Efficiency of using community organisations as catalysts for recruitment to continence promotion trials

This article is available open access through the publisher’s website from the link below. Copyright @ 2012 The Authors.Background - A major challenge for determining the effectiveness of community-based continence promotion campaigns is recruitment of a representative sample of incontinent participants who have not previously sought care. Purpose - To evaluate the efficiency of engaging community organisations as catalysts for recruitment of community-dwelling older women with incontinence to the ‘Continence across Continents’ randomised controlled trial. Methods - Seniors’ and women’s community-based organisations throughout the United Kingdom were solicited by telephone or email to assist recruitment for an open-label cluster randomised controlled trial testing three experimental continence promotion interventions and a control intervention for incontinent older women. Women aged 60 years and older who experienced at least weekly urinary incontinence and who had never sought treatment were eligible to participate. The response rate of the organisations and enrolment rate of eligible participants attending the continence promotion workshops were recorded. Differences in recruitment efficiency by intervention group were ascertained using analysis of variance statistics. Results - We contacted 408 community organisations over a 1-year period. Seventy organisations (17%) agreed to host a workshop, 249 (61%) did not provide a response, and 89 (22%) refused. Workshops were administered in a group format to 61 organisations (15%); 667 women attended, 583 (87%) submitted the screening questionnaire, and 437 (66%) met eligibility criteria for inclusion. A total of 192 women consented to participate in the trial, yielding a 44% recruitment efficiency among workshop attendees known to be eligible, with no significant difference in enrolment rates between groups. However, the mean participant recruitment rate per number of attendees at each workshop was only 29%, varying substantially between groups from 19% to 37%, with the lowest rate observed for the control group. The mean annual recruitment rate expressed as the number of enrolled participants per community organisation contacted was 0.5. Limitations - Reasons for women’s non-response were not collected. The findings may be country specific. Conclusions - The recruitment rate for a continence promotion trial among older women known to be eligible and attending workshops hosted by local community organisations was high (44%). Strategies are needed to bolster community organisations’ involvement in health promotion trials in general and for continence issues in particular

Discovery of Two Relativistic Neutron Star-White Dwarf Binaries

We have discovered two recycled pulsars in relativistic orbits as part of the first high-frequency survey of intermediate Galactic latitudes. PSR J1157-5112 is a 44 ms pulsar and the first recycled pulsar with an ultra-massive (M > 1.14 Mo) white dwarf companion. Millisecond pulsar J1757-5322 is a relativistic circular-orbit system which will coalesce due to the emission of gravitational radiation in less than 9.5 Gyr. Of the ~40 known circular orbit pulsars, J1757-5322 and J1157-5112 have the highest projected orbital velocities. There are now three local neutron-star/white-dwarf binaries that will coalesce in less than a Hubble time, implying a large coalescence rate for these objects in the local Universe. Systems such as J1141-6545 (Kaspi et al. 2000) are potential gamma-ray burst progenitors and dominate the coalescence rate, whilst lighter systems make excellent progenitors of millisecond pulsars with planetary or ultra-low mass companions.Comment: 4 pages, to appear in ApJ Letters. Uses aastex v 5.0, emulateapj5.sty, apjfonts.st

Effectiveness of continence promotion for older women via community organisations: A cluster randomised trial

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/Objectives: The primary objective of this cluster randomised controlled trial was to compare the effectiveness of the three experimental continence promotion interventions against a control intervention on urinary symptom improvement in older women with untreated incontinence recruited from community organisations. A second objective was to determine whether changes in incontinence-related knowledge and new uptake of risk-modifying behaviours explain these improvements. Setting: 71 community organisations across the UK. Participants: 259 women aged 60 years and older with untreated incontinence entered the trial; 88% completed the 3-month follow-up. Interventions: The three active interventions consisted of a single 60 min group workshop on (1) continence education (20 clusters, 64 women); (2) evidence-based self-management (17 clusters, 70 women); or (3) combined continence education and self-management (17 clusters, 61 women). The control intervention was a single 60 min educational group workshop on memory loss, polypharmacy and osteoporosis (17 clusters, 64 women). Primary and secondary outcome measures: The primary outcome was self-reported improvement in incontinence 3 months postintervention at the level of the individual. The secondary outcome was change in the International Consultation on Incontinence Questionnaire (ICIQ) from baseline to 3-month follow-up. Changes in incontinence-related knowledge and behaviours were also assessed. Results: The highest rate of urinary symptom improvement occurred in the combined intervention group (66% vs 11% of the control group, prevalence difference 55%, 95% CI 43% to 67%, intracluster correlation 0). 30% versus 6% of participants reported significant improvement respectively (prevalence difference 23%, 95% CI 10% to 36%, intracluster correlation 0). The number-needed-to-treat was 2 to achieve any improvement in incontinence symptoms, and 5 to attain significant improvement. Compared to controls, participants in the combined intervention reported an adjusted mean 2.05 point (95% CI 0.87 to 3.24) greater improvement on the ICIQ from baseline to 3-month follow-up. Changes in knowledge and self-reported risk-reduction behaviours paralleled rates of improvement in all intervention arms. Conclusions: Continence education combined with evidence-based self-management improves symptoms of incontinence among untreated older women. Community organisations represent an untapped vector for delivering effective continence promotion interventions.Canadian Institutes of Health Research – Institute on Aging and the Economic and Social Research Council (UK

Is the Bursting Radio-source GCRT J1745-3009 a Double Neutron Star Binary ?

