Full Text Available Abstract Background The increasing prevalence of type 2 diabetes poses a major public health challenge. Population-based screening and early treatment for type 2 diabetes could reduce this growing burden. However, the benefits of such a strategy remain uncertain. Methods and design The ADDITION-Cambridge study aims to evaluate the effectiveness and cost-effectiveness of (i a stepwise screening strategy for type 2 diabetes; and (ii intensive multifactorial treatment for people with screen-detected diabetes in primary care. 63 practices in the East Anglia region participated. Three undertook the pilot study, 33 were allocated to three groups: no screening (control, screening followed by intensive treatment (IT and screening plus routine care (RC in an unbalanced (1:3:3 randomisation. The remaining 27 practices were randomly allocated to IT and RC. A risk score incorporating routine practice data was used to identify people aged 40–69 years at high-risk of undiagnosed diabetes. In the screening practices, high-risk individuals were invited to take part in a stepwise screening programme. In the IT group, diabetes treatment is optimised through guidelines, target-led multifactorial treatment, audit, feedback, and academic detailing for practice teams, alongside provision of educational materials for newly diagnosed participants. Primary endpoints are modelled cardiovascular risk at one year, and cardiovascular mortality and morbidity at five years after diagnosis of diabetes. Secondary endpoints include all-cause mortality, development of renal and visual impairment, peripheral neuropathy, health service costs, self-reported quality of life, functional status and health utility. Impact of the screening programme at the population level is also assessed through measures of mortality, cardiovascular morbidity, health status and health service use among high-risk individuals. Discussion ADDITION-Cambridge is conducted in a defined high-risk group
Kinmonth Ann; Prevost A Toby; Barling Roslyn S; Williams Kate M; Simmons Rebecca K; Echouffo-Tcheugui Justin B; Wareham Nicholas J; Griffin Simon J
Abstract Background The increasing prevalence of type 2 diabetes poses a major public health challenge. Population-based screening and early treatment for type 2 diabetes could reduce this growing burden. However, the benefits of such a strategy remain uncertain. Methods and design The ADDITION-Cambridge study aims to evaluate the effectiveness and cost-effectiveness of (i) a stepwise screening strategy for type 2 diabetes; and (ii) intensive multifactorial treatment for people with screen-de...
Newsletter of the Philosophy Faculty. Articles by: Simon Blackburn, 'From the Chair' ; Nick Treanor, 'Inaugural lecture: What is distinctive about human thought?' ; Clare Chambers, 'Political Philosophy at Cambridge' ; Alexis Papazoglou,'Aspects of philosophy at Cambridge' ; Peter Smith, 'Principia at 100' ; Nigel Crisp, 'Turning the World Upside Down' ; Cain Todd, 'Fiction, Emotion, Imagination'; Fraser MacBride, 'Philosophy, St John's, Cambridge, 1986.'
This Workbook supports our bestselling Checkpoint English series, with exercises specifically matched to the Cambridge Progression tests and the Checkpoint English tests. - Offers plenty of additional questions for use in class or as homework. - Includes clearly identified questions on grammar and punctuation, comprehension, use of language and essay planning. - Follows the structure of the relevant textbook to ensure a thorough understanding of all aspects of the course. - Provides a space for Students to write their answers. This Workbook is matched to the Cambridge Secondary 1 Curriculum Fr
Groom, Colin R; Bruno, Ian J; Lightfoot, Matthew P; Ward, Suzanna C
The Cambridge Structural Database (CSD) contains a complete record of all published organic and metal-organic small-molecule crystal structures. The database has been in operation for over 50 years and continues to be the primary means of sharing structural chemistry data and knowledge across disciplines. As well as structures that are made public to support scientific articles, it includes many structures published directly as CSD Communications. All structures are processed both computationally and by expert structural chemistry editors prior to entering the database. A key component of this processing is the reliable association of the chemical identity of the structure studied with the experimental data. This important step helps ensure that data is widely discoverable and readily reusable. Content is further enriched through selective inclusion of additional experimental data. Entries are available to anyone through free CSD community web services. Linking services developed and maintained by the CCDC, combined with the use of standard identifiers, facilitate discovery from other resources. Data can also be accessed through CCDC and third party software applications and through an application programming interface. PMID:27048719
Geoff C. Harcourt; Peter Kriesler
David Ricardo’s key place in the history of economic thought is well established. However, both the understanding of his Principles of Political Economy and Taxation and its role in the development of economic analysis is much more controversial. Cambridge economists have contributed significantly to both of these issues. They have played an important part in two extremely divergent interpretations of Ricardo’s place in the development of economic thought. Understanding how Ricardo has been v...
Watson, Dave; Konrad, Nina
Endorsed by Cambridge International Examinations. Develop your students computational thinking and programming skills with complete coverage of the latest syllabus (0478) from experienced examiners and teachers. - Includes a Student CD-ROM with interactive tests, based on the short answer questions from both papers - Follows the order of the syllabus exactly, ensuring complete coverage - Introduces students to self-learning exercises, helping them learn how to use their knowledge in new scenarios This syllabus is for first examination from 2015.
Falko F Sniehotta
Full Text Available BACKGROUND: Interventions for dietary and physical activity changes in obese adults may be less effective for participants with additional obesity-related risk factors and co-morbidities than for otherwise healthy individuals. This study aimed to test the feasibility and acceptability of the recruitment, allocation, measurement, retention and intervention procedures of a randomised controlled trial of an intervention to improve physical activity and dietary practices amongst obese adults with additional obesity related risk factors. METHOD: Pilot single centre open-labelled outcome assessor-blinded randomised controlled trial of obese (Body Mass Index (BMI≥30 kg/m2 adults (age≥18 y with obesity related co-morbidities such as type 2 diabetes, impaired glucose tolerance or hypertension. Participants were randomly allocated to a manual-based group intervention or a leaflet control condition in accordance to a 2∶1 allocation ratio. Primary outcome was acceptability and feasibility of trial procedures, secondary outcomes included measures of body composition, physical activity, food intake and psychological process measures. RESULTS: Out of 806 potentially eligible individuals identified through list searches in two primary care general medical practices N = 81 participants (63% female; mean-age = 56.56(11.44; mean-BMI = 36.73(6.06 with 2.35(1.47 co-morbidities were randomised. Scottish Index of Multiple Deprivation (SIMD was the only significant predictor of providing consent to take part in the study (higher chances of consent for invitees with lower levels of deprivation. Participant flowcharts, qualitative and quantitative feedback suggested good acceptance and feasibility of intervention procedures but 34.6% of randomised participants were lost to follow-up due to overly high measurement burden and sub-optimal retention procedures. Participants in the intervention group showed positive trends for most psychological, behavioural
Review of: Giuditta Cordero Moss, International Commercial Contracts. Cambridge: Cambridge University Press, 2014. XV + 329 pages. ISBN: 9781107684713......Review of: Giuditta Cordero Moss, International Commercial Contracts. Cambridge: Cambridge University Press, 2014. XV + 329 pages. ISBN: 9781107684713...
Bulletin of the Atomic Scientists, 1977
Reproduced is the report made by a citizens' group in Cambridge, Massachusetts and presented to the city council that outlines safety regulations for the conduct of recombinant DNA research at Harvard University and the Massachusetts Institute of Technology. (CS)
Pamela Jane Smith
If honours and titles give measure of a man, then Professor Sir Grahame Clark was indeed important. Faculty Assistant Lecturer in the Faculty of Archaeology and Anthropology at Cambridge University from 1935-46, University Lecturer 1946-52, Disney Professor of Archaeology 1952-74, Head of the Department of Archaeology and Anthropology 1956-61 and 1968-71, Fellow of Peterhouse, Cambridge 1950-73, Master of Peterhouse 1...
Objective: In a prospective, randomised trial we investigated the influence of additional High-Dose-Rate-(HDR)-brachytherapy on tumor control and overall survival of patients suffering from inoperable central lung tumors treated with loco-regional external beam radiotherapy (EB-RT). Special attention was given to dose limiting side effects. Methods: Patients randomised in group A received loco-regional EB-RT up to 50 Gy (5 x 2 Gy per week), followed by a boost of 10 Gy also 2 Gy 5 times a week to the primary and adjacent lymphonodular metastases. Patients in group B additionally received an endoluminal HDR-afterloading-radiotherapy (192Ir) with 10 Gy calculated for 5 mm depth one week before and three weeks after EB-RT. Due to the advanced tumor stage, none of the patients received surgery before irradiation. Patients treated with chemotherapy were excluded from the study. Results: Until February 1996 all of 98 patients were evaluated. Both groups are comparable regarding age, gender, Karnofsky Performance State, tumor stage (mostly stage IIIb and IV) and histology. Squamous cell carcinoma (SCC) were found in 69%, whereas the rest consisted of adeno carcinoma (15%), large cell carcinoma (6%) and non small cell carcinoma (NSCLC) (10%), all subsets equally distributed between group A and B. Local control in group A (n=42) lasted for a median of 12 weeks, in group B (n=56) for a median of 21 weeks, a difference which is just significant (p≤0,05). The median overall survival was nearly identical (28 weeks). The subgroup of SCC, however, showed a median survival of 33 (group A) versus 40 weeks (group B), a difference which is not significant (p≤0.09), but might indicate an advantage for this histological group. The most serious side effect was fatal bleeding with 15% in group A and 21% in group B. Conclusions: At present, this study reveals improved local control by a boost of 2x10 Gy 192Ir-HDR-AL in addition to definitive EB-RT (group B) compared to EB-RT alone
Pamela Jane Smith
Full Text Available If honours and titles give measure of a man, then Professor Sir Grahame Clark was indeed important. Faculty Assistant Lecturer in the Faculty of Archaeology and Anthropology at Cambridge University from 1935-46, University Lecturer 1946-52, Disney Professor of Archaeology 1952-74, Head of the Department of Archaeology and Anthropology 1956-61 and 1968-71, Fellow of Peterhouse, Cambridge 1950-73, Master of Peterhouse 1973-80, he was a visiting lecturer at diverse universities; appointed CBE in 1971, he received many awards including the prestigious Erasmus Prize for 1990, presented by Prince Bernhard of the Netherlands, for his "long and inspiring devotion to prehistory" (Scarre 1991:10; and in June 1992, he was knighted. Yet well before fame and position were rewards, Clark made major contributions to the establishment of prehistory as an academic subject at Cambridge University. Cambridge was the first and, for many years, only British university granting an undergraduate degree which offered prehistory as a specialization. "The development of postgraduate research in prehistoric archaeology at Cambridge had to wait on the provision of undergraduate teaching;' Clark (1989b: 6 recently observed. The "faculty was the only one in Britain producing a flow of graduates in prehistoric archaeology" (Clark 1989a: 53.
Revised edition for the 2015 syllabus to help your students prepare for their examination and enhance their enjoyment of English. This title has been written for the revised Cambridge IGCSE First Language English (0500 and 0522) syllabuses, for first teaching from 2013. ? Develops the skills necessary to become a better reader and writer. ? Offers detailed advice and preparation for the examination. ? Teaches skills for successful writing of essays and coursework assignment. We are working with Cambridge International Examinations to gain endorsement for this title.
Presentation about research data sharing at the University of Cambridge given by Dr Marta Teperek on 20 January at central Cambridge, University of Cambridge. Presenation was open to all academics, research students and staff members.
Kennett, Heather; Konrad, Nina
The bestselling title, developed by International experts - now updated to offer comprehensive coverage of the core and extended topics in the latest syllabus. - Includes a student's CD-ROM featuring interactive tests and practice for all examination papers- Covers the core and supplement sections of the updated syllabus- Supported by the most comprehensive range of additional material, including Teacher Resources, Laboratory Books, Practice Books and Revision Guides- Written by renowned, expert authors with vast experience of teaching and examining international qualifications We are working
The Cambridge Infectious Diseases Consortium (CIDC) was established to provide a multi-institutional, world class quality environment for infectious disease research addressing important questions and for the recruitment and training of high quality veterinarians into careers in infectious disease research. The programme has been a demonstrable success in achieving these overall aims. The institutions that have played a key role in the consortium include the Department of Veterinary Medic...
One day in mid-June 2006 when I was on a visit to the Countryside Restoration Trust at Barton near Cambridge, Mr. Christopher Stevenson, the director of Program of Events for Newcomers & Academic Visitors, gave me a letter enclosing a notice and a ticket I booked nearly two months earlier. He told me that I was very lucky because a strictly limited number of tickets had been allocated to academic visitors. It was a ticket to admit me to the Honorary Degree Congregation and to the reception afterwards on Tuesday 27 June.
This book is a collection of reminiscences of many of the distinguished physicists who worked in Cambridge, mainly at the Cavendish Laboratory, during the early 1930s. The background to and sequence of theories and experiments which led to many important discoveries are given. Of particular interest are Chadwick's discovery of the neutron, the splitting of the atom by Cockcroft and Walton, the demonstration by Blackett and Occhialini of the existence of the positron, the fusion of deuterium nuclei by Rutherford and Oliphant and Chadwick and Goldhaber's demonstration of the nuclear photoelectric effect and derivation of the first accurate figure for the mass of the neutron. Thirteen chapters relevant to these are indexed separately. The others are more concerned with personalities and personal reminiscences. (UK)
From 1 August till 31 October, CERN users are invited to enjoy a trial access to all Cambridge University Press electronic books: http://ebooks.cambridge.org/. Please don't hesitate to send feedback to firstname.lastname@example.org.
With Checkpoint English Revision Guide for the Cambridge Secondary 1 test you can aim for the best grade with the help of relevant and accessible notes, examiner advice plus questions and answers on each key topic. - Clear explanations of every topic covered in the Cambridge Secondary 1 Checkpoint English syllabus. - Builds revision skills you need for success in the test. - Exam tips wirtten by test setters and examiners giving you their expert advice. This text has not been through the Cambridge endorsement process.
With Checkpoint Maths Revision Guide for the Cambridge Secondary 1 test you can aim for the best grade with the help of relevant and accessible notes, examiner advice plus questions and answers on each key topic. - Clear explanations of every topic covered in the Cambridge Secondary 1 Checkpoint Maths syllabus. - Builds revision skills you need for success in the test. - Exam tips wirtten by test setters and examiners giving you their expert advice. This text has not been through the Cambridge endorsement process.
Thomas, C N; Maiolino, R; Goldie, D J; Acedo, E de Lera; Wagg, J; Blundell, R; Paine, S; Zeng, L
The CAMbridge Emission Line Surveyor (CAMELS) is a pathfinder program to demonstrate on-chip spectrometry at millimetre wavelengths. CAMELS will observe at frequencies from 103-114.7 GHz, providing 512 channels with a spectral resolution of R = 3000. In this paper we describe the science goals of CAMELS, the current system level design for the instrument and the work we are doing on the detailed designs of the individual components. In addition, we will discuss our efforts to understand the impact that the design and calibration of the filter bank on astronomical performance. The shape of the filter channels, the degree of overlap and the nature of the noise all effect how well the parameters of a spectral line can be recovered. We have developed a new and rigorous method for analysing performance, based on the concept of Fisher information. This can in be turn coupled to a detailed model of the science case, allowing design trade-offs to be properly investigated.
Full Text Available Abstract Background Corticosteroid injection and physiotherapy are two commonly prescribed interventions for management of lateral epicondylalgia. Corticosteroid injections are the most clinically efficacious in the short term but are associated with high recurrence rates and delayed recovery, while physiotherapy is similar to injections at 6 weeks but with significantly lower recurrence rates. Whilst practitioners frequently recommend combining physiotherapy and injection to overcome harmful effects and improve outcomes, study of the benefits of this combination of treatments is lacking. Clinicians are also faced with the paradox that the powerful anti-inflammatory corticosteroid injections work well, albeit in the short term, for a non-inflammatory condition like lateral epicondylalgia. Surprisingly, these injections have not been rigorously tested against placebo injections. This study primarily addresses both of these issues. Methods A randomised placebo-controlled clinical trial with a 2 × 2 factorial design will evaluate the clinical efficacy, cost-effectiveness and recurrence rates of adding physiotherapy to an injection. In addition, the clinical efficacy and adverse effects of corticosteroid injection beyond that of a placebo saline injection will be studied. 132 participants with a diagnosis of lateral epicondylalgia will be randomly assigned by concealed allocation to one of four treatment groups – corticosteroid injection, saline injection, corticosteroid injection with physiotherapy or saline injection with physiotherapy. Physiotherapy will comprise 8 sessions of elbow manipulation and exercise over an 8 week period. Blinded follow-up assessments will be conducted at baseline, 4, 8, 12, 26 and 52 weeks after randomisation. The primary outcome will be a participant rating of global improvement, from which measures of success and recurrence will be derived. Analyses will be conducted on an intention-to-treat basis using linear
Bentvelsen, Stanislaus Cornelius Maria
Jet clustering algorithms are widely used to analyse hadronic events in high energy collisions. Recently a new clustering method, known as `Cambridge', has been introduced. In this article we present an algorithm to determine the transition values of ycut for this clustering scheme, which allows to resolve any event to a definite number of jets in the final state. We discuss some particularities of the Cambridge clustering method and compare its performance to the Durham clustering scheme for Monte Carlo generated e+e- annihilation events.
Stuart, Sonia; Cushing, Steve
Written by experts and in partnership with OCR, the brand-new OCR Cambridge Nationals in ICT Student's Book provides invaluable guidance for your teaching of the OCR Cambridge Nationals in ICT Level 1/2 . This textbook covers the mandatory Units 1 and 2 in detail, offering your students the knowledge and practice they require. Unit 1 - Understanding Computer Systems.; Coverage of use of applications and systems.; Case studies of how they are used for different purposes.; Exam style questions and guidance. Unit 2 - Using ICT to Create Business Solutions.; Coverage of the principles of use of re
The most cost effective and straightforward way to teach the revised syllabus, with all the core and extended content covered by a single book and accompanying free digital resources. . This title has been written for the revised Cambridge IGCSE Mathematics (0580) syllabus, for first teaching from 2013. . · Gives students the practice they require to deepen their understanding through plenty of questions. · Consolidates learning with unique digital resources on the CD, included free with every Student's Book. . We are working with Cambridge International Examinations to gain
"Scientists and students from the Weizmann Institute of Science in Rehovot and Cambridge University in England have tied for first place in a physics competition aimed at simulating the future functioning of the particle accelerator being built at the European center CERN and due to open in 2007" (1/2 page)
Downing, Jim; Carpenter, Grace
Cambridge University Library and MIT Libraries submit this proposal to share the outcomes of the digital preservation research work conducted through the DSpace@Cambridge project, concentrating on two main areas: Process Automation and Preservation Planning. Automation Digital preservation activity in its current form commonly involves a high level of human effort. In mediated archiving the archivist's efforts do not scale well. In self-archiving situations this effort can be a barri...
Bennell Kim L
Full Text Available Abstract Background Knee osteoarthritis (OA is one of the most common and costly chronic musculoskeletal conditions world-wide and is associated with substantial pain and disability. Many people with knee OA also experience co-morbidities that further add to the OA burden. Uptake of and adherence to physical activity recommendations is suboptimal in this patient population, leading to poorer OA outcomes and greater impact of associated co-morbidities. This pragmatic randomised controlled trial will investigate the clinical- and cost-effectiveness of adding telephone coaching to a physiotherapist-delivered physical activity intervention for people with knee OA. Methods/Design 168 people with clinically diagnosed knee OA will be recruited from the community in metropolitan and regional areas and randomly allocated to physiotherapy only, or physiotherapy plus nurse-delivered telephone coaching. Physiotherapy involves five treatment sessions over 6 months, incorporating a home exercise program of 4–6 exercises (targeting knee extensor and hip abductor strength and advice to increase daily physical activity. Telephone coaching comprises 6–12 telephone calls over 6 months by health practitioners trained in applying the Health Change Australia (HCA Model of Health Change to provide behaviour change support. The telephone coaching intervention aims to maximise adherence to the physiotherapy program, as well as facilitate increased levels of participation in general physical activity. The primary outcomes are pain measured by an 11-point numeric rating scale and self-reported physical function measured by the Western Ontario and McMaster Universities Osteoarthritis Index subscale after 6 months. Secondary outcomes include physical activity levels, quality-of-life, and potential moderators and mediators of outcomes including self-efficacy, pain coping and depression. Relative cost-effectiveness will be determined from health service usage and outcome
Alchemy in Cambridge captures the alchemical content of 56 manuscripts in Cambridge, in particular the libraries of Trinity College, Corpus Christi College and St John's College, the University Library and the Fitzwilliam Museum. As such, this catalogue makes visible a large number of previously unknown or obscured alchemica. While extant bibliographies, including those by M.R. James a century ago, were compiled by polymathic bibliographers for a wide audience of researchers, Alchemy in Cambridge benefits from the substantial developments in the history of alchemy, bibliography, and related scholarship in recent decades. Many texts are here identified for the first time. Another vital feature is the incorporation of information on alchemical illustrations in the manuscripts, intended to facilitate research on the visual culture of alchemy. The catalogue is aimed at historians of alchemy and science, and of high interest to manuscript scholars, historians of art and historians of college and university libraries. PMID:26245008
Revised edition for the 2015 syllabus offering the easiest and most cost effective way to teach both the speaking and listening components with one set of books covering two years and free digital material. This title has been written for the revised Cambridge IGCSE English as a Second Language (0510 and 0511) syllabuses, for first teaching from 2013. ? Prepares students for their exams with a focus on assessed language features, such as inference, opinion and attitude. ? Develops language abilities at an appropriate pace with extra interactive tests on a free CD-ROM. We are working with Cambr
SCAMP: standardised, concentrated, additional macronutrients, parenteral nutrition in very preterm infants: a phase IV randomised, controlled exploratory study of macronutrient intake, growth and other aspects of neonatal care
Full Text Available Abstract Background Infants born Methods We propose a single centre, randomised controlled exploratory trial of two standardised, concentrated neonatal parenteral nutrition regimens comparing a standard macronutrient content (maximum protein 2.8 g/kg/day; lipid 2.8 g/kg/day, dextrose 10% with a higher macronutrient content (maximum protein 3.8 g/kg/day; lipid 3.8 g/kg/day, dextrose 12% over the first 28 days of life. 150 infants 24-28 completed weeks gestation and birthweight Trial registration Current controlled trials: ISRCTN76597892; EudraCT Number: 2008-008899-14
Lang, Kenneth R.
The Cambridge Guide to the Solar System provides a comprehensive, funamental, and up-to-date description of the solar system. It is written in a concise, light and uniform style, without being unnecessarily weighted down with specialized materials or the variable writing of multiple authors. It is filled with vital facts and information for astronomers of all types and for anyone with a scientific interest in the Earth, our Moon, all the other planets and their satellites, and related topics such as asteroids, comets, meteorites and meteors. The language, style, ideas and profuse illustrations will attract the general reader as well as professionals. A thorough report for general readers, it includes much compact reference data. Metaphors, similes and analogies will be of immense help to the lay person or non-science student, and they add to the enjoyment of the material. Vignettes containing historical, literary and even artistic material make this book unusual and interesting, and enhance its scientific content. Kenneth Lang is professor of astronomy in the Physics and Astronomy Department at Tufts University. He is the author of several astrophysics books, including The Sun from Space (Springer Verlag, 2000), Astrophysical Formulae: Radiation, Gas Processes, and High Energy Physics (Springer Verlag, 1999), Sun, Earth and Sky (Copernicus Books, 1997), Astrophysical Data: Planets and Stars (Springer Verlag, 1993), and Wanderers in Space: Exploration and Discovery in the Solar System (Cambridge, 1991),
The Whipple Museum is part of the History and Philosophy of Science Department in the University of Cambridge. It is on your right as soon as you enter Free School Lane from Pembroke Street, and is normally open between 1:30 and 4:30 P.M. on weekdays. The main room, a hall with hammer-beam roof, is a relic of Stephen Perse’s school (1624) now flourishing elsewhere in the city. It houses a large collection of mathematical, physical and astronomical instruments — abaci, Napier’s bones, slide rules; sextants and other surveying instruments; telescopes, compasses and pocket sundials (especially of ivory from Nuremberg 1500-1700); and a Grand Orrery by George Adams (1750). The gallery of a second room is used for special exhibitions, often of items from the well-stocked store. Some specialist catalogues have been compiled and are on sale.
Douglas R. Givens
The Cambridge Illustrated History of Archaeology is another in a series of volumes devoted to the history of archaeology that have appeared in recent time. Paul Bahn, the editor of the volume, has broken down his coverage of the history of worldwide archaeology into the following arrangement 'The Archaeology of Archaeology", "Old Worlds and New, 1500-1760", "Antiquarians and Explorers, 1760-1820", "Science and Romantic...
McLaughlin, Colleen, Ed.
