292 research outputs found

    Energy Trends: September 2020

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    Energy Trends and Energy Prices are produced by the Department for Business, Energy and Industrial Strategy (BEIS) on a quarterly basis. Both periodicals are published concurrently in June, September, December and March. The September editions cover the second quarter of the current year

    An examination of intentions of recommending fitness centers by user members

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    The goal of this study was to examine what experiences members have with fitness centers that influence their intentions for recommendation. After item generation and content validity, as well as a pilot test, a survey was conducted among members of five different clubs (n=1750). The questionnaire included measures of service quality attributes, accessibility, well-being in life, well-being in a club, and intentions to recommend a fitness center. Results using a structural equation model provide evidence that only service quality attributes and well-being in a club have positive effect on intentions of users to recommend it. Well-being in life has a negative effect on the intentions for recommendation, while accessibility shows no predictive effect. These findings suggest implications for the management of a club, such as the need to create a pleasant environment and to provide a personalized service directed towards the members’ goals in order to improve well-being in a club and contribute to increase the intentions to recommend the fitness centers to others.O objetivo deste estudo foi examinar como as experiências de usuários de centros de atividade física interferem nas intenções em recomendar serviços. Depois de gerar itens e validar o conteúdo, aplicou-se um pré-teste, o questionário final foi aplicado a sócios de cinco clubes de fitness (n=1.750). O questionário incluiu atributos da qualidade do serviço, acessibilidade, bem-estar na vida, bem-estar no clube e intenção de recomendar. O modelo de equações estruturais mostrou que apenas os atributos da qualidade do serviço e bem-estar no clube têm um efeito positivo sobre as intenções de recomendar. O bem-estar na vida tem um efeito negativo sobre as intenções para recomendar, enquanto que a acessibilidade não mostra nenhum efeito preditivo. Estas conclusões sugerem a necessidade de criar um ambiente agradável nos clubes e de oferecer um serviço personalizado para os objetivos dos sócios, a fim de melhorar o bem-estar no clube e contribuir para a intenção de recomendar o ginásio. Palavras-chave: intenção de recomendar, atributos da qualSin financiación0.191 SJR (2014) Q3, posición 172/231 Health (social science), 1027/1811 Medicine (miscellaneous); Q4, 112/128 Sports scienceUE

    Gemcitabine with a specific conformal 3D 5FU radiochemotherapy technique is safe and effective in the definitive management of locally advanced pancreatic cancer

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    The aim of this phase II study was to assess the feasibility and efficacy of a specific three-dimensional conformal radiotherapy technique with concurrent continuous infusion of 5-fluorouracil (CI 5FU) sandwiched between gemcitabine chemotherapy in patients with locally advanced pancreatic cancer. Patients with inoperable cancer in the pancreatic head or body without metastases were given gemcitabine at 1000 mg m−2 weekly for 3 weeks followed by a 1-week rest and a 6-week period of radiotherapy and concurrent CI 5FU (200 mg m−2 day−1). The defined target volume was treated to 54 Gy in 30 daily fractions of 1.8 Gy. After 4 weeks' rest, gemcitabine treatment was re-initiated for three cycles (days 1, 8, 15, q28). Forty-one patients were enrolled. At the end of radiotherapy, one patient (2.4%) had a complete response and four patients (9.6%) had a partial response; at the end of treatment, three patients (7.3%) had a complete response and two patients (4.9%) had a partial response. Median survival time was 11.7 months, median time to progression was 7.1 months, and median time to failure of local control was 11.9 months. The 1- and 2-year survival rates were 46.3 and 9.8%, respectively. Treatment-related grade 3 and 4 toxicities were reported by 16 (39.0%) and four (9.8%) patients, respectively. Sixteen out of 41 patients did not complete the planned treatment and nine due to disease progression. This approach to treatment of locally advanced pancreatic cancer is safe and promising, with good local control for a substantial proportion of patients, and merits testing in a randomised trial

    Effect of SGLT2 inhibitors on stroke and atrial fibrillation in diabetic kidney disease: Results from the CREDENCE trial and meta-analysis

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    BACKGROUND AND PURPOSE: Chronic kidney disease with reduced estimated glomerular filtration rate or elevated albuminuria increases risk for ischemic and hemorrhagic stroke. This study assessed the effects of sodium glucose cotransporter 2 inhibitors (SGLT2i) on stroke and atrial fibrillation/flutter (AF/AFL) from CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation) and a meta-Analysis of large cardiovascular outcome trials (CVOTs) of SGLT2i in type 2 diabetes mellitus. METHODS: CREDENCE randomized 4401 participants with type 2 diabetes mellitus and chronic kidney disease to canagliflozin or placebo. Post hoc, we estimated effects on fatal or nonfatal stroke, stroke subtypes, and intermediate markers of stroke risk including AF/AFL. Stroke and AF/AFL data from 3 other completed large CVOTs and CREDENCE were pooled using random-effects meta-Analysis. RESULTS: In CREDENCE, 142 participants experienced a stroke during follow-up (10.9/1000 patient-years with canagliflozin, 14.2/1000 patient-years with placebo; hazard ratio [HR], 0.77 [95% CI, 0.55-1.08]). Effects by stroke subtypes were: ischemic (HR, 0.88 [95% CI, 0.61-1.28]; n=111), hemorrhagic (HR, 0.50 [95% CI, 0.19-1.32]; n=18), and undetermined (HR, 0.54 [95% CI, 0.20-1.46]; n=17). There was no clear effect on AF/AFL (HR, 0.76 [95% CI, 0.53-1.10]; n=115). The overall effects in the 4 CVOTs combined were: Total stroke (HRpooled, 0.96 [95% CI, 0.82-1.12]), ischemic stroke (HRpooled, 1.01 [95% CI, 0.89-1.14]), hemorrhagic stroke (HRpooled, 0.50 [95% CI, 0.30-0.83]), undetermined stroke (HRpooled, 0.86 [95% CI, 0.49-1.51]), and AF/AFL (HRpooled, 0.81 [95% CI, 0.71-0.93]). There was evidence that SGLT2i effects on total stroke varied by baseline estimated glomerular filtration rate (P=0.01), with protection in the lowest estimated glomerular filtration rate (45 mL/min/1.73 m2]) subgroup (HRpooled, 0.50 [95% CI, 0.31-0.79]). CONCLUSIONS: Although we found no clear effect of SGLT2i on total stroke in CREDENCE or across trials combined, there was some evidence of benefit in preventing hemorrhagic stroke and AF/AFL, as well as total stroke for those with lowest estimated glomerular filtration rate. Future research should focus on confirming these data and exploring potential mechanisms
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