The feasibility of delivering the ADVANCE digital intervention to reduce intimate partner abuse by men receiving substance use treatment:protocol for a non-randomised multi-centre feasibility study and embedded process evaluation

BACKGROUND: Compared to men in the general population, men in substance use treatment are more likely to perpetrate intimate partner abuse (IPA). The ADVANCE group intervention for men in substance use treatment is tailored to address substance use and IPA in an integrated way. In a feasibility trial pre-COVID, men who received the ADVANCE intervention via face-to-face group delivery showed reductions in IPA perpetration. Due to COVID-19, ADVANCE was adapted for remote digital delivery. METHODS/DESIGN: This mixed-methods non-randomised feasibility study, with a nested process evaluation, will explore the feasibility and acceptability of delivering the ADVANCE digital intervention to men in substance use treatment who have perpetrated IPA towards a female partner in the past year. Sixty men will be recruited from seven substance use treatment services in Great Britain. The ADVANCE digital intervention comprises a preparatory one-to-one session with a facilitator to set goals, develop a personal safety plan, and increase motivation and a preparatory online group to prepare men for taking part in the intervention. The core intervention comprises six fortnightly online group sessions and 12 weekly self-directed website sessions to recap and practise skills learned in the online group sessions. Each website session is followed by a one-to-one video/phone coaching session with a facilitator. Men will also receive their usual substance use treatment. Men’s female (ex) partners will be invited to provide outcome data and offered support from integrated safety services (ISS). Outcome measures for men and women will be sought post intervention (approximately 4 months post male baseline interview). Feasibility parameters to be estimated include eligibility, suitability, consent, recruitment, attendance, retention and follow-up rates. In-depth interviews or focus groups will explore the intervention’s acceptability to participants, facilitators and ISS workers. A secondary focus of the study will estimate pre-post-differences in outcome measures covering substance use, IPA, mental health, self-management, health and social care service use, criminal justice contacts and quality of life. DISCUSSION: Findings will inform the design of a multicentre randomised controlled trial evaluating the efficacy and cost-effectiveness of the ADVANCE digital intervention for reducing IPA. TRIAL REGISTRATION: The feasibility study was prospectively registered: ISRCTN66619273

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Les trésors du Mont-Saint-Michel : l'enluminure romane. Monique Dosdat, L'enluminure romane au Mont-Saint-Michel, Ed. Ouest-France, 1991

Potts Cassandra. Les trésors du Mont-Saint-Michel : l'enluminure romane. Monique Dosdat, L'enluminure romane au Mont-Saint-Michel, Ed. Ouest-France, 1991. In: Études Normandes, 40e année, n°4, 1991. Les 25 ans de l'Université de Rouen - les 40 ans d'Etudes Normandes. pp. 69-70

Les ducs normands et leurs nobles

Potts Cassandra. Les ducs normands et leurs nobles. In: Études Normandes, 35e année, n°3, 1986. La Saga des Normands. Prélude à l'année Guillaume le Conquérant. pp. 29-37

Une synthèse sur les mentalités religieuses en Normandie au XIe siècle. Dr J. Fournée, Les mentalités religieuses au XIe siècle en Normandie, 1988

Potts Cassandra. Une synthèse sur les mentalités religieuses en Normandie au XIe siècle. Dr J. Fournée, Les mentalités religieuses au XIe siècle en Normandie, 1988. In: Études Normandes, 37e année, n°4, 1988. Images d'histoire normande. p. 75

De Saint-Nicolas au Père Noël en Normandie

Potts Cassandra. De Saint-Nicolas au Père Noël en Normandie. In: Études Normandes, 37e année, n°4, 1988. Images d'histoire normande. pp. 75-76

Fécamp et sa campagne à l'époque des ducs de Normandie. R. Soulignac. Fécamp et sa campagne à l'époque des Ducs de Normandie, 1987

Potts Cassandra. Fécamp et sa campagne à l'époque des ducs de Normandie. R. Soulignac. Fécamp et sa campagne à l'époque des Ducs de Normandie, 1987. In: Études Normandes, 37e année, n°1, 1988. L'Université de Caen – Le Havre vers 1760 – Aspects de l'industrie normande. pp. 85-86

Les trésors du Mont-Saint-Michel : l'enluminure romane. Monique Dosdat, L'enluminure romane au Mont-Saint-Michel, Ed. Ouest-France, 1991

Potts Cassandra. Les trésors du Mont-Saint-Michel : l'enluminure romane. Monique Dosdat, L'enluminure romane au Mont-Saint-Michel, Ed. Ouest-France, 1991. In: Études Normandes, 40e année, n°4, 1991. Les 25 ans de l'Université de Rouen - les 40 ans d'Etudes Normandes. pp. 69-70