"Teachers Learning: Professional Development and Education" is part of The Cambridge Education Research series, edited by senior colleagues at the University of Cambridge Faculty of Education, which has a longstanding tradition of involvement in high quality, innovative teacher education and continuing professional development.…
A study protocol of a randomised controlled trial incorporating a health economic analysis to investigate if additional allied health services for rehabilitation reduce length of stay without compromising patient outcomes
Full Text Available Abstract Background Reducing patient length of stay is a high priority for health service providers. Preliminary information suggests additional Saturday rehabilitation services could reduce the time a patient stays in hospital by three days. This large trial will examine if providing additional physiotherapy and occupational therapy services on a Saturday reduces health care costs, and improves the health of hospital inpatients receiving rehabilitation compared to the usual Monday to Friday service. We will also investigate the cost effectiveness and patient outcomes of such a service. Methods/Design A randomised controlled trial will evaluate the effect of providing additional physiotherapy and occupational therapy for rehabilitation. Seven hundred and twelve patients receiving inpatient rehabilitation at two metropolitan sites will be randomly allocated to the intervention group or control group. The control group will receive usual care physiotherapy and occupational therapy from Monday to Friday while the intervention group will receive the same amount of rehabilitation as the control group Monday to Friday plus a full physiotherapy and occupational therapy service on Saturday. The primary outcomes will be patient length of stay, quality of life (EuroQol questionnaire, the Functional Independence Measure (FIM, and health utilization and cost data. Secondary outcomes will assess clinical outcomes relevant to the goals of therapy: the 10 metre walk test, the timed up and go test, the Personal Care Participation Assessment and Resource Tool (PC PART, and the modified motor assessment scale. Blinded assessors will assess outcomes at admission and discharge, and follow up data on quality of life, function and health care costs will be collected at 6 and 12 months after discharge. Between group differences will be analysed with analysis of covariance using baseline measures as the covariate. A health economic analysis will be carried out
Full Text Available Cambridge University has three tiers of libraries available to students: the University Library, departmental (subject libraries and college libraries. Over the past thirty years there has been increasing pressure on the colleges to provide more books, reader places and technical resources in their libraries, with the result that a number of new library buildings, of very different styles, have been opened. Other colleges have opted for refurbishment and extension of existing libraries. These libraries are small (30-100,000 books and intimate, often open 24 hours a day and with generous provision for lending books. Great importance is placed on keeping them at the heart of the college. Challenges for architects are the sensitive sites, restrictions on changes to listed buildings, and the limited space available. The constricted sites cause difficulties for the builders too. I will consider some solutions to these problems with reference to projects in four colleges: Pembroke, Peterhouse, Corpus Christi and Newnham. At Pembroke architects Freeland Rees Roberts have built an extension to a listed building and at Peterhouse they have adapted an adjoining room. Corpus Christi is moving its library to a Victorian building which has been internally redesigned by Wright + Wright. Newnham demolished a 1960s extension in order to develop the plot more efficiently to a design by John Miller + Partners. All the architects have shown sensitivity to the needs of their clients and ingenuity in making intensive use of limited space.
Prentice, P.; Acerini, C. L.; Eleftheriou, A.; Hughes, I A; Ong, K K; Dunger, D B
The Cambridge Baby Growth Study has been supported by the European Union Framework V, the World Cancer Research Foundation International, the Medical Research Council, the NIHR Cambridge Comprehensive Biomedical Research Centre, the Newlife Foundation for disabled children, the Mothercare Group Foundation, Mead Johnson Nutrition, the Evelyn Trust, the Wellbeing of Women, Diabetes UK and a collaborative research grant from the European Society for Paediatric Endocrinology.
Protocol for the ADDITION-Plus study: a randomised controlled trial of an individually-tailored behaviour change intervention among people with recently diagnosed type 2 diabetes under intensive UK general practice care
Full Text Available Abstract Background The increasing prevalence of type 2 diabetes poses both clinical and public health challenges. Cost-effective approaches to prevent progression of the disease in primary care are needed. Evidence suggests that intensive multifactorial interventions including medication and behaviour change can significantly reduce cardiovascular morbidity and mortality among patients with established type 2 diabetes, and that patient education in self-management can improve short-term outcomes. However, existing studies cannot isolate the effects of behavioural interventions promoting self-care from other aspects of intensive primary care management. The ADDITION-Plus trial was designed to address these issues among recently diagnosed patients in primary care over one year. Methods/Design ADDITION-Plus is an explanatory randomised controlled trial of a facilitator-led, theory-based behaviour change intervention tailored to individuals with recently diagnosed type 2 diabetes. 34 practices in the East Anglia region participated. 478 patients with diabetes were individually randomised to receive (i intensive treatment alone (n = 239, or (ii intensive treatment plus the facilitator-led individual behaviour change intervention (n = 239. Facilitators taught patients key skills to facilitate change and maintenance of key behaviours (physical activity, dietary change, medication adherence and smoking, including goal setting, action planning, self-monitoring and building habits. The intervention was delivered over one year at the participant's surgery and included a one-hour introductory meeting followed by six 30-minute meetings and four brief telephone calls. Primary endpoints are physical activity energy expenditure (assessed by individually calibrated heart rate monitoring and movement sensing, change in objectively measured dietary intake (plasma vitamin C, medication adherence (plasma drug levels, and smoking status (plasma cotinine levels at
Pilkington, J. D. H.; Scott, P. F.
The Fourth Cambridge Radio Survey (4C) Catalogue contains all survey data from the papers of Pilkington and Scott (1965MmRAS..69..183P) and Gower, Scott and Wills (1967MmRAS..71...49G). These data result from a survey of radio sources between declinations -07 and +80 degrees using the large Cambridge interferometer at 178 MHz. The computerized catalog contains for each source the 4C number, 1950 position, measured flux density, accuracy class, galactic coordinates, and remarks. For some sources miscellaneous brief comments such as cross identifications to the 3C catalog or remarks on contamination from nearby sources are given at the ends of the data records. A flag (*) is included if there are additional remarks in the published catalog. (1 data file).
Full Text Available Review of: Michele Renee Salzman, Marvina A. Sweeney & William Adler (eds., The Cambridge History of Religions in the Ancient World (2 vols. (New York: Cambridge University Press, 2013
Lazar, Jonathan; Heylighen, Ann; Dong, Hua
This book presents the proceedings of the 8th Cambridge Workshop on Universal Access and Assistive Technology (CWUAAT '14), incorporating the 11th Cambridge Workshop on Rehabilitation Robotics, held in Cambridge, England in March 2016. It presents novel and state-of-the-art research from an international group of leaders in the fields of universal access and assistive technology. It explores various issues including the reconciliation of usability, accessibility and inclusive design, the design of inclusive assistive and rehabilitation systems, measuring product demand and human capabilities, data mining and visualizing inclusion, legislation in inclusive design, and situational inclusive interfaces (automotive and aerospace). This book provides an invaluable resource to researchers, postgraduates, design practitioners, therapists and clinical practitioners, as well as design teachers.
This brand new series has been written for the University of Cambridge International Examinations course for AS and A Level Mathematics (9709). This title covers the requirements of M1 and M2. The authors are experienced examiners and teachers who have written extensively at this level, so have ensured all mathematical concepts are explained using language and terminology that is appropriate for students across the world. Students are provded with clear and detailed worked examples and questions from Cambridge International past papers, so they have the opportunity for plenty of essential exam
Porkess, Roger; Konrad, Nina
This brand new series has been written for the University of Cambridge International Examinations course for AS and A Level Mathematics (9709). This title covers the requirements of S1 and S2. The authors are experienced examiners and teachers who have written extensively at this level, so have ensured all mathematical concepts are explained using language and terminology that is appropriate for students across the world. Students are provded with clear and detailed worked examples and questions from Cambridge International past papers, so they have the opportunity for plenty of essenti
Douglas R. Givens
Full Text Available The Cambridge Illustrated History of Archaeology is another in a series of volumes devoted to the history of archaeology that have appeared in recent time. Paul Bahn, the editor of the volume, has broken down his coverage of the history of worldwide archaeology into the following arrangement 'The Archaeology of Archaeology", "Old Worlds and New, 1500-1760", "Antiquarians and Explorers, 1760-1820", "Science and Romanticism, 1820-1860", "The Search for Human Origins, 1860-1920", "Archaeology Comes of Age, 1920-1960", "New Techniques and Competing Philosophies, 1960-1990",and "Current Controversies and Future Trends". Bahn's volume explores many of the major developments in archaeological practice from both in the classical world and was as from the practice of archaeology in the Americas. The volume even gives the reader a glimpse into the origins and growth of archaeology in New Zealand. Of particular interest is coverage of the history of early archaeological efforts having to do with early studies of human origins.
Zafirovic-Vukotic, M.; Niemegeers, I.G.
The Cambridge Fast Ring is high-speed slotted ring. The features that make it suitable for use at very large transmission rates are the synchronous transmission, the simplicity of the medium-access-control protocol, and the possibility of immediate retransmission of erroneous packets. A novel analyt
Wilkinson, Christopher; Teperek, Marta
Presentation delivered by Chris Wilkinson and Marta Teperek on 10 March 2016 about: The Equipment Sharing Project and the Equipment Database The importance of Open Access and of sharing publications and research data Services available to researchers at Cambridge enabling them to find and use shared equipment and to help them manage and share their research.
Addition of docetaxel, zoledronic acid, or both to first-line long-term hormone therapy in prostate cancer (STAMPEDE): survival results from an adaptive, multiarm, multistage, platform randomised controlled trial
James, Nicholas D; Sydes, Matthew R; Clarke, Noel W; Mason, Malcolm D; Dearnaley, David P; Spears, Melissa R; Ritchie, Alastair W S; Parker, Christopher C; Russell, J Martin; Attard, Gerhardt; de Bono, Johann; Cross, William; Jones, Rob J; Thalmann, George; Amos, Claire; Matheson, David; Millman, Robin; Alzouebi, Mymoona; Beesley, Sharon; Birtle, Alison J; Brock, Susannah; Cathomas, Richard; Chakraborti, Prabir; Chowdhury, Simon; Cook, Audrey; Elliott, Tony; Gale, Joanna; Gibbs, Stephanie; Graham, John D; Hetherington, John; Hughes, Robert; Laing, Robert; McKinna, Fiona; McLaren, Duncan B; O'Sullivan, Joe M; Parikh, Omi; Peedell, Clive; Protheroe, Andrew; Robinson, Angus J; Srihari, Narayanan; Srinivasan, Rajaguru; Staffurth, John; Sundar, Santhanam; Tolan, Shaun; Tsang, David; Wagstaff, John; Parmar, Mahesh K B
Summary Background Long-term hormone therapy has been the standard of care for advanced prostate cancer since the 1940s. STAMPEDE is a randomised controlled trial using a multiarm, multistage platform design. It recruits men with high-risk, locally advanced, metastatic or recurrent prostate cancer who are starting first-line long-term hormone therapy. We report primary survival results for three research comparisons testing the addition of zoledronic acid, docetaxel, or their combination to standard of care versus standard of care alone. Methods Standard of care was hormone therapy for at least 2 years; radiotherapy was encouraged for men with N0M0 disease to November, 2011, then mandated; radiotherapy was optional for men with node-positive non-metastatic (N+M0) disease. Stratified randomisation (via minimisation) allocated men 2:1:1:1 to standard of care only (SOC-only; control), standard of care plus zoledronic acid (SOC + ZA), standard of care plus docetaxel (SOC + Doc), or standard of care with both zoledronic acid and docetaxel (SOC + ZA + Doc). Zoledronic acid (4 mg) was given for six 3-weekly cycles, then 4-weekly until 2 years, and docetaxel (75 mg/m2) for six 3-weekly cycles with prednisolone 10 mg daily. There was no blinding to treatment allocation. The primary outcome measure was overall survival. Pairwise comparisons of research versus control had 90% power at 2·5% one-sided α for hazard ratio (HR) 0·75, requiring roughly 400 control arm deaths. Statistical analyses were undertaken with standard log-rank-type methods for time-to-event data, with hazard ratios (HRs) and 95% CIs derived from adjusted Cox models. This trial is registered at ClinicalTrials.gov (NCT00268476) and ControlledTrials.com (ISRCTN78818544). Findings 2962 men were randomly assigned to four groups between Oct 5, 2005, and March 31, 2013. Median age was 65 years (IQR 60–71). 1817 (61%) men had M+ disease, 448 (15%) had N+/X M0, and 697 (24%) had N0M0. 165 (6
520BookreviewAmovable feast: ten millennia of food globalization. By Kenneth F. Kiple. Cambridge:Cambridge University Press. 2007. xvi + 364 pp. £15.99 hardback. ISBN 9780521793537SAGE Publications, Inc.2008DOI: 10.1177/14744740080150040703LuciusHallettUniversity of WyomingBasedlargely upon the author's The Cambridge world history of food (2000), thisbook offers an overview of the interaction between the world and the foodswe currently consume. Reviewing the history of domestication, sedentis...
Sykes, Richard A.; McCabe, Patrick; Allen, Frank H; Battle, Gary M.; Bruno, Ian J.; Wood, Peter A.
A collection of new software tools is presented for the analysis of geometrical, chemical and crystallographic data from the Cambridge Structural Database (CSD). This software supersedes the program Vista. The new functionality is integrated into the program Mercury in order to provide statistical, charting and plotting options alongside three-dimensional structural visualization and analysis. The integration also permits immediate access to other information about specific CSD entries throug...
Metaphor is more than an ostensible decoration of language. It is an integral part of human thought of ideologized world. This article analyzes the metaphor use of Chinese Premier Wen Jiabao’s speech at Cambridge in February 2009, in an at-tempt to display how the preferred metaphors serve the purpose of this speech and reflect Premier Wen ’s construction of Chi-na’s situation.
Procket Networks, a provider of high performance Internet Protocol (IP) technology and products has announced that the University of Cambridge has deployed the PRO/8801(TM) router into its research network to develop industry-leading deep packet inspection applications. The major application for this deployment is to identify and understand new traffic patterns created by large scale scientific computations and downloads such as the GRID (1 page).
In 1873 the chair of geology at the University of Cambridge fell vacant following the death of Adam Sedgwick. Nine candidates stepped forward, hoping to fill the post. The correspondence generated in the ensuing battle illuminates two areas of particular interest. First, the strategies hidden behind bland lists of successive professors: candidates, peers and patrons manoeuvred to influence the outcome of the competition and competitors tried to reinforce their geological respectability by col...
Philosophy Newsletter. Articles by: Edward Craig - From the Chairman. Onora O'Neill - "It's the newspapers I can't stand. Serena Olsaretti - The 2004 Annual Royal Institute of Philosophy Conference. Mary Leng - Mathematical Knowledge Conference. Postgraduate Conference. Jane Heal - Facts, Fables and Funds. Hugh Mellor - Uses and Abuses of Probability. Amanda Boyle - Nobody Knows Anything: Philosophy, Film and Me. Jaime Whyte - Seven Years at Cambridge Alex Oliver...
Rationale and design of the ADDITION-Leicester study, a systematic screening programme and Randomised Controlled Trial of multi-factorial cardiovascular risk intervention in people with Type 2 Diabetes Mellitus detected by screening
Farooqi A; Hiles S; Henson J; Barnett J; Campbell S; Taub N; Gray LJ; Srinivasan B; Khunti K.; Webb DR; Griffin SJ; Wareham NJ; Davies MJ
Abstract Background Earlier diagnosis followed by multi-factorial cardiovascular risk intervention may improve outcomes in Type 2 Diabetes Mellitus (T2DM). Latent phase identification through screening requires structured, appropriately targeted population-based approaches. Providers responsible for implementing screening policy await evidence of clinical and cost effectiveness from randomised intervention trials in screen-detected T2DM cases. UK South Asians are at particularly high risk of ...
Maria Cristina Marcuzzo
Full Text Available Research in economics using documentary archives provides clearer interpretations about the ideas and their development throughout time, in the context of the writing process in relation to the interlocutors and antagonists, and the nature of the problems addressed. This document presents examples of works with tough drafts, correspondence, tables of contents, notes, and related material of four economists of the "Cambridge Group": Piero Sraffa, Richard Kahn, Joan Robinson, and John Maynard Keynes. In each case the findings and importance of the research done in the files are described.
Grime, Yvette; Thacker, Mike
This brand-new Student Book provides a grammar-led approach with extensive exam preparation that will help you develop independent, culturally aware students of French ready for the exam. The book is written to the latest Cambridge International Examinations syllabus by experienced teachers. Extensive use of French reflects the style of the exams and, with specific advice and practice, it helps students use the acquired skills to their best ability. Topics on Francophone cultures are integrated throughout to ensure students gain the cultural awareness that is at the heart of this qualification
The ARIES Collaborative, a U.S. Department of Energy Building America research team, partnered with NeighborWorks America affiliate Homeowners' Rehab Inc. (HRI) of Cambridge, Massachusetts, to study improvements to the central hydronic heating system in one of the nonprofit's housing developments. The heating controls in the three-building, 42-unit Columbia Cambridge Alliance for Spanish Tenants housing development were upgraded. Fuel use in the development was excessive compared to similar properties. A poorly insulated thermal envelope contributed to high energy bills, but adding wall insulation was not cost-effective or practical. The more cost-effective option was improving heating system efficiency, which faced several obstacles, including inflexible boiler controls and failed thermostatic radiator valves. Boiler controls were replaced with systems that offer temperature setbacks and one that controls heat based on apartment temperature in addition to outdoor temperature. Utility bill analysis shows that post-retrofit weather-normalized heating energy use was reduced by 10%-31% (average of 19%). Indoor temperature cutoff reduced boiler runtime (and therefore heating fuel consumption) by 28% in the one building in which it was implemented. Nearly all savings were obtained during night which had a lower indoor temperature cut off (68°F) than day (73° F). This implies that the outdoor reset curve was appropriately adjusted for this building for daytime operation. Nighttime setback of heating system supply water temperature had no discernable impact on boiler runtime or gas bills.
The ARIES Collaborative, a U.S. Department of Energy Building America research team, partnered with NeighborWorks America affiliate Homeowners' Rehab Inc. (HRI) of Cambridge, Massachusetts, to study improvements to the central hydronic heating system in one of the nonprofit's housing developments. The heating controls in the three-building, 42-unit Columbia Cambridge Alliance for Spanish Tenants housing development were upgraded. Fuel use in the development was excessive compared to similar properties. A poorly insulated thermal envelope contributed to high energy bills, but adding wall insulation was not cost-effective or practical. The more cost-effective option was improving heating system efficiency. Efficient operation of the heating system faced several obstacles, including inflexible boiler controls and failed thermostatic radiator valves. Boiler controls were replaced with systems that offer temperature setbacks and one that controls heat based on apartment temperature in addition to outdoor temperature. Utility bill analysis shows that post-retrofit weather-normalized heating energy use was reduced by 10%-31% (average of 19%). Indoor temperature cutoff reduced boiler runtime (and therefore heating fuel consumption) by 28% in the one building in which it was implemented. Nearly all savings were obtained during night which had a lower indoor temperature cut off (68 degrees F) than day (73 degrees F). This implies that the outdoor reset curve was appropriately adjusted for this building for daytime operation. Nighttime setback of heating system supply water temperature had no discernable impact on boiler runtime or gas bills.
Reimer, C; Lødrup, A B; Smith, G;
of an alginate (Gaviscon Advance, Reckitt Benckiser, Slough, UK) on reflux symptoms in patients with persistent symptoms despite once daily PPI. METHODS: This was a multicentre, randomised, placebo-controlled, 7-day double-blind trial preceded by a 7-day run-in period. Reflux symptoms were assessed using...
Groom, Colin R; Allen, Frank H
The Cambridge Crystallographic Data Centre (CCDC) was established in 1965 to record numerical, chemical and bibliographic data relating to published organic and metal-organic crystal structures. The Cambridge Structural Database (CSD) now stores data for nearly 700,000 structures and is a comprehensive and fully retrospective historical archive of small-molecule crystallography. Nearly 40,000 new structures are added each year. As X-ray crystallography celebrates its centenary as a subject, and the CCDC approaches its own 50th year, this article traces the origins of the CCDC as a publicly funded organization and its onward development into a self-financing charitable institution. Principally, however, we describe the growth of the CSD and its extensive associated software system, and summarize its impact and value as a basis for research in structural chemistry, materials science and the life sciences, including drug discovery and drug development. Finally, the article considers the CCDC's funding model in relation to open access and open data paradigms. PMID:24382699
Battle, Gary M; Ferrence, Gregory M; Allen, Frank H
The Cambridge Structural Database (CSD) is a vast and ever growing compendium of accurate three-dimensional structures that has massive chemical diversity across organic and metal-organic compounds. For these reasons, the CSD is finding significant uses in chemical education, and these applications are reviewed. As part of the teaching initiative of the Cambridge Crystallographic Data Centre (CCDC), a teaching subset of more than 500 CSD structures has been created that illustrate key chemical concepts, and a number of teaching modules have been devised that make use of this subset in a teaching environment. All of this material is freely available from the CCDC website, and the subset can be freely viewed and interrogated using WebCSD, an internet application for searching and displaying CSD information content. In some cases, however, the complete CSD System is required for specific educational applications, and some examples of these more extensive teaching modules are also discussed. The educational value of visualizing real three-dimensional structures, and of handling real experimental results, is stressed throughout. PMID:20877495
The 1976 experience of Cambridge, Massachusetts, in settling the recombinant DNA research issue is unique in recent history as the first instance of essentially lay panels judging the conduct of scientific research. Furthermore, because the panel was composed of citizens who would be affected by the research, the experience suggests a model for conflict resolution in other areas of public controversy. With one of these, nuclear energy, the controversy has two important points in common: although the primary burden of any accident would be borne by the local community, benefits of the DNA research or reactor operation accrue to a much broader range of people; and in both issues there is a need to resolve the question, ''How safe is safe enough.'' It is therefore proposed that a panel similar to the Cambridge one could be established to deal with the controversy surrounding a proposed nuclear plant. In any community where there was such controversy, a panel could be convened to assess whether the plant was acceptable to that community. Such a panel would be composed of members of the community who were not affected directly by the plant. It would also have to have a restricted range of inquiry, oriented toward the specifics of the proposed plant. Such a plant review panel, under properly designed procedures, could change the licensing process to one concerned solely with safety and provide an appropriate forum for issues concerning the acceptability of nuclear power
This paper will report on two research projects at Cambridge University Library, one completed and the other still in progress, investigating the role of an institutional repository - using the DSpace software platform - to capture, disseminate and preserve research outputs at the University of Cambridge. The first project, DSpace@Cambridge (www.dspace.cam.ac.uk), ran from January 2003 to August 2006, and was a collaboration with MIT Libraries. Its initial objective was to establish and popul...
Boitor, Axenia Bianca; Bréatucu, Gabriel
This paper presents an analysis and a comparison of the software traders' attitude from Bras,ov and Cambridge cities regarding the online promotion and marketing strategies used on the software market. Two surveys among traders in Cambridge and Bras,ov were performed and the results of the research emphasize a consistent difference between the software traders from Cambridge and those from Bras,ov. A large orientation to the e-commerce was discovered between the software retailers from Cambri...
Lazar, J; Heylighen, A; Dong, H; Inclusive Designing : Joining Usability, Accessibility, and Inclusion
‘Inclusive Designing’ presents the proceedings of the seventh Cambridge Workshop on Universal Access and Assistive Technology (CWUAAT '14). It represents a unique multi-disciplinary workshop for the Inclusive Design Research community where designers, computer scientists, engineers, architects, ergonomists, policymakers and user communities can exchange ideas. The research presented at CWUAAT '14 develops methods, technologies, tools and guidance that support product designers and architects to design for the widest possible population for a given range of capabilities, within a contemporary social and economic context. In the context of developing demographic changes leading to greater numbers of older people and people with disabilities, the general field of Inclusive Design Research strives to relate the capabilities of the population to the design of products. Inclusive populations of older people contain a greater variation in sensory, cognitive and physical user capabilities. These variations may be...
Full Text Available Paper presents basic information about application of Optical Correlator (OC, specifically Cambridge Correlator, in system to recognize of traffic sign. Traffic Sign Recognition System consists of three main blocks, Preprocessing, Optical Correlator and Traffic Sign Identification. The Region of Interest (ROI is defined and chosen in preprocessing block and then goes to Optical Correlator, where is compared with database of Traffic Sign. Output of Optical Correlation is correlation plane, which consist of highly localized intensities, know as correlation peaks. The intensity of spots provides a measure of similarity and position of spots, how images (traffic signs are relatively aligned in the input scene. Several experiments have been done with proposed system and results and conclusion are discussed.
Sihombing, Boy Martua
This study entitled "The Effect of Service Quality on Customer Satisfaction in the Cosa Nostra Bistro Cambridge Field". This study aims to determine the effect of service quality indicators consisting of physical evidence, reliability, responsiveness, assurance, and empathy towards customer satisfaction on Cosa Nostra Bistro Cambridge Field. The theory used in this study is the theory related to service quality and customer satisfaction. The sample in this study as many as 90 people were t...
Standing in one of the old examination halls in Cambridge, Alan Macfarlane talks about the invention of competitive university examinations (in mathematics in the earlier C19) and the central role of Cambridge as one of the biggest exam setting boards in the world. Also what Camrbdige examinations are thought to be testing.
