Naval History by Conspiracy Theory: The British Admiralty before the First World War and the Methodology of Revisionism

Revisionist interpretations of British naval policy in the Fisher era claim that an elaborate smoke screen was created to hide the Royal Navy’s real policies; while documents showing the true goals were systematically destroyed. By asserting this, revisionists are able to dismiss those parts of the documentary record that contradict their theories, while simultaneously excusing the lack of evidence for their theories by claiming it has been destroyed. This article shows that this methodology is misleading and untenable

Factors in AIDS Dementia Complex Trial Design: Results and Lessons from the Abacavir Trial

OBJECTIVES: To determine the efficacy of adding abacavir (Ziagen, ABC) to optimal stable background antiretroviral therapy (SBG) to AIDS dementia complex (ADC) patients and address trial design. DESIGN: Phase III randomized, double-blind placebo-controlled trial. SETTING: Tertiary outpatient clinics. PARTICIPANTS: ADC patients on SBG for ≥8 wk. INTERVENTIONS: Participants were randomized to ABC or matched placebo for 12 wk. OUTCOME MEASURES: The primary outcome measure was the change in the summary neuropsychological Z score (NPZ). Secondary measures were HIV RNA and the immune activation markers β-2 microglobulin, soluble tumor necrosis factor (TNF) receptor 2, and quinolinic acid. RESULTS: 105 participants were enrolled. The median change in NPZ at week 12 was +0.76 for the ABC + SBG and +0.63 for the SBG groups (p = 0.735). The lack of efficacy was unlikely related to possible limited antiviral efficacy of ABC: at week 12 more ABC than placebo participants had plasma HIV RNA ≤400 copies/mL (p = 0.002). There were, however, other factors. Two thirds of patients were subsequently found to have had baseline resistance to ABC. Second, there was an unanticipated beneficial effect of SBG that extended beyond 8 wk to 5 mo, thereby rendering some of the patients at baseline unstable. Third, there was an unexpectedly large variability in neuropsychological performance that underpowered the study. Fourth, there was a relative lack of activity of ADC: 56% of all patients had baseline cerebrospinal fluid (CSF) HIV-1 RNA <100 copies/mL and 83% had CSF β-2 microglobulin <3 nmol/L at baseline. CONCLUSIONS: The addition of ABC to SBG for ADC patients was not efficacious, possibly because of the inefficacy of ABC per se, baseline drug resistance, prolonged benefit from existing therapy, difficulties with sample size calculations, and lack of disease activity. Assessment of these trial design factors is critical in the design of future ADC trials

Factors in AIDS Dementia Complex Trial Design: Results and Lessons from the Abacavir Trial

To determine the efficacy of adding abacavir (Ziagen, ABC) to optimal stable background antiretroviral therapy (SBG) to AIDS dementia complex (ADC) patients and address trial design

Britain's great security mirage: the Royal Navy and the Franco-Russian naval threat, 1898–1906

The attached is a post-print version of the article entitled "The Franco-Russian naval threat in British naval thinking, 1899-1906: a reappraisal". This was subsequently changed to "Britain's great security mirage: the Royal Navy and the Franco-Russian naval threat, 1898–1906" for the final published version.This article focuses on the relationship between the threat perception analyses of the British Admiralty and the strategic orientation of the Royal Navy at the outset of the twentieth century. The current view is that this was an era when fear of France and Russia drove British naval policy. However, as this article will show, Britain’s Naval Intelligence Department formed a low opinion of French and Russian naval capabilities at this time and this negative evaluation exerted considerable influence over decision-making. The belief that, owing to multiple qualitative deficiencies, these powers could definitely be beaten in battle lessened the standing of the Franco-Russian naval challenge and freed the Admiralty to consider the danger posed by other possible enemies, most notably Germany