A cohort study of the recovery of health and wellbeing following colorectal cancer (CREW study): protocol paper

Background: the number of people surviving colorectal cancer has doubled in recent years. While much of the literature suggests that most people return to near pre-diagnosis status following surgery for colorectal cancer, this literature has largely focused on physical side effects. Longitudinal studies in colorectal cancer have either been small scale or taken a narrow focus on recovery after surgery. There is a need for a comprehensive, long-term study exploring all aspects of health and wellbeing in colorectal cancer patients. The aim of this study is to establish the natural history of health and wellbeing in people who have been treated for colorectal cancer. People have different dispositions, supports and resources, likely resulting in individual differences in restoration of health and wellbeing. The protocol described in this paper is of a study which will identify who is most at risk of problems, assess how quickly people return to a state of subjective health and wellbeing, and will measure factors which influence the course of recovery. Methods: this is a prospective, longitudinal cohort study following 1000 people with colorectal cancer over a period of two years, recruiting from 30 NHS cancer treatment centres across the UK. Questionnaires will be administered prior to surgery, and 3, 9, 15 and 24 months after surgery, with the potential to return to this cohort to explore on-going issues related to recovery after cancer. Discussion: outcomes will help inform health care providers about what helps or hinders rapid and effective recovery from cancer, and identify areas for intervention development to aid this process. Once established the cohort can be followed up for longer periods and be approached to participate in related projects as appropriate and subject to funding<br/

Media(ted) fabrications: How the science-media symbiosis helped ‘sell’ cord banking

This paper considers the problematic role of the science–media symbiosis in the dissemination of misleading and emotionally manipulative information regarding services offered by CordBank, New Zealand's only umbilical cord blood banking facility. As this case study illustrates, the growing reliance of health and science reporters on the knowledge capital of medical specialists, biogenetic researchers, and scientists potentially enhances the ability of ‘expert’ sources to set the agenda for media representations of emerging medical and scientific developments, and may undermine the editorial independence of journalists and editors, many of whom in this case failed to critically evaluate deeply problematic claims regarding the current and future benefits of cord banking. Heavy reliance on established media frames of anecdotal personalization and technoboosterism also reinforced a proscience journalistic culture in which claims by key sources were uncritically reiterated and amplified, with journalistic assessments of the value of cord banking emphasizing potential benefits for individual consumers. It is argued that use of these media frames potentially detracts from due consideration of the broader social, ethical, legal, and health implications of emerging biomedical developments, along with the professional, personal, and increasingly also financial interests at stake in their public promotion, given the growing commercialization of biogenetic technologies

CaNaSTA - Crop Niche Selection for Tropical Agriculture, a Spatial Decision Support System

Farmers in the developing world frequently find themselves in uncertain and risky environments, often having to make decisions based on very little information. Risks for smallholder farmers are often critical because of their poverty. In addition, in the tropics and subtropics, the natural environment is spatially and temporally variable and often harsh, thereby increasing the uncertainty faced by these farmers. This research aims to improve forage adoption decisions in the developing world, thereby increasing sustainable intensification and ultimately contributing to increased sustainable world food production and the alleviation of under-nutrition

Application of satellite precipitation data to analyse and model arbovirus activity in the tropics

Background: Murray Valley encephalitis virus (MVEV) is a mosquito-borne Flavivirus (Flaviviridae: Flavivirus) which isclosely related to Japanese encephalitis virus, West Nile virus and St. Louis encephalitis virus. MVEV is enzootic innorthern Australia and Papua New Guinea and epizootic in other parts of Australia. Activity of MVEV in WesternAustralia (WA) is monitored by detection of seroconversions in flocks of sentinel chickens at selected sample sitesthroughout WA.Rainfall is a major environmental factor influencing MVEV activity. Utilising data on rainfall and seroconversions,statistical relationships between MVEV occurrence and rainfall can be determined. These relationships can be usedto predict MVEV activity which, in turn, provides the general public with important information about diseasetransmission risk. Since ground measurements of rainfall are sparse and irregularly distributed, especially in northWA where rainfall is spatially and temporally highly variable, alternative data sources such as remote sensing (RS)data represent an attractive alternative to ground measurements. However, a number of competing alternatives areavailable and careful evaluation is essential to determine the most appropriate product for a given problem.Results: The Tropical Rainfall Measurement Mission (TRMM) Multi-satellite Precipitation Analysis (TMPA) 3B42product was chosen from a range of RS rainfall products to develop rainfall-based predictor variables and buildlogistic regression models for the prediction of MVEV activity in the Kimberley and Pilbara regions of WA. Twomodels employing monthly time-lagged rainfall variables showed the strongest discriminatory ability of 0.74 and0.80 as measured by the Receiver Operating Characteristics area under the curve (ROC AUC).Conclusions: TMPA data provide a state-of-the-art data source for the development of rainfall-based predictivemodels for Flavivirus activity in tropical WA. Compared to ground measurements these data have the advantage ofbeing collected spatially regularly, irrespective of remoteness. We found that increases in monthly rainfall andmonthly number of days above average rainfall increased the risk of MVEV activity in the Pilbara at a time-lag oftwo months. Increases in monthly rainfall and monthly number of days above average rainfall increased the risk ofMVEV activity in the Kimberley at a lag of three months.I

