Drugs, ships and containers : how anti-terrorism benefits shipping security

Using ships to transport illicit drugs is not new; nor is the practice of concealing them
in shipping containers decreasing – or is it? This article questions whether recent container security initiatives created to stop terrorism have also achieved a decrease in the use of containers for smuggling illicit drugs. Or, are these maritime security regimes creating a false sense of achievement, being too limited in scope to be truly useful in this secondary role? Logically, improved detection of illicit drugs in containers shipped by sea is more likely when port personnel are better trained, x-ray scanners installed, port fencing improved and official collaboration encouraged. However, since the number of containers being electronically screened and physically searched has only marginally improved, the question is, is it enough?

Efficacy and adverse effects of venlafaxine in children and adolescents with ADHD : a systematic review of non-controlled and controlled trials

Attention deficit hyperactivity disorder (ADHD) is a common psychiatric disorder in children and adolescents. Stimulants are commonly prescribed for ADHD management. There is clinical trial evidence that some medications with noradrenergic properties such as atomoxetine are effective. It is of theoretical and practical importance if other agents with noradrenergic properties display a comparable pattern of efficacy.
This paper is a systematic review of the efficacy and safety of venlafaxine for treating children and adolescents with ADHD. MEDLINE, Google scholar, Scopus, and Web of science (ISI) databases were electronically searched in July 2012, updated on November 2012. Time and language of publication were not exclusion criteria. Efficacy outcomes were assessed by a valid and reliable parent- and/or teacher-reported instrument to evaluate clinical symptoms. Adverse effects were also evaluated.

There were three uncontrolled trials and only two double blind controlled clinical trials. Venlafaxine appeared effective for treating ADHD. The rates of some adverse effects of venlafaxine were less than those documented for methylphenidate.

While one of the two small controlled trials did not find difference between venlafaxine ad methylphenidate, the other trial reported lower efficacy for venlafaxine. Headache, insomnia, and nausea were among the most common adverse effects.

This systematic review provides preliminary support that venlafaxine may have short term utility in treating ADHD in children and adolescents. However, before recommending venlafaxine for treatment, more robust and larger clinical trials, in particular providing evidence of its long-term efficacy, safety and tolerability are required.

Evaluating police interviewing practices with suspects in child-sexual abuse cases

This article examined adherence to current best practice recommendations for police interviewing of individuals suspected of committing child-sexual offences. We analysed 81 police records of interviews (electronically recorded and then transcribed) with suspects in child-sexual abuse cases in England and Australia. Overall we found areas of skilled practice, indicating that police interviewing in Australia and England is in a far better place than 20 years ago. However, this study also demonstrated that there is still a gap between the recommended guidelines for interviewing and what actually happens in practice. Specifically, limitations were found in the following areas: transparency of the interview process; introduction of allegations; disclosure of evidence; questioning techniques; and the interviewing approach or manner adopted. The practical implications of these findings are discussed.

Analyzing track sprint cyclists' performances using position-specific maximal-torque and power-cadence relationships

Previous studies have demonstrated the importance of maximal Torque-Cadence (T-C) and Power-Cadence (P-C) relationships, for the performances of world class track sprint cyclists. If these relationships are affected by the function of the lower limb muscles, the ability of cyclists to generate torque and power at a given cadence may vary depending on their riding position. During sprint events (individual and team sprints and Keirin), cyclists alternate between standing and seated positions. The T-C and P-C relationships may change with the position adopted by the cyclists. PURPOSE: The aim of this study was to evaluate the necessity to define position specific maximal T-C and P-C relationships. METHODS: Eight junior elite track cyclists from the National Talent Identification squad undertook two inertial-load tests that consisted of four all-out sprints each. One test was undertaken at the velodrome in a standing position on a carbon fibre track bike, and the other test was completed in a seated position on an air-braked stationary ergometer. A calibrated SRM power meter interfaced to a custom instrumentation package was used for all mechanical measurements. Maximal T-C and P-C relationships were analysed to calculate maximal Torque (T0), maximal Power (Pmax) and optimal pedalling cadence (PCopt). RESULTS: All individual T-C and P-C relationships obtained for both body positions were fitted by linear regressions (r2=0.95 ± 0.02) and second order polynomials (r2=0.96 ± 0.01), respectively. T0 was higher (209 ± 2.2N.m vs. 177.0 ± 3.9N.m, p<0.05), PCopt was lower (112.5 ± 11.4rpm vs. 120.1 ± 6.7rpm, p<0.05), and Pmax was higher (1261 ± 235W vs. 1076 ± 183W, p<0.05) in standing position compared to seated position. CONCLUSION: Analysis of track sprint cyclists’ performances can be improved by the determination of position-specific maximal T-C and P-C relationships .

