4 research outputs found
'It's a film' : medium specificity as textual gesture in Red road and The unloved
British cinema has long been intertwined with television. The
buzzwords of the transition to digital media, 'convergence' and
'multi-platform delivery', have particular histories in the British
context which can be grasped only through an understanding of the
cultural, historical and institutional peculiarities of the British film
and television industries. Central to this understanding must be two
comparisons: first, the relative stability of television in the duopoly
period (at its core, the licence-funded BBC) in contrast to the repeated
boom and bust of the many different financial/industrial combinations
which have comprised the film industry; and second, the cultural and
historical connotations of 'film' and 'television'. All readers of this
journal will be familiar – possibly over-familiar – with the notion that
'British cinema is alive and well and living on television'. At the end of
the first decade of the twenty-first century, when 'the end of medium
specificity' is much trumpeted, it might be useful to return to the
historical imbrication of British film and television, to explore both
the possibility that medium specificity may be more nationally specific
than much contemporary theorisation suggests, and to consider some
of the relationships between film and television manifest at a textual
level in two recent films, Red Road (2006) and The Unloved (2009)
Screening for type 2 diabetes and population mortality over 10 years (ADDITION-Cambridge): a cluster-randomised controlled trial.
BACKGROUND: The increasing prevalence of type 2 diabetes poses a major public health challenge. Population-based screening and early treatment for type 2 diabetes could reduce this growing burden. However, uncertainty persists around the benefits of screening for type 2 diabetes. We assessed the effect of a population-based stepwise screening programme on mortality. METHODS: In a pragmatic parallel group, cluster-randomised trial, 33 general practices in eastern England were randomly assigned by the method of minimisation in an unbalanced design to: screening followed by intensive multifactorial treatment for people diagnosed with diabetes (n=15); screening plus routine care of diabetes according to national guidelines (n=13); and a no-screening control group (n=5). The study population consisted of 20,184 individuals aged 40-69 years (mean 58 years), at high risk of prevalent undiagnosed diabetes, on the basis of a previously validated risk score. In screening practices, individuals were invited to a stepwise programme including random capillary blood glucose and glycated haemoglobin (HbA(1c)) tests, a fasting capillary blood glucose test, and a confirmatory oral glucose tolerance test. The primary outcome was all-cause mortality. All participants were flagged for mortality surveillance by the England and Wales Office of National Statistics. Analysis was by intention-to-screen and compared all-cause mortality rates between screening and control groups. This study is registered, number ISRCTN86769081. FINDINGS: Of 16,047 high-risk individuals in screening practices, 15,089 (94%) were invited for screening during 2001-06, 11,737 (73%) attended, and 466 (3%) were diagnosed with diabetes. 4137 control individuals were followed up. During 184,057 person-years of follow up (median duration 9·6 years [IQR 8·9-9·9]), there were 1532 deaths in the screening practices and 377 in control practices (mortality hazard ratio [HR] 1·06, 95% CI 0·90-1·25). We noted no significant reduction in cardiovascular (HR 1·02, 95% CI 0·75-1·38), cancer (1·08, 0·90-1·30), or diabetes-related mortality (1·26, 0·75-2·10) associated with invitation to screening. INTERPRETATION: In this large UK sample, screening for type 2 diabetes in patients at increased risk was not associated with a reduction in all-cause, cardiovascular, or diabetes-related mortality within 10 years. The benefits of screening might be smaller than expected and restricted to individuals with detectable disease. FUNDING: Wellcome Trust; UK Medical Research Council; National Health Service research and development support; UK National Institute for Health Research; University of Aarhus, Denmark; Bio-Rad