Does self monitoring of blood glucose as opposed to urinalysis provide additional benefit in patients newly diagnosed with type 2 diabetes receiving structured education? The DESMOND SMBG randomised controlled trial protocol
Dallosso Helen M
Full Text Available Abstract Background The benefit of self-monitoring of blood glucose (SMBG in people with type 2 diabetes on diet or oral agents other than sulphonylureas remains uncertain. Trials of interventions incorporating education about self-monitoring of blood glucose have reported mixed results. A recent systematic review concluded that SMBG was not cost-effective. However, what was unclear was whether a cheaper method of self-monitoring (such as urine glucose monitoring could produce comparable benefit and patient acceptability for less cost. Methods/Design The DESMOND SMBG trial is comparing two monitoring strategies (blood glucose monitoring and urine testing over 18 months when incorporated into a comprehensive self-management structured education programme. It is a multi-site cluster randomised controlled trial, conducted across 8 sites (7 primary care trusts in England, UK involving individuals with newly diagnosed Type 2 diabetes. The trial has 80% power to demonstrate equivalence in mean HbA1c (the primary end-point at 18 months of within ± 0.5% assuming 20% drop out and 20% non-consent. Secondary end-points include blood pressure, lipids, body weight and psychosocial measures as well as a qualitative sub-study. Practices were randomised to one of two arms: participants attend a DESMOND programme incorporating a module on self-monitoring of either urine or blood glucose. The programme is delivered by accredited educators who received specific training about equipoise. Biomedical data are collected and psychosocial scales completed at baseline, and 6, 12, and 18 months post programme. Qualitative research with participants and educators will explore views and experiences of the trial and preferences for methods of monitoring. Discussion The DESMOND SMBG trial is designed to provide evidence to inform the debate about the value of self-monitoring of blood glucose in people with newly diagnosed type 2 diabetes. Strengths include a setting in
Mortazavi, Forough; Akaberi, Arash
Pregnancy adds many sources of concerns to women's daily life worries. Excessive worry can affect maternal physiological and psychological state that influences the pregnancy outcomes. The aim of this study was to validate the Cambridge Worry Scale (CWS) in a sample of Iranian pregnant women. After translation of the CWS, ten experts evaluated the items and added six items to the 17-item scale. In a descriptive cross-sectional study, 405 of pregnant women booked for prenatal care completed the Farsi CWS. We split the sample randomly. Exploratory factor analysis (EFA) was conducted on the first half of the sample to disclose the factorial structure of the 23-item scale. The results of the EFA on the Farsi CWS indicated four factors altogether explained 51.5% of variances. Confirmatory factor analysis (CFA) was done on the second half of the sample. The results of the CFA showed that the model fit our data (chi-square/df = 2.02, RMSEA = 0.071, SRMR = 0.071, CFI = 0.95, and NNFI = 0.94). Cronbach's alpha coefficient for the Farsi CWS was 0.883. The Farsi CWS is a reliable and valid instrument for understanding common pregnancy worries in the third trimester of pregnancy in Iranian women. PMID:27293974
Kojić-Prodić, B.; Molčanov, K.
U 2005. obilježila se 40-godišnjica postojanja i rada svjetski poznatog centra Cambridge Crystallographic Data Centre (CCDC), čija je temeljna svrha prikupljanje, provjera i čuvanje kristalografskih podataka koji uz bibliografske podatke sadrže i koordinate atoma i iona koji određuju trodimenzionalnu strukturu molekula u kristalu. Cambridge Structural Database (CSD), jedna od prvih elektroničkih baza podataka, najveća je i najznačajnija baza kristalografskih podataka na svijetu s gotovo 40...
Kojić-Prodić, Biserka; Molčanov, Krešimir
U 2005. obilježila se 40-godišnjica postojanja i rada svjetski poznatog centra Cambridge Crystallographic Data Centre (CCDC), čija je temeljna svrha prikupljanje, provjera i čuvanje kristalografskih podataka koji uz bibliografske podatke sadrže i koordinate atoma i iona koji određuju trodimenzionalnu strukturu molekula u kristalu. Cambridge Structural Database (CSD), jedna od prvih elektroničkih baza podataka, najveća je i najznačajnija baza kristalografskih podataka na svijetu...
Presentation about Research Data Services at Cambridge and our perspective on Jisc RDM shared services pilot. Presentation given by Marta Teperek at IDCC16 on 22 February 2016, Amsterdam, Netherlands.
Kojić-Prodić B.; Molčanov K.
This article is dedicated to the memory of Dr. F. H. Allen and the 50th anniversary of the Cambridge Crystallographic Data Centre (CCDC); the world-renowned centre for deposition and control of crystallographic data including atomic coordinates that define the three-dimensional structures of organic molecules and metal complexes containing organic ligands. The mission exposed at the web site (http://www.ccdc.cam.ac.uk) is clearly stated: “The Cambridge Crystallographic Data Centre (CCDC) is d...
Thomas, Ian R.; Bruno, Ian J.; Cole, Jason C; Macrae, Clare F.; Pidcock, Elna; Wood, Peter A.
WebCSD, a new web-based application developed by the Cambridge Crystallographic Data Centre, offers fast searching of the Cambridge Structural Database using only a standard internet browser. Search facilities include two-dimensional substructure, molecular similarity, text/numeric and reduced cell searching. Text, chemical diagrams and three-dimensional structural information can all be studied in the results browser using the efficient entry summaries and embedded three-dimensional viewer.
Lipton, Allan; Berenson, James R; Body, Jean-Jacques; Boyce, Brendan F.; Bruland, Oyvind S.; Carducci, Michael A; Cleeland, Charles S.; Clohisy, Denis R.; Coleman, Robert E.; Cook, Richard J.; Guise, Theresa A.; Pearse, Roger N.; Powles, Trevor J; Rogers, Michael J; Roodman, G. David
The First Cambridge Conference on Advances in Treating Metastatic Bone Cancer, a symposium held in Cambridge, Massachusetts, October 28 to 29, 2005, was convened to discuss recent advances and research related to the natural history of bone metastases and skeletal complications, bone cancer biology, treatment of myeloma and other solid tumors, and treatment-induced bone loss. The conference format combined brief presentations with extended periods of discussion. The conclusions reached during...
Combination of Insecticide Treated Nets and Indoor Residual Spraying in Northern Tanzania Provides Additional Reduction in Vector Population Density and Malaria Transmission Rates Compared to Insecticide Treated Nets Alone: A Randomised Control Trial.
Full Text Available Indoor residual spraying (IRS combined with insecticide treated nets (ITN has been implemented together in several sub-Saharan countries with inconclusive evidence that the combined intervention provides added benefit. The impact on malaria transmission was evaluated in a cluster randomised trial comparing two rounds of IRS with bendiocarb plus universal coverage ITNs, with ITNs alone in northern Tanzania. From April 2011 to December 2012, eight houses in 20 clusters per study arm were sampled monthly for one night with CDC light trap collections. Anopheles gambiae s.l. were identified to species using real time PCR Taq Man and tested for the presence of Plasmodium falciparum circumsporozoite protein. ITN and IRS coverage was estimated from household surveys. IRS coverage was more than 85% in two rounds of spraying in January and April 2012. Household coverage with at least one ITN per house was 94.7% after the universal coverage net campaign in the baseline year and the proportion of household with all sleeping places covered by LLIN was 50.1% decreasing to 39.1% by the end of the intervention year. An.gambiae s.s. comprised 80% and An.arabiensis 18.3% of the anopheline collection in the baseline year. Mean An.gambiae s.l. density in the ITN+IRS arm was reduced by 84% (95%CI: 56%-94%, p = 0.001 relative to the ITN arm. In the stratum of clusters categorised as high anopheline density at baseline EIR was lower in the ITN+IRS arm compared to the ITN arm (0.5 versus 5.4 per house per month, Incidence Rate Ratio: 0.10, 95%CI: 0.01-0.66, p-value for interaction <0.001. This trial provides conclusive evidence that combining carbamate IRS and ITNs produces major reduction in Anopheles density and entomological inoculation rate compared to ITN alone in an area of moderate coverage of LLIN and high pyrethroid resistance in An.gambiae s.s.
We provide a brief history of the project to correct the spherical aberration of the scanning transmission electron microscope (STEM) that started in Cambridge (UK) and continued in Kirkland (WA, USA), Yorktown Heights (NY, USA), and other places. We describe the project in the full context of other aberration correction research and related work, partly in response to the incomplete context presented in the paper “In quest of perfection in electron optics: A biographical sketch of Harald Rose on the occasion of his 80th birthday”, recently published in Ultramicroscopy. - Highlights: • We provide a brief history of the Cambridge project to correct the spherical aberration of the scanning transmission electron microscope (STEM). • We describe the project in the full context of other aberration correction work and related research. • We summarize our corrector development work that followed the Cambridge project, and which was the first to reach higher spatial resolution than any non-corrected electron microscope
Brown, L. Michael [Cavendish Laboratory, University of Cambridge, J.J. Thomson Avenue, Cambridge CB3 0HE (United Kingdom); Batson, Philip E. [Institute for Advanced Materials, Devices and Nanotechnology, Rutgers University, Piscataway, NJ 08854 (United States); Department of Physics, Rutgers University, Piscataway, NJ 08854 (United States); Department of Materials Science, Rutgers University, Piscataway, NJ 08854 (United States); Dellby, Niklas [Nion Company, 11515 NE 118th Street, Kirkland, WA 98034 (United States); Krivanek, Ondrej L. [Nion Company, 11515 NE 118th Street, Kirkland, WA 98034 (United States); Department of Physics, Arizona State University, Tempe, AZ 85287 (United States)
We provide a brief history of the project to correct the spherical aberration of the scanning transmission electron microscope (STEM) that started in Cambridge (UK) and continued in Kirkland (WA, USA), Yorktown Heights (NY, USA), and other places. We describe the project in the full context of other aberration correction research and related work, partly in response to the incomplete context presented in the paper “In quest of perfection in electron optics: A biographical sketch of Harald Rose on the occasion of his 80th birthday”, recently published in Ultramicroscopy. - Highlights: • We provide a brief history of the Cambridge project to correct the spherical aberration of the scanning transmission electron microscope (STEM). • We describe the project in the full context of other aberration correction work and related research. • We summarize our corrector development work that followed the Cambridge project, and which was the first to reach higher spatial resolution than any non-corrected electron microscope.
Full Text Available Lauren Ball,1 Jennifer Crowley,2 Celia Laur,3 Minha Rajput-Ray,3 Stephen Gillam,4 Sumantra Ray3 1Nutrition and Dietetics, School of Allied Health Sciences, Centre for Health Practice Innovation, Griffith University, Queensland, Brisbane, Australia; 2Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; 3Need for Nutrition Education/Innovation Programme, Medical Research Council Human Nutrition Research, Cambridge, UK; 4Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK Abstract: Landmark reports have confirmed that it is within the core responsibilities of doctors to address nutrition in patient care. There are ongoing concerns that doctors receive insufficient nutrition education during medical training. This paper provides an overview of a medical nutrition education initiative at the University of Cambridge, School of Clinical Medicine, including 1 the approach to medical nutrition education, 2 evaluation of the medical nutrition education initiative, and 3 areas identified for future improvement. The initiative utilizes a vertical, spiral approach during the clinically focused years of the Cambridge undergraduate and graduate medical degrees. It is facilitated by the Nutrition Education Review Group, a group associated with the UK Need for Nutrition Education/Innovation Programme, and informed by the experiences of their previous nutrition education interventions. Three factors were identified as contributing to the success of the nutrition education initiative including the leadership and advocacy skills of the nutrition academic team, the variety of teaching modes, and the multidisciplinary approach to teaching. Opportunities for continuing improvement to the medical nutrition education initiative included a review of evaluation tools, inclusion of nutrition in assessment items, and further alignment of the Cambridge curriculum with the
this essay analyzes and assesses Cambridge English Skills Real Reading 2 from the perspective of communicative approach.The first part analyzes the theoretical basis of the textbook,including the organizational,pragmatic competence.The second part analyzes the syllabus contents.The last part analyzes the material and tasks of it.In summary,Cambridge English Skills Real Reading 2 is mainly communicative textbook from several aspects based on the detailed assessment and explanation.It can be helpful to the designing of reading textbooks.
Kenyon, Sara; Jolly, Kate; Hemming, Karla; Hope, Lucy; Blissett, Jackie; Dann, Sophie-Anna; Lilford, Richard; MacArthur, Christine
Objectives We sought evidence of effectiveness of lay support to improve maternal and child outcomes in disadvantaged families. Design Prospective, pragmatic, individually randomised controlled trial. Setting 3 Maternity Trusts in West Midlands, UK. Participants Following routine midwife systematic assessment of social risk factors, 1324 nulliparous women were assigned, using telephone randomisation, to standard maternity care, or addition of referral to a Pregnancy Outreach Worker (POW) serv...
Stokes Emma; Cusack Tara; Galvin Rose
Abstract Background Stroke is a leading cause of disability among adults worldwide. Evidence suggests that increased duration of exercise therapy following stroke has a positive impact on functional outcome following stroke. The main objective of this randomised controlled trial is to evaluate the impact of additional family assisted exercise therapy in people with acute stroke. Methods/Design A prospective multi-centre single blind randomised controlled trial will be conducted. Forty patient...
Full Text Available Abstract Background In view of the high costs of mass-media campaigns, it is important to understand whether it is possible for a media campaign to have significant population effects over a short period of time. This paper explores this question specifically in reference to stigma and discrimination against people with mental health problems using the Time to Change Cambridge anti-stigma campaign as an example. Methods 410 face-to-face interviews were performed pre, during and post campaign activity to assess campaign awareness and mental health-related knowledge, attitudes and behaviours. Results Although campaign awareness was not sustained following campaign activity, significant and sustained shifts occurred for mental health-related knowledge items. Specifically, there was a 24% (p If a friend had a mental health problem, I know what advice to give them to get professional help, following the campaign. Additionally, for the statement: Medication can be an effective treatment for people with mental health problems, there was a 10% rise (p = 0.05 in the proportion of interviewees responding 'agree' or 'strongly agree' following the campaign. These changes, however, were not evident for attitudinal or behaviour related questions. Conclusions Although these results only reflect the impact of one small scale campaign, these preliminary findings suggest several considerations for mass-media campaign development and evaluation strategies such as: (1 Aiming to influence outcomes pertaining to knowledge in the short term; (2 Planning realistic and targeted outcomes over the short, medium and long term during sustained campaigns; and (3 Monitoring indirect campaign effects such as social discourse or other social networking/contact in the evaluation.
The paper is a report to cover the proceedings of the Knowledge Economy Forum VI held in Cambridge, UK in 2007. This report encapsulates the end product of the conference with regard to the current state of the European knowledge economy, especially in Eastern Europe.
Battle, Gary M.; Kyd, Gwenda O.; Groom, Colin R.; Allen, Frank H.; Day, Juliet; Upson, Timothy
The living world is a rich source of chemicals with many medicines, dyes, flavorings, and foodstuffs having their origins in compounds produced by plants. We describe a chemical trail through the plant holdings of the Cambridge University Botanic Gardens. Visitors to the gardens are provided with a laminated trail guide with 22 stopping points…
Benjamin, Shanti Isabelle
This study investigates the typical textual features that are most frequently targeted in short-answer reading comprehension questions of the Cambridge University "O" Level English Paper 2. Test writers' awareness of how textual features impact on understanding of meanings in text decisions will determine to great extent their decisions…
Cambridge Conference on School Mathematics, Newton, MA.
The Cambridge Conference on School Mathematics (CCSM) was an association of prominent mathematicians who had a concern for mathematics education at school level, from kindergarten through grade twelve. These mathematicians organized three main conferences in three areas of mathematics education, and have carried on activities related to the…
Hassan, Nurul Huda; Shih, Chih-Min
This article describes and reviews the Singapore-Cambridge General Certificate of Education Advanced Level General Paper (GP) examination. As a written test that is administered to preuniversity students, the GP examination is internationally recognised and accepted by universities and employers as proof of English competence. In this article, the…
Wong, S. Godwin
This report describes the APL (Accountable unit, Program, and line item) budget system, a computerized three-dimensional program budget system that has been implemented in the Cambridge (Massachusetts) School Department. Various chapters discuss the differences between traditional budgeting and program budgeting, present an overview of te APL…
A randomised trial of the effect and cost-effectiveness of early intensive multifactorial therapy on 5-year cardiovascular outcomes in individuals with screen-detected type 2 diabetes: the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care (ADDITION-Europe) study.
Simmons, Rebecca K; Borch-Johnsen, Knut; Lauritzen, Torsten; Rutten, Guy Ehm; Sandbæk, Annelli; van den Donk, Maureen; Black, James A; Tao, Libo; Wilson, Edward Cf; Davies, Melanie J; Khunti, Kamlesh; Sharp, Stephen J; Wareham, Nicholas J; Griffin, Simon J
BACKGROUND Intensive treatment (IT) of cardiovascular risk factors can halve mortality among people with established type 2 diabetes but the effects of treatment earlier in the disease trajectory are uncertain. OBJECTIVE To quantify the cost-effectiveness of intensive multifactorial treatment of screen-detected diabetes. DESIGN Pragmatic, multicentre, cluster-randomised, parallel-group trial. SETTING Three hundred and forty-three general practices in Denmark, the Netherlands, and Cambridge and Leicester, UK. PARTICIPANTS Individuals aged 40-69 years with screen-detected diabetes. INTERVENTIONS Screening plus routine care (RC) according to national guidelines or IT comprising screening and promotion of target-driven intensive management (medication and promotion of healthy lifestyles) of hyperglycaemia, blood pressure and cholesterol. MAIN OUTCOME MEASURES The primary end point was a composite of first cardiovascular event (cardiovascular mortality/morbidity, revascularisation and non-traumatic amputation) during a mean [standard deviation (SD)] follow-up of 5.3 (1.6) years. Secondary end points were (1) all-cause mortality; (2) microvascular outcomes (kidney function, retinopathy and peripheral neuropathy); and (3) patient-reported outcomes (health status, well-being, quality of life, treatment satisfaction). Economic analyses estimated mean costs (UK 2009/10 prices) and quality-adjusted life-years from an NHS perspective. We extrapolated data to 30 years using the UK Prospective Diabetes Study outcomes model [version 1.3; (©) Isis Innovation Ltd 2010; see www.dtu.ox.ac.uk/outcomesmodel (accessed 27 January 2016)]. RESULTS We included 3055 (RC, n = 1377; IT, n = 1678) of the 3057 recruited patients [mean (SD) age 60.3 (6.9) years] in intention-to-treat analyses. Prescription of glucose-lowering, antihypertensive and lipid-lowering medication increased in both groups, more so in the IT group than in the RC group. There were clinically important improvements
Full Text Available Mime, Music and Drama on the Eighteenth-Century Stage by Edward Nye (Cambridge University Press, 2011 has the merit of inspiring a strong reflection on ballet d'action, connected with cultural, literaturary and philosophic environment of Eighteenth century. The author, with brilliant insight and careful historical research, explores the most debated issues of the new genre, providing an unusual interpretation. The review traces the focal points and the structure of the book, developing further consideration of some of the most challenging aspects offered by the text.
Yung, M; South, M
OBJECTIVES—To determine whether children with severe acute asthma treated with large doses of inhaled salbutamol, inhaled ipratropium, and intravenous steroids are conferred any further benefits by the addition of aminophylline given intravenously. STUDY DESIGN—Randomised, double blind, placebo controlled trial of 163 children admitted to hospital with asthma who were unresponsive to nebulised salbutamol. RESULTS—The placebo and treatment groups of children were similar at b...
Smith Helen; Nikodem V Cheryl; Hofmeyr G Justus; Brown Heather; Garner Paul
Abstract Background Most women delivering in South African State Maternity Hospitals do not have a childbirth companion; in addition, the quality of care could be better, and at times women are treated inhumanely. We piloted a multi-faceted intervention to encourage uptake of childbirth companions in state hospitals, and hypothesised that lay carers would improve the behaviour of health professionals. Methods We conducted a pilot randomised controlled trial of an intervention to promote child...
Can machines think? Alan Turing's decades-old question still influences artificial intelligence because of the simple test he proposed in his article in Mind. In this article, "AI Magazine collects presentations about the first round of the classic Turing Test of machine intelligence, held November 8, 1991 at The Computer Museum, Boston. Robert Epstein, Director Emeritus, Cambridge Center for Behavioral Studies, and an adjunct professor of psychology, Boston University, University of Massachu...
Ball L; Crowley J; Laur C; Rajput-Ray M; Gillam S; Ray S
Lauren Ball,1 Jennifer Crowley,2 Celia Laur,3 Minha Rajput-Ray,3 Stephen Gillam,4 Sumantra Ray3 1Nutrition and Dietetics, School of Allied Health Sciences, Centre for Health Practice Innovation, Griffith University, Queensland, Brisbane, Australia; 2Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; 3Need for Nutrition Education/Innovation Programme, Medical Research Council Human Nutrition Research, Cambridge, UK; 4Department of Public Health and Primary C...
Chronic heart failure, as a result of acute myocardial infarction, is a leading cause of death worldwide. Combining diagnostic imaging modalities may aid the direct assessment of experimental treatments targeting heart failure in vivo. Here we present preliminary data using the Cambridge combined PET/MRI imaging system in a mouse model of acute myocardial infarction. The split-magnet design can deliver uncompromised MRI and PET performance, for better assessment of disease and treatment in a preclinical environment
Petrovski, Kiro R.; Michelle Mc Arthur
This article describes few steps of the application of the modified Calgary-Cambridge Guides (CCG) to consultations in bovine medicine. A review of pertinent clinical communication skills literature in human medicine was integrated with the burgeoning research within veterinary medicine. In particular, there are more recent studies examining companion animal veterinarian’s communication skills and outcomes which can be extrapolated to practitioners. This was integrated into a teaching example...
Cho, Sun-Joo; Wilmer, Jeremy; Herzmann, Grit; McGugin, Rankin; Fiset, Daniel; Van Gulick, Ana E.; Ryan, Katie; Gauthier, Isabel
We evaluated the psychometric properties of the Cambridge face memory test (CFMT; Duchaine & Nakayama, 2006). First, we assessed the dimensionality of the test with a bi-factor exploratory factor analysis (EFA). This EFA analysis revealed a general factor and three specific factors clustered by targets of CFMT. However, the three specific factors appeared to be minor factors that can be ignored. Second, we fit a unidimensional item response model. This item response model showed that the CFMT...
Buonincontri, Guido, E-mail: email@example.com [Wolfson Brain Imaging Centre, University of Cambridge, Box 65, Addenbrooke' s Hospital, Hills Road, Cambridge, CB2 0QQ (United Kingdom); Sawiak, Stephen J. [Wolfson Brain Imaging Centre, University of Cambridge, Box 65, Addenbrooke' s Hospital, Hills Road, Cambridge, CB2 0QQ (United Kingdom); Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge (United Kingdom); Methner, Carmen; Krieg, Thomas [Department of Medicine, University of Cambridge, Cambridge (United Kingdom); Hawkes, Robert C.; Adrian Carpenter, T. [Wolfson Brain Imaging Centre, University of Cambridge, Box 65, Addenbrooke' s Hospital, Hills Road, Cambridge, CB2 0QQ (United Kingdom)
Chronic heart failure, as a result of acute myocardial infarction, is a leading cause of death worldwide. Combining diagnostic imaging modalities may aid the direct assessment of experimental treatments targeting heart failure in vivo. Here we present preliminary data using the Cambridge combined PET/MRI imaging system in a mouse model of acute myocardial infarction. The split-magnet design can deliver uncompromised MRI and PET performance, for better assessment of disease and treatment in a preclinical environment.
Wong, R; Allen, F. H.; Willett, P.
Four groups of the most highly cited scientific articles (46 in total), which either describe the Cambridge Structural Database (CSD) System or report scientific research applications of the CSD, have been selected for citation analysis. The analysis has been carried out to study the scientific importance of crystal structure information made available to the international research community via the CSD or via reviews and research articles that make use of the CSD as a primary information sou...
Ravi Gupta; Richard P Allan; Ashwini Pundeer; Sourav Das; Mohan Dhyani; Deepak Goel
Background: Restless legs syndrome also known as Willis-Ekbom′s Disease (RLS/WED) is a common illness. Cambridge-Hopkins diagnostic questionnaire for RLS (CHRLSq) is a good diagnostic tool and can be used in the epidemiological studies. However, its Hindi version is not available. Thus, this study was conducted to translate and validate it in the Hindi speaking population. Materials and Methods: After obtaining the permission from the author of the CHRLSq, it was translated into Hindi languag...
