Proof and proving in current classroom materials

Research across many countries reports that teaching the key ideas of proof and proving to all students is not an easy task. This paper reports on the session of the BSRLM Geometry Working Group which examined current classroom material from the UK with the intention of uncovering the ‘opportunities for proof’ in geometry that are provided by such material. To carry out such an analysis three analytical frameworks are compared. Two of the analytical frameworks, while placing proof and proving in a wider context of learners’ mathematics, may not fully uncover the detail of proof and proving. The third analytical framework, while permitting a detailed analysis of explicit proof and proving, may not fully account for textbooks that devote most space to discussions of proof and proving and/or contain problems that implicitly provoke proof. This comparison reveals some of the complexity of textbook analysis and suggests that further work is needed on a suitable analytical framework

Criterion validity and reliability of an instrumented mouthguard under pendulum impactor conditions

The popularity of instrumented mouthguards (iMGs) use to measure head impact kinematics in contact sports is growing. To accurately compare between systems, mouthguards should be subjected to standardised laboratory validation testing. The study aimed to establish the validity and reliability of a mouthguard system under independently collected pendulum impactor conditions. A NOCSAE anthropometric testing device with attached mouthguard was impacted in four different locations (front, front boss, rear, rear boss) at four target linear accelerations (25, 50, 75 and 100 g) with two different impactor caps (padded and rigid). Peak linear acceleration, peak rotational velocity and peak rotational acceleration values from the mouthguard were compared against the reference data with a battery of statistical tests, namely R squared values, Lin’s concordance correlation coefficient, intraclass correlation coefficients and Bland Altman analysis. Results indicate the iMG produces valid and reliable data comparable to that of the anthropomorphic testing device reference, with all measured variables reported ‘excellent’ intraclass correlation coefficients above 0.95; concordance correlation coefficients above 0.95; minimal average bias with Bland Altman analysis and R squared values above 0.92 for all measured variables. Results indicate the iMG is appropriately valid and reliable enough to next establish on-field validity

Helping you help yourself (HYHY) for people with mild breathlessness: a service evaluation in Wales

Pulmonary rehabilitation (PR) is an evidence-based intervention which improves exercise capacity and quality of life (QoL) for patients with chronic obstructive pulmonary disease (COPD). Commonly, outpatient rehabilitation is available for patients with significant breathlessness (Medical Research Council (MRC) >3). This evaluation explored changes in exercise capacity and knowledge of condition and their relationship with the impact of COPD (CAT score) at baseline following a community exercise and education programme delivered by the British Lung Foundation (BLF) in people with mild breathlessness (MRC ≤2). Methods: People with mild breathlessness, MRC ≤2, were recruited from GP surgeries, the BLF website and support groups. The 6-week Helping You Help Yourself (HYHY) programme included weekly exercise, education and social engagement. Participants were assessed at baseline using the COPD Assessment Tool (CAT), six-minute walk test (6MWT), Bristol COPD Knowledge quiz (BKQ), and questions on self-management was assessed by questionnaire. After 6 weeks 6MWT, BKQ and self-management were assessed and related to CAT at baseline. The usefulness of the programme to participants was also assessed by questionnaire. Results: In the 210 patients who completed assessments before and after rehabilitation, there was an increase in 6MWT distance, median (IQR) 60 (30-80)m and BKQ 3 (1-4) points (P<0.05), and most elements of self-management improved. Almost all participants considered HYHY useful (P<0.05). There was no relationship between baseline CAT score and change in outcome measures (P>0.05). Conclusion: The results support the provision of community rehabilitation as an alternative to hospital-based interventions to support and promote self-management in people with mild breathlessness across the severity of disease burden as measured by CAT

Effectiveness of a brief school-based body image intervention 'Dove Confident Me: Single Session' when delivered by teachers and researchers: Results from a cluster randomised controlled trial

© 2015 The Authors. This study evaluated a 90-min single session school-based body image intervention (Dove Confident Me: Single Session), and investigated if delivery could be task-shifted to teachers. British adolescents (N = 1707; 11-13 years; 50.83% girls) participated in a cluster randomised controlled trial [lessons as usual control; intervention teacher-led (TL); intervention researcher-led (RL)]. Body image, risk factors, and psychosocial and disordered eating outcomes were assessed 1-week pre-intervention, immediate post-intervention, and 4-9.5 weeks follow-up. Multilevel mixed-models showed post-intervention improvements for intervention students relative to control in body esteem (TL; girls only), negative affect (TL), dietary restraint (TL; girls only), eating disorder symptoms (TL), and life engagement (TL; RL). Awareness of sociocultural pressures increased at post-intervention (TL). Effects were small-medium in size (ds 0.19-0.76) and were not maintained at follow-up. There were no significant differences between conditions at post or follow-up on body satisfaction, appearance comparisons, teasing, appearance conversations and self-esteem. The intervention had short-term benefits for girls' body image and dietary restraint, and for eating disorder symptoms and some psychosocial outcomes among girls and boys. A multi-session version of the intervention is likely to be necessary for sustained improvements. Teachers can deliver this intervention effectively with minimal training, indicating broader scale dissemination is feasible. Trial registration: ISRCTN16782819

