Creating the Future of Health

Creating the Future of Health is the fascinating story of the first fifty years of the Cumming School of Medicine at the University of Calgary. Founded on the recommendation of the Royal Commission on Health Services in 1964 the Cumming School has, from the very beginning, focused on innovation and excellence in health education. With a pioneering focus on novel, responsive and systems-based approaches, it was one of the first faculties to pilot multi-year training programs in family medicine and remains one of only two three-year medical schools in North America. Drawing on interviews with key players and extensive research into documents and primary material, Creating the Future of Health traces the history of the school through the leadership of its Deans. This is a story of perseverance through fiscal turbulence, sweeping changes to health care and health care education, and changing ideas of what health services are and what they should do. It is a story of triumph, of innovation, and of the tenacious spirit that thrives to this day at the Cumming School of Medicine

A Protocol for NMR Analysis of the Enantiomeric Excess of Chiral Diols Using an Achiral Diboronic Acid Template

A practically simple derivatization protocol for determining the enantiopurity of chiral diols by ¹H NMR spectroscopic analysis is described. Diols were treated with 0.5 equiv of 1,3-phenyldiboronic acid to afford mixtures of diastereomeric boronate esters whose homochiral/heterochiral ratios are an accurate reflection of the diol’s enantiopurity

Mixed Methods EvAluation of the high-volume low-complexity Surgical hUb pRogrammE (MEASURE) : a mixed methods study protocol

ABSTRACT INTRODUCTION: The waiting list for elective surgery in England recently reached over 7.8 million people and waiting time targets have been missed since 2010. The high-volume low complexity (HVLC) surgical hubs programme aims to tackle the backlog of patients awaiting elective surgery treatment in England. This study will evaluate the impact of HVLC surgical hubs on productivity, patient care and the workforce. METHODS AND ANALYSIS: This 4-year project consists of 6 inter-linked work packages (WPs) and is informed by the Consolidated Framework for Implementation Research. WP1: Mapping current and future HVLC provision in England through document analysis, quantitative datasets (e.g., Hospital Episodes Statistics) and interviews with national service leaders. WP2: Exploring the effects of HVLC hubs on key performance outcomes, primarily the volume of low-complexity patients treated, using quasi-experimental methods. WP3: Exploring the impact and implementation of HVLC hubs on patients, health professionals and the local NHS through approximately nine longitudinal, multi-method qualitative case studies. WP4: Assessing productivity of HVLC surgical hubs using the Centre for Health Economics NHS productivity measure and Lord Carter’s operational productivity measure. WP5: Conducting a mixed-methods appraisal will assess the influence of HVLC surgical hubs on the workforce using: qualitative data (WP3) and quantitative data (e.g. NHS England’s workforce statistics and intelligence from WP2). WP6: Analysing the costs and consequences of HVLC surgical hubs will assess their achievements in relation to their resource use to establish value for money. A Patient and Public Involvement Group (PPI) will contribute to study design and materials. ETHICS AND DISSEMINATION: The study has been approved by the East Midlands – Nottingham Research Ethics Committee 23/EM/0231. Dissemination plans include multiple academic and non-academic outputs (e.g. Peer-reviewed journals, conferences, social media) and a continuous, feedback-loop of findings to key stakeholders (e.g. NHS England) to influence policy development. STUDY REGISTRATION: Researchregistry9364

The 2020 report of The Lancet Countdown on health and climate change: responding to converging crises

The Lancet Countdown is an international collaboration, established to provide an independent, global monitoring system dedicated to tracking the emerging health profile of the changing climate. The 2020 report presents 43 indicators across five sections: climate change impacts, exposures, and vulnerability; adaptation, planning, and resilience for health; mitigation actions and health co-benefits; economics and finance; and public and political engagement. This report represents the findings and consensus of the 35 leading academic institutions and UN agencies that make up the Lancet Countdown, and draws on the expertise of climate scientists, geographers, and engineers; of energy, food, and transport experts; and of economists, social and political scientists, data scientists, public health professionals, and doctors

Effects of fluoxetine on functional outcomes after acute stroke (FOCUS): a pragmatic, double-blind, randomised, controlled trial

