The twilight world of British business politics: the Spring Sunningdale conferences since the 1960s

This article explores a previously unknown form of interaction, known as Spring Sunningdale, between the British business elite and its civil servant equivalent in Whitehall. These began in 1963 and were still continuing only a few years ago. The continuity and stability of these meetings stands in contrast to wider changes in the nature of business–government relations in Britain during this period, particularly since the election of the Thatcher government in 1979. The article analyses why there was such continuity and what the senior civil servants and the captains of industry who attended these annual meetings gained from them

Failure to report protocol violations in clinical trials: a threat to internal validity?

<p>Abstract</p> <p>Background</p> <p>Excessive protocol violations (PV), which can be defined as preventable mistakes in study conduct, may result in patient harm and introduce errors into a clinical trial's results leading to flawed trial conclusions.</p> <p>The purpose of this project was to gain a better understanding of reported PVs, to describe current practice with regards to the use of methods for the reduction of PVs and to investigate relationships between clinical trial characteristics and PVs.</p> <p>Methods</p> <p>We reviewed 80 clinical trials conducted across a broad range of medical specialties published in four major general medical journals (The Lancet, NEJM, JAMA, BMJ). Eligible papers were identified using a PubMed search. For each included trial, two authors independently abstracted information on trial characteristics, PV reporting and PV rates and interventions used to reduce PVs. PVs were categorised into one of five distinct types: enrolment, randomisation, study intervention, patient compliance and data collection errors. Associations between PVs and study characteristics were investigated using logistic regression.</p> <p>Results</p> <p>Eighty clinical trials (20 from each journal) were identified from 101 consecutive PubMed abstracts. The median number of participants was 701 (range: 20 to 162, 367) and the median number of participating sites was 15 (range: 1 to 701). Nineteen percent (15/80) of included trials were single centre trials. The median study duration was 24 months (range: 5.81 - 127 months) and 74% (59/80) of included trials were primarily academic funded.</p> <p>Thirty two percent (26/80) of included trials failed to provide explicit reporting of any type of PV and none (0/80) of the trials provided explicit reporting of all five types of PVs. Larger clinical trials (more patients, more sites, longer duration, more complex management structure) were more likely to have more complete reporting of PV's.</p> <p>Only 9% (7/80) of trials reported the use of a specific study method to prevent PVs. Use of a run-in phase was the only method reported.</p> <p>Conclusions</p> <p>PVs are under-reported. Although the CONSORT statement provides guidance on the reporting of PVs, reporting requirements are not explicit for all types of PVs. As a first step towards improved reporting by authors, we recommend the CONSORT statement highlight the importance of PVs by making reporting requirements more explicit.</p

Suppressing restricted shock separation in a subscale rocket nozzle using contour geometry

The use of a thrust-optimized contour (TOC) for the supersonic nozzle in a rocket engine will inherently maximize the propulsive efficiency and payload capacity of the entire launch system. A TOC can be approximated using a skewed parabola, commonly referred to as a thrust-optimized parabola (TOP), and the TOP contour can be manipulated to avoid undesirable flow separation during low-altitude operation by increasing the static wall pressure at the expense of thrust (approximately 0.1 0.2%). For this reason, a TOP design is often used in nozzles with a high area ratio, such as those used in the Vulcain and Vulcain 2 corestage engines, and suggests that ensuring full-flowing operation at low-altitude conditions can be considered a nozzle design requirement. Unfortunately, any thrust-optimized nozzle may excite an undesirable shift between a free shock separation (FSS) and restricted shock separation (RSS) mode during engine startup and shutdown. The shift between an FSS and an RSS flowregimewas first noticed during operation of the high-area-ratio J2-S engine, and the RSS condition consequently was deemed responsible for inducing high structural loading to the nozzle walls. However, it was later found that the highest levels of side loading were, in fact, caused by the transition process to and from the RSS flow condition, as opposed to the RSS phenomenon itself. Because the precise flow mechanisms that drive the transition to and from the RSS condition are still not fully understood, the structural loading that occurs as a result of RSS appears to currently be accepted as a design consideration in core-stage rocket nozzles. A nozzle contour that was capable of suppressing the RSS flow condition itself would inherently prevent the transition to and from RSS and, therefore, decrease the structural loading that occurs during these transition phases. For a net benefit to be realized, the resulting nozzle must produce an equal or greater thrust coefficient compared to the existing design, as well as avoid flow separation during low-altitude operation. In this paper, a set of equivalent thrust-optimized nozzle contours have been produced using an arc-based design method to determine if the suppression of RSS could be achieved by manipulating the contour geometry. The subscale Volvo S1 TOP nozzle that was designed by Volvo Aero Corporation (now GKN Aerospace Engine Systems) was selected as the test case due to the availability of experimental data that captures the transition from FSS to RSS and to ensure that a positive result may be applicable to a full-scale rocket engine, because this nozzle has been shown to possess equivalent flow characteristics to the core-stage Vulcain engine nozzle