Poisoning by British Plants

The properties of poisonous plants have been recognised for thousands of years. To-day we see the active constituents of some such plants, accurately determined and concentrated in tablets and mixtures, used in the practice of therapeutics.Cases of poisoning by plants though now uncommon, do still occur occasionally. Various factors are responsible for the drop in incidence over the last century. The general standard of living has been raised and people no longer require to supplement their diet with roots and fruits on pain of starvation, when mistakes are liable to occur. Better education combined with suspicions as to the wholesomeness of various fruits provides a barrier against reckless indulgence. Farming is carried out intensively and crops arc cleaner than before, thus reducing possible contamination of grain. The potential murderer or suicide now has the vast range of dangerous drugs to choose from provided he can obtain them. Many of the plants themselves have now a limited distribution. The using of any available land for grazing or ploughing and the drainage of marshes, burning of scrub and felling of timber has reduced the available habitats

Bending Properties of Nickel Electrodes for Nickel-Hydrogen Batteries

Recent changes in manufacturing have resulted in nickel-hydrogen batteries that fail prematurely by electrical shorting, This failure is believed to be a result of a blistering problem in the nickel electrodes. In this study the bending properties of nickel electrodes are investigated in an attempt to correlate the bending properties of the electrode with its propensity to blister. Nickel electrodes from three different batches of material were tested in both the as-received and impregnated forms. The effects of specimen curvature and position within the electrode on the bending strength were studied, and within-electrode and batch-to-batch variations were addressed. Two color-imaging techniques were employed to differentiate between the phases within the electrodes. These techniques aided in distinguishing the relative amounts of nickel hyroxide surface loading on each electrode, thereby relating surface loading to bend strength. Bend strength was found to increase with the amount of surface loading

Deliberating stratospheric aerosols for climate geoengineering and the SPICE project

Increasing concerns about the narrowing window for averting dangerous climate change have prompted calls for research into geoengineering, alongside dialogue with the public regarding this as a possible response. We report results of the first public engagement study to explore the ethics and acceptability of stratospheric aerosol technology and a proposed field trial (the Stratospheric Particle Injection for Climate Engineering (SPICE) ‘pipe and balloon’ test bed) of components for an aerosol deployment mechanism. Although almost all of our participants were willing to allow the field trial to proceed, very few were comfortable with using stratospheric aerosols. This Perspective also discusses how these findings were used in a responsible innovation process for the SPICE project initiated by the UK’s research councils

Impact of the Chelsea critical care physical assessment (CPAx) tool on clinical outcomes of surgical and trauma patients in an intensive care unit: An experimental study

Background: Critically ill patients following traumatic injury or major surgery are at risk of loss of skeletal muscle mass, which leads to decreased physical function. Early rehabilitation in an intensive care unit (ICU) is thought to preserve or restore physical functioning. The Chelsea critical care physical assessment (CPAx) is a measurement tool used to assess physical function in the ICU. Objectives: To determine whether the use of the CPAx tool as part of physiotherapy patient assessment, in two adult trauma and surgical ICU settings where early patient mobilisation forms part of standard physiotherapy practice, had an impact on ICU and hospital length of stay (LOS) through delivery of problem-oriented treatment plans. Method: A single-centred pre–post quasi-experimental study was conducted. The population was a consecutive sample of surgical and trauma ICU patients. Participants’ functional ability was assessed with the CPAx tool on alternative days during their ICU stay, and rehabilitation goals were modified according to their CPAx score. Intensive care unit and hospital LOS data were collected and compared to data of a matched historical control group. Descriptive and inferential statistics were used. Results: A total of 26 ICU patients were included in the intervention group (n = 26). They received CPAx-guided therapy, and outcomes were matched with ICU patients in the historical control group (n = 26). The median sequential organ failure assessment (SOFA) score was significantly higher in the control group (p = 0.005) (3.5 [IQR 2–6.3]) versus (2 [IQR 1.8–2.5]) for the intervention group. The median admission CPAx score for the intervention group was 33.5 (IQR 16.1–44), and the median ICU discharge score was 38 (IQR 28.5–43.8). No significant differences were found in ICU days (control 2.7 [IQR 1.1–5.2]; intervention 3.7 [IQR 2.3–5.4]; p = 0.27) or hospital LOS (control 13.5 [IQR 9.3–18.3]; intervention 11.4 [IQR 8.4–20.3], p = 0.42). Chelsea critical care physical assessment scores on ICU admission had a moderate negative correlation with hospital LOS (r = -0.58, p = 0.00, n = 23). Chelsea critical care physical assessment scores at ICU discharge had strong positive correlation with discharge SOFA scores (r = 0.7; p = 0.025; n = 10). Conclusion: Problem-oriented patient rehabilitation informed by the CPAx tool resulted in improvement of physical function but did not reduce ICU or hospital LOS. Clinical implications: A higher level of physical function at ICU admission, measured with CPAx, was associated with shorter hospital LOS.South African Society of Physiotherapy Research Foundatio