Can we evaluate population screening strategies in UK general practice? A pilot randomised controlled trial comparing postal and opportunistic screening for genital chlamydial infection

STUDY OBJECTIVE: To assess whether opportunistic and postal screening strategies for Chlamydia trachomatis can be compared with usual care in a randomised trial in general practice DESIGN: Feasibility study for a randomised controlled trial. SETTING: Three West of Scotland general medical practices: one rural, one urban/deprived and one urban/affluent. PARTICIPANTS: 600 women aged 16-30 years, 200 from each of three participating practices selected at random from a sample of West of Scotland practices that had expressed interest in the study. The women could opt out of the study. Those who did not were randomly assigned to one of three groups: postal screening, opportunistic screening or usual care. MAIN RESULTS: 38% (85/221) of the approached practices expressed interest in the study. Data were collected successfully from the 3 participating practices, although intensive support was required. There were considerable workload implications for staff, both in relation to implementing the screening strategies and managing the research process. 124 of the 600 women opted out of the study. During the four-month study period, 55% (81/146) of the control group attended their practice but none was offered screening. 59% (80/136) women in the opportunistic group attended their practice of whom 55% (44/80) were offered screening. Of those, 64% (28/44) accepted, representing 21% of the opportunistic group. 48% (59/124) of the postal group returned samples. CONCLUSION: A randomised controlled trial comparing postal and opportunistic screening for chlamydial infection in general practice is feasible, though resource intensive. There may be problems with generalising from screening trials in which patients may opt out from the offer of screening

Stocking rate and rate of superphosphate in a higher rainfall area

In its virgin state the area carried a forest association of red-gum and jarrah, and the soils are typical of large areas in the south-west of Western Australia. These gravelly soils have a high requirement for phosphate during their first years under pasture, and this trial was designed to investigate the relationship between rate of phosphate, stocking rate and pasture production over a number of seasons

Large‑scale analysis of iliopsoas muscle volumes in the UK Biobank

Psoas muscle measurements are frequently used as markers of sarcopenia and predictors of health. Manually measured cross-sectional areas are most commonly used, but there is a lack of consistency regarding the position of the measurement and manual annotations are not practical for large population studies. We have developed a fully automated method to measure iliopsoas muscle volume (comprised of the psoas and iliacus muscles) using a convolutional neural network. Magnetic resonance images were obtained from the UK Biobank for 5000 participants, balanced for age, gender and BMI. Ninety manual annotations were available for model training and validation. The model showed excellent performance against out-of-sample data (average dice score coefficient of 0.9046 ± 0.0058 for six-fold cross-validation). Iliopsoas muscle volumes were successfully measured in all 5000 participants. Iliopsoas volume was greater in male compared with female subjects. There was a small but significant asymmetry between left and right iliopsoas muscle volumes. We also found that iliopsoas volume was significantly related to height, BMI and age, and that there was an acceleration in muscle volume decrease in men with age. Our method provides a robust technique for measuring iliopsoas muscle volume that can be applied to large cohorts

A multi-season investigation of glacier surface roughness lengths through in situ and remote observation

The roughness length values for momentum, temperature, and water vapour are key inputs to the bulk aerodynamic method for estimating turbulent heat flux. Measurements of site-specific roughness length are rare for glacier surfaces, and substantial uncertainty remains in the values and ratios commonly assumed when parameterising turbulence. Over three melt seasons, eddy covariance observations were implemented to derive the momentum and scalar roughness lengths at several locations on two mid-latitude mountain glaciers. In addition, two techniques were developed in this study for the remote estimation of momentum roughness length, utilising lidar-derived digital elevation models with a 1×1&thinsp;m resolution. Seasonal mean momentum roughness length values derived from eddy covariance observations at each location ranged from 0.7 to 4.5&thinsp;mm for ice surfaces and 0.5 to 2.4&thinsp;mm for snow surfaces. From one season to the next, mean momentum roughness length values over ice remained relatively consistent at a given location (0–1&thinsp;mm difference between seasonal mean values), while within a season, temporal variability in momentum roughness length over melting snow was found to be substantial (&gt; an order of magnitude). The two remote techniques were able to differentiate between ice and snow cover and return momentum roughness lengths that were within 1–2&thinsp;mm (≪ an order of magnitude) of the in situ eddy covariance values. Changes in wind direction affected the magnitude of the momentum roughness length due to the anisotropic nature of features on a melting glacier surface. Persistence in downslope wind direction on the glacier surfaces, however, reduced the influence of this variability. Scalar roughness length values showed considerable variation (up to 2.5 orders of magnitude) between locations and seasons and no evidence of a constant ratio with momentum roughness length or each other. Of the tested estimation methods, the Andreas (1987) surface renewal model returned scalar roughness lengths closest to those derived from eddy covariance observations. Combining this scalar method with the remote techniques developed here for estimating momentum roughness length may facilitate the distributed parameterisation of turbulent heat flux over glacier surfaces without in situ measurements.</p

