Reporting and dealing with missing quality of life data in RCTs : has the picture changed in the last decade?

Peer reviewedPublisher PD

Couching in Nigeria: prevalence, risk factors and visual acuity outcomes.

PURPOSE: Couching is an ancient treatment for cataract which is still practiced in some of the poorer developing countries, particularly in sub-Saharan Africa. The purpose of this study is to describe risk factors for couching and visual acuity outcomes in a nationally representative sample of adults aged 40 years and above in Nigeria. METHODS: Probability in proportion size methods were used to identify a representative sample. Of the 15,375 adults enumerated, 13,582 were interviewed and examined. Examination included logMar acuities, slit lamp examination and dilated fundoscopy with digital fundus imaging. RESULTS: Almost half of the 583 eyes undergoing a procedure for cataract had been couched (249 eyes, 42.7%). Individuals living in rural areas (P = 0.033) and in the two underserved northern administrative zones (P = 0.33; P = 0.002) were more likely to have been couched. Visual outcomes were poor according to World Health Organization categories, with 55.8% of people and 73.1% of eyes having a presenting visual acuity of less than 3/60 and only 9.7% and 2.4% of people and eyes respectively having a good outcome (6/18 or better). None were wearing an aphakic correction, and with correction acuities improved but 42.6% of eyes were still blind (< 3/60). CONCLUSIONS: Couching is still widely practiced in Nigeria and visual outcomes are very poor. The population needs to be made aware of the risks associated with the procedure, and services for high quality, affordable cataract surgery need to be expanded, particularly in rural areas and in the north of the country

Critical current degradation in HTS wires due to cyclic mechanical strain

HTS wires, which may be used in many devices such as magnets and rotating machines, may be subjected to mechanical strains from electromagnetic, thermal and centripetal forces. In some applications these strains will be repeated several thousand times during the lifetime of the device. We have measured critical current degradation due to repeated strain cycles for both compressive and tensile strains. Results for BSCCO-2223 HTS conductor samples are presented for strain values up to 0.5% and cycle numbers up to and beyond 10/sup 4/

Lifetime cancer risk and combined oral contraceptives : the Royal College of General Practitioners’ Oral Contraception Study

Funding: The study has received funding from the Royal College of General Practitioners, Medical Research Council, Imperial Cancer Research Fund, British Heart Foundation, Schering AG, Schering Health Care Ltd, Wyeth Ayerst International, Ortho Cilag and, Searle. None of these funders have contributed to the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review or approval of the manuscript.Peer reviewedPostprin

A double-edged sword: the merits and the policy implications of Google Translate in higher education

Machine translation, specifically Google Translate is freely available on a number of devices, and is improving in its ability to provide grammatically accurate translations. This development has the potential to provoke a major transformation in the internationalisation process at universities, since students may be, in the future, able to use technology to circumvent traditional language learning processes. While this is a potentially empowering move that may facilitate academic exchange and the diversification of the learner and researcher community at an international level, it is also a potentially problematic issue in two main respects. Firstly, the technology is at present unable to align to the socio-linguistic aspects of university level writing and may be misunderstood as a remedy to lack of writer language proficiency – a role it is not able to fulfil. Secondly, it introduces a new dimension to the production of academic work that may clash with Higher Education policy and, thus, requires legislation, in particular in light issues such as plagiarism and academic misconduct. This paper considers these issues against the background of English as a Global Lingua Franca, and argues two points. First of these is that HEIs need to develop an understanding and code of practice for the use of this technology. Secondly, three strands of potential future research will be presente

A stromal cell niche sustains ILC2-mediated type-2 conditioning in adipose tissue.

Group-2 innate lymphoid cells (ILC2), type-2 cytokines, and eosinophils have all been implicated in sustaining adipose tissue homeostasis. However, the interplay between the stroma and adipose-resident immune cells is less well understood. We identify that white adipose tissue-resident multipotent stromal cells (WAT-MSCs) can act as a reservoir for IL-33, especially after cell stress, but also provide additional signals for sustaining ILC2. Indeed, we demonstrate that WAT-MSCs also support ICAM-1-mediated proliferation and activation of LFA-1-expressing ILC2s. Consequently, ILC2-derived IL-4 and IL-13 feed back to induce eotaxin secretion from WAT-MSCs, supporting eosinophil recruitment. Thus, MSCs provide a niche for multifaceted dialogue with ILC2 to sustain a type-2 immune environment in WAT

Clinical peripherality: development of a peripherality index for rural health services

BACKGROUND: The configuration of rural health services is influenced by geography. Rural health practitioners provide a broader range of services to smaller populations scattered over wider areas or more difficult terrain than their urban counterparts. This has implications for training and quality assurance of outcomes. This exploratory study describes the development of a "clinical peripherality" indicator that has potential application to remote and rural general practice communities for planning and research purposes. METHODS: Profiles of general practice communities in Scotland were created from a variety of public data sources. Four candidate variables were chosen that described demographic and geographic characteristics of each practice: population density, number of patients on the practice list, travel time to nearest specialist led hospital and travel time to Health Board administrative headquarters. A clinical peripherality index, based on these variables, was derived using factor analysis. Relationships between the clinical peripherality index and services offered by the practices and the staff profile of the practices were explored in a series of univariate analyses. RESULTS: Factor analysis on the four candidate variables yielded a robust one-factor solution explaining 75% variance with factor loadings ranging from 0.83 to 0.89. Rural and remote areas had higher median values and a greater scatter of clinical peripherality indices among their practices than an urban comparison area. The range of services offered and the profile of staffing of practices was associated with the peripherality index. CONCLUSION: Clinical peripherality is determined by the nature of the practice and its location relative to secondary care and administrative and educational facilities. It has features of both gravity model-based and travel time/accessibility indicators and has the potential to be applied to training of staff for rural and remote locations and to other aspects of health policy and planning. It may assist planners in conceptualising the effects on general practices of centralising specialist clinical services or administrative and educational facilities