprise about 20-25\% of all known CVs. Zeeman and cyclotron spectroscopy of MCVs have revealed the presence of fields in the range $\sim 7-230$\,MG. Complex field geometries have been inferred in the high field MCVs (the polars) whilst magnetic field strength and structure in the lower field group (intermediate polars, IPs) are much harder to establish. The origin of fields in MWDs is still being debated. While the fossil field hypothesis remains an attractive possibility, field generation within the common envelope of a binary system has been gaining momentum, since it would explain the absence of MWDs paired with non-degenerate companions and also the lack of relatively wide pre-MCVs.Comment: 73 pages, 22 figures, 2 large tables. Invited review chapter on Magnetic White Dwarfs to appear in Space Science Reviews, Springe