Barriers to primary care clinician adherence to clinical guidelines for the management of low back pain: protocol of a systematic review and meta-synthesis of qualitative studies.

INTRODUCTION: Low back pain is the highest ranked condition contributing to years lived with disability, and is a significant economic and societal burden. Evidence-based clinical practice guidelines are designed to improve quality of care and reduce practice variation by providing graded recommendations based on the best available evidence. Studies of low back pain guideline implementation have shown no or modest effects at changing clinical practice. OBJECTIVES: To identify enablers and barriers to adherence to clinical practice guidelines for the management of low back pain. METHODS AND ANALYSIS: A systematic review and meta-synthesis of qualitative studies that will be conducted and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement guidelines. Eight databases will be searched using a priori inclusion/exclusion criteria. Two independent reviewers will conduct a structured review and meta-synthesis, and a third reviewer will arbitrate where there is disagreement. This protocol has been registered on PROSPERO 2014. ETHICS AND DISSEMINATION: Ethical approval is not required. The systematic review will be published in a peer-reviewed journal. The review will also be disseminated electronically, in print and at conferences. Updates of the review will be conducted to inform and guide healthcare translation into practice. TRIAL REGISTRATION NUMBER: PROSPERO 2014:CRD42014012961. Available from http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42014012961.

Comparison of fracture rates between indigenous and non-indigenous populations: a systematic review protocol

INTRODUCTION: Over recent years, there has been concerted effort to 'close the gap' in the disproportionately reduced life expectancy and increased morbidity experienced by indigenous compared to non-indigenous persons. Specific to musculoskeletal health, some data suggest that indigenous peoples have a higher risk of sustaining a fracture compared to non-indigenous peoples. This creates an imperative to identify factors that could explain differences in fracture rates. This protocol presents our aim to conduct a systematic review, first, to determine whether differences in fracture rates exist for indigenous versus non-indigenous persons and, second, to identify any risk factors that might explain these differences.

METHODS AND ANALYSIS: We will conduct a systematic search of PubMed, OVID, MEDLINE, CINAHL and EMBASE to identify articles that compare all-cause fracture rates at any skeletal site between indigenous and non-indigenous persons of any age. Eligibility of studies will be determined by 2 independent reviewers. Studies will be assessed for methodological quality using a previously published process. We will conduct a meta-analysis and use established statistical methods to identify and control for heterogeneity where appropriate. Should heterogeneity prevents numerical syntheses, we will undertake a best-evidence analysis to determine the level of evidence for differences in fracture between indigenous and non-indigenous persons.

ETHICS AND DISSEMINATION: This systematic review will use published data; thus, ethical permissions are not required. In addition to peer-reviewed publication, findings will be presented at (inter)national conferences, disseminated electronically and in print, and will be made available to key country-specific decision-makers with authority for indigenous health.

New perspectives on the annihilation electrogenerated chemiluminescence of mixed metal complexes in solution

Preliminary explorations of the annihilation electrogenerated chemiluminescence (ECL) of mixed metal complexes have revealed opportunities to enhance emission intensities and control the relative intensities from multiple luminophores through the applied potentials. However, the mechanisms of these systems are only poorly understood. Herein, we present a comprehensive characterisation of the annihilation ECL of mixtures of tris(2,2′-bipyridine)ruthenium(ii) hexafluorophosphate ([Ru(bpy)3](PF6)2) and fac-tris(2-phenylpyridine)iridium(iii) ([Ir(ppy)3]). This includes a detailed investigation of the change in emission intensity from each luminophore as a function of both the applied electrochemical potentials and the relative concentrations of the two complexes, and a direct comparison with two mixed (Ru/Ir) ECL systems for which emission from only the ruthenium-complex was previously reported. Concomitant emission from both luminophores was observed in all three systems, but only when: (1) the applied potentials were sufficient to generate the intermediates required to form the electronically excited state of both complexes; and (2) the concentration of the iridium complex (relative to the ruthenium complex) was sufficient to overcome quenching processes. Both enhancement and quenching of the ECL of the ruthenium complex was observed, depending on the experimental conditions. The observations were rationalised through several complementary mechanisms, including resonance energy transfer and various energetically favourable electron-transfer pathways.