Quality of life in the five years after intensive care : a cohort study

Peer reviewedPublisher PD

Eltrombopag for the treatment of chronic idiopathic (immune) thrombocytopenic purpura : A Single Technology Appraisal

Evidence Review Group (ERG) final report for the National Institute for Health and Clinical ExcellencePublisher PD

Systematic review of the efficacy and safety of using mesh in surgery for uterine or vaginal vault prolapse

The original publication is available at www.springerlink.comPeer reviewedPostprin

Choice architecture modifies fruit and vegetable purchasing in a university campus grocery store : time series modelling of a natural experiment

Background In developed countries, adolescent and young adult diets have been found to be nutritionally poor. The aim of this study was to examine whether a choice architecture intervention, re-arrangement of produce within a grocery store to increase the accessibility of fruit and vegetables, affected purchasing behaviour on a university campus. Methods A database of daily sales data from January 2012 to July 2017 was obtained from a campus grocery store. Two changes to the layout were made during this time period. In January 2015, fruit and vegetables were moved from the back of the store, furthest from the entrance, to the aisle closest to the entrance and an entrance-facing display increasing their accessibility. In April 2016, the entrance-facing display of fruit and vegetables was replaced with a chiller cabinet so that fruit and vegetables remained more accessible than during the baseline period, but less accessible than in the period immediately previously. A retrospective interrupted time series analysis using dynamic regression was used to model the data and to examine the effect of the store re-arrangements on purchasing. All analyses were carried out both for sales-by-quantity and for sales-by-money. Results The first shop re-arrangement which made fruit and vegetables more prominent, increased the percentage of total sales that were fruit and vegetables, when analysed by either items purchased or money spent. The second rearrangement also had a positive effect on the percentage of total sales that were fruit and vegetables compared to baseline, however this was not significant at the 5% level. Over the five year period, the percentage of sales that were fruit and vegetables declined both in terms of items purchased, and money spent. Conclusions Increasing accessibility of fruit and vegetables in a grocery store is a feasible way to improve the diet of students in tertiary education. There is evidence of declining fruit and vegetable consumption among the studied population, which should be further investigated

Randomised trial of glutamine, selenium, or both, to supplement parenteral nutrition for critically ill patients

Peer reviewedPublisher PD

Experiences of living with visible difference: Individual and social reflections

Many health conditions impact upon an individual’s appearance and result in an altered appearance (“visible difference”). The presence of visible difference is associated with a variety of psychosocial difficulties and challenges, yet calls for an integrated theory of adjustment remain largely unanswered. This qualitative research, conducted in the United Kingdom, drew upon 22 interviews conducted with participants who had a variety of visible differences. It examined their experiences and reflections related to their difference and the impact that their visible difference had upon their lives. A thematic analysis produced two themes. The first of which was predominantly concerned with the impact of visible difference upon the individual whilst the second captured the inherently social nature of appearance and appearance based judgements. The analysis is considered in light of the contention that an integrated theory of adjustment to visible difference is required and participants’ experiences with healthcare professionals and the implications for those providing care are introduced

Use of expert knowledge in evaluating costs and benefits of alternative service provisions: A case study

Objectives: A treatment pathway model was developed to examine the costs and benefits of the current bowel cancer service in England and to evaluate potential alternatives in service provision. To use the pathway model, various parameters and probability distributions had to be specified. They could not all be determined from empirical evidence and, instead, expert opinion was elicited in the form of statistical quantities that gave the required information. The purpose of this study is to describe the procedures used to quantify expert opinion and note examples of good practice contained in the case study. Methods: The required information was identified and preparatory discussion with four experts refined the questions they would be asked. In individual elicitation sessions they quantified their opinions, mainly in the form of point and interval estimates for specified variables. New methods have been developed for quantifying expert opinion and these were implemented in specialized software that uses interactive graphics. This software was used to elicit opinion about quantities related to measurable covariates. Results: Assessments for thirty-four quantities were elicited and available checks supported their validity. Eight points of good practice in eliciting and using expert judgment were evident. Parameters and probability distributions needed for the pathway model were determined from the elicited assessments. Simulation results from the pathway model were used to inform policy on bowel cancer service provision. Conclusions: The study illustrates that quantifying and using expert judgment can be acceptable in real problems of practical importance. For full benefit to be gained from expert knowledge, elicitation must be conducted carefully and should be reported in detail

Efficacy of property marking as a situational crime prevention strategy

Burglary and stealing are crimes that have a significant impact and cost on its victims and society. To mitigate such crimes, property marking is a situational crime prevention strategy that attempts to prevent through dissuasion. There are many forms of property marking, yet there is limited research of its efficacy. Where there have been such studies, there has been some indications of success. Therefore, the study assessed the efficacy of property marking to reduce burglary and stealing crimes. The study undertook a quantitate approach using non-equivalent control groups to assess the geo-spatial impact of property marking when applied at a saturation level. Three housing groups were established (N878), comprising an experimental (n278), adjacent (n300) and control (n300) groups, with significance measured using a Wald Chi-square method. Results indicated that when property marking is applied at saturation levels (≥80%), both burglary and stealing crimes decreased significantly. Furthermore, that displacement for both burglary and stealing occurred in the adjacent area. Recommendations suggest that property marking should not be used in a sporadic manner; instead, targeted at an optimal saturation level. Such targeting should have the aim to target burglary and stealing hotspots and saturate these areas for property marking to work effectively

2-De­oxy-2,3-O-isopropyl­idene-2,4-di-C-methyl-β-l-arabinose

X-ray crystallography unequivocally confirmed the stereochemistry of the C atom at position 2 in the carbon scaffold of the title mol­ecule, C10H18O4. The pyran­ose ring exists in a chair conformation with the methyl group on the C atom in the 2 position in an equatorial configuration. The absolute stereochemistry was determined from the starting material. The crystal structure consists of O—H⋯O hydrogen-bonded chains of mol­ecules running parallel to the b axis

2,3-O-(S)-Benzyl­idene-2-C-methyl-d-ribono-1,4-lactone

The crystal structure of the title compound, C13H14O5, establishes (i) the (S) – rather than (R) – configuration at the acetal carbon and (ii) that both the acetal and the lactone form five- rather than six-membered rings; the absolute configuration is determined by the use of 2-C-methyl-d-ribono-1,4-lactone as the starting material. The compound consists of hydrogen-bonded chains of mol­ecules running along the a axis; there are no unusual packing features. Only classical hydrogen bonding has been considered