Boyd, Robert; Boyd, C A Richard
The nature of Cambridge (UK) placental and fetal research in the middle third of the twentieth century is reviewed on the basis of published literature and personal recollection. Joseph Barcroft is a central figure who came to fetal research late in an extremely productive career which is briefly sketched. Contemporaneous Cambridge academics in the field included J.D. Boyd (the authors father), J. Hammond, F.H.A. Marshall, R.A. McCance, J. Needham, A.S. Parkes and Elsie Widdowson. The then current Cambridge academic geography is explained and features of its scientific life such as funding, institutional structure and ethos, teaching and clinical duties, domestic and gender roles, and political context, including war and empire, are briefly considered. The testing of research findings against general principles and use of quantitative thinking are identified as important features. Intergenerational connections, often within individual families, are identified as a striking feature. The long-term impact of Cambridge work of this period; locally, in current trophoblast and feto-placental genetic research, in Oxford in probably influencing G.S. Dawes research leadership, and internationally, especially through D.H. Barron, and through him to the Denver School, is considered. That human placental and embryological specimens collected by J.D. Boyd have received a new lease of life as the "Boyd Collection", including use by Allen Enders is noted. Mechanisms for the maintenance of scientific quality and productivity during the period, mainly through the scientist himself relying on an internalised sense of "obligation", are contrasted with those current in the UK and more widely; formal peer-review at frequent intervals, with subsequent allocation of short-term funding. The strengths and weaknesses of each are considered. PMID:19876838
Full Text Available BACKGROUND: The Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR is the first disease-specific instrument for assessing patient-reported symptoms, functioning and quality of life (QoL in pulmonary arterial hypertension (PAH.
2011 saw the seventh year of test pit excavation within currently occupied rural settlements (CORS) in East Anglia carried out under the supervision of Access Cambridge Archaeology (ACA) directed by Dr Carenza Lewis at the University of Cambridge. As in previous years, this archaeological activity combines education and university outreach (particularly within the secondary school sector) with the archaeological investigation of currently occupied rural settlements (CO...
Donskov, F; Middleton, M; Fode, K;
Histamine inhibits formation and release of phagocyte-derived reactive oxygen species, and thereby protects natural killer and T cells against oxidative damage. Thus, the addition of histamine may potentially improve the efficacy of interleukin-2 (IL-2). Two randomised phase II trials of IL-2 with...... randomised phase III trial is warranted to clarify the potential role of adding histamine to IL-2 in mRCC....
Roč. 17, 1a (2010), b24-b26. ISSN 1211-5894. [Discussions in Structural Molecular Biology /8./. Nové Hrady, 18.03.2010-20.03.2010] R&D Projects: GA AV ČR IAA500500701; GA ČR GA305/07/1073 Institutional research plan: CEZ:AV0Z40500505 Keywords : organic chemistry * Cambridge Structure Database * molecular structure Subject RIV: CD - Macromolecular Chemistry http://xray.cz/ms/bul2010-1a/friday2.pdf
Allen, Frank H; Cruz-Cabeza, Aurora J; Wood, Peter A; Bardwell, David A
As part of a programme of work to extend central-group coverage in the Cambridge Crystallographic Data Centre's (CCDC) IsoStar knowledge base of intermolecular interactions, we have studied the hydrogen-bonding abilities of squaric acid (H2SQ) and its mono- and dianions (HSQ(-) and SQ(2-)) using the Cambridge Structural Database (CSD) along with dispersion-corrected density functional theory (DFT-D) calculations for a range of hydrogen-bonded dimers. The -OH and -C=O groups of H2SQ, HSQ(-) and SQ(2-) are potent donors and acceptors, as indicated by their hydrogen-bond geometries in available crystal structures in the CSD, and by the attractive energies calculated for their dimers with acetone and methanol, which were used as model acceptors and donors. The two anions have sufficient examples in the CSD for their addition as new central groups in IsoStar. It is also shown that charge- and resonance-assisted hydrogen bonds involving H2SQ and HSQ(-) are similar in strength to those made by carboxylate COO(-) acceptors, while hydrogen bonds made by the dianion SQ(2-) are somewhat stronger. The study reinforces the value of squaric acid and its anions as cocrystal formers and their actual and potential importance as isosteric replacements for carboxylic acid and carboxylate functions. PMID:24056361
Brueton, V. C.; Tierney, J.; Stenning, S; Harding, S; Meredith, S.; Nazareth, I; Rait, G
Background Loss to follow-up from randomised trials can introduce bias and reduce study power, affecting the generalisability, validity and reliability of results. Many strategies are used to reduce loss to follow-up and improve retention but few have been formally evaluated. Objectives To quantify the effect of strategies to improve retention on the proportion of participants retained in randomised trials and to investigate if the effect varied by trial strategy and trial setting. Search met...
Plas, R. N.; Benninga, M.A.; Redekop, W. K.; Taminiau, J A; Büller, H A
AIMS: To evaluate biofeedback training in children with encopresis and the effect on psychosocial function. DESIGN: Prospective controlled randomised study. PATIENT INTERVENTIONS: A multimodal treatment of six weeks. Children were randomised into two groups. Each group received dietary and toilet advice, enemas, oral laxatives, and anorectal manometry. One group also received five biofeedback training sessions. MAIN OUTCOME MEASURES: Successful treatment was defined as less than two episodes ...
Cho, Gavin; Anie, Kofi A; Buckton, Jacky; Kiilu, Patricia; Layton, Mark; Alexander, Lydia; Hemmaway, Claire; Sutton, Dorothy; Amos, Claire; Doré, Caroline J; Kahan, Brennan; Meredith, Sarah
Objectives Sickle With Ibuprofen and Morphine (SWIM) trial was designed to assess whether co-administration of ibuprofen (a non-steroidal anti-inflammatory drug) resulted in a reduction of opioid consumption delivered by patient-controlled analgesia (PCA) for acute pain in sickle cell disease. Design A randomised, placebo-controlled, double-blind trial. Setting UK multicentre trial in acute hospital setting. Participants Adults with sickle cell disease of any gender and phenotype aged 16 years and over. Interventions Oral ibuprofen at a dose of 800 mg three times daily or placebo in addition to opioids (morphine or diamorphine) administered via PCA pump for up to 4 days. Main outcome measures The primary outcome measure was opioid consumption over 4 days following randomisation. Results The SWIM trial closed early because it failed to randomise to its target of 316 patients within a reasonable time. Conclusions The key issues identified include the unanticipated length of time between informed consent and randomisation, difficulties in randomisation of patients in busy emergency departments, availability of trained staff at weekends and out of hours, fewer centres than expected using PCA routinely for sickle cell pain treatment, lack of research staff and support for participation, and the trial design. There are implications for future UK trials in sickle cell disease. Trial registration number ISRCTN97241637, NCT00880373; Pre-results. PMID:27288381
Jackson, B. V.; Hick, P. L.; Kojima, M.; Yokobe, A.
We have produced a computer assisted tomography program that optimizes a three-dimensional model to fit observational data. We have used this program with interplanetary scintillation data from Nagoya, Japan, and Cambridge, England. The program iterates to a least squares solution fit of observed data using solar rotation and solar wind motion to provide perspective views of each point in space accessible to the observations. We plot the optimized model as Carrington maps in velocity V and density Ne for the two data sets with resolutions of 10° in heliographic longitude and latitude. We map the model to 1 AU and compare this to in situ observations from the IMP spacecraft. From this comparison we find ΔNe~Ne0.3. We plot Carrington maps extrapolated to the solar surface to compare with Yohkoh Soft X ray Telescope (SXT), Sacramento Peak green line, and Mark III K-coronameter observations. High velocities modeled at the solar surface for individual rotations trace coronal holes (including polar ones) observed in SXT data. Regions of high density modeled from the Cambridge scintillation level data generally show a high correlation with regions of high solar activity observed as bright in Yohkoh SXT and green line observations. There is also a general correspondence of the regions of high density and the areas which are bright in K-coronameter observations.
Schulz, Kenneth F; Grimes, David A
The randomised controlled trial sets the gold standard of clinical research. However, randomisation persists as perhaps the least-understood aspect of a trial. Moreover, anything short of proper randomisation courts selection and confounding biases. Researchers should spurn all systematic, non-random methods of allocation. Trial participants should be assigned to comparison groups based on a random process. Simple (unrestricted) randomisation, analogous to repeated fair coin-tossing, is the most basic of sequence generation approaches. Furthermore, no other approach, irrespective of its complexity and sophistication, surpasses simple randomisation for prevention of bias. Investigators should, therefore, use this method more often than they do, and readers should expect and accept disparities in group sizes. Several other complicated restricted randomisation procedures limit the likelihood of undesirable sample size imbalances in the intervention groups. The most frequently used restricted sequence generation procedure is blocked randomisation. If this method is used, investigators should randomly vary the block sizes and use larger block sizes, particularly in an unblinded trial. Other restricted procedures, such as urn randomisation, combine beneficial attributes of simple and restricted randomisation by preserving most of the unpredictability while achieving some balance. The effectiveness of stratified randomisation depends on use of a restricted randomisation approach to balance the allocation sequences for each stratum. Generation of a proper randomisation sequence takes little time and effort but affords big rewards in scientific accuracy and credibility. Investigators should devote appropriate resources to the generation of properly randomised trials and reporting their methods clearly. PMID:11853818
Emery, E F; Greenough, A; Gamsu, H R
Colloid infusions are often given to treat hypotension in preterm infants. The aim of this work was to assess whether it was the amount of protein or the volume of the colloid infused which accounted for the observed increase in blood pressure. Sixty preterm infants were randomised (20 in each group) to receive 5 ml/kg 20% albumin, 15 ml/kg fresh frozen plasma, or 15 ml/kg 4.5% albumin. All infusions were given at a rate of 5 ml/kg/hour in addition to maintenance fluids. The infants were rand...
Full Text Available This article is dedicated to the memory of Dr. F. H. Allen and the 50th anniversary of the Cambridge Crystallographic Data Centre (CCDC; the world-renowned centre for deposition and control of crystallographic data including atomic coordinates that define the three-dimensional structures of organic molecules and metal complexes containing organic ligands. The mission exposed at the web site (http://www.ccdc.cam.ac.uk is clearly stated: “The Cambridge Crystallographic Data Centre (CCDC is dedicated to the advancement of chemistry and crystallography for the public benefit through providing high quality information, software and services.” The Cambridge Structural Database (CSD, one among the first established electronic databases, nowadays is one of the most significant crystallographic databases in the world. In the International Year of Crystallography 2014, the CSD announced in December over 750,000 deposited structures. The use of the extensive and rapidly growing database needs support of sophisticated and efficient software for checking, searching, analysing, and visualising structural data. The seminal role of the CSD in researches related to crystallography, chemistry, materials science, solid state physics and chemistry, (biotechnology, life sciences, and pharmacology is widely known. The important issues of the CCDC are the accuracy of deposited data and development of software for checking the data. Therefore, the Crystallographic Information File (CIF is introduced as the standard text file format for representing crystallographic information. Among the most important software for users is ConQuest, which enables searching all the CSD information fields, and the web implementation WebCSD software. Mercury is available for visualisation of crystal structures and crystal morphology including intra- and intermolecular interactions with graph-set notations of hydrogen bonds, and analysis of geometrical parameters. The CCDC gives even
Luciana, Monica; Nelson, Charles A
In this article, children's performance on subtasks from the Cambridge Neuropsychological Testing Automated Battery (CANTAB) is described. Two samples were recruited, one of which included children who spoke English as a second language. Children in this group also completed subtests from the Wechsler Intelligence Scale for Children-Third Revision (WISC-III). Despite the fact that ESL children scored over 1 SD below the norm on the WISC-III Vocabulary subtest, there were no CANTAB performance distinctions between primary versus secondary English-language speakers. In addition, several aspects of CANTAB performance were significantly correlated with verbal and nonverbal IQ. When developmental trends were examined, findings indicated that several aspects of frontal lobe function (memory span, working memory, and planning skills) are not functionally mature, by the age of 12 years. Implications for use of the CANTAB in clinical studies are discussed. PMID:12661972
This paper is a summary report on the Second International Congress of Applied Linguistics held in Cambridge, England in September 1969. Because of the large number of papers delivered, only a selection of the papers delivered in any one section of the Congress are considered, and the author attempts to identify current interests and trends in…
Full Text Available Abstract Background Cognitive deficits in schizophrenia are associated with psychosocial deficits that are primarily responsible for the poor long-term outcome of this disease. Auditory sensory gating P50 deficits are correlated with neuropsychological deficits in attention, one of the principal cognitive disturbances in schizophrenia. Our studies suggest that the α7 nicotinic acetylcholine receptor (α7 nAChR agonist tropisetron might be a potential therapeutic drug for cognitive deficits in schizophrenia. Therefore, it is of particular interest to investigate the effects of tropisetron on the cognitive deficits in patients with schizophrenia. Methods A randomised, placebo-controlled trial of tropisetron in patients with schizophrenia was performed. A total of 40 patients with chronic schizophrenia who had taken risperidone (2 to 6 mg/day were enrolled. Subjects were randomly assigned to a fixed titration of tropisetron (n = 20, 10 mg/day or placebo (n = 20 in an 8-week double-blind trial. Auditory sensory gating P50 deficits and Quality of Life Scale (QLS, Cambridge Neuropsychological Test Automated Battery (CANTAB, and Positive and Negative Syndrome Scale (PANSS scores were measured. Results In all, 33 patients completed the trial. Tropisetron was well tolerated. Administration of tropisetron, but not placebo, significantly improved auditory sensory gating P50 deficits in non-smoking patients with schizophrenia. The score on the rapid visual information processing (sustained visual attention task of CANTAB was significantly improved by tropisetron treatment. Total and subscale scores of PANSS were not changed by this trial. QLS scores in the all patients, but not non-smoking patients, were significantly improved by tropisetron trial. Conclusions This first randomised, double-blind, placebo-controlled trial supports the safety and efficacy of adjunctive tropisetron for treatment of cognitive deficits in schizophrenia.
Tartu Ülikooli filosoofia osakonna teadur ja eetikakeskuse stipendiaat Eva Piirimäe kaitses Cambridgeì Ülikoolis doktorikraadi ideede ajaloo erialal doktoritööga "Thomas Abbt (1738-1766) and the Philosophical Genesis of German Nationalism"
Bao-Shi Zhang; Feng Zhang
Abstract Two new spider species of the genus Chrysso O. P.-Cambridge, 1882 are reported from Hainan Island, China, Chrysso bifurca sp. n. (male, female) and Chrysso bicuspidata sp. n. (male, female). Chrysso bimaculata Yoshida, 1998is recorded from China for the first time.
Full Text Available A review of the book by Jonathan Schlefer: The Assumptions Economists Make (Cambridge, Mass., and London: Belknap Press of Harvard University Press, 2012, €26,10 / £21.95 / US$28.95, 356pp HBK (English, ISBN: 9780674052260.
The material requirements for plasma-facing components in a nuclear fusion reactor are some of the strictest and most challenging facing us today. These materials are simultaneously exposed to extreme heat loads (20 MW/m2 steady-state, 1 GW/m2 in millisecond transients) and particle fluxes (>1024 m-2 s-1) while also undergoing high neutron irradiation (1018 neutrons/m2 s). At the Cambridge Laboratory of Accelerator Studies of Surfaces (CLASS), many of the most important issues in plasma-surface interaction research, such as plasma-driven material erosion and deposition, material transport and irradiation and hydrogenic retention are investigated with the use of a 1.7 MV tandem ion accelerator. Ion-Beam Analysis (IBA) is used to investigate and quantify changes in materials due to plasma exposure and ion irradiation is used as a proxy for neutron irradiation to investigate plasma-surface interactions for irradiated materials. This report will outline the capabilities and current research activities at CLASS.
Full Text Available Conformations of the crystalline 3,3,3-trifluoro-2-methoxy-2-phenylpropanamide derivatives (MTPA amides deposited in the Cambridge Structural Database (CSD were examined statistically as Racid-enantiomers. The majority of dihedral angles (48/58, ca. 83% of the amide carbonyl groups and the trifluoromethyl groups ranged from –30° to 0° with an average angle θ1 of −13°. The other conformational properties were also clarified: (1 one of the fluorine atoms was antiperiplanar (ap to the amide carbonyl group, forming a staggered conformation; (2 the MTPA amides prepared from primary amines showed a Z form in amide moieties; (3 in the case of the MTPA amide prepared from a primary amine possessing secondary alkyl groups (i.e., Mosher-type MTPA amide, the dihedral angles between the methine groups and the carbonyl groups were syn and indicative of a moderate conformational flexibility; (4 the phenyl plane was inclined from the O–Cchiral bond of the methoxy moiety with an average dihedral angle θ2 of +21°; (5 the methyl group of the methoxy moiety was ap to the ipso-carbon atom of the phenyl group.
Radiation damage due to the incident electron beam imposes a fundamental limitation on the information obtainable by electron microscopy about organic materials; it is desirable therefore that exposure of the specimen to the electron beam should be restricted to the actual period during which the image is being recorded. A description is given of methods employed in the observation of the organic aromatic hydrocarbons quaterrylene, ovalene and coronene with the Cambridge University 600kV high resolution electron microscope (HREM). In particular, the condenser-objective mode of operation of this microscope lends itself to the use of an area-defining aperture below the second condenser lens conjugate with the specimen. Furthermore, operation at the higher accelerating voltage of this instrument could be anticipated to reduce the rate of damage, depending on the dominant beam-specimen interaction, whilst the increased width of the first broad band of the contrast transfer function of this microscope at the optimum defocus may overcome the reported resolution limitation of current 100kV microscopes for the observation of related materials. (author)
White, Jon; Sofat, Reecha; Hemani, Gibran; Shah, Tina; Engmann, Jorgen; Dale, Caroline; Shah, Sonia; Kruger, Felix A; Giambartolomei, Claudia; Swerdlow, Daniel I; Palmer, Tom; McLachlan, Stela; Langenberg, Claudia; Zabaneh, Delilah; Lovering, Ruth; Cavadino, Alana; Jefferis, Barbara; Finan, Chris; Wong, Andrew; Amuzu, Antoinette; Ong, Ken; Gaunt, Tom R; Warren, Helen; Davies, Teri-Louise; Drenos, Fotios; Cooper, Jackie; Ebrahim, Shah; Lawlor, Debbie A; Talmud, Philippa J; Humphries, Steve E; Power, Christine; Hypponen, Elina; Richards, Marcus; Hardy, Rebecca; Kuh, Diana; Wareham, Nicholas; Ben-Shlomo, Yoav; Day, Ian N; Whincup, Peter; Morris, Richard; Strachan, Mark W J; Price, Jacqueline; Kumari, Meena; Kivimaki, Mika; Plagnol, Vincent; Whittaker, John C; Smith, George Davey; Dudbridge, Frank; Casas, Juan P; Holmes, Michael V; Hingorani, Aroon D
Summary Background Increased circulating plasma urate concentration is associated with an increased risk of coronary heart disease, but the extent of any causative effect of urate on risk of coronary heart disease is still unclear. In this study, we aimed to clarify any causal role of urate on coronary heart disease risk using Mendelian randomisation analysis. Methods We first did a fixed-effects meta-analysis of the observational association of plasma urate and risk of coronary heart disease. We then used a conventional Mendelian randomisation approach to investigate the causal relevance using a genetic instrument based on 31 urate-associated single nucleotide polymorphisms (SNPs). To account for potential pleiotropic associations of certain SNPs with risk factors other than urate, we additionally did both a multivariable Mendelian randomisation analysis, in which the genetic associations of SNPs with systolic and diastolic blood pressure, HDL cholesterol, and triglycerides were included as covariates, and an Egger Mendelian randomisation (MR-Egger) analysis to estimate a causal effect accounting for unmeasured pleiotropy. Findings In the meta-analysis of 17 prospective observational studies (166 486 individuals; 9784 coronary heart disease events) a 1 SD higher urate concentration was associated with an odds ratio (OR) for coronary heart disease of 1·07 (95% CI 1·04–1·10). The corresponding OR estimates from the conventional, multivariable adjusted, and Egger Mendelian randomisation analysis (58 studies; 198 598 individuals; 65 877 events) were 1·18 (95% CI 1·08–1·29), 1·10 (1·00–1·22), and 1·05 (0·92–1·20), respectively, per 1 SD increment in plasma urate. Interpretation Conventional and multivariate Mendelian randomisation analysis implicates a causal role for urate in the development of coronary heart disease, but these estimates might be inflated by hidden pleiotropy. Egger Mendelian randomisation analysis, which accounts for
McKone, Elinor; Stokes, Sacha; Liu, Jia; Cohan, Sarah; Fiorentini, Chiara; Pidcock, Madeleine; Yovel, Galit; Broughton, Mary; Pelleg, Michel
Other-race and other-ethnicity effects on face memory have remained a topic of consistent research interest over several decades, across fields including face perception, social psychology, and forensic psychology (eyewitness testimony). Here we demonstrate that the Cambridge Face Memory Test format provides a robust method for measuring these effects. Testing the Cambridge Face Memory Test original version (CFMT-original; European-ancestry faces from Boston USA) and a new Cambridge Face Memory Test Chinese (CFMT-Chinese), with European and Asian observers, we report a race-of-face by race-of-observer interaction that was highly significant despite modest sample size and despite observers who had quite high exposure to the other race. We attribute this to high statistical power arising from the very high internal reliability of the tasks. This power also allows us to demonstrate a much smaller within-race other ethnicity effect, based on differences in European physiognomy between Boston faces/observers and Australian faces/observers (using the CFMT-Australian). PMID:23118912
Full Text Available Although there were ten chairs of archaeology at universities in Germany, and one in France, by the mid-nineteenth century, in Great Britain it was the amateur societies and museums (the British Museum in particular that encouraged the study of this subject. In 1851 John Disney established the first university chair in Great Britain at Cambridge University. His proposal was initially received with considerable caution by the governing body of the university, and was only accepted by the narrowest margin of eight votes to seven. His agreement with the University of Cambridge stipulated that six lectures a year should be given on the subject of ‘Classical, Medieval, and other Antiquities, the Fine Arts and all matters and things connected therewith’ (Clark 1904, 222–225. However university archaeology was slow to establish its academic credibility nationally, and it was more than thirty years before Oxford University established its chair of classical archaeology. The Cambridge Board of Anthropological Studies, which included instruction in prehistoric archaeology, was not created until 1915, and as late as 1945 there were still only a few university lecturers in archaeology in Great Britain. It was not until 1946 that Oxford University appointed a Professor of Prehistoric Archaeology (Wilson 2002, 153; Daniel 1976, 6–12; Smith 2004, 4–5, 53–54.
Sodha, Reena; Sivanadarajah, Naveethan; Alam, Mahbub
Objectives To ascertain whether the use of oral glucosamine influences symptoms or functional outcomes in patients with chronic low back pain (LBP) thought to be related to spinal osteoarthritis (OA). Design Systematic review of randomised control trials. Searches were performed up to March 2011 on Medline, AMED, CINHAL, Cochrane and EMBASE with subsequent reference screening of retrieved studies. In addition, the grey literature was searched via opensigle. Included studies were required to i...
Full Text Available BACKGROUND: It is an inherent assumption in randomised controlled trials that the drug effect can be estimated by subtracting the response during placebo from the response during active drug treatment. OBJECTIVE: To test the assumption of additivity. The primary hypothesis was that the total treatment effect is smaller than the sum of the drug effect and the placebo effect. The secondary hypothesis was that non-additivity was most pronounced in participants with large placebo effects. METHODS: We used a within-subject randomised blinded balanced placebo design and included 48 healthy volunteers (50% males, mean (SD age 23.4 (6.2 years. Experimental pain was induced by injections of hypertonic saline into the masseter muscle. Participants received four injections with hypertonic saline along with lidocaine or matching placebo in randomised order: A: received hypertonic saline/told hypertonic saline; B: received hypertonic saline+lidocaine/told hypertonic saline; C: received hypertonic saline+placebo/told hypertonic saline+pain killer; D: received hypertonic saline+lidocaine/told hypertonic saline+pain killer. The primary outcome measure was the area under the curve (AUC, mm(2 of pain intensity during injections. RESULTS: There was a significant difference between the sum of the drug effect and the placebo effect (mean AUC 6279 mm(2 (95% CI, 4936-7622 and the total treatment effect (mean AUC 5455 mm(2 (95% CI, 4585-6324 (P = 0.049. This difference was larger for participants with large versus small placebo effects (P = 0.015, and the difference correlated significantly with the size of the placebo effect (r = 0.65, P = 0.006. CONCLUSION: Although this study examined placebo effects and not the whole placebo response as in randomised controlled trials, it does suggest that the additivity assumption may be incorrect, and that the estimated drug effects in randomised controlled trials may be underestimated, particularly in studies
Goud, R.; de Keizer, N F; ter Riet, G; Wyatt, J C; Hasman, A.; Hellemans, I.M.; Peek, N.
OBJECTIVE: To determine the extent to which computerised decision support can improve concordance of multidisciplinary teams with therapeutic decisions recommended by guidelines. DESIGN: Multicentre cluster randomised trial. PARTICIPANTS: Multidisciplinary cardiac rehabilitation teams in Dutch centres and their cardiac rehabilitation patients. INTERVENTIONS: Teams received an electronic patient record system with or without additional guideline based decision support. MAIN OUTCOME MEASURES: C...