GCRT J1745-3009 is a peculiar transient radio-source in the direction of the Galactic Center. It was observed to emit a series of ~ 1 Jy bursts at 0.33 GHz, with typical duration ~ 10 min and at apparently regular intervals of ~ 77 min. If the source is indeed at the distance of the Galactic Center as it seems likely, we show that its observational properties are compatible with those expected from a double neutron star binary, similar to the double pulsar system J0737-3039. In the picture we propose the (coherent) radio emission comes from the shock originating in the interaction of the wind of the more energetic pulsar with the magnetosphere of the companion. The observed modulation of the radio signal is the consequence of an eccentric orbit, along which the separation between the two stars varies. This cyclically drives the shock inside the light cylinder radius of the less energetic pulsar.Comment: 5 pages, 3 figures, accepted for publication in The Astrophysical Journal Letters, comment on geodetic precession adde

Evolution of Neutron-Star, Carbon-Oxygen White-Dwarf Binaries

At least one, but more likely two or more, eccentric neutron-star, carbon-oxygen white-dwarf binaries with an unrecycled pulsar have been observed. According to the standard scenario for evolving neutron stars which are recycled in common envelope evolution we expect to observe \gsim 50 such circular neutron star-carbon oxygen white dwarf binaries, since their formation rate is roughly equal to that of the eccentric binaries and the time over which they can be observed is two orders of magnitude longer, as we shall outline. We observe at most one or two such circular binaries and from that we conclude that the standard scenario must be revised. Introducing hypercritical accretion into common envelope evolution removes the discrepancy by converting the neutron star into a black hole which does not emit radio waves, and therefore would not be observed.Comment: 25 pages, 1 figure, accepted in Ap

A Survey of Best Monotone Degree Conditions for Graph Properties

We survey sufficient degree conditions, for a variety of graph properties, that are best possible in the same sense that Chvatal's well-known degree condition for hamiltonicity is best possible.Comment: 25 page

An Unusual Spectral State of an Ultra-luminous Very Soft X-ray Source during Outburst

We report the results of Chandra and XMM-Newton observations of a new outburst of an ultra-luminous X-ray source in M101. During a Chandra monitoring observation of M101, M101 ULX-1 was found to be in outburst in 2004 December, the second outburst in 2004. The peak bolometric luminosity is about 3e40 erg/s (7e39 erg/s in 0.3-7 keV). The outburst spectra are very soft and can generally be fitted with a blackbody model with temperatures of 40-80 eV, similar to supersoft X-ray sources in the Milky Way and in the Magellanic Clouds. In one Chandra observation, the source spectrum appears to be harder with a temperature of 150 eV. Such a spectral state is rarely seen in M101 ULX-1 and no X-ray source in the Milky Way shows this kind of spectrum. However, such an unusual spectral state very likely belongs to a new class of X-ray sources, quasisoft X-ray sources, recently discovered in nearby galaxies. M101 ULX-1 returned to supersoft state in a subsequent XMM-Newton observation. Based on the two outbursts in 2004, the extremely high luminosity (L_bol=1e40-1e41 erg/s), very soft X-ray spectra (kT=40-150 eV), transient behavior, and state transition provide strong evidence that M101 ULX-1 harbors an intermediate-mass black hole.Comment: 4 pages, 2 figures, accepted for publication in ApJ

A Massive White Dwarf Companion to the Eccentric Binary Pulsar System PSR B2303+46

Pulsars in close, eccentric binary systems are usually assumed to have another neutron star as a companion. These double neutron star binaries have proven to be the best laboratories for experimental General Relativity and are the most secure candidates for gravitational wave interferometers. We present deep B, V, and R images of the field containing the eccentric binary pulsar system PSR B2303+46. We find a faint, blue object (B=26.60+/-0.09; (B-R)_0=-0.4+/-0.2) coincident with the timing position. We suggest this object is the optical counterpart to the PSR B2303+46 system. The counterpart is too bright to reflect emission from the pulsar or a neutron star companion. Most likely, the companion of PSR B2303+46 is not a neutron star but a massive white dwarf. We show that the observations are consistent with a hot white dwarf companion (T_eff>~5*10^4 K) with cooling age equal the characteristic age of the pulsar (t_cool~30 Myr) and mass within the range set by timing observations and the Chandrasekhar mass (1.2<M_C<1.4 M_sun). Given the eccentric orbit, the white dwarf must have formed before the neutron star, from what was originally the more massive star in the binary. Due to mass transfer, the originally less massive star could become sufficiently massive to end its life in a supernova explosion and form the radio pulsar. We constrain the mass of the pulsar to be in the range 1.24<M_psr<1.44 M_sun.Comment: Revised version, with only very small changes. 6 pages, 1 figure, uses aas4pp2.sty, psfig.sty. Accepted for publication in Astrophysical Journal Letter

Optical Detection of Two Intermediate Mass Binary Pulsar Companions

We report the detection of probable optical counterparts for two Intermediate Mass Binary Pulsar (IMBP) systems, PSR J1528-3146 and PSR J1757-5322. Recent radio pulsar surveys have uncovered a handful of these systems with putative massive white dwarf companions, thought to have an evolutionary history different from that of the more numerous class of Low Mass Binary Pulsars (LMBPs) with He white dwarf companions. The study of IMBP companions via optical observations offers us several new diagnostics: the evolution of main sequence stars near the white-dwarf-neutron star boundary, the physics of white dwarfs close to the Chandrasekhar limit, and insights into the recycling process by which old pulsars are spun up to high rotation frequencies. We were unsuccessful in our attempt to detect optical counterparts of PSR J1141-6545, PSR J1157-5112, PSR J1435-6100, and PSR J1454-5846.Comment: 9 pages, 2 figures, accepted for publication in ApJ