Pro/con debate: In patients who are potential candidates for organ donation after cardiac death, starting medications and/or interventions for the sole purpose of making the organs more viable is an acceptable practice

Several hospitals have been developing programmes for organ donation after cardiac death. Such programmes offer options for organ donation to patients who do not meet brain-death criteria but wish to donate their organs after withdrawal of life-support. These programmes also increase the available organ pool at a time when demand exceeds supply. Given that potential donors are managed in intensive care units, intensivists will be key components of these programmes. Donation after cardiac death clearly carries a number of important ethical issues with it. In the present issue of Critical Care two established groups debate the ethical acceptability of using medications/interventions in potential organ donors for the sole purpose of making the organs more viable. Such debates will be an increasingly common component of intensivists' future practice

Aerodynamics of an Aerofoil in Transonic Ground Effect: Numerical Study at Full-scale Reynolds Numbers

The potential positive effects of ground proximity on the aerodynamic performance of a wing or aerofoil have long been established, but at transonic speeds the formation of shock waves between the body and the ground plane would have significant consequences. A numerical study of the aerodynamics of an RAE2822 aerofoil section in ground effect flight was conducted at freestream Mach numbers from 0·5 to 0·9, at a range of ground clearances and angles of incidence. It was found that in general the aerofoil\u27s lifting capability was still improved with decreasing ground clearance up until the point at which a lower surface shock wave formed (most commonly at the lowest clearances). The critical Mach number for the section was reached considerably earlier in ground effect than it would be in freest ream, and the buffet boundary was therefore also reached at an earlier stage. The flowfields observed were relatively sensitive to changes in any given variable, and the lower surface shock had a destabilizing effect on the pitching characteristics of the wing, indicating that sudden changes in both altii11de and attitude would be experienced during sustained transonic flight close to the ground plane. Since ground proximity hastens the lower surface shock formation, no gain in aerodynamic efficiency can be gained by flying in ground effect once that shock is present

Competition between Diffusion and Fragmentation: An Important Evolutionary Process of Nature

We investigate systems of nature where the common physical processes diffusion and fragmentation compete. We derive a rate equation for the size distribution of fragments. The equation leads to a third order differential equation which we solve exactly in terms of Bessel functions. The stationary state is a universal Bessel distribution described by one parameter, which fits perfectly experimental data from two very different system of nature, namely, the distribution of ice crystal sizes from the Greenland ice sheet and the length distribution of alpha-helices in proteins.Comment: 4 pages, 3 figures, (minor changes

An evaluation of enteral nutrition practices and nutritional provision in children during the entire length of stay in critical care

&lt;b&gt;Background&lt;/b&gt; Provision of optimal nutrition in children in critical care is often challenging. This study evaluated exclusive enteral nutrition (EN) provision practices and explored predictors of energy intake and delay of EN advancement in critically ill children.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Methods&lt;/b&gt; Data on intake and EN practices were collected on a daily basis and compared against predefined targets and dietary reference values in a paediatric intensive care unit. Factors associated with intake and advancement of EN were explored.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Results&lt;/b&gt; Data were collected from 130 patients and 887 nutritional support days (NSDs). Delay to initiate EN was longer in patients from both the General Surgical and congenital heart defect (CHD) Surgical groups [Median (IQR); CHD Surgical group: 20.3 (16.4) vs General Surgical group: 11.4 (53.5) vs Medical group: 6.5 (10.9) hours; p &lt;= 0.001]. Daily fasting time per patient was significantly longer in patients from the General Surgical and CHD Surgical groups than those from the Medical group [% of 24 h, Median (IQR); CHD Surgical group: 24.0 (29.2) vs General Surgical group: 41.7 (66.7) vs Medical group: 9.4 (21.9); p &lt;= 0.001]. A lower proportion of fluids was delivered as EN per patient (45% vs 73%) or per NSD (56% vs 73%) in those from the CHD Surgical group compared with those with medical conditions. Protein and energy requirements were achieved in 38% and 33% of the NSDs. In a substantial proportion of NSDs, minimum micronutrient recommendations were not met particularly in those patients from the CHD Surgical group. A higher delivery of fluid requirements (p &lt; 0.05) and a greater proportion of these delivered as EN (p &lt; 0.001) were associated with median energy intake during stay and delay of EN advancement. Fasting (31%), fluid restriction (39%) for clinical reasons, procedures requiring feed cessation and establishing EN (22%) were the most common reasons why target energy requirements were not met.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Conclusions&lt;/b&gt; Provision of optimal EN support remains challenging and varies during hospitalisation and among patients. Delivery of EN should be prioritized over other "non-nutritional" fluids whenever this is possible.&lt;p&gt;&lt;/p&gt