Kiro R. Petrovski
Full Text Available This article describes few steps of the application of the modified Calgary-Cambridge Guides (CCG to consultations in bovine medicine. A review of pertinent clinical communication skills literature in human medicine was integrated with the burgeoning research within veterinary medicine. In particular, there are more recent studies examining companion animal veterinarian’s communication skills and outcomes which can be extrapolated to practitioners. This was integrated into a teaching example of a reproductive case consultation. The first article deals with the 1 Preparation, 2 Initiating the Session and 3 Gathering Information sections. The aim of the modified CCG is to provide a set of skills to facilitate a relationship-centred approach to consultations in bovine medicine, both at the individual animal and population level. They were initially developed for human medicine and expanded recently for use in veterinary medicine. The CCG enable the practitioner to facilitate interacting with that particular client at the time of the consultation. It is likely that the majority of practitioners do use many of the skills recommended by the modified CCG. These skills are often gained through experience. However, they may not use the skills intentionally and with purpose for a specific communication goal or outcome. Practitioners can improve their communication skills using the set of skills as recommended by the modified CCG. They allow the practitioner to gain insight into the client’s understanding of the problem, including underlying aetiology, epidemiology and pathophysiology. The guides also provide opportunity to understand client’s expectations regarding the outcome, motivation and willingness to change and adherence.
Full Text Available Background: Restless legs syndrome also known as Willis-Ekbom′s Disease (RLS/WED is a common illness. Cambridge-Hopkins diagnostic questionnaire for RLS (CHRLSq is a good diagnostic tool and can be used in the epidemiological studies. However, its Hindi version is not available. Thus, this study was conducted to translate and validate it in the Hindi speaking population. Materials and Methods: After obtaining the permission from the author of the CHRLSq, it was translated into Hindi language by two independent translators. After a series of forward and back translations, the finalized Hindi version was administered to two groups by one of the authors, who were blinded to the clinical diagnosis. First group consisted of RLS/WED patients, where diagnosis was made upon face to face interview and the other group - the control group included subjects with somatic symptoms disorders or exertional myalgia or chronic insomnia. Each group had 30 subjects. Diagnosis made on CHRLSq was compared with the clinical diagnosis. Statistical Analysis: Analysis was done using Statistical Package for Social Sciences (SPSS v 21.0. Descriptive statistics was calculated. Proportions were compared using chi-square test; whereas, categorical variables were compared using independent sample t-test. Sensitivity, specificity, and positive predictive value of the translated version of questionnaire were calculated. Results: Average age was comparable between the cases and control group (RLS/WED = 39.1 ± 10.1 years vs 36.2 ± 11.4 years in controls; P = 0.29. Women outnumbered men in the RLS/WED group (87% in RLS/WED group vs 57% among controls; χ2 = 6.64; P = 0.01. Both the sensitivity and specificity of the translated version was 83.3%. It had the positive predictive value of 86.6%. Conclusion: Hindi version of CHRLSq has positive predictive value of 87% and it can be used to diagnose RLS in Hindi speaking population.
Boylan, J F
Practising physicians individualise treatments, hoping to achieve optimal outcomes by tackling relevant patient variables. The randomised controlled trial (RCT) is universally accepted as the best means of comparison. Yet doctors sometimes wonder if particular patients might benefit more from treatments that fared worse in the RCT comparisons. Such clinicians may even feel ostracised by their peers for stepping outside treatments based on RCTs and guidelines. Are RCTs the only acceptable evaluations of how patient care can be assessed and delivered? In this controversy we explore the interpretation of RCT data for practising clinicians facing individualised patient choices. First, critical care anaesthetists John Boylan and Brian Kavanagh emphasise the dangers of bias and show how Bayesian approaches utilise prior probabilities to improve posterior (combined) probability estimates. Secondly, Jane Armitage, of the Clinical Trial Service Unit in Oxford, argues why RCTs remain essential and explores how the quality of randomisation can be improved through systematic reviews and by avoiding selective reporting.
De Roos, Carlijn; Greenwald, Ricky; Hollander-Gijsman, Margien den; Noorthoorn, Eric; van Buuren, Stef; Jongh, Ad De
Background: Building on previous research with disaster-exposed children and adolescents, a randomised clinical trial was performed in the treatment of trauma-related symptoms. In the current study two active treatments were compared among children in a broad age range and from a wide diversity of ethnic populations. Objective: The primary aim was to compare the effectiveness and efficiency of Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitisation and Reprocessing (EMDR). Design...
"The Cambridge-Cranfield High Performance Computing Facility (HPCF), a collaborative environment for data and numerical intensive computing privately run by the University of Cambridge and Cranfield University, has purchased 10 Sun Fire(TM) 15K servers from Sun Microsystems, Inc.. The total investment, which includes more than $40 million in Sun technology, will dramatically increase the computing power, reliability, availability and scalability of the HPCF" (1 page).
Panter Jenna; Griffin Simon; Jones Andrew; Mackett Roger; Ogilvie David
Abstract Purpose Environmental perceptions and psychological measures appear to be associated with walking and cycling behaviour; however, their influence is still unclear. We assessed these associations using baseline data from a quasi-experimental cohort study of the effects of major transport infrastructural developments in Cambridge, UK. Methods Postal surveys were sent to adults who travel to work in Cambridge (n = 1582). Questions asked about travel modes and time spent travelling to an...
Hróbjartsson, Asbjørn; Thomsen, Ann Sofia Skou; Emanuelsson, Frida; Tendal, Britta; Hilden, Jørgen; Boutron, Isabelle; Ravaud, Philippe; Brorson, Stig
To evaluate the impact of non-blinded outcome assessment on estimated treatment effects in randomised clinical trials with binary outcomes.......To evaluate the impact of non-blinded outcome assessment on estimated treatment effects in randomised clinical trials with binary outcomes....
Torgerson, Carole J.
The randomised controlled trial (RCT) is an evaluative method used by social scientists in order to establish whether or not an intervention is effective. This contribution discusses the fundamental aspects of good RCT design. These are illustrated through the use of a recently completed RCT which evaluated an information and communication…
Kojić-Prodić, B.; Molčanov, K.
Prikaz je posvećen uspomeni na dr. F. H. Allena i obilježavanju 50-godišnjice The Cambridge Crystallographic Data Centre (CCDC), svjetski poznatog centra, koji pohranjuje i provjerava kristalografske podatke, uključujući koordinate atoma koje određuju trodimenzijsku strukturu organskih molekula i metalnih kompleksa s organskim ligandima. Misija institucije istaknuta na njezinim web-stranicama je jasna: “Centar za kristalografske podatke u Cambridgeu (CCDC) potpomaže napredak kemije i kristalo...
Full Text Available Abstract Background While there are increasing data implicating poor recognition of physical inactivity as a potential barrier to healthy behaviour change, the efficacy of feedback to promote physical activity is uncertain. Using a randomised controlled trial nested within a population-based cohort study, we plan to test three variations of physical activity feedback against a control group. Our primary objective is to assess the efficacy of physical activity feedback in promoting physical activity behaviour change. Secondary objectives are to determine the influence of feedback on physical activity awareness and cognitions, and to compare behavioural effects by type of feedback. Methods/Design We aim to recruit 500 healthy participants aged 30 to 55 years from the ongoing Fenland Study (Cambridge, UK. Following careful phenotyping during baseline measurement (anthropometric, clinical, body composition and fitness measurements, as well as questionnaires assessing self-reported and self-rated physical activity, psychosocial correlates of physical activity behaviour, diet, lifestyle and general health, participants wear a combined heart rate and movement sensor (Actiheart® for six continuous days and nights. After receipt of the physical activity data (around 2 weeks later, participants are randomly allocated to either a control group (no feedback or one of three types of personalised physical activity feedback ('simple', 'visualised' or 'contextualised', and complete repeat measures of self-rated physical activity and psychosocial correlates. Approximately five weeks after receiving feedback, all participants wear the Actiheart® for another six-day follow-up period and complete repeat questionnaires. Values at outcome, adjusted for baseline, will be compared between randomised groups. Discussion Given the randomised trial design and use of objective measure of physical activity, this study is likely to provide valuable insights into the
Ji; Zhao; Shengmei; Lu; Linyan; Hu; Can; Li
Using FFC-Cambridge Process to prepare Si from SiO2 is a promising method to prepare nanostructured and highly pure silicon for solar cells.However,the method still has many problems unsolved and the controlling effect of the cell voltage on silicon product is not clear.Here we report in this article that nano cluster-like silicon product with purity of 99.95%has been prepared by complete conversion of raw material SiO2,quartz glass plate,using constant cell voltage electrolysis FFC-Cambridge Process.By analysis of XRD,EDS,TEM,HRTEM and ICP-AES as well as the discussion from the thermodynamics calculation,the morphology and components of the product based on the change of cell voltage are clarified.It is clear that pure silicon could be prepared at the cell voltage of 1.7 2.1 V in this reaction system.The silicon material have cluster-like structure which are made of silicon nanoparticles in 20 100 nm size.Interestingly,the cluster-like nano structure of the silicon can be tuned by the used cell voltage.The purity,yield and the energy cost of silicon product prepared at the optimized cell voltage are discussed.The purity of the silicon product could be further improved,hence this method is promising for the preparation of solar grade silicon in future.
AIM: To investigate the usefulness of secretin injection MRCP for the diagnosis of mild chronic pancreatitis. METHODS: Sixteen patients having mild chronic pancreatitis according to the Cambridge classification and 12 control subjects with no abnormal findings on the pancreatogram were examined for the diagnostic accuracy of secretin injection-MRCP regarding abnormal branch pancreatic ducts associated with mild chronic pancreatitis (Cambridge Classification), using endoscopic retrograde cholangiopancreatography (ERCP) for comparison. RESULTS: The sensitivity and specificity for abnormal branch pancreatic ducts determined by two reviewers were respectively 55%-63% and 75%-83% in the head, 57%-64% and 82%-83% in the body, and 44%-44%and 72%-76% in the tail of the pancreas. The sensitivity and specificity for mild chronic pancreatitis were 56%-63% and 92%-92%, respectively. Interobserver abnormal branch pancreatic duct and of mild chronic pancreatitis was good to excellent. CONCLUSION: Secretin injection-MRCP might be useful for the diagnosis of mild chronic pancreatitis.
Full Text Available Judgments of naturalness of foods tend to be more influenced by the process history of a food, rather than its actual constituents. Two types of processing of a ``natural'' food are to add something or to remove something. We report in this study, based on a large random sample of individuals from six countries (France, Germany, Italy, Switzerland, UK and USA that additives are considered defining features of what makes a food not natural, whereas ``subtractives'' are almost never mentioned. In support of this, skim milk (with major subtraction of fat is rated as more natural than whole milk with a small amount of natural vitamin D added. It is also noted that ``additives'' is a common word, with a synonym reported by a native speaker in 17 of 18 languages, whereas ``subtractive'' is lexicalized in only 1 of the 18 languages. We consider reasons for additivity dominance, relating it to omission bias, feature positive bias, and notions of purity.
Paul Rozin; Claude Fischler; Christy Shields-Argeles
Judgments of naturalness of foods tend to be more influenced by the process history of a food, rather than its actual constituents. Two types of processing of a ``natural'' food are to add something or to remove something. We report in this study, based on a large random sample of individuals from six countries (France, Germany, Italy, Switzerland, UK and USA) that additives are considered defining features of what makes a food not natural, whereas ``subtractives'' are almost never mentioned....
I.M. Custers; P.A. Flierman; P. Maas; T. Cox; T.J.H.M. van Dessel; M.H. Gerards; M.H. Mochtar; C.A.H. Janssen; F. van der Veen; B.W.J. Mol
Objective To evaluate the effectiveness of 15 minutes of immobilisation versus immediate mobilisation after intrauterine insemination. Design Randomised controlled trial. Setting One academic teaching hospital and six non-academic teaching hospitals. Participants Women having intrauterine inseminati
Walker, D.; Gutierrez, JP; TORRES, P.; Bertozzi, SM
OBJECTIVE: To assess effects on condom use and other sexual behaviour of an HIV prevention programme at school that promotes the use of condoms with and without emergency contraception. DESIGN: Cluster randomised controlled trial. SETTING: 40 public high schools in the state of Morelos, Mexico. PARTICIPANTS: 10 954 first year high school students. INTERVENTION: Schools were randomised to one of three arms: an HIV prevention course that promoted condom use, the same course with emergency contr...
Hyde, T.P.; Craddock, H.L.; Gray, J C; Pavitt, S. H.; Hulme, C; Godfrey, M.; Fernandez, C; Navarro-Coy, N; Dillon, S.; Wright, J; S. Brown; Dukanovic, G.; Brunton, P.A.
Objectives There is continuing demand for non-implant prosthodontic treatment and yet there is a paucity of high quality Randomised Controlled Trial (RCT) evidence for best practice. The aim of this research was to provide evidence for best practice in prosthodontic impressions by comparing two impression materials in a double-blind, randomised, crossover, controlled, clinical trial. Methods Eighty-five patients were recruited, using published eligibility criteria, to the trial at Leeds Denta...
Charles, Pierre; Giraudeau, Bruno; Dechartres, Agnes; Baron, Gabriel; Ravaud, Philippe
Objectives To assess quality of reporting of sample size calculation, ascertain accuracy of calculations, and determine the relevance of assumptions made when calculating sample size in randomised controlled trials. Design Review. Data sources We searched MEDLINE for all primary reports of two arm parallel group randomised controlled trials of superiority with a single primary outcome published in six high impact factor general medical journals between 1 January 2005 and 31 December 2006. All...
Rosenbek, John C
Researchers and clinicians often disagree about what it means to provide the best possible care. This paper's purpose is to propose ways of resolving the disagreements. The first is to have both groups re-examine the three equal components of evidence-based practice, a re-examination that begins with rejection of the randomised clinical trial's tyranny. The second is for researchers to design rehabilitation research based on a biopsychosocial rather than a biomedical model. The third is for both groups to redefine translational research so that it means both translation from the laboratory to the clinic and from the clinic to the laboratory. The fourth is to advocate for a science of dissemination that is as robust as rehabilitation's present science of discovery. Most examples are drawn from the literature on acquired neurologic speech and language disorders. PMID:27124262
van Haselen Robbert
Full Text Available Abstract Background The 'Hawthorne Effect' may be an important factor affecting the generalisability of clinical research to routine practice, but has been little studied. Hawthorne Effects have been reported in previous clinical trials in dementia but to our knowledge, no attempt has been made to quantify them. Our aim was to compare minimal follow-up to intensive follow-up in participants in a placebo controlled trial of Ginkgo biloba for treating mild-moderate dementia. Methods Participants in a dementia trial were randomised to intensive follow-up (with comprehensive assessment visits at baseline and two, four and six months post randomisation or minimal follow-up (with an abbreviated assessment at baseline and a full assessment at six months. Our primary outcomes were cognitive functioning (ADAS-Cog and participant and carer-rated quality of life (QOL-AD. Results We recruited 176 participants, mainly through general practices. The main analysis was based on Intention to treat (ITT, with available data. In the ANCOVA model with baseline score as a co-variate, follow-up group had a significant effect on outcome at six months on the ADAS-Cog score (n = 140; mean difference = -2.018; 95%CI -3.914, -0.121; p = 0.037 favouring the intensive follow-up group, and on participant-rated quality of life score (n = 142; mean difference = -1.382; 95%CI -2.642, -0.122; p = 0.032 favouring minimal follow-up group. There was no significant difference on carer quality of life. Conclusion We found that more intensive follow-up of individuals in a placebo-controlled clinical trial of Ginkgo biloba for treating mild-moderate dementia resulted in a better outcome than minimal follow-up, as measured by their cognitive functioning. Trial registration Current controlled trials: ISRCTN45577048
Full Text Available Abstract Background Stroke is a leading cause of disability among adults worldwide. Evidence suggests that increased duration of exercise therapy following stroke has a positive impact on functional outcome following stroke. The main objective of this randomised controlled trial is to evaluate the impact of additional family assisted exercise therapy in people with acute stroke. Methods/Design A prospective multi-centre single blind randomised controlled trial will be conducted. Forty patients with acute stroke will be randomised into either an experimental or control group. The experimental group will receive routine therapy and additional lower limb exercise therapy in the form of family assisted exercises. The control group will receive routine therapy with no additional formal input from their family members. Participants will be assessed at baseline, post intervention and followed up at three months using a series of standardised outcome measures. A secondary aim of the project is to evaluate the impact of the family mediated exercise programme on the person with stroke and the individual(s assisting in the delivery of exercises using a qualitative methodology. The study has gained ethical approval from the Research Ethics Committees of each of the clinical sites involved in the study. Discussion This study will evaluate a structured programme of exercises that can be delivered to people with stroke by their 'family members/friends'. Given that the progressive increase in the population of older people is likely to lead to an increased prevalence of stroke in the future, it is important to reduce the burden of this illness on the individual, the family and society. Family mediated exercises can maximise the carry over outside formal physiotherapy sessions, giving patients the opportunity for informal practice. Trial Registration The protocol for this study is registered with the US NIH Clinical trials registry (NCT00666744
Galvin, Rose; Cusack, Tara; Stokes, Emma
Background Stroke is a leading cause of disability among adults worldwide. Evidence suggests that increased duration of exercise therapy following stroke has a positive impact on functional outcome following stroke. The main objective of this randomised controlled trial is to evaluate the impact of additional family assisted exercise therapy in people with acute stroke. Methods/Design A prospective multi-centre single blind randomised controlled trial will be conducted. Forty patients with acute stroke will be randomised into either an experimental or control group. The experimental group will receive routine therapy and additional lower limb exercise therapy in the form of family assisted exercises. The control group will receive routine therapy with no additional formal input from their family members. Participants will be assessed at baseline, post intervention and followed up at three months using a series of standardised outcome measures. A secondary aim of the project is to evaluate the impact of the family mediated exercise programme on the person with stroke and the individual(s) assisting in the delivery of exercises using a qualitative methodology. The study has gained ethical approval from the Research Ethics Committees of each of the clinical sites involved in the study. Discussion This study will evaluate a structured programme of exercises that can be delivered to people with stroke by their 'family members/friends'. Given that the progressive increase in the population of older people is likely to lead to an increased prevalence of stroke in the future, it is important to reduce the burden of this illness on the individual, the family and society. Family mediated exercises can maximise the carry over outside formal physiotherapy sessions, giving patients the opportunity for informal practice. Trial Registration The protocol for this study is registered with the US NIH Clinical trials registry (NCT00666744) PMID:18570643
Buttgereit, Frank; Mehta, Daksha; Kirwan, John; Szechinski, Jacek; Boers, Maarten; Alten, Rieke E; Supronik, Jerzy; Szombati, Istvan; Romer, Ulrike; Witte, Stephan; Saag, Kenneth G.
Objective To assess the efficacy and safety of low-dose prednisone chronotherapy using a new modified-release (MR) formulation for the treatment of rheumatoid arthritis (RA). Methods In this 12-week, double-blind, placebo-controlled study, patients with active RA (n=350) were randomised 2:1 to receive MR prednisone 5 mg or placebo once daily in the evening in addition to their existing RA disease-modifying antirheumatic drug (DMARD) treatment. The primary end point was the percentage of patie...
Haakstad, Lene Annette Hagen; Bø, Kari
Objectives: To assess whether a 12-week supervised exercise-programme with an additional 30 min of moderate self-imposed physical activity on the non-supervised weekdays prevents excessive weight gain in pregnancy, as well as postpartum weight retention. Methods: One hundred and five sedentary, nulliparous pregnant women with a mean age of 30.7 ± 4.0 years and a pre-pregnancy body mass index of 23.8 ± 4.3 kg/m2 were randomised to either an exercise group (EG, n = 52) or a control group (C...
Savović, J; Jones, He; Altman, Dg;
The design of randomised controlled trials (RCTs) should incorporate characteristics (such as concealment of randomised allocation and blinding of participants and personnel) that avoid biases resulting from lack of comparability of the intervention and control groups. Empirical evidence suggests...
F.H. Allen; A.J. Cruz-Cabeza; P.A. Wood; D.A. Bardwell
As part of a programme of work to extend central-group coverage in the Cambridge Crystallographic Data Centre's (CCDC) IsoStar knowledge base of intermolecular interactions, we have studied the hydrogen-bonding abilities of squaric acid (H(2)SQ) and its mono-and dianions (HSQ(-) and SQ(2-)) using th
Piquero, Alex R.; Farrington, David P.; Nagin, Daniel S.; Moffitt, Terrie E.
Researchers have hypothesized that over the life course, criminal offending varies with problems in other domains, including life failure and physical and mental health. To examine this issue, the authors use data from the Cambridge Study in Delinquent Development, a prospective longitudinal survey of 411 South London males first studied at age 8…
Gaerlan, Barbara S.
Daniel Boone Schirmer had a lasting impact on the movement in the United States to oppose martial law in the Philippines from 1972 until his death in 2006. He was active in several AMLM institutions such as the Philippines Information Bulletin, Friends of the Filipino People, and the Philippines program of the Goddard-Cambridge Graduate Program in Social Change.
Battle, Gary M.; Allen, Frank H.; Ferrence, Gregory M.
Parts 1 and 2 of this series described the educational value of experimental three-dimensional (3D) chemical structures determined by X-ray crystallography and retrieved from the crystallographic databases. In part 1, we described the information content of the Cambridge Structural Database (CSD) and discussed a representative teaching subset of…
Full Text Available Pulmonary rehabilitation programs only modestly enhance daily physical activity levels in patients with chronic obstructive pulmonary disease (COPD. This randomised controlled trial investigates the additional effect of an individual activity counselling program during pulmonary rehabilitation on physical activity levels in patients with moderate to very severe COPD.Eighty patients (66 ± 7 years, 81% male, forced expiratory volume in 1 second 45 ± 16% of predicted referred for a six-month multidisciplinary pulmonary rehabilitation program were randomised. The intervention group was offered an additional eight-session activity counselling program. The primary outcomes were daily walking time and time spent in at least moderate intense activities.Baseline daily walking time was similar in the intervention and control group (median 33 [interquartile range 16-47] vs 29 [17-44] whereas daily time spent in at least moderate intensity was somewhat higher in the intervention group (17[4-50] vs 12[2-26] min. No significant intervention*time interaction effects were observed in daily physical activity levels. In the whole group, daily walking time and time spent in at least moderate intense activities did not significantly change over time.The present study identified no additional effect of eight individual activity counselling sessions during pulmonary rehabilitation to enhance physical activity levels in patients with COPD.clinicaltrials.gov NCT00948623.
Mackenzie, Isla S; Wei, Li; Rutherford, Daniel; Findlay, Evelyn A; Saywood, Wendy; Campbell, Marion K; Macdonald, Thomas M
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT * Recruitment is key to the success of clinical trials. * Many clinical trials fail to achieve adequate recruitment. * Public understanding and engagement in clinical research could be improved. WHAT THIS STUDY ADDS * 'Get Randomised' is the first campaign of its kind in the UK. * It is possible to improve public awareness of clinical research using the media. * Further work is needed to determine whether improved public awareness leads to increased participation in clinical research in the future. AIM To increase public awareness and understanding of clinical research in Scotland. METHODS A generic media campaign to raise public awareness of clinical research was launched in 2008. The 'Get Randomised' campaign was a Scotland-wide initiative led by the University of Dundee in collaboration with other Scottish universities. Television, radio and newspaper advertising showed leading clinical researchers, general practitioners and patients informing the public about the importance of randomised clinical trials (RCTs). 'Get Randomised' was the central message and interested individuals were directed to the http://www.getrandomised.org website for more information. To assess the impact of the campaign, cross-sectional surveys were conducted in representative samples of 1040 adults in Scotland prior to campaign launch and again 6 months later. RESULTS There was an improvement in public awareness of clinical trials following the campaign; 56.7% [95% confidence interval (CI) 51.8, 61.6] of the sample recalled seeing or hearing advertising about RCTs following the campaign compared with 14.8% (10.8, 18.9) prior to the campaign launch (difference = 41.4%; 95% CI for difference 35.6, 48.3; P advertising, 49% felt that the main message was that people should take part more in medical research. However, on whether they would personally take part in a clinical trial if asked, there was little difference in response following the campaign
Ainsworth, Hannah; Hewitt, Catherine E.; Higgins, Steve; Wiggins, Andy; Torgerson, David J.; Torgerson, Carole J.
Randomised controlled trials (RCTs) can be at risk of bias. Using data from a RCT, we considered the impact of post-randomisation bias. We compared the trial primary outcome, which was administered blindly, with the secondary outcome, which was not administered blindly. From 44 schools, 522 children were randomised to receive a one-to-one maths…
London, N. J.; Osman, F A; Ramagopal, K; Journeaux, S F
OBJECTIVE: To investigate whether hyaluronidase (Hyalase) is a useful and justified addition to haematoma block for pain relief. METHODS: The study was a randomised double blind trial of 33 consecutive patients attending the accident and emergency department for manipulation of distal radius fracture under haematoma block. Control patients received 1% lignocaine; the treatment group received 1% lignocaine plus 1500 IU hyaluronidase. Manipulation occurred 10 minutes after instituting the block...
