Ethics, evidence based sports medicine, and the use of platelet rich plasma in the English Premier League

The use of platelet rich plasma (PRP) as a novel treatment is discussed in the context of a qualitative research study comprising 38 interviews with sports medicine practitioners and other stakeholders working within the English Premier League during the 2013-16 seasons. Analysis of the data produced several overarching themes: conservatism versus experimentalism in medical attitudes; therapy perspectives divergence; conflicting versions of appropriate evidence; subcultures; community beliefs/practices; and negotiation of medical decision-making. The contested evidence base for the efficacy of PRP is presented in the context of a broader professional shift towards evidence based medicine within sports medicine. Many of the participants while accepting this shift are still committed to casuistic practices where clinical judgment is flexible and does not recognize a context-free hierarchy of evidentiary standards to ethically justifiable practice. We also discuss a tendency in the data collected to consider the use of deceptive, placebo-like, practices among the clinician participants that challenge dominant understandings of informed consent in medical ethics. We conclude that the complex relation between evidence and ethics requires greater critical scrutiny for this emerging specialism within the medical community

Study on Doping Prevention: A map of Legal, Regulatory and Prevention Practice Provisions in EU 28

Historically, anti-doping efforts have focused on the detection and deterrence of doping in elite and competitive sport. There is, however, a growing concern that doping is occurring outside the organised sporting system; giving rise to the belief that the misuse of doping agents in recreational sport has become a societal problem and a public health issue that must be addressed. The EU Commission awarded a contract (EAC/2013/0617) to a Consortium to undertake this Study with the aim of developing the evidence-base for policies designed to combat doping in recreational sport. Fourteen internationally recognised experts shaped the Study which comprised (i) the collection of primary data through a structured survey, and (ii) secondary data through literature searches and website analysis. All 28 Member States participated in the information-gathering process. Specifically, this involved a systematic study of the ethical considerations, legal position, prevention research landscape, and current practise in relation to the prevention of doping in recreational sport. The Study provides a comprehensive overview of current practice and legislation as it applies to the prevention of doping and promotes and supports the sharing of best practices in the EU regarding the fight against doping in recreational sport. It concludes with seven recommendations for future action that focus on the need for a coordinated response in relation to the problems arising from doping in recreational sport

Pharmacist-led management of chronic pain in primary care:results from a randomised controlled exploratory trial

To compare the effectiveness of pharmacist medication review, with or without pharmacist prescribing, with standard care, for patients with chronic pain

Trajectories through semantic spaces in schizophrenia and the relationship to ripple bursts

Human cognition is underpinned by structured internal representations that encode relationships between entities in the world (cognitive maps). Clinical features of schizophrenia-from thought disorder to delusions-are proposed to reflect disorganization in such conceptual representations. Schizophrenia is also linked to abnormalities in neural processes that support cognitive map representations, including hippocampal replay and high-frequency ripple oscillations. Here, we report a computational assay of semantically guided conceptual sampling and exploit this to test a hypothesis that people with schizophrenia (PScz) exhibit abnormalities in semantically guided cognition that relate to hippocampal replay and ripples. Fifty-two participants [26 PScz (13 unmedicated) and 26 age-, gender-, and intelligence quotient (IQ)-matched nonclinical controls] completed a category- and letter-verbal fluency task, followed by a magnetoencephalography (MEG) scan involving a separate sequence-learning task. We used a pretrained word embedding model of semantic similarity, coupled to a computational model of word selection, to quantify the degree to which each participant's verbal behavior was guided by semantic similarity. Using MEG, we indexed neural replay and ripple power in a post-task rest session. Across all participants, word selection was strongly influenced by semantic similarity. The strength of this influence showed sensitivity to task demands (category > letter fluency) and predicted performance. In line with our hypothesis, the influence of semantic similarity on behavior was reduced in schizophrenia relative to controls, predicted negative psychotic symptoms, and correlated with an MEG signature of hippocampal ripple power (but not replay). The findings bridge a gap between phenomenological and neurocomputational accounts of schizophrenia

Financial Doping in the English Premier League

Whilst the relationship between money and success in elite sport is acknowledged, the exact nature, extent and implications of this relationship is one that has not been carefully examined. In this paper we have three main aims. Firstly, to provide empirical evidence of the extent that money buys success in the English Premier League. Secondly, to evaluate this evidence from a sports ethics perspective, and, finally, to discuss potential solutions to the problem. We argue that the evident performance advantage teams gain through financial investments is contrary to the spirit of sport as it undermines athletic excellence and the ‘sweet tension of uncertainty of outcome’ that is central to good competition. Consequently, financial investments in elite football ought to be regulated and controlled. We argue, however, that current attempts to do so (via Financial Fair Play Regulations) are inadequate as they focus on issues concerning financial health, rather than the health of the game in terms of spirit and fairness

An assessment of the torrefaction of North American pine and life cycle greenhouse gas emissions

Bioenergy is increasingly being used to meet EU objectives for renewable energy generation and reducing greenhouse gas (GHG) emissions. Problems with using biomass however include high moisture contents, lower calorific value and poor grindability when compared to fossil fuels. Torrefaction is a pre-treatment process that aims to address these issues. In this paper four torrefaction treatments of pine were performed and a mass-energy balance calculated. Using experimental data, a pellet production supply chain incorporating torrefaction was modelled and compared to an existing wood pellet system to determine life-cycle GHG emissions. Two utility fuels, wood chips and natural gas, were considered to provide process heat in addition to volatile gases released during torrefaction (torgas). Experimental results show that torrefaction reduces the moisture content and increases the calorific value of the fuels. Increasing torrefaction temperature and residence time results in lower mass and energy yields. GHG emissions reduce with increasing torrefaction severity. Emissions from drying &amp; torrefaction and shipping are the highest GHG contributors to the supply chain. All 4 torrefaction conditions assessed outperformed traditional wood pellet supply chain emissions but more land is required which increases with temperature and residence time. Sensitivity analysis results show that emissions increase significantly where natural gas is used for utility fuel and no torgas is utilised.</p

Elucigene FH20 and LIPOchip for the diagnosis of familial hypercholesterolaemia : a systematic review and economic evaluation

PMID: 22469073 [PubMed - indexed for MEDLINE] Free full textPeer reviewedPublisher PD

Aspirin reduces lipopolysaccharide induced pulmonary inflammation in human models of ARDS

International audienc

Off-Shell Rho-Omega Mixing Through Quark Loops With Non-Perturbative Meson Vertex And Quark Mass Functions

The momemtum dependence of the off-shell $\rho$-$\omega$ mixing amplitude is calculated through a two-quark loop diagram, using non-perturbative meson-quark vertex functions for the $\rho$ and $\omega$ mesons, as well as non-perturbative quark propagators. Both these quantities are generated self-consistently through an interlinked BSE-cum-SDE approach with a 3D support for the BSE kernel with two basic constants which are pre- checked against a wide cross section of both meson and baryon spectra within a common structural framework for their respective 3D BSE's. With this pre-calibration, the on-shell strength works out at -2.434$\delta(m_q^2)$ in units of the change in "constituent mass squared", which is consistent with the $e^+e^-$ to $\pi^+\pi^-$ data for a u-d mass difference of ~4 MeV ,while the relative off-shell strength (0.99 $\pm$ 0.01) lies midway between quark-loop and QCD-SR results. We also calculate the photon-mediated $\rho$-$\omega$ propagator whose off-shell structure has an additional pole at $q^2$=0. The implications of these results vis-a-vis related investigations are discussed.Comment: 12 Pages, latex file, NTUTH-94-0