Effect of laser shock peening on residual stress and fatigue life of clad 2024 aluminium sheet containing scribe defects

Laser peening at a range of power densities has been applied to 2-mm-thick sheets of 2024 T351 aluminium. The induced residual stress field was measured using incremental hole drilling and synchrotron X-ray diffraction techniques. Fatigue samples were subjected to identical laser peening treatments followed by scribing at the peen location to introduce stress concentrations, after which they were fatigue tested. The residual stresses were found to be non-biaxial: orthogonal to the peen line they were tensile at the surface, moving into the desired compression with increased depth. Regions of peen spot overlap were associated with large compression strains; the centre of the peen spot remaining tensile. Fatigue lives showed moderate improvement over the life of unpeened samples for 50 μm deep scribes, and slight improvement for samples with 150 μm scribes. Use of the residual stress intensity Kresid approach to calculate fatigue life improvement arising from peening was unsuccessful at predicting the relative effects of the different peening treatments. Possible reasons for this are explored

Reducing training frequency from 3 or 4 sessions/week to 2 sessions/week does not attenuate improvements in maximal aerobic capacity with reduced-exertion high-intensity interval training (REHIT)

In the present randomised-controlled trial we investigated the effect of REHIT training frequency (2/3/4 sessions/week for 6 weeks) on maximal aerobic capacity (V̇O2max) in 42 inactive individuals (13 women; mean±SD age: 25±5 y, V̇O2max: 35±5 mL·kg-1·min-1). Changes in V̇O2max were not significantly different between the three groups (2 sessions/week: +10.2%; 3 sessions/week: +8.1%; 4 sessions per week: +7.3%). In conclusion, a training frequency of 2 sessions/week is sufficient for REHIT to improve V̇O2max. We demonstrate that reducing REHIT training frequency from 3 or 4 to 2 sessions/week does not attenuate improvements in the key health marker of V̇O2max. Key words: V̇O2max; sprint interval training; SIT; Wingate sprint; exercise; healt

A feasibility randomised controlled trial of the New Orleans intervention of infant mental health: a study protocol

Child maltreatment is associated with life-long social, physical, and mental health problems. Intervening early to provide maltreated children with safe, nurturing care can improve outcomes. The need for prompt decisions about permanent placement (i.e., regarding adoption or return home) is internationally recognised. However, a recent Glasgow audit showed that many maltreated children “revolve” between birth families and foster carers. This paper describes the protocol of the first exploratory randomised controlled trial of a mental health intervention aimed at improving placement permanency decisions for maltreated children. This trial compares an infant's mental health intervention with the new enhanced service as usual for maltreated children entering care in Glasgow. As both are new services, the trial is being conducted from a position of equipoise. The outcome assessment covers various fields of a child’s neurodevelopment to identify problems in any ESSENCE domain. The feasibility, reliability, and developmental appropriateness of all outcome measures are examined. Additionally, the potential for linkage with routinely collected data on health and social care and, in the future, education is explored. The results will inform a definitive randomised controlled trial that could potentially lead to long lasting benefits for the Scottish population and which may be applicable to other areas of the world

Dealing with mobility: Understanding access anytime, anywhere

The rapid and accelerating move towards the adoption and use of mobile technologies has increasingly provided people and organisations with the ability to work away from the office and on the move. The new ways of working afforded by these technologies are often characterised in terms of access to information and people ‘anytime, anywhere’. This paper presents a study of mobile workers that highlights different facets of access to remote people and information, and different facets of anytime, anywhere. Four key factors in mobile work are identified from the study: the role of planning, working in ‘dead time’, accessing remote technological and informational resources, and monitoring the activities of remote colleagues. By reflecting on these issues, we can better understand the role of technology and artefact use in mobile work and identify the opportunities for the development of appropriate technological solutions to support mobile workers