Full Text Available Purpose. Hyaluronidase is an enzyme that temporarily liquefies the interstitial barrier, allowing easy dispersal of local anaesthetic through cleavage of tissue planes. This prospective, blinded, randomised controlled study investigates the utility of adding hyaluronidase to local anaesthetic in the setting of carpal tunnel release. Methods. 70 consecutive carpal tunnel release patients were recruited and randomised into a control group only receiving local anaesthetic and a hyaluronidase group receiving both hyaluronidase and local anaesthetic. Pain scores were rated using the visual analogue scale (VAS by patients immediately after local anaesthetic injection and again immediately after the carpal tunnel release. Results. Preoperative VAS scores, taken after local anaesthetic injection, were greater than postoperative VAS scores. Postoperative VAS scores were significantly lower in the hyaluronidase group and tourniquet times were significantly shorter in the hyaluronidase group. Conclusion. Hyaluronidase addition to local anaesthetic in carpal tunnel release resulted in significant reductions in operative time and pain immediately after operation.
Geretsegger, Monika; Holck, Ulla; Gold, Christian
.e., number of music therapy sessions per week) affects outcome of therapy, and to determine cost-effectiveness. Methods Children aged between 4;0 and 6;11 years who are diagnosed with autism spectrum disorder will be randomly assigned to one of three conditions. Parents of all participants will receive three...... sessions of parent counselling (at 0, 2, and 5 months). In addition, children randomised to the two intervention groups will be offered individual, improvisational music therapy over a period of five months, either one session (low-intensity) or three sessions (high-intensity) per week. Generalised effects...... of music therapy will be measured using standardised scales completed by blinded assessors (Autism Diagnostic Observation Schedule, ADOS) and parents (Social Responsiveness Scale, SRS) before and 2, 5, and 12 months after randomisation. Cost effectiveness will be calculated as man years. A group sequential...
Carlijn de Roos
Full Text Available Background : Building on previous research with disaster-exposed children and adolescents, a randomised clinical trial was performed in the treatment of trauma-related symptoms. In the current study two active treatments were compared among children in a broad age range and from a wide diversity of ethnic populations. Objective : The primary aim was to compare the effectiveness and efficiency of Cognitive Behavioural Therapy (CBT and Eye Movement Desensitisation and Reprocessing (EMDR. Design : Children (n=52, aged 4–18 were randomly allocated to either CBT (n=26 or EMDR (n=26 in a disaster mental health after-care setting after an explosion of a fireworks factory. All children received up to four individual treatment sessions over a 4–8 week period along with up to four sessions of parent guidance. Blind assessment took place pre- and post-treatment and at 3 months follow-up on a variety of parent-rated and self-report measures of post-traumatic stress disorder symptomatology, depression, anxiety, and behaviour problems. Analyses of variance (general linear model repeated measures were conducted on the intention-to-treat sample and the completers. Results : Both treatment approaches produced significant reductions on all measures and results were maintained at follow-up. Treatment gains of EMDR were reached in fewer sessions. Conclusion : Standardised CBT and EMDR interventions can significantly improve functioning of disaster-exposed children.For the abstract in other languages, please see Supplementary files under Reading Tools online
Full Text Available Abstract Background Childhood asthma is common in Cape Town, a province of South Africa, but is underdiagnosed by general practitioners. Medications are often prescribed inappropriately, and care is episodic. The objective of this study is to assess the impact of educational outreach to general practitioners on asthma symptoms of children in their practice. Methods This is a cluster randomised trial with general practices as the unit of intervention, randomisation, and analysis. The setting is Mitchells Plain (population 300,000, a dormitory town near Cape Town. Solo general practitioners, without nurse support, operate from storefront practices. Caregiver-reported symptom data were collected for 318 eligible children (2 to 17 years with moderate to severe asthma, who were attending general practitioners in Mitchells Plain. One year post-intervention follow-up data were collected for 271 (85% of these children in all 43 practices. Practices randomised to intervention (21 received two 30-minute educational outreach visits by a trained pharmacist who left materials describing key interventions to improve asthma care. Intervention and control practices received the national childhood asthma guideline. Asthma severity was measured in a parent-completed survey administered through schools using a symptom frequency and severity scale. We compared intervention and control group children on the change in score from pre-to one-year post-intervention. Results Symptom scores declined an additional 0.84 points in the intervention vs. control group (on a nine-point scale. p = 0.03. For every 12 children with asthma exposed to a doctor allocated to the intervention, one extra child will have substantially reduced symptoms. Conclusion Educational outreach was accepted by general practitioners and was effective. It could be applied to other health care quality problems in this setting.
Englar, Ryane E; Williams, Melanie; Weingand, Kurt
Effective communication in health care benefits patients. Medical and veterinary schools not only have a responsibility to teach communication skills, the American Veterinary Medical Association (AVMA) Council on Education (COE) requires that communication be taught in all accredited colleges of veterinary medicine. However, the best strategy for designing a communications curriculum is unclear. The Calgary-Cambridge Guide (CCG) is one of many models developed in human medicine as an evidence-based approach to structuring the clinical consultation through 71 communication skills. The model has been revised by Radford et al. (2006) for use in veterinary curricula; however, the best approach for veterinary educators to teach communication remains to be determined. This qualitative study investigated if one adaptation of the CCG currently taught at Midwestern University College of Veterinary Medicine (MWU CVM) fulfills client expectations of what constitutes clinically effective communication. Two focus groups (cat owners and dog owners) were conducted with a total of 13 participants to identify common themes in veterinary communication. Participants compared communication skills they valued to those taught by MWU CVM. The results indicated that while the CCG skills that MWU CVM adopted are applicable to cat and dog owners, they are not comprehensive. Participants expressed the need to expand the skillset to include compassionate transparency and unconditional positive regard. Participants also expressed different communication needs that were attributed to the species of companion animal owned. PMID:27075274
McCullogh, R.W. [Jacques Whitford Environment Ltd., Dartmouth, NS (Canada); Burkill, R. [Transport Canada, Ottawa, ON (Canada)
Several remote sites in Arctic Canada are contaminated with diesel fuel from leaky storage tanks. Soil remediation in these permafrost areas is expensive and time consuming. A study was conducted at the Cambridge Bay Transmitter site to develop a soil treatment method that can be used to clean-up small volumes of contaminated soils at sites across the Arctic with similar climates and geology. Bioremediation is generally an effective way to treat contaminated soils, but ambient temperature is the main limiting factor associated with bioremediation of hydrocarbon impacted soil in Arctic environments. As temperatures approach 5 degrees C, the rates of microbial activity are very much reduced. This study examined the temperature of the soil to determine the performance of bioremediation processes and to optimize heat preservation. A series of thermocouples were installed to monitor soil and ambient temperatures. The statistical data showing the temperature conditions at the site can be applied to other contaminated sites. This paper described the data logger installation, the available data and how it can be used to design and monitor remediation projects in the Arctic. 5 refs., 9 figs.
Background and purpose: Post mastectomy radiotherapy (PMRT) reduces loco-regional recurrence (LRR) and has been associated with survival benefit. It is recommended for patients with T3/T4 tumours and/or ⩾4 positive lymph nodes (LN). The role of PMRT in 1–3 positive LN and LN negative patients is contentious. The C-PMRT index has been designed for selecting PMRT patients, using independent prognostic factors for LRR. This study reports a 10 year experience using this index. Materials and methods: The C-PMRT index was constructed using the following prognostic factors (a) number of positive LN/lymphovascular invasion, (b) tumour size (c) margin status and (d) tumour grade. Patients were categorised as high (H) risk, intermediate (I) risk and low (L) risk. PMRT was recommended for H and I risk patients. The LRR, distant metastasis and overall survival (OS) rates were measured from the day of mastectomy. Results: From 1999 to 2009, 898 invasive breast cancers in 883 patients were treated by mastectomy (H: 323, I: 231 and L: 344). At a median follow up of 5.2 years, 4.7% (42/898) developed LRR. The 5-year actuarial LRR rates were 6%, 2% and 2% for the H, I and L risk groups, respectively. 1.6% (14/898) developed isolated LRR (H risk n = 4, I risk group n = 0 and L risk n = 10). The 5-year actuarial overall survival rates were 67%, 77% and 90% for H, I and L risk groups, respectively. Conclusion: Based on published literature, one would have expected a higher LRR rate in the I risk group without adjuvant RT. We hypothesise that the I risk group LRR rates have been reduced to that of the L risk group by the addition of RT. Apart from LN status and tumour size, other prognostic factors should also be considered in selecting patients for PMRT. This pragmatic tool requires further validation
Full Text Available Abstract Background Most women delivering in South African State Maternity Hospitals do not have a childbirth companion; in addition, the quality of care could be better, and at times women are treated inhumanely. We piloted a multi-faceted intervention to encourage uptake of childbirth companions in state hospitals, and hypothesised that lay carers would improve the behaviour of health professionals. Methods We conducted a pilot randomised controlled trial of an intervention to promote childbirth companions in hospital deliveries. We promoted evidence-based information for maternity staff at 10 hospitals through access to the World Health Organization Reproductive Health Library (RHL, computer hardware and training to all ten hospitals. We surveyed 200 women at each site, measuring companionship, and indicators of good obstetric practice and humanity of care. Five hospitals were then randomly allocated to receive an educational intervention to promote childbirth companions, and we surveyed all hospitals again at eight months through a repeat survey of postnatal women. Changes in median values between intervention and control hospitals were examined. Results At baseline, the majority of hospitals did not allow a companion, or access to food or fluids. A third of women were given an episiotomy. Some women were shouted at (17.7%, N = 2085, and a few reported being slapped or struck (4.3%, N = 2080. Despite an initial positive response from staff to the childbirth companion intervention, we detected no difference between intervention and control hospitals in relation to whether a companion was allowed by nursing staff, good obstetric practice or humanity of care. Conclusion The quality and humanity of care in these state hospitals needs to improve. Introducing childbirth companions was more difficult than we anticipated, particularly in under-resourced health care systems with frequent staff changes. We were unable to determine whether the presence
Shamash, J; Powles, T; Sarker, S J; Protheroe, A; Mithal, N; Mills, R.; Beard, R; Wilson, P; Tranter, N.; O'Brien, N; McFaul, S; Oliver, T
Background: The role of further hormone therapy in castration-resistant prostate cancer (CRPC) remains unclear. We performed a multi-centre randomised phase III study comparing the use of Dexamethasone, Aspirin, and immediate addition of Diethylstilbestrol (DAiS) vs Dexamethasone, Aspirin, and deferred (until disease progression) addition of Diethylstilbestrol (DAdS). Methods: From 2001 to 2008, 270 men with chemotherapy-naive CRPC were randomly assigned, in a 1 : 1 ratio, to receive either D...
The sealing performance of the seal gasket and labyrinth ring of cigarette catching device of smoking machine is not easy to find. Through studying the definition and calculation method of the rejection rate of Cambridge filter, the seal of cigarette filter is judged by the interception rate of Cambridge filter to ensure the accurate detection data of the mainstream smoke.%吸烟机卷烟捕集器密封垫片和迷宫环密封性能好坏不易直观发现，通过研究剑桥滤片截留率的定义与计算方法，依据剑桥滤片截留率数据判断卷烟捕集器密封性，保证主流烟气的检测数据准确。
Full Text Available OBJECTIVE: To undertake an economic evaluation alongside the largest randomised controlled trial comparing Levonorgestrel-releasing intrauterine device ('LNG-IUS' and usual medical treatment for women with menorrhagia in primary care; and compare the cost-effectiveness findings using two alternative measures of quality of life. METHODS: 571 women with menorrhagia from 63 UK centres were randomised between February 2005 and July 2009. Women were randomised to having a LNG-IUS fitted, or usual medical treatment, after discussing with their general practitioner their contraceptive needs or desire to avoid hormonal treatment. The treatment was specified prior to randomisation. For the economic evaluation we developed a state transition (Markov model with a 24 month follow-up. The model structure was informed by the trial women's pathway and clinical experts. The economic evaluation adopted a UK National Health Service perspective and was based on an outcome of incremental cost per Quality Adjusted Life Year (QALY estimated using both EQ-5D and SF-6D. RESULTS: Using EQ-5D, LNG-IUS was the most cost-effective treatment for menorrhagia. LNG-IUS costs £100 more than usual medical treatment but generated 0.07 more QALYs. The incremental cost-effectiveness ratio for LNG-IUS compared to usual medical treatment was £1600 per additional QALY. Using SF-6D, usual medical treatment was the most cost-effective treatment. Usual medical treatment was both less costly (£100 and generated 0.002 more QALYs. CONCLUSION: Impact on quality of life is the primary indicator of treatment success in menorrhagia. However, the most cost-effective treatment differs depending on the quality of life measure used to estimate the QALY. Under UK guidelines LNG-IUS would be the recommended treatment for menorrhagia. This study demonstrates that the appropriate valuation of outcomes in menorrhagia is crucial.
Wreghitt, T G; Whipp, J.; Redpath, C.; Hollingworth, W.
This prospective study analyses infections with varicella-zoster virus (VZV) in Addenbrooke's Hospital, Cambridge during 1987-92 and examines the spread of infection. In total, 93 patients and staff experienced VZV infection. Twenty-one patients had varicella and 49 experienced zoster. None of 101 patients and 1 of 625 staff members in contact with varicella cases acquired infection. By contrast, 2 of 227 patients, and 5 of 1039 staff in contact with zoster cases acquired varicella. One out o...
Meads David M; Ratcliffe Julie; McKenna Stephen P; Brazier John E
Abstract Background Pulmonary Hypertension is a severe and incurable disease with poor prognosis. A suite of new disease-specific measures – the Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) – was recently developed for use in this condition. The purpose of this study was to develop and validate a preference based measure from the CAMPHOR that could be used in cost-utility analyses. Methods Items were selected that covered major issues covered by the CAMPHOR QoL scale (activities,...
Comparison of the Diagnostic Accuracy of Neuropsychological Tests in Differentiating Alzheimer's Disease from Mild Cognitive Impairment: Can the Montreal Cognitive Assessment Be Better than the Cambridge Cognitive Examination?
Martinelli, José Eduardo; Cecato, Juliana Francisca; Bartholomeu, Daniel; Montiel, José Maria
Objective Considering the lack of studies on measures that increase the diagnostic distinction between Alzheimer's disease (AD) and mild cognitive impairment (MCI) and on the role of the Cambridge Cognitive Examination (CAMCOG) in this, our study aims to compare the utility of the CAMCOG, Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) in helping to differentiate AD from MCI in elderly people with >4 years of schooling. Method A total of 136 elderly subjects – 39...
Full Text Available Given the importance of effective treatments for children with reading impairment, paired with growing concern about the lack of scientific replication in psychological science, the aim of this study was to replicate a quasi-randomised trial of sight word and phonics training using a randomised controlled trial (RCT design. One group of poor readers (N = 41 did 8 weeks of phonics training (i.e., phonological decoding and then 8 weeks of sight word training (i.e., whole-word recognition. A second group did the reverse order of training. Sight word and phonics training each had a large and significant valid treatment effect on trained irregular words and word reading fluency. In addition, combined sight word and phonics training had a moderate and significant valid treatment effect on nonword reading accuracy and fluency. These findings demonstrate the reliability of both phonics and sight word training in treating poor readers in an era where the importance of scientific reliability is under close scrutiny.
Russell Ian T
Full Text Available Abstract Background There is wide recognition that pragmatic randomised trials are the best vehicle for economic evaluation. This is because trials provide the best chance of ensuring internal validity, not least through the rigorous prospective collection of patient-specific data. Furthermore the marginal cost of collecting economic data alongside clinical data is typically modest. UK Clinical Research Collaboration (UKCRC does not require a standard operating procedure (SOP for economic evaluation as a prerequisite for trial unit registration. We judge that such a SOP facilitates the integration of health economics into trials. Methods A collaboration between health economists and trialists at Bangor University led to the development of a SOP for economic evaluation alongside pragmatic trials, in addition to the twenty SOPs required by UKCRC for registration, which include randomisation, data management and statistical analysis. Results Our recent telephone survey suggests that no other UKCRC-registered trials unit currently has an economic SOP. Conclusion We argue that UKCRC should require, from all Trials Units undertaking economic evaluation and seeking registration or re-registration, a SOP for economic evaluation as one of their portfolio of supporting SOPs.
Full Text Available Abstract Background The activitystat hypothesis proposes that when physical activity or energy expenditure is increased or decreased in one domain, there will be a compensatory change in another domain to maintain an overall, stable level of physical activity or energy expenditure. To date, there has been no experimental study primarily designed to test the activitystat hypothesis in adults. The aim of this trial is to determine the effect of two different imposed exercise loads on total daily energy expenditure and physical activity levels. Methods This study will be a randomised, multi-arm, parallel controlled trial. Insufficiently active adults (as determined by the Active Australia survey aged 18–60 years old will be recruited for this study (n=146. Participants must also satisfy the Sports Medicine Australia Pre-Exercise Screening System and must weigh less than 150 kg. Participants will be randomly assigned to one of three groups using a computer-generated allocation sequence. Participants in the Moderate exercise group will receive an additional 150 minutes of moderate to vigorous physical activity per week for six weeks, and those in the Extensive exercise group will receive an additional 300 minutes of moderate to vigorous physical activity per week for six weeks. Exercise targets will be accumulated through both group and individual exercise sessions monitored by heart rate telemetry. Control participants will not be given any instructions regarding lifestyle. The primary outcome measures are activity energy expenditure (doubly labeled water and physical activity (accelerometry. Secondary measures will include resting metabolic rate via indirect calorimetry, use of time, maximal oxygen consumption and several anthropometric and physiological measures. Outcome measures will be conducted at baseline (zero weeks, mid- and end-intervention (three and six weeks with three (12 weeks and six month (24 week follow-up. All assessors will be
Bland J Martin
Full Text Available Abstract Background Several reviews of published cluster randomised trials have reported that about half did not take clustering into account in the analysis, which was thus incorrect and potentially misleading. In this paper I ask whether cluster randomised trials are increasing in both number and quality of reporting. Methods Computer search for papers on cluster randomised trials since 1980, hand search of trial reports published in selected volumes of the British Medical Journal over 20 years. Results There has been a large increase in the numbers of methodological papers and of trial reports using the term 'cluster random' in recent years, with about equal numbers of each type of paper. The British Medical Journal contained more such reports than any other journal. In this journal there was a corresponding increase over time in the number of trials where subjects were randomised in clusters. In 2003 all reports showed awareness of the need to allow for clustering in the analysis. In 1993 and before clustering was ignored in most such trials. Conclusion Cluster trials are becoming more frequent and reporting is of higher quality. Perhaps statistician pressure works.
Topping, K. J.; Miller, D.; Murray, P.; Henderson, S.; Fortuna, C.; Conlin, N.
Background: Large-scale randomised controlled trials (RCT) are relatively rare in education. The present study was an attempt to scale up previous small peer tutoring projects, while investing only modestly in continuing professional development for teachers. Purpose: A two-year RCT of peer tutoring in mathematics was undertaken in one local…
Vanlerberghe, V; Toledo, M. E.; Rodríguez, M.; Gomez, D.; Baly, A; Benitez, J. R.; Van der Stuyft, P.
OBJECTIVE: To assess the effectiveness of an integrated community based environmental management strategy to control Aedes aegypti, the vector of dengue, compared with a routine strategy. DESIGN: Cluster randomised trial. SETTING: Guantanamo, Cuba. PARTICIPANTS: 32 circumscriptions (around 2000 inhabitants each). INTERVENTIONS: The circumscriptions were randomly allocated to control clusters (n=16) comprising routine Aedes control programme (entomological surveillance, source reduction, selec...
Vanlerberghe, V; Toledo, M. E.; Rodriguez, M.; Gómez, D.; Baly, D; Baly, A; Benítez, J. R.; Van der Stuyft, P.
Objective: To assess the effectiveness of an integrated community based environmental management strategy to control Aedes aegypti, the vector of dengue, compared with a routine strategy. Design Cluster randomised trial. Setting Guantanamo, Cuba. Participants 32 circumscriptions (around 2000 inhabitants each). Interventions: The circumscriptions were randomly allocated to control clusters (n=16) comprising routine Aedes control programme (entomological surveillance, sourc...
Vancampfort, D.; Vansteelandt, K.; Scheewe, T.; Probst, M.; Knapen, J.; De Herdt, A.; De Hert, M.
Vancampfort D, Vansteelandt K, Scheewe T, Probst M, Knapen J, De Herdt A, De Hert M. Yoga in schizophrenia: a systematic review of randomised controlled trials. Objective: The objective of this systematic review was to assess the effectiveness of yoga as a complementary treatment on general psychopa
Custers, Inge M; Flierman, Paul A; Maas, Pettie; Cox, Tessa; Van Dessel, Thierry J H M; Gerards, Mariette H; Mochtar, Monique H; Janssen, Catharina A H; van der Veen, Fulco; Ben Willem J. Mol
Objective To evaluate the effectiveness of 15 minutes of immobilisation versus immediate mobilisation after intrauterine insemination. Design Randomised controlled trial. Setting One academic teaching hospital and six non-academic teaching hospitals. Participants Women having intrauterine insemination for unexplained, cervical factor, or male subfertility. Interventions 15 minutes of immobilisation or immediate mobilisation after insemination. Main outcome measure Ongoing pregnancy per couple...
Three hundred and thirteen patients with squamous cell cancer of the head and neck were entered in a randomised clinical trial to determine whether the addition of methotrexate during the course of irradiation improved the rate of primary control and subsequent survival. The overall primary control (P=0.016) and survival (P=0.075) for the patients receiving methotrexate was better than the patients treated by radiotherapy alone. The improvement in primary control (P=0.0019) and survival (P=0.0089) in patients with oropharyngeal cancers who had methotrexate in addition to radiotherapy is statistically significant. The treatment was well tolerated and there has been no increase of late morbidity. (author)
Helliwell Philip S
Full Text Available Abstract Background Whilst evidence exists to support the use of single treatments such as orthoses and footwear, the effectiveness of podiatry-led care as a complex intervention for patients with rheumatoid arthritis (RA related foot problems is unknown. The aim of this study was to undertake an exploratory randomised controlled parallel arm clinical trial (RheumAFooT to inform the design and implementation of a definitive trial and to understand the potential benefits of this care. Methods Patients with a definite diagnosis of RA, stable drug management 3 months prior to entry, and a current history of foot problems (pain, deformity, stiffness, skin or nail lesions, or footwear problems were recruited from a hospital outpatient rheumatology clinic and randomised to receive 12 months of podiatry treatment or no care. The primary outcome was change in foot health status using the impairment/footwear (LFISIF and activity limitation/participation restriction (LFISAP subscales of the Leeds Foot Impact Scale. Disease Activity Score (DAS, Health Assessment Questionnaire (HAQ score and walking speed (m/s were also recorded. Results Of the 80 patients identified, 64 patients were eligible to participate in the pilot and 34 were recruited. 16 patients were randomised to receive podiatry led foot care and 18 received no care. Against a backdrop of stable disease (DAS and HAQ scores, there was a statistically significant between group difference in the change in foot health status for foot impairment (LFISIF but not activity/participation (LFISAP or function (walking speed over 12 months. In the podiatry arm, 1 patient declined treatment following randomisation (did not want additional hospital visits and 3 self-withdrew (lost to follow-up. Patients received an average of 3 consultations for assessment and treatment comprising routine care for skin and nail lesions (n = 3, foot orthoses (n = 9, footwear referral to the orthotist (n = 5, and ultrasound
Full Text Available Abstract Background The global burden of the major vascular diseases is projected to rise and to remain the dominant non-communicable disease cluster well into the twenty first century. The Department of Health in England has developed the NHS Health Check service as a policy initiative to reduce population vascular disease risk. The aims of this study were to monitor population changes in cardiovascular disease (CVD risk factors over the first year of the new service and to assess the value of tailored lifestyle support, including motivational interview with ongoing support and referral to other services. Methods Randomised trial comparing NHS Health Check service only with NHS Health Check service plus additional lifestyle support in Stoke on Trent, England. Thirty eight general practices and 601 (365 usual care, 236 additional lifestyle support patients were recruited and randomised independently between September 2009 and February 2010. Changes in population CVD risk between baseline and one year follow-up were compared, using intention-to-treat analysis. The primary outcome was the Framingham 10 year CVD risk score. Secondary outcomes included individual modifiable risk measures and prevalence of individual risk categories. Additional lifestyle support included referral to a lifestyle coach and free sessions as needed for: weight management, physical activity, cook and eat and positive thinking. Results Average population CVD risk decreased from 32.9% to 29.4% (p Conclusions The NHS Health Check service in Stoke on Trent resulted in significant reduction in estimated population CVD risk. There was no evidence of further benefit of the additional lifestyle support services in terms of absolute CVD risk reduction.
The effect of restricted randomisations on the validity and efficiency of using spatial model as well as more common analysis of variance methods for analysing field trials was examined by simulating yields in agricultural fields with known spatial variation and analysing those using eight...
