Qalb ta’ Tifel

Ġabra ta’ poeżiji u proża li tinkludi: Lil Malta ta’ Dun Karm – Fuq il-Fruntiera ta’ Dun Karm – Jum li jibqa’ jissemma ta’ Ġużè Chetcuti – Xbihet Malta ta’ Arthur V. Vassallo – Għanja ta’ Mħabba ta’ Ġużè Chetcuti – Żewġ Poeżijiet tal-kittieb Malti Antonio Calleja ta’ A. C. – Twettiqa ta’ Calleja – Lil Ħabib Għeluq Sninu ta’ Calleja – Taħt is-Salib ta’ R. M. B. – Lil Dun Karm ta’ Fran. Camilleri – Frak mill-weraq ta’ Byron ta’ A. C. – Irrid Immur Ta’ Xbiex ta’ Fran. Camilleri – Il-Cottonera fil-Ħamrun ta’ N. Biancardi – Qalb ta’ Tifel ta’ R. M. B.N/

Nationwide randomised trial evaluating elective neck dissection for early stage oral cancer (SEND study) with meta-analysis and concurrent real-world cohort.

BACKGROUND Guidelines remain unclear over whether patients with early stage oral cancer without overt neck disease benefit from upfront elective neck dissection (END), particularly those with the smallest tumours. METHODS We conducted a randomised trial of patients with stage T1/T2 N0 disease, who had their mouth tumour resected either with or without END. Data were also collected from a concurrent cohort of patients who had their preferred surgery. Endpoints included overall survival (OS) and disease-free survival (DFS). We conducted a meta-analysis of all six randomised trials. RESULTS Two hundred fifty randomised and 346 observational cohort patients were studied (27 hospitals). Occult neck disease was found in 19.1% (T1) and 34.7% (T2) patients respectively. Five-year intention-to-treat hazard ratios (HR) were: OS HR = 0.71 (p = 0.18), and DFS HR = 0.66 (p = 0.04). Corresponding per-protocol results were: OS HR = 0.59 (p = 0.054), and DFS HR = 0.56 (p = 0.007). END was effective for small tumours. END patients experienced more facial/neck nerve damage; QoL was largely unaffected. The observational cohort supported the randomised findings. The meta-analysis produced HR OS 0.64 and DFS 0.54 (p < 0.001). CONCLUSION SEND and the cumulative evidence show that within a generalisable setting oral cancer patients who have an upfront END have a lower risk of death/recurrence, even with small tumours. CLINICAL TRIAL REGISTRATION NIHR UK Clinical Research Network database ID number: UKCRN 2069 (registered on 17/02/2006), ISCRTN number: 65018995, ClinicalTrials.gov Identifier: NCT00571883

Internal and External Barriers to Energy Efficiency: Made-to-Measure Policy Interventions

This paper has two objectives. First it provides a correlation between internal and external barriers to energy efficiency and consumer behaviour related to two domains. It evaluates behaviour related to energy curtailment, which represents routine, repetitive effort to decrease consumption on a day-to-day basis. It also considers behaviour related to investments, which are one time actions such as purchasing new energy efficiency technologies.. Second, it assesses the effectiveness of the different interventions and programs in addressing the two types of barriers (internal and external) with the aim of informing the policy debate. By assessing the value of a large number of interventions, this paper is one of the first that combines in a unified framework the main findings of different disciplines, from economics to psychology