Colorectal cancer screening with faecal immunochemical testing, sigmoidoscopy or colonoscopy: a clinical practice guideline

Clinical question Recent 15-year updates of sigmoidoscopy screening trials triggered the clinical questions: Does colorectal cancer screening make an important difference to health outcomes in individuals initiating screening at age 50 to 79? Is there a preferable approach among the screening options faecal immunochemical test (FIT) every year or every two years, or a single sigmoidoscopy or colonoscopy

Conceptualising fields of action for sustainable intensification A systematic literature review and application to regional case studies

[EN] After two decades of research on sustainable intensification (SI), namely securing food production on less environmental cost, heterogeneous understandings and perspectives prevail in a broad and partly fragmented scientific literature. Structuring and consolidating contributions to provide practice-oriented guidelines are lacking. The objectives of this study are to (1) comprehensively explore the academic SI literature, (2) propose an implementation-oriented conceptual framework, and (3) demonstrate its applicability for region-specific problem settings. In a systematic literature review of 349 papers covering the international literature of 20 years of SI research, we identified SI practices and analysed temporal, spatial and disciplinary trends and foci. Based on key SI practices, a conceptual framework was developed differentiating four fields of action from farm to regional and landscape scale and from land use to structural optimisation. Its applicability to derive region specific SI solutions was successfully tested through stakeholder processes in four European case studies. Disciplinary boundaries and the separation of the temporal and spatial strands in the literature prevent a holistic address of SI. This leads to the dominance of research describing SI practices in isolation, mainly on the farm scale. Coordinated actions on the regional scale and the coupling of multiple practices are comparatively un-derrepresented. Results from the case studies demonstrate that implementation is extremely context-sensitive and thus crucially depends on the situational knowledge of farmers and stakeholders. Although, there is no 'one size fits all' solution, practitioners in all regions identified the need for integrated solutions and common action to implement suitable SI strategies at the regional landscape level and in local ecosystems.This research was financially supported by the European Commission under grant agreement 652615 and conducted in the context of the ERA-Net FACCE SURPLUS project VITAL, with the national funders NWO (Netherlands), BMBF (Germany), INIA (Spain), ANR (France).Weltin, M.; Zasada, I.; Piorr, A.; Debolini, M.; Geniaux, G.; Moreno-Pérez, OM.; Scherer, L.... (2018). Conceptualising fields of action for sustainable intensification A systematic literature review and application to regional case studies. Agriculture Ecosystems & Environment. 257:68-80. https://doi.org/10.1016/j.agee.2018.01.023S688025

Gendering the careers of young professionals: some early findings from a longitudinal study. in Organizing/theorizing: developments in organization theory and practice

Wonders whether companies actually have employees best interests at heart across physical, mental and spiritual spheres. Posits that most organizations ignore their workforce – not even, in many cases, describing workers as assets! Describes many studies to back up this claim in theis work based on the 2002 Employment Research Unit Annual Conference, in Cardiff, Wales

Genetic diversity fuels gene discovery for tobacco and alcohol use

Tobacco and alcohol use are heritable behaviours associated with 15% and 5.3% of worldwide deaths, respectively, due largely to broad increased risk for disease and injury(1-4). These substances are used across the globe, yet genome-wide association studies have focused largely on individuals of European ancestries(5). Here we leveraged global genetic diversity across 3.4 million individuals from four major clines of global ancestry (approximately 21% non-European) to power the discovery and fine-mapping of genomic loci associated with tobacco and alcohol use, to inform function of these loci via ancestry-aware transcriptome-wide association studies, and to evaluate the genetic architecture and predictive power of polygenic risk within and across populations. We found that increases in sample size and genetic diversity improved locus identification and fine-mapping resolution, and that a large majority of the 3,823 associated variants (from 2,143 loci) showed consistent effect sizes across ancestry dimensions. However, polygenic risk scores developed in one ancestry performed poorly in others, highlighting the continued need to increase sample sizes of diverse ancestries to realize any potential benefit of polygenic prediction.Peer reviewe

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)