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

Specific pollinator attraction and the diversification of sexually deceptive Chiloglottis (Orchidaceae)

Abstract.: Evidence indicates that sexually deceptive Chiloglottis R.Br. (Orchidaceae) taxa specifically attract their thynnine wasp (Tiphiidae) pollinators through the floral odour mimicry of female wasp sex pheromones. We use amplified fragment length polymorphisms (AFLPs) to reconstruct the species-level phylogeny of Chiloglottis, make a preliminary evaluation of genetic distinctions between species, and compare the historical association among orchids and their pollinators using wasp sequence data from a previous study. AFLPs show large differences between three sub-generic clades relative to that found among species within each clade. Interspecific genetic barriers are indicated by AFLP discontinuities among species unlike in previously reported DNA sequence data. However, such barriers are demonstrated clearly in only one of the two pairs of sympatric species sampled more intensively. We interpret these patterns as indicating either (i) a rapid and recent radiation of species within each clade following histories of stasis or extinction, or (ii) alternating cycles of divergence and gene flow acting to homogenize genetic differences among species within each of the three clade

Secondary prevention of stroke: Using the experiences of patients and carers to inform the development of an educational resource

Copyright @ The Author 2008. This article is available open access through the publisher’s website at the link below.Background. Patients who have had one stroke are at increased risk of another. Secondary prevention strategies that address medical risk factors and promote healthy lifestyles can reduce the risk. However, concordance with secondary prevention strategies is poor and there has been little research into patient and carer views. Objectives. To explore the experiences of patients and carers of receiving secondary prevention advice and use these to inform the development of an educational resource. Methods. A total of 38 participants (25 patients and 13 carers) took part in the study which used an action research approach. Focus groups and interviews were undertaken with patients and carers who had been discharged from hospital after stroke (between 3 and 24 months previously). Framework analysis was used to examine the data and elicit action points to develop an educational resource. Results. Participants’ main concern was their desire for early access to information. They commented on their priorities for what information or support they needed, the difficulty of absorbing complex information whilst still an in-patient and how health professionals’ use of language was often a barrier to understanding. They discussed the facilitators and barriers to making lifestyle changes. The educational resource was developed to include specific advice for medical and lifestyle risk factors and an individual action plan. Conclusion. An educational resource for secondary prevention of stroke was developed using a participatory methodology. Our findings suggest that this resource is best delivered in a one-to-one manner, but further work is needed to identify its potential utility.Peninsula Primary Care Research Networ

Biological characteristics and mortality of western butterfish (Pentapodus vitta), an abundant bycatch species of prawn trawling and recreational fishing in a large subtropical embayment

The western butterfish (Pentapodus vitta) is numerous in the bycatch of prawn trawling and recreational fishing in Shark Bay, Western Australia. We have thus determined crucial aspects of its biological characteristics and the potential impact of fishing on its abundance within this large subtropical marine embayment. Although both sexes attained a maximum age of 8 years, males grow more rapidly and to a larger size. Maturity is attained at the end of the first year of life and spawning occurs between October and January. The use of a Bayesian approach to combine independent estimates for total mortality, Z, and natural mortality, M, yielded slightly higher point estimates for Z than M. This result indicates that P. vitta is lightly impacted by fishing. It is relevant that, potentially, the individuals can spawn twice before recruitment into the fishery and that 73% of recreationally caught individuals are returned live to the water

Self-monitoring for improving control of blood pressue in patients with hypertension

The objective of this review is to determine the effect of SBPM in adults with hypertension on blood pressure control as compared to OBPM or usual care

Assessment of cardiovascular risk in primary care.

No abstrac

Beyond the helium buffer: C-12(2)- rotational cooling in cold traps with H-2 as a partner gas: interaction forces and quantum dynamics

The scattering cross-sections and corresponding rate coefficients for rotationally inelastic collisions of 12 C−2 (2Σ+g) with H2 (1Σ+g) are presented over a broad range of cold-trap temperatures. They have been calculated using quantum scattering theory that employs a new ab initio potential energy surface. The rate coefficients for the inelastic processes in the anionic partner are used to model the thermalisation dynamics of 12 C−2 using H2 as a buffer gas, a trap partner which is found here to be far more efficient than the typical buffer gas He and even more so than when using Ar as a partner gas. The microscopic physics underlying these findings is discussed in some detail. We additionally compute and discuss 12 C−2 quadrupole transitions by spontaneous emission and use the newly computed rates to show that the anion's rotational levels should be in local thermal equilibrium at typical interstellar conditions