365 research outputs found
Polls and the political process: the use of opinion polls by political parties and mass media organizations in European postโcommunist societies (1990โ95)
Opinion polling occupies a significant role within the political process of most liberal-capitalist societies, where it is used by governments, parties and the mass media alike. This paper examines the extent to which polls are used for the same purposes in the post-communist countries of Central and Eastern Europe, and in particular, for bringing political elites and citizens together. It argues that these political elites are more concerned with using opinion polls for gaining competitive advantage over their rivals and for reaffirming their political power, than for devolving political power to citizens and improving the general processes of democratization
Six weeks of home enteral nutrition versus standard care after esophagectomy or total gastrectomy for cancer: study protocol for a randomized controlled trial
Background: Each year approximately 3000 patients in the United Kingdom undergo surgery for esophagogastric
cancer. Jejunostomy feeding tubes, placed at the time of surgery for early postoperative nutrition, have been
shown to have a positive impact on clinical outcomes in the short term. Whether feeding out of hospital is of
benefit is unknown. Local experience has identified that between 15 and 20% of patients required โrescueโ
jejunostomy feeding for nutritional problems and weight loss while at home. This weight loss and poor nutrition
may contribute to the detrimental effect on the overall quality of life (QoL) reported in these patients.
Methods/Design: This randomized pilot and feasibility study will provide preliminary information on the routine
use of jejunostomy feeding after hospital discharge in terms of clinical benefits and QoL. Sixty participants
undergoing esophagectomy or total gastrectomy will be randomized to receive either a planned program of six
weeks of home jejunostomy feeding after discharge from hospital (intervention) or treatment-as-usual (control). The
intention of this study is to inform a multi-centre randomized controlled trial. The primary outcome measures will
be recruitment and retention rates at six weeks and six months. Secondary outcome measures will include disease
specific and general QoL measures, nutritional parameters, total and oral nutritional intake, hospital readmission
rates, and estimates of healthcare costs. Up to 20 participants will also be enrolled in a qualitative sub-study that will
explore participantsโ and carersโ experiences of home tube feeding.
The results will be disseminated by presentation at surgical, gastroenterological and dietetic meetings and
publication in appropriate peer review journals. A patient-friendly lay summary will be made available on the
University of Leicester and the University Hospitals of Leicester NHS Trust websites. The study has full ethical and
institutional approval and started recruitment in July 2012.
Trial registration: UKClinical Research Network ID #12447 (Main study); UKCRN ID#13361 (Qualitative sub study);
ClinicalTrials.gov #NCT01870817 (First registered 28 May 2013
Transplantation of Adult Mouse iPS Cell-Derived Photoreceptor Precursors Restores Retinal Structure and Function in Degenerative Mice
This study was designed to determine whether adult mouse induced pluripotent stem cells (iPSCs), could be used to produce retinal precursors and subsequently photoreceptor cells for retinal transplantation to restore retinal function in degenerative hosts. iPSCs were generated using adult dsRed mouse dermal fibroblasts via retroviral induction of the transcription factors Oct4, Sox2, KLF4 and c-Myc. As with normal mouse ES cells, adult dsRed iPSCs expressed the pluripotency genes SSEA1, Oct4, Sox2, KLF4, c-Myc and Nanog. Following transplantation into the eye of immune-compromised retinal degenerative mice these cells proceeded to form teratomas containing tissue comprising all three germ layers. At 33 days post-differentiation a large proportion of the cells expressed the retinal progenitor cell marker Pax6 and went on to express the photoreceptor markers, CRX, recoverin, and rhodopsin. When tested using calcium imaging these cells were shown to exhibit characteristics of normal retinal physiology, responding to delivery of neurotransmitters. Following subretinal transplantation into degenerative hosts differentiated iPSCs took up residence in the retinal outer nuclear layer and gave rise to increased electro retinal function as determined by ERG and functional anatomy. As such, adult fibroblast-derived iPSCs provide a viable source for the production of retinal precursors to be used for transplantation and treatment of retinal degenerative disease
A mixed-methods feasibility study of a new digital health support package for people after stroke : The Recovery-focused Community support to Avoid readmissions and improve Participation after Stroke (ReCAPS) intervention
Background
Evidence for digital health programmes to support people living with stroke is growing. We assessed the feasibility of a protocol and procedures for the Recovery-focused Community support to Avoid readmissions and improve Participation after Stroke (ReCAPS) trial.
Methods
We conducted a mixed-method feasibility study. Participants with acute stroke were recruited from three hospitals (Melbourne, Australia). Eligibility: Adults with stroke discharged from hospital to home within 10 days, modified Rankin Score 0โ4 and prior use of Short Message System (SMS)/email. While in hospital, recruited participants contributed to structured person-centred goal setting and completed baseline surveys including self-management skills and health-related quality of life. Participants were randomised 7โ14 days after discharge via REDCapยฎ (1:1 allocation). Following randomisation, the intervention group received a 12-week programme of personalised electronic support messages (average 66 messages sent by SMS or email) aligned with their goals. The control group received six electronic administrative messages. Feasibility outcomes included the following: number of patients screened and recruited, study retainment, completion of outcome measures and acceptability of the ReCAPS intervention and trial procedures (e.g. participant satisfaction survey, clinician interviews). Protocol fidelity outcomes included number of goals developed (and quality), electronic messages delivered, stop messages received and engagement with messages. We undertook inductive thematic analysis of interview/open-text survey data and descriptive analysis of closed survey questions.
Results
Between November 2018 and October 2019, 312 patients were screened; 37/105 (35%) eligible patients provided consent (mean age 61 years; 32% female); 33 were randomised (17 to intervention). Overall, 29 (88%) participants completed the12-week outcome assessments with 12 (41%) completed assessments in the allocated timeframe and 16 also completing the satisfaction survey (intervention=10). Overall, trial participants felt that the study was worthwhile and most would recommend it to others. Six clinicians participated in one of three focus group interviews; while they reported that the trial and the process of goal setting were acceptable, they raised concerns regarding the additional time required to personalise goals.
Conclusion
The study protocol and procedures were feasible with acceptable retention of participants. Consent and goal personalisation procedures should be centralised for the phase III trial to reduce the burden on hospital clinicians.
Trial registration
Australian New Zealand Clinical Trials Registry, ACTRN12618001468213 (date 31/08/2018); Universal Trial Number: U1111-1206-723
Incidence of AIDS-Defining Opportunistic Infections in a Multicohort Analysis of HIV-infected Persons in the United States and Canada, 2000โ2010
Background. There are few recent data on the rates of AIDS-defining opportunistic infections (OIs) among human immunodeficiency virus (HIV)โinfected patients in care in the United States and Canada
- โฆ