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.

Contraction/expansion flows: The pressure drop and related issues

Binding, David; Phillips, P.M.; Philips, T.N., (2006) 'Contraction/expansion flows: The pressure drop and related issues', Journal of Non-Newtonian Fluid Mechanics 137 pp.31-38 RAE2008

Pressure-induced amorphization and an amorphous-amorphous transition in densified porous silicon

Deb, S. K., Wilding, M. C., Somayazulu, M., McMillan, P. F. (2001). Pressure-induced amorphization and an amorphous-amorphous transition in densified porous silicon. Nature, 414, 528-530. RAE2008

The rheology of collapsing zeolites amorphized by temperature and pressure

Greaves, G.; Meneau, F.; ap Gwynn, I.A.; Wade, S., (2003). The rheology of collapsing zeolites amorphized by temperature and pressure. Nature Materials 2, 622-629. RAE2008

Strong High Pressure Systems Influencing the Weather in Poland During the Period 1971-2000

This paper shows preliminary results of research into the occurrence of strong anticyclonic systems that influenced the weather in Poland during the period 1971–2000. The study was based on NCEP/NCAR reanalysis data, including daily values of the 1000 and 500 hPa geopotential heights, maps of mentioned geopotential heights and maps of sea-level field pressure. With the use of these data a number of exceptionally strong high-pressure systems were identified, together with their areas of origin and subsequent development patterns. They were then broken down into five groups with similar dynamics. The numbers of systems in each group were not found to follow any significant change trends in the long term. The greatest differences between groups were identified in terms of their annual occurrence rates and centre pressure values.

Pressure induced anisotropy of electrical conductivity in polycrystalline molybdenum disulfide

Anisotropic specimens of MoS2 are obtained by pressing the microcrystalline powder into special die. This inelastic compression results in a rearrangement of the disulfide micro platelets observed by Atomic Force Microscopy and reflected in the macroscopic anisotropy in electrical conductivity in these samples. The conductivity measured parallel and perpendicular to the direction of applied pressure exhibits an anisotropy factor of ∼10 at 1 GPa. This behaviour of the conductivity as a function of applied pressure is explained as the result of the simultaneous influence of a rearrangement of the micro platelets in the solid and the change of the inter-grain distances.

Keeping their heads down: Shame and pride in the stories of Protestants in the Irish Republic

This study draws on a number of in-depth interviews to explore the ethnic aspect of Protestantism in the Republic of Ireland. We explore themes of shame and pride around issues of identity, together with a sense of loss of a minority rapidly losing cultural distinctiveness. Following Ireland‘s division, the ordinary Protestants of the south, comprising a range of religious denominations bound by history, intermarriage and culture, found themselves in a society in which their story was rarely told. The dominant narrative was one of a Catholic people, long oppressed by a wealthy Protestant minority. The story of ordinary Protestants, including those in rural and urban poverty, went largely unheard. Today, ordinary Protestants – small farmers, shop keepers, housewives – tell the story of Ireland as seen through their family‘s narratives. Themes of pride and shame, often intertwined, form a thread that binds their testimony, drawing on family, personal and local history, folklore and statements of identity.

The implementation of a translational study involving a primary care based behavioral program to improve blood pressure control: The HTN-IMPROVE study protocol (01295).

BACKGROUND: Despite the impact of hypertension and widely accepted target values for blood pressure (BP), interventions to improve BP control have had limited success. OBJECTIVES: We describe the design of a 'translational' study that examines the implementation, impact, sustainability, and cost of an evidence-based nurse-delivered tailored behavioral self-management intervention to improve BP control as it moves from a research context to healthcare delivery. The study addresses four specific aims: assess the implementation of an evidence-based behavioral self-management intervention to improve BP levels; evaluate the clinical impact of the intervention as it is implemented; assess organizational factors associated with the sustainability of the intervention; and assess the cost of implementing and sustaining the intervention. METHODS: The project involves three geographically diverse VA intervention facilities and nine control sites. We first conduct an evaluation of barriers and facilitators for implementing the intervention at intervention sites. We examine the impact of the intervention by comparing 12-month pre/post changes in BP control between patients in intervention sites versus patients in the matched control sites. Next, we examine the sustainability of the intervention and organizational factors facilitating or hindering the sustained implementation. Finally, we examine the costs of intervention implementation. Key outcomes are acceptability and costs of the program, as well as changes in BP. Outcomes will be assessed using mixed methods (e.g., qualitative analyses--pattern matching; quantitative methods--linear mixed models). DISCUSSION: The study results will provide information about the challenges and costs to implement and sustain the intervention, and what clinical impact can be expected.