A multidisciplinary approach to the study of slope instability in Derbyshire, with particular reference to Matlock

This study of slope instability in the Matlock region of Derbyshire uses, and tests the applicability of, a variety of techniques from reconnaissance through to site investigation. The aims have been to (i) provide a greater understanding of landsliding in this area and (ii) produce a critical assessment of the techniques employed. A procedure was developed for the application of Landsat-5 TM imagery to slope stability studies, however, such imagery was found to be of very limited use in the study area. Morphological and geomorphological mapping from aerial photographs and in the field proved to be of greatest use for supplying information on landslide location, morphology, type and recent activity, and also in identifying surface water conditions. These techniques are relatively rapid, require the minimum of equipment, and provide a large amount of relevant data in a short time. They are also applicable to both reconnaissance surveys and site investigations. The geomorphological survey of Oker Hill near Matlock revealed a large multiple rotational landslide. An ochre-precipitating spring is situated within this landslide. A similar spring occurs on Mam Tor landslide in north Derbyshire, and Vear (1981) has shown this to be evidence of pyrite oxidation of the shale, a process which is believed to lead to periodic slope failure. Analysis of core material from two boreholes through the Oker Hill landslide confirmed that pyrite has been lost from the failed material and that the present base of the weathered zone is in the pyritic shale. Pyrite oxidation is resulting in iron oxide staining, the loss of sulphur (presumably as sulphuric acid which will participate in further reactions) and in an overall deterioration of the rock quality of the shale

Objects As Polyagents: Tracing The Histories Of The Gweagal Spears

This paper explores the capacity for objects entangled in complex - and often painful - histories to become constituted of multiple agencies (Gell 1998) through their interaction with various actants in complex and ever-expanding networks of association (Latour 1993; 2005). It does so by analysing how such objects become symbols for multiple histories, presences, and political agendas throughout their social lives (Appadurai 1986; Kopytoff 1986). The paper also examines how these objects influence and construct the pathways of their social lives through their polyagency. ‘Polyagency’ reflects a theory of object agency that I have developed through engaging literature on materiality and agency (Gell 1998), consumption and object movement (Appadurai 1986; Kopytoff 1986), and networks of relationality (Latour 2005). It considers the multiple gathered identities that objects come to embody through the sum of their interactions with various human actors during the objects’ social lives - agencies which then become efficacious in later interactions with people. The productivity of this theory is demonstrated by applying it to the analysis of a complicated repatriation case involving the Gweagal Spears, currently owned by Trinity College and held at the Museum of Archaeology and Anthropology in Cambridge. This application illustrates the impact that innovations in theory and repatriation cases can have on the perceived role of museums regarding object return, decolonisation and reconciliation efforts through relationship-building with source communities.Isaac Newton Trust and Corpus Christi College (under the 'Newton College Masters Scheme'

A multidisciplinary approach to the study of slope instability in Derbyshire, with particular reference to Matlock

This study of slope instability in the Matlock region of Derbyshire uses, and tests the applicability of, a variety of techniques from reconnaissance through to site investigation. The aims have been to (i) provide a greater understanding of landsliding in this area and (ii) produce a critical assessment of the techniques employed. A procedure was developed for the application of Landsat-5 TM imagery to slope stability studies, however, such imagery was found to be of very limited use in the study area. Morphological and geomorphological mapping from aerial photographs and in the field proved to be of greatest use for supplying information on landslide location, morphology, type and recent activity, and also in identifying surface water conditions. These techniques are relatively rapid, require the minimum of equipment, and provide a large amount of relevant data in a short time. They are also applicable to both reconnaissance surveys and site investigations. The geomorphological survey of Oker Hill near Matlock revealed a large multiple rotational landslide. An ochre-precipitating spring is situated within this landslide. A similar spring occurs on Mam Tor landslide in north Derbyshire, and Vear (1981) has shown this to be evidence of pyrite oxidation of the shale, a process which is believed to lead to periodic slope failure. Analysis of core material from two boreholes through the Oker Hill landslide confirmed that pyrite has been lost from the failed material and that the present base of the weathered zone is in the pyritic shale. Pyrite oxidation is resulting in iron oxide staining, the loss of sulphur (presumably as sulphuric acid which will participate in further reactions) and in an overall deterioration of the rock quality of the shale

Rationing of total knee replacement: a cost-effectiveness analysis on a large trial data set

PMID: 22290396 [PubMed] PMCID: PMC3269047 Free PMC ArticlePeer reviewedPublisher PD

'Online' geriatric assessment procedure for older adults referred for geriatric assessment during an acute care episode for consideration of reliability of triage decisions