Background Results of small trials indicate that fluoxetine might improve functional outcomes after stroke. The FOCUS trial aimed to provide a precise estimate of these effects. Methods FOCUS was a pragmatic, multicentre, parallel group, double-blind, randomised, placebo-controlled trial done at 103 hospitals in the UK. Patients were eligible if they were aged 18 years or older, had a clinical stroke diagnosis, were enrolled and randomly assigned between 2 days and 15 days after onset, and had focal neurological deficits. Patients were randomly allocated fluoxetine 20 mg or matching placebo orally once daily for 6 months via a web-based system by use of a minimisation algorithm. The primary outcome was functional status, measured with the modified Rankin Scale (mRS), at 6 months. Patients, carers, health-care staff, and the trial team were masked to treatment allocation. Functional status was assessed at 6 months and 12 months after randomisation. Patients were analysed according to their treatment allocation. This trial is registered with the ISRCTN registry, number ISRCTN83290762. Findings Between Sept 10, 2012, and March 31, 2017, 3127 patients were recruited. 1564 patients were allocated fluoxetine and 1563 allocated placebo. mRS data at 6 months were available for 1553 (99·3%) patients in each treatment group. The distribution across mRS categories at 6 months was similar in the fluoxetine and placebo groups (common odds ratio adjusted for minimisation variables 0·951 [95% CI 0·839–1·079]; p=0·439). Patients allocated fluoxetine were less likely than those allocated placebo to develop new depression by 6 months (210 [13·43%] patients vs 269 [17·21%]; difference 3·78% [95% CI 1·26–6·30]; p=0·0033), but they had more bone fractures (45 [2·88%] vs 23 [1·47%]; difference 1·41% [95% CI 0·38–2·43]; p=0·0070). There were no significant differences in any other event at 6 or 12 months. Interpretation Fluoxetine 20 mg given daily for 6 months after acute stroke does not seem to improve functional outcomes. Although the treatment reduced the occurrence of depression, it increased the frequency of bone fractures. These results do not support the routine use of fluoxetine either for the prevention of post-stroke depression or to promote recovery of function. Funding UK Stroke Association and NIHR Health Technology Assessment Programme

An empirical study of marriage and social stratification

The dual objectives of this thesis are to assess the merits of certain statistical methods as applied to sociological data and to use statistical methods to produce interesting and worthwhile substantive results. The main statistical focus of the thesis is the analysis of two-way tables, for which purpose association models and correspondence analysis are used. Some of the tables analysed require the application of quasi-association models and association models with more than one dimension. Elsewhere in the thesis a proportional hazards model and various log-linear models are fitted. The substantive focus of the thesis is the relationship between marital formation/dissolution and social stratification in modern Britain. Particular attention is paid to assortative marriage for social status, with the relationships between spouses' occupations, educational levels and social origins being considered in detail. Assortative marriage for religion and for party political identification/voting intention are also examined. The data analysed come from a variety of social surveys, including both government surveys (e.g. various General Household Surveys, and the Family Formation Survey) and academic surveys (e.g. the Oxford Mobility Survey and the Social Change and Economic Life Initiative survey). The thesis conclusively demonstrates the utility of association models, log-linear models and proportional hazards models as applied to data relating to marital formation/dissolution. Among the numerous substantive findings are that there was a significant post-war decline in the strength of the relationship between spouses' social origins, and that unemployment appears to cause an increase in the risk of marital dissolution.</p

A Protocol for NMR Analysis of the Enantiomeric Excess of Chiral Diols Using an Achiral Diboronic Acid Template

A practically simple derivatization protocol for determining the enantiopurity of chiral diols by 1H NMR spectroscopic analysis is described. Diols were treated with 0.5 equiv of 1,3-phenyldiboronic acid to afford mixtures of diastereomeric boronate esters whose homochiral/heterochiral ratios are an accurate reflection of the diol’s enantiopurity

A Simple Protocol for NMR Analysis of the Enantiomeric Excess of Chiral Diols Using an Achiral Diboronic Acid Template

This repository contains the experimental data discussed in the manuscript. Including, 1H NMR, 13C NMR, 11B NMR (FID and PDF) and Mass Spectra for compound 1d and complexes of 1a, 1b, 1c, 1d, 1e and 1f with 1,3-phenyldiboronic acid. Output files from energy minimisation and equilibrium geometry calculations using a semi-empirical (PM3) method to calculate the lowest energy conformations of the heterochiral (meso) and homochiral boronate esters (RR and SS) derived from 1-phenyl-1,3-propanediol 1c. A calibration curve in Excel format for using the measured de to obtain the absolute ee of the sample