Sleep apnoea and its impact on public health

In 1997 we published a systematic review on the health effects of obstructive sleep apnoea and the effectiveness of treatment with CPAP. This generated much controversy and considerable correspondence. About half the letters received by the authors suggested that the paper was just stating the obvious, the other half that the paper was completely inaccurate. To help clarify our findings this paper will discuss the public health impact of sleep apnoea and the rationale behind systematic reviews

Mechanisms of optical angular momentum transfer to nematic liquid crystalline droplets

A detailed study is presented that evaluates the relative importance of wave plate behavior, scattering processes and absorption phenomena in transferring optical torque from circularly polarized light to optically trapped nematic droplets. A wide range of parameters is considered: droplet diameters between 1 and 15 µm, birefringence values from 0.15 to 0.26 and trapping beam powers from 50 mW to 400 mW. Wave plate behavior is verified through the dependence of torque on droplet diameter and material birefringence. The dependence of the magnitude of the torque on material birefringence confirms the additional importance of the scattering mechanism. Absorption processes are found to be negligible

What's the evidence that NICE guidance has been implemented? Results from a national evaluation using time series analysis, audit of patients' notes, and interviews

OBJECTIVES: To assess the extent and pattern of implementation of guidance issued by the National Institute for Clinical Excellence (NICE). DESIGN: Interrupted time series analysis, review of case notes, survey, and interviews. SETTING: Acute and primary care trusts in England and Wales. PARTICIPANTS: All primary care prescribing, hospital pharmacies; a random sample of 20 acute trusts, 17 mental health trusts, and 21 primary care trusts; and senior clinicians and managers from five acute trusts. MAIN OUTCOME MEASURES: Rates of prescribing and use of procedures and medical devices relative to evidence based guidance. RESULTS: 6308 usable patient audit forms were returned. Implementation of NICE guidance varied by trust and by topic. Prescribing of some taxanes for cancer (P <0.002) and orlistat for obesity (P <0.001) significantly increased in line with guidance. Prescribing of drugs for Alzheimer’s disease and prophylactic extraction of wisdom teeth showed trends consistent with, but not obviously a consequence of, the guidance. Prescribing practice often did not accord with the details of the guidance. No change was apparent in the use of hearing aids, hip prostheses, implantable cardioverter defibrillators, laparoscopic hernia repair, and laparoscopic colorectal cancer surgery after NICE guidance had been issued. CONCLUSIONS: Implementation of NICE guidance has been variable. Guidance seems more likely to be adopted when there is strong professional support, a stable and convincing evidence base, and no increased or unfunded costs, in organisations that have established good systems for tracking guidance implementation and where the professionals involved are not isolated. Guidance needs to be clear and reflect the clinical context

Effects of bovine somatotrophin (bST) on ovarian function in post-partum beef cows

Full text not available. Only the abstract. DOI: 10.1071/RD9960951The effects of bovine somatotrophin (bST) on ovarian follicle development and function and associated gonadotrophin profiles during the first nine weeks post partum were investigated in beef cows. Thirty-two cows (Shorthorn x Galloway) in moderately low body condition (BC) at calving were fed to maintain BC thereafter. At Weeks 2, 4, 6 and 8 post partum, animals were injected with 320 mg bovine somatotrophin (bST) (T, treated; n = 17) or with the carrier oil only (C, control; n = 15). Ovulation occurred in 4 of 17 T cows and 0 of 15 C cows (P = 0.10) by nine week post partum. Treatment with bST did not affect the numbers of small (3-8 mm in diameter) or large (> 8 mm in diameter) follicles or the granulosa cell populations but enhanced the oestradiol (P < 0.05) and insulin-like growth factor-I (IGF-I) content (P < 0.01) of large follicles by nine weeks post partum. It did not significantly affect the testosterone concentrations of large follicles. Circulating concentrations of growth hormone (GH) and IGF-I were higher in T cows than in C cows (P < 0.001) but were unrelated to gonadotrophin profiles or gonadotrophin receptor concentrations in the follicles. At Week 8, plasma insulin concentrations were higher in T cows than in C cows both before (P < 0.05) and after (P < 0.05) glucose injection. It is concluded that GH may play an important role in mediating the effects of nutritional state on ovarian function during the post-partum period, possibly through alteration of intrafollicular IGF-I concentrations

Solar sail capture trajectories at Mercury

Mercury is an ideal environment for future planetary exploration by solar sail since it has proved difficult to reach with conventional propulsion and hence remains largely unexplored. In addition, its proximity to the Sun provides a solar sail acceleration of order ten times the sail characteristic acceleration at 1 AU. Conventional capture techniques are shown to be unsuitable for solar sails and a new method is presented. It is shown that capture is bound by upper and lower limits on the orbital elements of the approach orbit and that failure to be within limits results in a catastrophic collision with the planet. These limits are presented for a range of capture inclinations and sail characteristic accelerations. It is found that sail hyperbolic excess velocity is a critical parameter during capture at Mercury, with only a narrow allowed band in order to avoid collision with the planet. The new capture methodis demonstrated for a Mercury sample return mission