I Never Believed In Angels Until I Met You : Girl Of The Cross

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The Portacaval‐shunted rat : a new model for the study of the mechanisms controlling voluntary ethanol consumption and ethanol preference?

Portacaval anastomosis (PCA) is a surgical procedure whereby blood from the portal vein is shunted into the inferior vena cava. PCA in the rat results in a significant increase (from 0.77 ± 0.26 to 3.51 ± 0.37 g of ethanol/kg/day) in voluntary ethanol consumption in a free‐choice paradigm between water and 5% ethanol solution. After PCA surgery, increased voluntary ethanol consumption starts abruptly at 6 to 7 days and is maintained for > 28 weeks. Voluntary ethanol consumption in rats after PCA results in blood ethanol levels up to 158 mg%. After PCA, the ethanol preference ratio (defined as the percentage of total fluid intake constituted by ethanol) increased from 19 ± 2% to 78 ± 2% (p < 0.001). Administration of the nonselective opioid receptor antagonist naloxone (5 mg/kg, sc) resulted in a significant 6‐fold attenuation of voluntary ethanol consumption by rats with PCA, an effect that was not mediated by an effect on locomotor activity. These findings, together with previous reports of widespread alterations of the μ‐ and δ‐opioid receptors in the brain after PCA, suggest that increased voluntary ethanol consumption and ethanol preference in PCA rats may result from activation of the endogenous opioid system. Preliminary studies suggest that rats with PCA manifest behavioral signs consistent with the development of dependence. The portacaval‐shunted rat may provide a useful preparation for the study of mechanisms, in particular those involving the liver, implicated in the development of increased voluntary ethanol consumption and ethanol preference

The Metropolis and Evangelical Life: Coherence and Fragmentation in the ‘Lost City of London’

This article examines the interplay of different processes of cultural and subjective fragmentation experienced by conservative evangelical Anglicans, based on an ethnographic study of a congregation in central London. The author focuses on the evangelistic speaking practices of members of this church to explore how individuals negotiate contradictory norms of interaction as they move through different city spaces, and considers their response to tensions created by the demands of their workplace and their religious lives. Drawing on Georg Simmel’s ‘The Metropolis and Mental Life’, the author argues that their faith provides a sense of coherence and unity that responds to experiences of cultural fragmentation characteristic of everyday life in the city, while simultaneously leading to a specific consciousness of moral fragmentation that is inherent to conservative evangelicalism

Critical evaluation of the neoclassical model for the equilibrium electrostatic field in a tokamak

The neoclassical prescription to use an equation of motion to determine the electrostatic field within a tokamak plasma is fraught with difficulties. Herein we examine two popular expressions for the equilibrium electrostatic field so determined and show that one fails to withstand a formal scrutiny thereof while the other fails to respect the vector nature of the diamagnetic current. Reconsideration of the justification for the presence of the equilibrium electrostatic field indicates that no field is needed for a neutral plasma when considering the net bound current defined as the curl of the magnetization. With any shift in the toroidal magnetic flux distribution, a dynamic electric field is generated with both radial and poloidal components, providing an alternate explanation for any measurements thereof.Comment: 13 pages, 2 figures, moderate revision, final version, edited for length, to appear in MR

Ages and Metallicities of Hickson Compact Group Galaxies

Hickson Compact Groups (HCGs) constitute an interesting extreme in the range of environments in which galaxies are located, as the space density of galaxies in these small groups are otherwise only found in the centres of much larger clusters. The work presented here uses Lick indices to make a comparison of ages and chemical compositions of galaxies in HCGs with those in other environments (clusters, loose groups and the field). The metallicity and relative abundance of `$\alpha$-elements' show strong correlations with galaxy age and central velocity dispersion, with similar trends found in all environments. However, we show that the previously reported correlation between $\alpha$-element abundance ratios and velocity dispersion disappears when a full account is taken of the the abundance ratio pattern in the calibration stars. This correlation is thus found to be an artifact of incomplete calibration to the Lick system. Variations are seen in the ranges and average values of age, metallicity and $\alpha$-element abundance ratios for galaxies in different environments. Age distributions support the hierarchical formation prediction that field galaxies are on average younger than their cluster counterparts. However, the ages of HCG galaxies are shown to be more similar to those of cluster galaxies than those in the field, contrary to the expectations of current hierarchical models. A trend for lower velocity dispersion galaxies to be younger was also seen. This is again inconsistent with hierarchical collapse models, but is qualitatively consistent with the latest N-body-SPH models based on monolithic collapse in which star formation continues for many Gyr in low mass halos.Comment: 18 pages. Submitted for publication in MNRA

Estimating the number needed to treat from continuous outcomes in randomised controlled trials: methodological challenges and worked example using data from the UK Back Pain Exercise and Manipulation (BEAM) trial

Background Reporting numbers needed to treat (NNT) improves interpretability of trial results. It is unusual that continuous outcomes are converted to numbers of individual responders to treatment (i.e., those who reach a particular threshold of change); and deteriorations prevented are only rarely considered. We consider how numbers needed to treat can be derived from continuous outcomes; illustrated with a worked example showing the methods and challenges. Methods We used data from the UK BEAM trial (n = 1, 334) of physical treatments for back pain; originally reported as showing, at best, small to moderate benefits. Participants were randomised to receive 'best care' in general practice, the comparator treatment, or one of three manual and/or exercise treatments: 'best care' plus manipulation, exercise, or manipulation followed by exercise. We used established consensus thresholds for improvement in Roland-Morris disability questionnaire scores at three and twelve months to derive NNTs for improvements and for benefits (improvements gained+deteriorations prevented). Results At three months, NNT estimates ranged from 5.1 (95% CI 3.4 to 10.7) to 9.0 (5.0 to 45.5) for exercise, 5.0 (3.4 to 9.8) to 5.4 (3.8 to 9.9) for manipulation, and 3.3 (2.5 to 4.9) to 4.8 (3.5 to 7.8) for manipulation followed by exercise. Corresponding between-group mean differences in the Roland-Morris disability questionnaire were 1.6 (0.8 to 2.3), 1.4 (0.6 to 2.1), and 1.9 (1.2 to 2.6) points. Conclusion In contrast to small mean differences originally reported, NNTs were small and could be attractive to clinicians, patients, and purchasers. NNTs can aid the interpretation of results of trials using continuous outcomes. Where possible, these should be reported alongside mean differences. Challenges remain in calculating NNTs for some continuous outcomes

Should Endovascular Repair Be Reimbursed for Low Risk Abdominal Aortic Aneurysm Patients? Evidence from Ontario, Canada

Background. This paper presents unpublished clinical and economic data associated with open surgical repair (OSR) in low risk (LR) patients and how it compares with EVAR and OSR in high risk (HR) patients with an AAA > 5.5 cm. Design. Data from a 1-year prospective observational study was used to compare EVAR in HR patients versus OSR in HR and LR patients. Results. Between 2003 and 2005, 140 patients were treated with EVAR and 195 with OSR (HR: 52; LR: 143). The 1-year mortality rate with EVAR was statistically lower than HR OSR patients and comparable to LR OSR patients. One-year health-related quality of life was lower in the EVAR patients compared to OSR patients. EVAR was cost-effective compared to OSR HR but not when compared to OSR LR patients. Conclusions. Despite a similar clinical effectiveness, these results suggest that, at the current price, EVAR is more expensive than open repair for low risk patients

Forum: Parental education and child mortality

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