Background Comprehensive geriatric assessment has been shown to improve patient outcomes, but the geriatricians who deliver it are in short-supply. A web-based method of comprehensive geriatric assessment has been developed with the potential to improve access to specialist geriatric expertise. The current study aims to test the reliability and safety of comprehensive geriatric assessment performed “online” in making geriatric triage decisions. It will also explore the accuracy of the procedure in identifying common geriatric syndromes, and its cost relative to conventional “live” consultations. Methods/Design The study population will consist of 270 acutely hospitalized patients referred for geriatric consultation at three sites. Paired assessments (live and online) will be conducted by independent, blinded geriatricians and the level of agreement examined. This will be compared with the level of agreement between two independent, blinded geriatricians each consulting with the patient in person (i.e. “live”). Agreement between the triage decision from live-live assessments and between the triage decision from live-online assessments will be calculated using kappa statistics. Agreement between the online and live detection of common geriatric syndromes will also be assessed using kappa statistics. Resource use data will be collected for online and live-live assessments to allow comparison between the two procedures. Discussion If the online approach is found to be less precise than live assessment, further analysis will seek to identify patient subgroups where disagreement is more likely. This may enable a protocol to be developed that avoids unsafe clinical decisions at a distance. Trial registration Trial registration number: ACTRN1261100093692

Partial factorial trials : comparing methods for statistical analysis and economic evaluation

The KAT trial was funded by the National Institute Health for Research (NIHR) Health Technology Assessment Programme (project number 95/10/01) and has been published in full in Health Technology Assessment. The NIHR provided partial funding of the Health Economics Research Centre during the time this research was undertaken. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the NIHR, NHS or the Department of Health.Peer reviewedPublisher PD

A randomised controlled trial of the clinical effectiveness and cost-effectiveness of different knee prostheses : the Knee Arthroplasty Trial (KAT)

Peer reviewedPublisher PD

The use of patient-reported outcome measures to guide referral for hip and knee replacement. Part 1: the development of an evidence based model linking pre-operative score to the probability of gaining benefit from surgery

Aims To calculate how the likelihood of obtaining measurable benefit from hip or knee arthroplasty varies with preoperative patient-reported scores. Methods Existing UK data from 222,933 knee and 209,760 hip arthroplasty patients were used to model an individual’s probability of gaining meaningful improvement after surgery based on their preoperative Oxford Knee or Hip Score (OKS/OHS). A clinically meaningful improvement after arthroplasty was defined as ≥ 8 point improvement in OHS, and ≥ 7 in OKS. Results The upper preoperative score threshold, above which patients are unlikely to achieve any meaningful improvement from surgery, is 41 for knees and 40 for hips. At lower scores, the probability of improvement increased towards a maximum of 88% (knee) and 95% for (hips). Conclusion By our definition of meaningful improvement, patients with preoperative scores above 41 (OKS) and 40 (OHS) should not be routinely referred to secondary care for possible arthroplasty. Using lower thresholds would incrementally increase the probability of meaningful benefit for those referred but will exclude some patients with potential to benefit. The findings are useful to support the complex shared decision-making process in primary care for referral to secondary care; and in secondary care for experienced clinicians counselling patients considering knee or hip arthroplasty, but should not be used in isolation

Preferred reporting items for studies mapping onto preference-based outcome measures: The MAPS statement

'Mapping' onto generic preference-based outcome measures is increasingly being used as a means of generating health utilities for use within health economic evaluations. Despite publication of technical guides for the conduct of mapping research, guidance for the reporting of mapping studies is currently lacking. The MAPS (MApping onto Preference-based measures reporting Standards) statement is a new checklist, which aims to promote complete and transparent reporting of mapping studies. The primary audiences for the MAPS statement are researchers reporting mapping studies, the funders of the research, and peer reviewers and editors involved in assessing mapping studies for publication. A de novo list of 29 candidate reporting items and accompanying explanations was created by a working group comprised of six health economists and one Delphi methodologist. Following a two-round, modified Delphi survey with representatives from academia, consultancy, health technology assessment agencies and the biomedical journal editorial community, a final set of 23 items deemed essential for transparent reporting, and accompanying explanations, was developed. The items are contained in a user friendly 23 item checklist. They are presented numerically and categorised within six sections, namely: (i) title and abstract; (ii) introduction; (iii) methods; (iv) results; (v) discussion; and (vi) other. The MAPS statement is best applied in conjunction with the accompanying MAPS explanation and elaboration document. It is anticipated that the MAPS statement will improve the clarity, transparency and completeness of reporting of mapping studies. To facilitate dissemination and uptake, the MAPS statement is being co-published by eight health economics and quality of life journals, and broader endorsement is encouraged. The MAPS working group plans to assess the need for an update of the reporting checklist in five years' time. This statement was published jointly in Applied Health Economics and Health Policy, Health and Quality of Life Outcomes, International Journal of Technology Assessment in Health Care, Journal of Medical Economics, Medical Decision Making, PharmacoEconomics, and Quality of Life Research