Verbakel, Natasha J.; Langelaan, Maaike; Verheij, Theo J M; Wagner, Cordula; Zwart, Dorien L M
Background: A constructive safety culture is essential for the successful implementation of patient safety improvements. Aim: To assess the effect of two patient safety culture interventions on incident reporting as a proxy of safety culture. Design and setting: A three-arm cluster randomised trial
Gibson, Peter G.
Background Worldwide, cough is regarded as a challenging clinical problem due to its frequency and often limited therapeutic options. Chronic cough that remains refractory to usual medical treatment causes significant quality of life impairment in people with this problem. Methods We have examined current evidence on recent additions in the treatment of cough, specifically treatment of refractory chronic cough with speech pathology and gabapentin. Relevant randomised control trials, reviews and case reports were identified through a PubMed and SCOPUS search of English-language literature referring to these concepts over the last eight years. Summary Of the one hundred and two articles comprising this review the majority investigated the role of the transient receptor potential (TRP) receptors TRP Vanilloid 1 (TRPV1) and TRPA1 in cough and the potential of TRP antagonists as effective anti-tussives. However, these have only been tested in the laboratory and therefore their clinical effectiveness is unknown. Behavioural treatments such as speech pathology have gained momentum and this was evident in the increasing number of articles investigating its positive effect on cough. Investigation on the effectiveness of neuromodulating medications in the treatment of cough have been supported primarily through case series reports and prospective reviews however; their use (particularly gabapentin) has been significantly advanced through recently conducted randomised controlled trials. Conclusions Recent additions in the treatment of chronic cough have been significant as they consider cough to have a unifying diagnosis of cough hypersensitivity with or without the presence of a neuropathic basis. Primarily, effective treatments for chronic cough target these areas and include behavioural treatment such as speech pathology and pharmaceutical treatment with neuromodulating medications such as gabapentin. PMID:25383209
da Luz Maurício Antônio
Full Text Available Abstract Background Chronic low back pain is an expensive and difficult condition to treat. One of the interventions widely used by physiotherapists in the treatment of chronic non-specific low back pain is exercise therapy based upon the Pilates principles. Pilates exercises can be performed with or without specific equipment. These two types of Pilates exercises have never been compared on a high-quality randomised controlled trial. Methods/design This randomised controlled trial with a blinded assessor will evaluate eighty six patients of both genders with chronic low back pain, aged between 18 and 60 years, from one Brazilian private physiotherapy clinic. The patients will be randomly allocated into two groups: Mat Group will perform the exercises on the ground while the Equipment-based Group will perform the Pilates method exercises on the following equipment: Cadillac, Reformer, Ladder Barrel, and Step Chair. The general and specific disability of the patient, kinesiophobia, pain intensity and global perceived effect will be evaluated by a blinded assessor before randomisation and at six weeks and six months after randomisation. In addition, the expectation of the participants and their confidence with the treatment will be evaluated before randomisation and after the first treatment session, respectively. Discussion This will be the first study aiming to compare the effectiveness of Mat and Equipment-based Pilates exercises in patients with chronic non-specific low back pain. The results may help health-care professionals in clinical decision-making and could potentially reduce the treatment costs of this condition. Trial registration Brazilian Registry of Clinical Trials RBR-7tyg5j
Sorenson, Jason R.
Material accumulating and washing off urban street surfaces and ultimately into stormwater drainage systems represents a substantial nonpoint source of solids, phosphorus, and other constituent loading to waterways in urban areas. Cost and lack of usable space limit the type and number of structural stormwater source controls available to municipalities and other public managers. Non-structural source controls such as street cleaning are commonly used by cities and towns for construction, maintenance and aesthetics, and may reduce contaminant loading to waterways. Effectiveness of street cleaning is highly variable and potential improvements to water quality are not fully understood. In 2009, the U.S. Geological Survey, in cooperation with the Massachusetts Department of Environmental Protection, the U.S. Environmental Protection Agency, and the city of Cambridge, Massachusetts, and initiated a study to better understand the physical and chemical nature of the organic and inorganic solid material on street surfaces, evaluate the performance of a street cleaner at removing street solids, and make use of the Source Loading and Management Model (SLAMM) to estimate potential reductions in solid and phosphorus loading to the lower Charles River from various street-cleaning technologies and frequencies. Average yield of material on streets collected between May and December 2010, was determined to be about 740 pounds per curb-mile on streets in multifamily land use and about 522 pounds per curb-mile on commercial land-use streets. At the end-of-winter in March 2011, about 2,609 and 4,788 pounds per curb-mile on average were collected from streets in multifamily and commercial land-use types, respectively. About 86 percent of the total street-solid yield from multifamily and commercial land-use streets was greater than or equal to 0.125 millimeters in diameter (or very fine sand). Observations of street-solid distribution across the entire street width indicated that as
Tanner, J; Khan, D; Walsh, S; Chernova, J; Lamont, S; Laurent, T
Though brushes are no longer used on the hands and forearms during the surgical scrub, they are still widely used on the nails. The aim of this study was to determine whether nail picks and nail brushes are effective in providing additional decontamination during a surgical hand scrub. A total of 164 operating department staff were randomised to undertake one of the following three surgical hand-scrub protocols: chlorhexidine only; chlorhexidine and a nail pick; or chlorhexidine and a nail brush. Bacterial hand sampling was conducted before and 1h after scrubbing using a modified version of the glove juice method. No statistically significant differences in bacterial numbers were found between any two of the three intervention groups. Nail brushes and nail picks used during surgical hand scrubs do not decrease bacterial numbers and are unnecessary. PMID:19162371
Adamsen, Lis; Quist, Morten; Andersen, Christina;
OBJECTIVE: To assess the effect of a multimodal group exercise intervention, as an adjunct to conventional care, on fatigue, physical capacity, general wellbeing, physical activity, and quality of life in patients with cancer who were undergoing adjuvant chemotherapy or treatment for advanced...... disease. DESIGN: Randomised controlled trial. SETTING: Two university hospitals in Copenhagen, Denmark. PARTICIPANTS: 269 patients with cancer; 73 men, 196 women, mean age 47 years (range 20-65) representing 21 diagnoses. Main exclusion criteria were brain or bone metastases. 235 patients completed follow......-up. INTERVENTION: Supervised exercise comprising high intensity cardiovascular and resistance training, relaxation and body awareness training, massage, nine hours weekly for six weeks in addition to conventional care, compared with conventional care. MAIN OUTCOME MEASURES: European Organization for Research...
Lam, Carly Siu Yin; Tang, Wing Chun; Tse, Dennis Yan-Yin; Tang, Ying Yung; To, Chi Ho
Aims To determine if ‘Defocus Incorporated Soft Contact’ (DISC) lens wear slows childhood myopia progression. Methods A 2-year double-blind randomised controlled trial was carried out in 221 children aged 8–13 years, with myopia between −1.00 and −5.00 Dioptres (D) and astigmatism ≤1.00 D. Subjects were randomly assigned to the DISC (n=111) or single vision (SV; n=110) contact lens group. DISC lenses incorporated concentric rings, which provided an addition of +2.50 D, alternating with the no...
James, Nicholas D.; Sydes, Matthew R.; Mason, Malcolm D; Clarke, Noel W; Anderson, John; Dearnaley, David P; Dwyer, John; Jovic, Gordana; Ritchie, Alastair WS; Russell, J Martin; Sanders, Karen; Thalmann, George N; Bertelli, Gianfilippo; Birtle, Alison J; O'Sullivan, Joe M
Summary Background Long-term hormone therapy alone is standard care for metastatic or high-risk, non-metastatic prostate cancer. STAMPEDE—an international, open-label, randomised controlled trial—uses a novel multiarm, multistage design to assess whether the early additional use of one or two drugs (docetaxel, zoledronic acid, celecoxib, zoledronic acid and docetaxel, or zoledronic acid and celecoxib) improves survival in men starting first-line, long-term hormone therapy. Here, we report the...
McNulty, C A M; Hogan, A.; Ricketts, E.; Wallace, L.; Oliver, I; Campbell, R.; Kalwij, S.; O'Connell, E; Charlett, A.
Objective: To determine if a structured complex intervention increases opportunistic chlamydia screening testing of patients aged 15-24 years attending English general practitioner (GP) practices. Methods: A prospective, Cluster Randomised Controlled Trial with a modified Zelen design involving 160 practices in South West England in 2010. The intervention was based on the Theory of Planned Behaviour (TPB). It comprised of practice-based education with up to two additional contacts to incre...
Vanessa Chen-Hussey; Ilona Carneiro; Hongkham Keomanila; Rob Gray; Sihamano Bannavong; Saysana Phanalasy; Lindsay, Steven W
BACKGROUND Mosquito vectors of malaria in Southeast Asia readily feed outdoors making malaria control through indoor insecticides such as long-lasting insecticidal nets (LLINs) and indoor residual spraying more difficult. Topical insect repellents may be able to protect users from outdoor biting, thereby providing additional protection above the current best practice of LLINs. METHODS AND FINDINGS A double blind, household randomised, placebo-controlled trial of insect repellent to reduc...
The INIS Study. International Neonatal Immunotherapy Study: non-specific intravenous immunoglobulin therapy for suspected or proven neonatal sepsis: an international, placebo controlled, multicentre randomised trial
Background Sepsis is an important cause of neonatal death and perinatal brain damage, particularly in preterm infants. While effective antibiotic treatment is essential treatment for sepsis, resistance to antibiotics is increasing. Adjuvant therapies, such as intravenous immunoglobulin, therefore offer an important additional strategy. Three Cochrane systematic reviews of randomised controlled trials in nearly 6,000 patients suggest that non-specific, polyclonal intravenous immunoglobulin is ...
The INIS Study. International Neonatal Immunotherapy Study: Non-specific intravenous immunoglobulin therapy for suspected or proven neonatal sepsis: An international, placebo controlled, multicentre randomised trial
Brocklehurst, P; Brearley, S; Haque, K; Leslie, A; Salt, A; Stenson, B.; Stephenson, J; Tarnow-Mordi, W; INIS Study Collaborative Group, The
Background: Sepsis is an important cause of neonatal death and perinatal brain damage, particularly in preterm infants. While effective antibiotic treatment is essential treatment for sepsis, resistance to antibiotics is increasing. Adjuvant therapies, such as intravenous immunoglobulin, therefore offer an important additional strategy. Three Cochrane systematic reviews of randomised controlled trials in nearly 6,000 patients suggest that non-specific, polyclonal intravenous immunoglobuli...
Seymour, Matthew T; Brown, Sarah R; Middleton, Gary; Maughan, Timothy; Richman, Susan; Gwyther, Stephen; Lowe, Catherine; Seligmann, Jennifer F; Wadsley, Jonathan; Maisey, Nick; Chau, Ian; Hill, Mark; Dawson, Lesley; Falk, Stephen; O'Callaghan, Ann
Summary Background Therapeutic antibodies targeting EGFR have activity in advanced colorectal cancer, but results from clinical trials are inconsistent and the population in which most benefit is derived is uncertain. Our aim was to assess the addition of panitumumab to irinotecan in pretreated advanced colorectal cancer. Methods In this open-label, randomised trial, we enrolled patients who had advanced colorectal cancer progressing after fluoropyrimidine treatment with or without oxaliplati...
Chen-Hussey, V; Carneiro, I.; Keomanila, H.; Gray., R; Bannavong, S; Phanalasy, S.; Lindsay, SW
BACKGROUND Mosquito vectors of malaria in Southeast Asia readily feed outdoors making malaria control through indoor insecticides such as long-lasting insecticidal nets (LLINs) and indoor residual spraying more difficult. Topical insect repellents may be able to protect users from outdoor biting, thereby providing additional protection above the current best practice of LLINs. METHODS AND FINDINGS A double blind, household randomised, placebo-controlled trial of insect repellent to reduc...
Vlieger, A.M.; Robroch, A.; van Buuren, S; Kiers, J; Rijkers, G.; Benninga, M A; Biesebeke, R. te
The addition of probiotics to infant formula has been shown to be an efficient way to increase the number of beneficial bacteria in the intestine in order to promote a gut flora resembling that of breast-fed infants. The objective of the present study was to evaluate the safety and tolerance of a combination of two probiotic strains in early infancy. A group of 126 newborns were randomised to receive a prebiotic-containing starter formula supplemented with Lactobacillus paracasei ssp. paracas...
Jonge, Suzan; de Vos, Robert-Jan; van Schie, Hans; Verhaar, Jan; Weir, Adam; Tol, Johannes
textabstractOBJECTIVE: The study examined whether the addition of a night splint to eccentric exercises is beneficial for functional outcome in chronic mid-portion Achilles tendinopathy. DESIGN: One-year follow-up of a randomised controlled single blinded clinical trial. SETTING: Sports medicine department in a general hospital. PATIENTS: 58 patients (70 tendons) were included. INTERVENTIONS: All patients completed a 12-week heavy load eccentric training programme. One group received a night ...
de Mey, Christian; Nassr, Nassr; Lahu, Gezim
Background Roflumilast is an oral, selective phosphodiesterase 4 inhibitor with anti-inflammatory effects in chronic obstructive pulmonary disease (COPD). The addition of roflumilast to long-acting bronchodilators improves lung function in patients with moderate-to-severe COPD. The present study investigated drug-drug interaction effects between inhaled formoterol and oral roflumilast. Methods This was a single-centre (investigational clinic), open, randomised, multiple-dose, parallel-group s...
Pellicer, Adelina; Greisen, Gorm; Benders, Manon;
Near-infrared spectroscopy-derived regional tissue oxygen saturation of haemoglobin (rStO2) reflects venous oxygen saturation. If cerebral metabolism is stable, rStO2 can be used as an estimate of cerebral oxygen delivery. The SafeBoosC phase II randomised clinical trial hypothesises....... The treatment guideline is presented to assist neonatologists in making decisions in relation to cerebral oximetry readings in preterm infants within the SafeBoosC phase II randomised clinical trial. The evidence grades were relatively low and the guideline cannot be recommended outside a research setting...... of the literature and assessment of the quality of evidence and the grade of recommendation for each of the interventions. Results and Conclusions: A clinical intervention algorithm based on the main determinants of cerebral perfusion-oxygenation changes during the first hours after birth was generated...
Wang Vedelø, Tina; Lomborg, Kirsten
) nonadherence to research protocols and (iii) economic and organisational obstacles. These three challenges and barriers were inter-related and all were affected by time and timing. Conclusion: Randomised controlled trials are complex, expensive, time-consuming and highly demanding for researchers and the...... clinical nursing staff. Two lessons learned from this integrative review can be highlighted. First, we recommend researchers openly to share their experiences of barriers and challenges. They should describe factors that may have inhibited the desired outcome. Second, efforts to improve the collaboration...... between nurse researchers and clinicians, including education, training and support may increase the success rate and quality of nurse-led studies using the randomised controlled trial....
O'Carroll Ronan E
Full Text Available Abstract Background Throughout the world there is an insufficient supply of donor organs to meet the demand for organ transplantations. This paper presents a protocol for a randomised controlled trial, testing whether a simple, theory-based anticipated regret manipulation leads to a significant increase in posthumous organ donor registrations. Methods We will use a between-groups, prospective randomised controlled design. A random sample of 14,520 members of the adult Scottish general public will be contacted via post. These participants will be randomly allocated into 1 of the 4 conditions. The no questionnaire control (NQC group will simply receive a letter and donor registration form. The questionnaire control (QC arm will receive a questionnaire measuring their emotions and non-cognitive affective attitudes towards organ donation. The theory of planned behavior (TPB group will complete the emotions and affective attitudes questionnaire plus additional items assessing their cognitive attitudes towards organ donation, perceived control over registration and how they think significant others view this action. Finally, the anticipated regret (AR group will complete the same indices as the TPB group, plus two additional anticipated regret items. These items will assess the extent to which the participant anticipates regret for not registering as an organ donor in the near future. The outcome variable will be NHS Blood and Transplant verified registrations as an organ donor within 6 months of receiving our postal intervention. Discussion This study will assess whether simply asking people to reflect on the extent to which they may anticipate regret for not registering as an organ donor increases organ donor registration 6 months later. If successful, this simple and easy to administer theory-based intervention has the potential to save lives and money for the NHS by reducing the number of people receiving treatments such as dialysis. This
Khoury, G A; Lewis, M.C.; Meleagros, L; Lewis, A A
Sixty one patients were entered in a randomised trial to compare transverse loop colostomy with loop ileostomy after a colorectal anastomosis thought to be at risk of dehiscence. Radiologically proven breakdown of the colorectal anastomosis occurred in 13% of these selected patients and most frequently in the colostomy group. Ileostomies functioned earlier than colostomies (P less than 0.001) but there was no other significant difference in outcome between the groups. In 52 patients intestina...
Kemp, R; Hayward, P.; Applewhaite, G.; Everitt, B; David, A
OBJECTIVE--To determine whether compliance therapy, a cognitive-behavioural intervention, could improve compliance with treatment and hence social adjustment in acutely psychotic inpatients, and if so, whether the effect persisted six months later. DESIGN--Randomised controlled trial of compliance therapy and non-specific counselling, each comprising 4-6 sessions lasting 10-60 minutes. SETTING--Acute psychiatric admissions ward serving an inner London catchment area. SUBJECTS--47 patients wit...
Kahan, B. C.; Morris, T. P.
Many clinical trials restrict randomisation using stratified blocks or minimisation to balance prognostic factors across treatment groups. It is widely acknowledged in the statistical literature that the subsequent analysis should reflect the design of the study, and any stratification or minimisation variables should be adjusted for in the analysis. However, a review of recent general medical literature showed only 14 of 41 eligible studies reported adjusting their primary analysis for strat...
Tsogt, Bazarragchaa; Manaseki-Holland, Semira; Pollock, Jon; Blair, Peter S.; Fleming, Peter
Objective To investigate thermal balance of infants in a Mongolian winter, and compare the effects of traditional swaddling with an infant sleeping-bag in apartments or traditional tents (Gers). Design A substudy within a randomised controlled trial. Setting Community in Ulaanbaatar, Mongolia. Subjects A stratified randomly selected sample of 40 swaddled and 40 non-swaddled infants recruited within 48 h of birth. Intervention Sleeping-bags and baby outfits of total thermal resistance equivale...
Jones, D. A.; West, R R
OBJECTIVE: To evaluate rehabilitation after myocardial infarction. DESIGN: Randomised controlled trial of rehabilitation in unselected myocardial infarction patients in six centres, baseline data being collected on admission and by structured interview (of patients and spouses) shortly after discharge and outcome being assessed by structured interview at six months and clinical examination at 12 months. SETTING: Six district general hospitals. SUBJECTS: All 2328 eligible patients admitted ove...
Zhang, Anthony L.; Yuan Ming Di; Christopher Worsnop; Brian H. May; Cliff Da Costa; Xue, Charlie C.L.
This study investigated the efficacy and safety of ear acupressure (EAP) as a stand-alone intervention for smoking cessation and the feasibility of this study design. Adult smokers were randomised to receive EAP specific for smoking cessation (SSEAP) or a nonspecific EAP (NSEAP) intervention which is not typically used for smoking cessation. Participants received 8 weekly treatments and were requested to press the five pellets taped to one ear at least three times daily. Participants were fol...
Mahomed, K.; Nyoni, R.; Mulambo, T.; Kasule, J.; Jacobus, E.
OBJECTIVE--To compare effectiveness of different methods of monitoring intrapartum fetal heart rate. DESIGN--Prospective randomised controlled trial. SETTING--Referral maternity hospital, Harare, Zimbabwe. SUBJECTS--1255 women who were 37 weeks or more pregnant with singleton cephalic presentation and normal fetal heart rate before entry into study. INTERVENTIONS--Intermittent monitoring of fetal heart rate by electronic monitoring, Doppler ultrasound, use of Pinard stethoscope by a research ...
Hawthorne, A. B.; Logan, R. F.; Hawkey, C. J.; Foster, P. N.; Axon, A T; Swarbrick, E T; Scott, B B; Lennard-Jones, J E
OBJECTIVE--To determine whether azathioprine can prevent relapse in ulcerative colitis. DESIGN--One year placebo controlled double blind trial of withdrawal or continuation of azathioprine. SETTING--Outpatient clinics of five hospitals. SUBJECTS--79 patients with ulcerative colitis who had been taking azathioprine for six months or more. Patients in full remission for two months or more (67), and patients with chronic low grade or corticosteroid dependent disease (12) were randomised separate...
DiazOrdaz, K; Kenward, M G; Gomes, M; Grieve, R
Missing observations are common in cluster randomised trials. The problem is exacerbated when modelling bivariate outcomes jointly, as the proportion of complete cases is often considerably smaller than the proportion having either of the outcomes fully observed. Approaches taken to handling such missing data include the following: complete case analysis, single-level multiple imputation that ignores the clustering, multiple imputation with a fixed effect for each cluster and multilevel multiple imputation. We contrasted the alternative approaches to handling missing data in a cost-effectiveness analysis that uses data from a cluster randomised trial to evaluate an exercise intervention for care home residents. We then conducted a simulation study to assess the performance of these approaches on bivariate continuous outcomes, in terms of confidence interval coverage and empirical bias in the estimated treatment effects. Missing-at-random clustered data scenarios were simulated following a full-factorial design. Across all the missing data mechanisms considered, the multiple imputation methods provided estimators with negligible bias, while complete case analysis resulted in biased treatment effect estimates in scenarios where the randomised treatment arm was associated with missingness. Confidence interval coverage was generally in excess of nominal levels (up to 99.8%) following fixed-effects multiple imputation and too low following single-level multiple imputation. Multilevel multiple imputation led to coverage levels of approximately 95% throughout. © 2016 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd. PMID:26990655
Can they recover? An assessment of adult adjustment problems among males in the abstainer, recovery, life-course persistent, and adolescence-limited pathways followed up to age 56 in the Cambridge Study in Delinquent Development.
Jennings, Wesley G; Rocque, Michael; Fox, Bryanna Hahn; Piquero, Alex R; Farrington, David P
Much research has examined Moffitt's developmental taxonomy, focusing almost exclusively on the distinction between life-course persistent and adolescence-limited offenders. Of interest, a handful of studies have identified a group of individuals whose early childhood years were marked by extensive antisocial behavior but who seemed to recover and desist (at least from severe offending) in adolescence and early adulthood. We use data from the Cambridge Study in Delinquent Development to examine the adult adjustment outcomes of different groups of offenders, including a recoveries group, in late middle adulthood, offering the most comprehensive investigation of this particular group to date. Findings indicate that abstainers comprise the largest group of males followed by adolescence-limited offenders, recoveries, and life-course persistent offenders. Furthermore, the results reveal that a host of adult adjustment problems measured at ages 32 and 48 in a number of life-course domains are differentially distributed across these four offender groups. In addition, the recoveries and life-course persistent offenders often show the greatest number of adult adjustment problems relative to the adolescence-limited offenders and abstainers. PMID:26027850
Bateman, D Nicholas; Dear, James W; Thanacoody, H K Ruben; Thomas, Simon H L; Eddleston, Michael; Sandilands, Euan A; Coyle, Judy; Cooper, Jamie G.; Rodriguez, Aryelly; Butcher, Isabella; Lewis, Steff C.; Vliegenthart, A D Bastiaan; Veiraiah, Aravindan; Webb, David J.; Gray, Alasdair
BACKGROUND: Paracetamol poisoning is common worldwide. It is treated with intravenous acetylcysteine, but the standard regimen is complex and associated with frequent adverse effects related to concentration, which can cause treatment interruption. We aimed to ascertain whether adverse effects could be reduced with either a shorter modified acetylcysteine schedule, antiemetic pretreatment, or both. METHODS: We undertook a double-blind, randomised factorial study at three UK hospitals, between...
, insight into illness, recovery style, social support, locus of control, service engagement and coping with crises situations. The interviews take place before randomisation, nine month later and finally eighteen months after randomisation. Discussion This study examines the effects of two types of crisis plans. In addition, the results offer an understanding of the way these advance statements work and whether it is more effective to include a patients' advocate in the process of creating a psychiatric advance statement. These statements may be an intervention to prevent crises and the use of compulsion in mental health care. The strength and limitations of this study are discussed. Trial registration Current Controlled Trails NTR1166.
