William Hope Hodgson's borderlands: monstrosity, other worlds, and the future at the fin de siècle.

William Hope Hodgson has generally been understood as the author of several atmospheric sea-horror stories and two powerful but flawed horror science fiction novels. There has been no substantial study analysing the historical and cultural context of his fiction or its place in the Gothic, horror, and science fiction literary traditions. Through analysing the theme of borderlands, this thesis contextualises Hodgson’s novels and short stories within these traditions and within late Victorian cultural discourse. Liminal other world realms, boundaries of corporeal monstrosity, and the imagined future of the world form key elements of Hodgson’s fiction, reflecting the currents of anxiety and optimism characterising fin-de-siècle British society. Hodgson’s early career as a sailor and his interest in body-building and physical culture colour his fiction. Fin-de-siècle discourses of evolution, entropy, spiritualism, psychical research, and the occult also influence his ideas. In The House on the Borderland (1908) and The Night Land (1912), the known world brushes against other forms of reality, exposing humanity to incomprehensible horrors. In The Ghost Pirates (1909), the sea forms a liminal region on the borderland of materiality and immateriality in which other world encounters can take place. In The Night Land and The Boats of the ‘Glen Carrig’ (1907), evolution gives rise to strange monstrous forms existing on the borderlines of species and identity. In Hodgson’s science fiction—The House on the Borderland and The Night Land—the future of the earth forms a temporal borderland of human existence shaped by fin-de-siècle fears of entropy and the heat-death of the sun. Alongside the work of other writers such as H. G. Wells and Arthur Machen, Hodgson’s four novels respond to the borderland discourses of the fin de siècle, better enabling us to understand the Gothic literature of the period as well as Hodgson’s position as a writer who offers a unique imaginative perspective on his contemporary culture.

Mixed methods feasibility study for a trial of blood pressure telemonitoring for people who have had stroke/transient ischaemic attack (TIA).

Background Good blood pressure (BP) control reduces the risk of recurrence of stroke/transient ischaemic attack (TIA). Although there is strong evidence that BP telemonitoring helps achieve good control, none of the major trials have considered the effectiveness in stroke/TIA survivors. We therefore conducted a feasibility study for a trial of BP telemonitoring for stroke/ TIA survivors with uncontrolled BP in primary care. Method Phase 1 was a pilot trial involving 55 patients stratified by stroke/TIA randomised 3:1 to BP telemonitoring for 6 months or usual care. Phase 2 was a qualitative evaluation and comprised semi-structured interviews with 16 trial participants who received telemonitoring and 3 focus groups with 23 members of stroke support groups and 7 carers. Results Overall, 125 patients (60 stroke patients, 65 TIA patients) were approached and 55 (44%) patients were randomised including 27 stroke patients and 28 TIA patients. Fifty-two participants (95%) attended the 6-month follow-up appointment, but one declined the second daytime ambulatory blood pressure monitoring (ABPM) measurement resulting in a 93% completion rate for ABPM − the proposed primary outcome measure for a full trial. Adherence to telemonitoring was good; of the 40 participants who were telemonitoring, 38 continued to provide readings throughout the 6 months. There was a mean reduction of 10.1 mmHg in systolic ABPM in the telemonitoring group compared with 3.8 mmHg in the control group, which suggested the potential for a substantial effect from telemonitoring. Our qualitative analysis found that many stroke patients were concerned about their BP and telemonitoring increased their engagement, was easy, convenient and reassuring Conclusions A full-scale trial is feasible, likely to recruit well and have good rates of compliance and follow-up.