A longitudinal study of muscle strength and function in patients with cancer cachexia

Purpose Patients with cancer frequently experience an involuntary loss of weight (in particular loss of muscle mass), defined as cachexia, with profound implications for independence and quality of life. The rate at which such patients’ physical performance declines has not been well established. The aim of this study was to determine the change in muscle strength and function over 8 weeks in patients with already established cancer cachexia, to help inform the design and duration of physical activity interventions applicable to this patient group. Methods Patients with thoracic and gastrointestinal cancer, with unintentional weight loss of >5% in 6 months or BMI < 20 plus 2% weight loss were included. Physical and functional assessments (baseline, 4 weeks, 8 weeks) included: isometric quadriceps and hamstring strength, handgrip, standing balance, 10m walk time and timed up and go. Results Fifty patients (32 male), mean ±SD age 65 ±10 years and BMI 24.9 ±4.3kg/m2 were recruited. Thoracic cancer patients had lower muscle strength and function (p0.05). Baseline variables did not differentiate between completers and non-completers (p>0.05). Conclusions More than a third of patients with established cancer cachexia in our study were stable over 8 weeks, suggesting a subgroup who may benefit from targeted interventions of reasonable duration. Better understanding the physical performance parameters which characterize and differentiate these patients has important clinical implications for cancer multidisciplinary team practice

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

BRCA2 polymorphic stop codon K3326X and the risk of breast, prostate, and ovarian cancers

Background: The K3326X variant in BRCA2 (BRCA2*c.9976A&gt;T; p.Lys3326*; rs11571833) has been found to be associated with small increased risks of breast cancer. However, it is not clear to what extent linkage disequilibrium with fully pathogenic mutations might account for this association. There is scant information about the effect of K3326X in other hormone-related cancers. Methods: Using weighted logistic regression, we analyzed data from the large iCOGS study including 76 637 cancer case patients and 83 796 control patients to estimate odds ratios (ORw) and 95% confidence intervals (CIs) for K3326X variant carriers in relation to breast, ovarian, and prostate cancer risks, with weights defined as probability of not having a pathogenic BRCA2 variant. Using Cox proportional hazards modeling, we also examined the associations of K3326X with breast and ovarian cancer risks among 7183 BRCA1 variant carriers. All statistical tests were two-sided. Results: The K3326X variant was associated with breast (ORw = 1.28, 95% CI = 1.17 to 1.40, P = 5.9x10- 6) and invasive ovarian cancer (ORw = 1.26, 95% CI = 1.10 to 1.43, P = 3.8x10-3). These associations were stronger for serous ovarian cancer and for estrogen receptor–negative breast cancer (ORw = 1.46, 95% CI = 1.2 to 1.70, P = 3.4x10-5 and ORw = 1.50, 95% CI = 1.28 to 1.76, P = 4.1x10-5, respectively). For BRCA1 mutation carriers, there was a statistically significant inverse association of the K3326X variant with risk of ovarian cancer (HR = 0.43, 95% CI = 0.22 to 0.84, P = .013) but no association with breast cancer. No association with prostate cancer was observed. Conclusions: Our study provides evidence that the K3326X variant is associated with risk of developing breast and ovarian cancers independent of other pathogenic variants in BRCA2. Further studies are needed to determine the biological mechanism of action responsible for these associations

Using the AR-V7 biomarker to determine treatment in metastatic castrate resistant prostate cancer, a feasibility randomised control trial, conclusions from the VARIANT trial [version 2; peer review: 2 approved]

Background: Prostate cancer is the most commonly diagnosed malignancy in the UK. Castrate resistant prostate cancer (CRPC) can be difficult to manage with response to next generation hormonal treatment variable. AR-V7 is a protein biomarker that can be used to predict response to treatment and potentially better inform management in these patients. Our aim was to establish the feasibility of conducting a definitive randomised controlled trial comparing the clinical utility of AR-V7 biomarker assay in personalising treatments for patients with metastatic CRPC within the United Kingdom (UK) National Health Service (NHS).  Due to a number of issues the trial was not completed successfully, we aim to discuss and share lessons learned herein. Methods: We conducted a randomised, open, feasibility trial, which aimed to recruit 70 adult men with metastatic CRPC within three secondary care NHS trusts in the UK to be run over an 18-month period. Participants were randomised to personalised treatment based on AR-V7 status (intervention) or standard care (control). The primary outcome was feasibility, which included: recruitment rate, retention and compliance. Additionally, a baseline prevalence of AR-V7 expression was to be estimated. Results: Fourteen participants were screened and 12 randomised with six into each arm over a nine-month period. Reliability issues with the AR-V7 assay meant prevalence was not estimated. Due to limited recruitment the study did not complete to target. Conclusions: Whilst the trial did not complete to target, we have ascertained that men with advanced cancer are willing to take part in trials utilising biomarker guided treatment. A number of issues were identified that serve as important learning points in future clinical trials