Lanini, Simone; Zumla, Alimuddin; Ioannidis, John P A; Di Caro, Antonino; Krishna, Sanjeev; Gostin, Lawrence; Girardi, Enrico; Pletschette, Michel; Strada, Gino; Baritussio, Aldo; Portella, Gina; Apolone, Giovanni; Cavuto, Silvio; Satolli, Roberto; Kremsner, Peter; Vairo, Francesco; Ippolito, Giuseppe
The Ebola outbreak that has devastated parts of west Africa represents an unprecedented challenge for research and ethics. Estimates from the past three decades emphasise that the present effort to contain the epidemic in the three most affected countries (Guinea, Liberia, and Sierra Leone) has been insufficient, with more than 24,900 cases and about 10,300 deaths, as of March 25, 2015. Faced with such an exceptional event and the urgent response it demands, the use of randomised controlled trials (RCT) for Ebola-related research might be both unethical and infeasible and that potential interventions should be assessed in non-randomised studies on the basis of compassionate use. However, non-randomised studies might not yield valid conclusions, leading to large residual uncertainty about how to interpret the results, and can also waste scarce intervention-related resources, making them profoundly unethical. Scientifically sound and rigorous study designs, such as adaptive RCTs, could provide the best way to reduce the time needed to develop new interventions and to obtain valid results on their efficacy and safety while preserving the application of ethical precepts. We present an overview of clinical studies registered at present at the four main international trial registries and provide a simulation on how adaptive RCTs can behave in this context, when mortality varies simultaneously in either the control or the experimental group. PMID:25881871
Full Text Available The aim of this systematic review was to determine the effectiveness of acupuncture for the treatment of whiplash associated disorder (WAD. Twenty databases were searched from their inceptions to Oct. 2013. Randomised clinical trials (RCTs of acupuncture (AT, electroacupuncture (EA, or dry needling (DN for the treatment of WAD were considered eligible. The risk of bias was assessed using the Cochrane tool. Six RCTs met the inclusion criteria. Most of the included RCTs have serious methodological flaws. Four of the RCTs showed effectiveness of AT, AT in addition to usual care (UC, AT in addition to herbal medicine (HM or EA was more effective than relaxation, sham EA, sham EA in addition to HM or UC for conditioned pain modulation (CPM and alleviating pain. In one RCT, DN in addition to physiotherapy (PT had no effect compared to sham-DN in addition to PT for the reduction of pain. None of the RCTs showed that AT/EA/DN was more effective than various types of control groups in reducing disability/function. One RCT did not report between-group comparisons of any outcome measures. The evidence for the effectiveness of AT/EA/DN for the treatment of WAD is limited. Therefore, more research in this area is warranted.
McDermott, Christopher J; Bradburn, Mike J; Maguire, Chin; Cooper, Cindy L; Baird, Wendy O; Baxter, Susan K; Cohen, Judith; Cantrill, Hannah; Dixon, Simon; Ackroyd, Roger; Baudouin, Simon; Bentley, Andrew; Berrisford, Richard; Bianchi, Stephen; Bourke, Stephen C; Darlison, Roy; Ealing, John; Elliott, Mark; Fitzgerald, Patrick; Galloway, Simon; Hamdalla, Hisham; Hanemann, C Oliver; Hughes, Philip; Imam, Ibrahim; Karat, Dayalan; Leek, Roger; Maynard, Nick; Orrell, Richard W; Sarela, Abeezar; Stradling, John; Talbot, Kevin; Taylor, Lyn; Turner, Martin; Simonds, Anita K; Williams, Tim; Wedzicha, Wisia; Young, Carolyn; Shaw, Pamela J
BACKGROUND Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease resulting in death, usually from respiratory failure, within 2-3 years of symptom onset. Non-invasive ventilation (NIV) is a treatment that when given to patients in respiratory failure leads to improved survival and quality of life. Diaphragm pacing (DP), using the NeuRx/4(®) diaphragm pacing system (DPS)™ (Synapse Biomedical, Oberlin, OH, USA), is a new technique that may offer additional or alternative benefits to patients with ALS who are in respiratory failure. OBJECTIVE The Diaphragm Pacing in patients with Amyotrophic Lateral Sclerosis (DiPALS) trial evaluated the effect of DP on survival over the study duration in patients with ALS with respiratory failure. DESIGN The DiPALS trial was a multicentre, parallel-group, open-label, randomised controlled trial incorporating health economic analyses and a qualitative longitudinal substudy. PARTICIPANTS Eligible participants had a diagnosis of ALS (ALS laboratory-supported probable, clinically probable or clinically definite according to the World Federation of Neurology revised El Escorial criteria), had been stabilised on riluzole for 30 days, were aged ≥ 18 years and were in respiratory failure. We planned to recruit 108 patients from seven UK-based specialist ALS or respiratory centres. Allocation was performed using 1 : 1 non-deterministic minimisation. INTERVENTIONS Participants were randomised to either standard care (NIV alone) or standard care (NIV) plus DP using the NeuRX/4 DPS. MAIN OUTCOME MEASURES The primary outcome was overall survival, defined as the time from randomisation to death from any cause. Secondary outcomes were patient quality of life [assessed by European Quality of Life-5 Dimensions, three levels (EQ-5D-3L), Short Form questionnaire-36 items and Sleep Apnoea Quality of Life Index questionnaire]; carer quality of life (EQ-5D-3L and Caregiver Burden Inventory); cost-utility analysis and health
Brooks, G.; Miles, J. N. V.; Torgerson, C. J.; Torgerson, D. J.
Background: Computer software is widely used to support literacy learning. There are few randomised trials to support its effectiveness. Therefore, there is an urgent need to rigorously evaluate computer software that supports literacy learning. Methods: We undertook a pragmatic randomised controlled trial among pupils aged 11-12 within a single…
La Cour, Jeppe Lerche; Brok, Jesper; Gøtzsche, Peter C
To assess if authors of randomised clinical trials convey the fact that they have used surrogate outcomes and discussed their validity.......To assess if authors of randomised clinical trials convey the fact that they have used surrogate outcomes and discussed their validity....
Jones, Fiona; Gage, Heather; Drummond, Avril; Bhalla, Ajay; Grant, Robert; Lennon, Sheila; McKevitt, Christopher; Riazi, Afsane; Liston, Matthew
OBJECTIVES: To test the feasibility of conducting a controlled trial into the effectiveness of a self-management programme integrated into stroke rehabilitation. DESIGN: A feasibility cluster-randomised design was utilised with stroke rehabilitation teams as units of randomisation. SETTING: Community-based stroke rehabilitation teams in London. PARTICIPANTS: 78 patients with a diagnosis of stroke requiring community based rehabilitation. INTERVENTION: The interv...
Pratt, D.; Tarrier, N.; Dunn, G.; Awenat, Y.; Shaw, J.; Ulph, F.; Gooding, P.
Background Prisoners have an exceptional risk of suicide. Cognitive behavioural therapy for suicidal behaviour has been shown to offer considerable potential, but has yet to be formally evaluated within prisons. This study investigated the feasibility of delivering and evaluating a novel, manualised cognitive behavioural suicide prevention (CBSP) therapy for suicidal male prisoners. Methods A pilot randomised controlled trial of CBSP in addition to treatment as usual (CBSP; n=31) compared to treatment as usual alone (TAU; n=31), was conducted in a male prison in England. The primary outcome was self-injurious behaviour occurring within the past six months. Secondary outcomes were dimensions of suicidal ideation, psychiatric symptomatology, personality dysfunction and psychological determinants of suicide, including depression and hopelessness. The trial was prospectively registered (number ISRCTN59909209). Results Relative to TAU, participants receiving CBSP therapy achieved a significantly greater reduction in suicidal behaviours with a moderate treatment effect (Cohen’s d=−0.72, 95%CI: −1.71 to 0.09; baseline mean [SD], TAU: 1.39[3.28] vs CBSP: 1.06[2.10], 6 months mean [SD], TAU: 1.48[3.23] vs CBSP: 0.58[1.52]). Significant improvements were achieved on measures of psychiatric symptomatology and personality dysfunction. Improvements on psychological determinants of suicide were non-significant. More than half of participants in the CBSP group achieved a clinically significant recovery by the end of therapy, compared to a quarter of the TAU group. Conclusions The delivery and evaluation of cognitive behavioural suicide prevention therapy within a prison is feasible. CBSP therapy offers significant promise in the prevention of prison suicide and an adequately powered randomised controlled trial is warranted. PMID:26165919
Hodgson, Jan; Metcalfe, Sylvia; Gaff, Clara; Donath, Susan; Delatycki, Martin B; Winship, Ingrid; Skene, Loane; Aitken, MaryAnne; Halliday, Jane
When an inherited genetic condition is diagnosed in an individual it has implications for other family members. Privacy legislation and ethical considerations can restrict health professionals from communicating directly with other family members, and so it is frequently the responsibility of the first person in a family to receive the diagnosis (the proband) to share this news. Communication of genetic information is challenging and many at-risk family members remain unaware of important information that may be relevant to their or their children's health. We conducted a randomised controlled trial in six public hospitals to assess whether a specifically designed telephone counselling intervention improved family communication about a new genetic diagnosis. Ninety-five probands/parents of probands were recruited from genetics clinics and randomised to the intervention or control group. The primary outcome measure was the difference between the proportion of at-risk relatives who contacted genetics services for information and/or genetic testing. Audit of the family genetic file after 18 months revealed that 25.6% of intervention group relatives compared with 20.9% of control group relatives made contact with genetic services (adjusted odds ratio (OR) 1.30, 95% confidence interval 0.70-2.42, P=0.40). Although no major difference was detected overall between the intervention and control groups, there was more contact in the intervention group where the genetic condition conferred a high risk to offspring (adjusted OR 24.0, 95% confidence interval 3.4-168.5, P=0.001). The increasing sophistication and scope of genetic testing makes it imperative for health professionals to consider additional ways of supporting families in communicating genetic information. PMID:26130486
Full Text Available Abstract Background In patients with COPD progressive dyspnoea leads to a sedentary lifestyle. To date, no studies exist investigating the effects of Nordic Walking in patients with COPD. Therefore, the aim was to determine the feasibility of Nordic Walking in COPD patients at different disease stages. Furthermore we aimed to determine the short- and long-term effects of Nordic Walking on COPD patients' daily physical activity pattern as well as on patients exercise capacity. Methods Sixty COPD patients were randomised to either Nordic Walking or to a control group. Patients of the Nordic Walking group (n = 30; age: 62 ± 9 years; FEV1: 48 ± 19% predicted underwent a three-month outdoor Nordic Walking exercise program consisting of one hour walking at 75% of their initial maximum heart rate three times per week, whereas controls had no exercise intervention. Primary endpoint: daily physical activities (measured by a validated tri-axial accelerometer; secondary endpoint: functional exercise capacity (measured by the six-minute walking distance; 6MWD. Assessment time points in both groups: baseline, after three, six and nine months. Results After three month training period, in the Nordic Walking group time spent walking and standing as well as intensity of walking increased (Δ walking time: +14.9 ± 1.9 min/day; Δ standing time: +129 ± 26 min/day; Δ movement intensity: +0.40 ± 0.14 m/s2 while time spent sitting decreased (Δ sitting time: -128 ± 15 min/day compared to baseline (all: p Conclusions Nordic Walking is a feasible, simple and effective physical training modality in COPD. In addition, Nordic Walking has proven to positively impact the daily physical activity pattern of COPD patients under short- and long-term observation. Clinical trial registration Nordic Walking improves daily physical activities in COPD: a randomised controlled trial - ISRCTN31525632
Full Text Available Abstract Background Intrapartum fetal hypoxia remains an important cause of death and permanent handicap and in a significant proportion of cases there is evidence of suboptimal care related to fetal surveillance. Cardiotocographic (CTG monitoring remains the basis of intrapartum surveillance, but its interpretation by healthcare professionals lacks reproducibility and the technology has not been shown to improve clinically important outcomes. The addition of fetal electrocardiogram analysis has increased the potential to avoid adverse outcomes, but CTG interpretation remains its main weakness. A program for computerised analysis of intrapartum fetal signals, incorporating real-time alerts for healthcare professionals, has recently been developed. There is a need to determine whether this technology can result in better perinatal outcomes. Methods/design This is a multicentre randomised clinical trial. Inclusion criteria are: women aged ≥ 16 years, able to provide written informed consent, singleton pregnancies ≥ 36 weeks, cephalic presentation, no known major fetal malformations, in labour but excluding active second stage, planned for continuous CTG monitoring, and no known contra-indication for vaginal delivery. Eligible women will be randomised using a computer-generated randomisation sequence to one of the two arms: continuous computer analysis of fetal monitoring signals with real-time alerts (intervention arm or continuous CTG monitoring as previously performed (control arm. Electrocardiographic monitoring and fetal scalp blood sampling will be available in both arms. The primary outcome measure is the incidence of fetal metabolic acidosis (umbilical artery pH ecf > 12 mmol/L. Secondary outcome measures are: caesarean section and instrumental vaginal delivery rates, use of fetal blood sampling, 5-minute Apgar score Discussion This study will provide evidence of the impact of intrapartum monitoring with computer analysis and real
Full Text Available Abstract Background Sending a monetary incentive with postal questionnaires has been found to improve the proportion of responders, in research in non-healthcare settings. However, there is little research on use of incentives to improve follow-up rates in clinical trials, and existing studies are inconclusive. We conducted a randomised trial among participants in the Managing Injuries of the Neck Trial (MINT to investigate the effects on the proportion of questionnaires returned and overall non-response of sending a £5 gift voucher with a follow-up questionnaire. Methods Participants in MINT were randomised to receive either: (a a £5 gift voucher (incentive group or (b no gift voucher (no incentive group, with their 4 month or 8 month follow-up questionnaire. We recorded, for each group, the number of questionnaires returned, the number returned without any chasing from the study office, the overall number of non-responders (after all chasing efforts by the study office, and the costs of following up each group. Results 2144 participants were randomised, 1070 to the incentive group and 1074 to the no incentive group. The proportion of questionnaires returned (RR 1.10 (95% CI 1.05, 1.16 and the proportion returned without chasing (RR 1.14 (95% CI 1.05, 1.24 were higher in the incentive group, and the overall non-response rate was lower (RR 0.68 (95% CI 0.53, 0.87. Adjustment for injury severity and hospital of recruitment to MINT made no difference to these results, and there were no differences in results between the 4-month and 8-month follow up questionnaires. Analysis of costs suggested a cost of £67.29 per additional questionnaire returned. Conclusion Monetary incentives may be an effective way to increase the proportion of postal questionnaires returned and minimise loss to follow-up in clinical trials. Trial registration number ISRCTN61305297
Downs, S. H.; Black, N.
OBJECTIVE: To test the feasibility of creating a valid and reliable checklist with the following features: appropriate for assessing both randomised and non-randomised studies; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting, internal validity (bias and confounding) and power, but also for external validity. DESIGN: A pilot version was first developed, based on epidemiological principles, reviews, and existing checklists...
attend unblinded assessments at baseline, 3, 6 and 12 months, in addition to their usual care. After the intervention, usual care would be provided. Ethics approval: York Research Ethics Committee (Ref: 01/08/016 approved the study protocol. Discussion We hope the trial will demonstrate feasibility of a pragmatic randomised trial of BITES and help quantify therapeutic effect. A follow up multi-centre trial powered to detect this effect could provide further evidence. Trial registration Current Controlled Trials ISRCTN75807800
Full Text Available Abstract Background Electronic Voting Systems have been used for education in a variety of disciplines. Outcomes from these studies have been mixed. Because results from these studies have been mixed, we examined whether an EVS system could enhance a lecture's effect on educational outcomes. Methods A cohort of 127 Year 5 medical students at the University of Adelaide was stratified by gender, residency status and academic record then randomised into 2 groups of 64 and 63 students. Each group received consecutive 40-minute lectures on two clinical topics. One group received the EVS for both topics. The other group received traditional teaching only. Evaluation was undertaken with two, 15-question multiple-choice questionnaires (MCQ assessing knowledge and problem solving and undertaken as a written paper immediately before and after the lectures and repeated online 8–12 weeks later. Standardised institutional student questionnaires were completed for each lecture and independent observers assessed student behaviour during the lectures. Lecturer's opinions were assessed by a questionnaire developed for this study. Results Two-thirds of students randomised to EVS and 59% of students randomised to traditional lectures attended. One-half of the students in the EVS group and 41% in the traditional group completed all questionnaires. There was no difference in MCQ scores between EVS and traditional lectures (p = 0.785. The cervical cancer lectures showed higher student ranking in favour of EVS in all parameters. The breast cancer lectures showed higher ranking in favour of traditional lectures in 5 of 7 parameters (p Conclusion In this setting, EVS technology used in large group lectures did not offer significant advantages over the more traditional lecture format.
Bach flower remedies continue to be popular and its proponents make a range of medicinal claims for them. The aim of this systematic review was to critically evaluate the evidence for these claims. Five electronic databases were searched without restrictions on time or language. All randomised clinical trials of flower remedies were included. Seven such studies were located. All but one were placebo-controlled. All placebo-controlled trials failed to demonstrate efficacy. It is concluded that the most reliable clinical trials do not show any differences between flower remedies and placebos. PMID:20734279
Hannah S. Mumby; Elks, Cathy E; Shengxu Li; Sharp, Stephen J.; Kay-Tee Khaw; Luben, Robert N; Wareham, Nicholas J; Loos, Ruth J. F.; Ken K Ong
To infer the causal association between childhood BMI and age at menarche, we performed a mendelian randomisation analysis using twelve established “BMI-increasing” genetic variants as an instrumental variable (IV) for higher BMI. In 8,156 women of European descent from the EPIC-Norfolk cohort, height was measured at age 39–77 years; age at menarche was self-recalled, as was body weight at age 20 years, and BMI at 20 was calculated as a proxy for childhood BMI. DNA was genotyped for twelve BM...
Korn, E L; Baumrind, S
The standard design for randomised clinical trials may be inappropriate when the clinician believes that one of the treatments being tested is superior for the patient, or when the clinician has a preference for one of the treatments. For such instances the suggestion is that the patient is randomly allocated to treatment only when there is clinical disagreement about treatment of choice for that patient, and then the patient is assigned to a clinician who had thought that the regimen allocated is the one most appropriate for that patient. PMID:1670796
Jarvis, M. J.; Raw, M.; Russell, M A; Feyerabend, C
The effectiveness of 2 mg nicotine chewing-gum as an aid to stopping smoking was compared with a placebo containing 1 mg nicotine, but unbuffered, in a double-blind randomised trial. Of 58 subjects given the active gum, 27 (47%) were not smoking at one-year follow-up compared with 12 (21%) of the 58 subjects treated with placebo (p less than 0.025). By the most stringent criterion of outcome, 18 (31%) subjects in the active treatment group and eight (14%) in the placebo group had not smoked a...
Full Text Available The article is dedicated to 40th anniversary of The Cambridge Crystallographic Data Centre (CCDC, the world-known centre (http://www.ccdc.cam.ac.uk responsible for deposition and control of crystallographic data, including atomic coordinates that define the three-dimensional structures of organic molecules and metal complexes containing organic ligands. Cambride Structural Database (CSD, one among the first established electronic databases, nowadays is the most significant crystallographic database in the world. CSD has about 400,000 deposited structures. The use of the extensive database, which is growing rapidly, needs support of efficient and sophisticated software for searching, analysing and visualising structural data. The seminal role of CSD in the research related to crystallography, chemistry, material sciences, solid state physics and chemistry, life sciences, pharmacology, and in particular in drug design, has been documented in more than 1300 scientific papers. The important issues of CCDC are the accuracy of deposited data and development of software that enables a wide variety of applications. Such demanding project requires higly competent team of experts; thus the article brings into focus the scientific approach of the team based on the long tradition in crystallography, modelling and informatics. The article is not dedicated to 40th anniversary of the centre only, but it also reveals how Cambridge Structural Database can be used in the research and teaching. The use of electronic media and computer graphics makes data mining" very efficient and useful but also esthetically appealing due to the molecular architecture. At the Rudjer Bošković Institute, Zagreb, Croatia there is The National Affiliated Centre of Cambridge Crystallographic Data Centre responsible for communication and dissemination of CSD in Croatia, Slovenia and Macedonia. The use of CSD is illustrated by two examples performed and published by the presenting
Gregor, A.; Cull, A. [Western General Hospital, Edinburgh (United Kingdom); Stephens, R.J.; Girling, D.J.; Machin, D. [Medical Research Council Cancer Trials Office, Cambridge (United Kingdom); Kirkpatrick, J.A. [EORTC Data Center, Brussels (Belgium); Yarnold, J.R. [Royal Marsden NHS Trust, Sutton (United Kingdom); Macbeth, F.R. [Llandough Hospital, Clinical Effectiveness Support Unit, Llandough (United Kingdom); Stout, R. [Christie Hospital, Radiotherapy Dept., Manchester (United Kingdom)
Prophylactic cranial irradiation (PCI) reduces the risk of cranial metastasis in small cell lung cancer (SCLC), but the magnitude and value of this reduction, the risks of radiation morbidity and whether PCI influences survival are unclear. We conducted a randomised trial in patients with limited-stage SCLC who had had a complete response to induction therapy. Initially, patients were randomised equally to (1) PCI 36 Gy in 18 daily fractions, (2) PCI 24 Gy in 12 fractions and (3) no PCI; subsequently, to increase the rate of accrual, randomisation was to clinicians` choice of PCI regimen versus no PCI (at a 3:2 ratio). The endpoints were appearance of brain metastases, survival, cognitive function, and quality of life (QoL). Three hundred and fourteen patients (194 PCI, 120 No PCI) were randomised. In the revised design, the most commonly used PCI regimens were 30 Gy in 10 fractions and 8 Gy in a single dose. With PCI, there was a large and highly significant reduction in brain metastases (HR = 0.44, 95% CI 0.29-0.67), a significant advantage in brain-metastasis-free survival (HR = 0.75, 95% CI 0.58-0.96) and a non-significant overall survival advantage (HR 0.86, 95% CI 0.66-1.12). In both groups, there was impairment of cognitive function and QoL before PCI and additional impairment of 6 months and 1 year, butt no consistent difference between the two groups and thus no evidence over 1 year of major impairment attributable to PCI. PCI can safely reduce the risk of brain metastases. Further research is needed to define optimal dose and fractionation and to clarify the effect on survival. Patients with SCLC achieving a complete response to induction therapy should be offered PCI. (author).
Wiangkham, Taweewat; Duda, Joan; Haque, M Sayeed; Price, Jonathan; Rushton, Alison
Introduction Whiplash-associated disorder (WAD) causes substantial social and economic burden internationally. Up to 60% of patients with WAD progress to chronicity. Research therefore needs to focus on effective management in the acute stage to prevent the development of chronicity. Approximately 93% of patients are classified as WADII (neck complaint and musculoskeletal sign(s)), and in the UK, most are managed in the private sector. In our recent systematic review, a combination of active and behavioural physiotherapy was identified as potentially effective in the acute stage. An Active Behavioural Physiotherapy Intervention (ABPI) was developed through combining empirical (modified Delphi study) and theoretical (social cognitive theory focusing on self-efficacy) evidence. This pilot and feasibility trial has been designed to inform the design of an adequately powered definitive randomised controlled trial. Methods and analysis Two parallel phases. (1) An external pilot and feasibility cluster randomised double-blind (assessor and participants), parallel two-arm (ABPI vs standard physiotherapy) clinical trial to evaluate procedures and feasibility. Six UK private physiotherapy clinics will be recruited and cluster randomised by a computer-generated randomisation sequence. Sixty participants (30 each arm) will be assessed at recruitment (baseline) and at 3 months postbaseline. The planned primary outcome measure is the neck disability index. (2) An embedded exploratory qualitative study using semistructured indepth interviews (n=3–4 physiotherapists) and a focus group (n=6–8 patients) and entailing the recruitment of purposive samples will explore perceptions of the ABPI. Quantitative data will be analysed descriptively. Qualitative data will be coded and analysed deductively (identify themes) and inductively (identify additional themes). Ethics and dissemination This trial is approved by the University of Birmingham Ethics Committee (ERN_15-0542). Trial
Carvalho, Leonardo S; Shimano, Yulie; Candiani, David F; Bonaldo, Alexandre B
Seven new species of the spider genus Xeropigo O. P.-Cambridge are described from Brazil, increasing the genus member list up to 16 species. X. piripiri n. sp., X. aitatu n. sp., and X. cajuina n. sp. are described from the state of Piauí. X. crispim n. sp. is described from the states of Ceará, Piauí, and Maranhão. X. oxente n. sp. is described from the state of Rio Grande do Norte. X. canga n. sp. is described from the state of Minas Gerais. X. ufo n. sp. is described from the state of Mato Grosso. The geographical distribution of X. tridentiger, X. camilae, X. pachitea, and X. perene is updated. A key to all species of Xeropigo is presented and possible relationships among all species of the genus are discussed. PMID:27395095
Warren, W. H., Jr.
The machine readable catalogue contains survey data from the papers of Pilkington and Scott and Gower, Scott and Wills. These data result from a survey of radio sources between declinations -07 deg and +80 deg using the large Cambridge interferometer at 178 MHz. The computerized catalog contains for each source the 4C number, 1950 position, measured flux density, and accuracy class. For some sources miscellaneous brief comments such as cross identifications to the 3C catalog or remarks on contamination from nearby sources are given at the ends of the data records. A detailed description of the machine readable catalog as it is currently being distributed by the Astronomical Data Center is given to enable users to read and process the data.
Molten salts find use in the reprocessing of spent nuclear oxide fuel. In the common approach, the mixed metal oxides of the spent fuel are reduced chemically to the corresponding metals in a melt of LiCI in a two-step process, and the resulting metals are then separated by electro-deposition in a melt of LiCI/KCI. The FFC-Cambridge process is a relatively new metallurgical method, which allows the electrochemical reduction of metal oxides in a melt of CaCI2 in one step. This article summarises the history and fundamentals of the process, and depicts proven applications and potential benefits in spent fuel reprocessing. (author)