Supervised walking in comparison with fitness training for chronic back pain in physiotherapy: results of the SWIFT single-blinded randomized controlled trial (ISRCTN17592092)

Effectiveness of brief/minimal contact self-activation interventions that encourage participation in physical activity (PA) for chronic low back pain (CLBP >12 weeks) is unproven. The primary objective of this assessor-blinded randomized controlled trial was to investigate the difference between an individualized walking programme (WP), group exercise class (EC), and usual physiotherapy (UP, control) in mean change in functional disability at 6 months. A sample of 246 participants with CLBP aged 18 to 65 years (79 men and 167 women; mean age ± SD: 45.4 ± 11.4 years) were recruited from 5 outpatient physiotherapy departments in Dublin, Ireland. Consenting participants completed self-report measures of functional disability, pain, quality of life, psychosocial beliefs, and PA were randomly allocated to the WP (n = 82), EC (n = 83), or UP (n = 81) and followed up at 3 (81%; n = 200), 6 (80.1%; n = 197), and 12 months (76.4%; n = 188). Cost diaries were completed at all follow-ups. An intention-to-treat analysis using a mixed between-within repeated-measures analysis of covariance found significant improvements over time on the Oswestry Disability Index (Primary Outcome), the Numerical Rating Scale, Fear Avoidance-PA scale, and the EuroQol EQ-5D-3L Weighted Health Index (P < 0.05), but no significant between-group differences and small between-group effect sizes (WP: mean difference at 6 months, 6.89 Oswestry Disability Index points, 95% confidence interval [CI] -3.64 to -10.15; EC: -5.91, CI: -2.68 to -9.15; UP: -5.09, CI: -1.93 to -8.24). The WP had the lowest mean costs and the highest level of adherence. Supervised walking provides an effective alternative to current forms of CLBP management.

Genetic studies of body mass index yield new insights for obesity biology

Obesity is heritable and predisposes to many diseases. To understand the genetic basis of obesity better, here we conduct a genome-wide association study and Metabochip meta-analysis of body mass index (BMI), a measure commonly used to define obesity and assess adiposity, in up to 339,224 individuals. This analysis identifies 97 BMI-associated loci (P < 5 × 10(-8)), 56 of which are novel. Five loci demonstrate clear evidence of several independent association signals, and many loci have significant effects on other metabolic phenotypes. The 97 loci account for ∼2.7% of BMI variation, and genome-wide estimates suggest that common variation accounts for >20% of BMI variation. Pathway analyses provide strong support for a role of the central nervous system in obesity susceptibility and implicate new genes and pathways, including those related to synaptic function, glutamate signalling, insulin secretion/action, energy metabolism, lipid biology and adipogenesis.

THE SAAF STUDY: evaluation of the Safeguarding Children Assessment and Analysis Framework (SAAF), compared with management as usual, for improving outcomes for children and young people who have experienced, or are at risk of, maltreatment: study protocol for a randomised controlled trial

Background: Serious case reviews and research studies have indicated weaknesses in risk assessments conducted by child protection social workers. Social workers are adept at gathering information but struggle with analysis and assessment of risk. The Department for Education wants to know if the use of a structured decision-making tool can improve child protection assessments of risk.

Methods/design: This multi-site, cluster-randomised trial will assess the effectiveness of the Safeguarding Children Assessment and Analysis Framework (SAAF). This structured decision-making tool aims to improve social workers' assessments of harm, of future risk and parents' capacity to change. The comparison is management as usual.

Inclusion criteria: Children's Services Departments (CSDs) in England willing to make relevant teams available to be randomised, and willing to meet the trial's training and data collection requirements.

Exclusion criteria: CSDs where there were concerns about performance; where a major organisational restructuring was planned or under way; or where other risk assessment tools were in use.

Six CSDs are participating in this study. Social workers in the experimental arm will receive 2 days training in SAAF together with a range of support materials, and access to limited telephone consultation post-training. The primary outcome is child maltreatment. This will be assessed using data collected nationally on two key performance indicators: the first is the number of children in a year who have been subject to a second Child Protection Plan (CPP); the second is the number of re-referrals of children because of related concerns about maltreatment. Secondary outcomes are: i) the quality of assessments judged against a schedule of quality criteria and ii) the relationship between the three assessments required by the structured decision-making tool (level of harm, risk of (re) abuse and prospects for successful intervention).

Discussion: This is the first study to examine the effectiveness of SAAF. It will contribute to a very limited literature on the contribution that structured decision-making tools can make to improving risk assessment and case planning in child protection and on what is involved in their effective implementation.

Swift and Conversational Culture

Swift often noted his aversion to coffee-house conversation and to tavern talk, to gossip and company, and to being buried in Dublin in the years of his Deanship. Yet the popular myth of a morose, unsociable Swift belies both his engagement with various literary and political clubs in his early career and his participation in collaborative and experimental poetic games in his Dublin circles. This essay considers Swift’s involvement with three clubs in London (the Saturday Club, the Brothers’ Club, and the Scriblerians) and his writings on a number of fictional clubs (the Athenian Society, the Calves-Head Club, and a putative Society for the correction of the English language). While Swift wrote very little of his experience of actual clubs, the latter three, in addition to the Scriblerian Club as an imagined, rather than actual clubs, resulted in a number of defining poems and works in his career. When Swift settled in Dublin, poetry written and exchanged in a number of sociable circles characterised much of his published verse and gave glimpses of the circles and informal clubs which he formed among friends there. Although these poems are often dismissed as ‘trifles’, the essay argues that the poems are crucial for our understandings of ‘conversational culture’ or sociability in Swift’s Dublin.

Time-lapse monitoring of climate effects on earthworks using surface waves

The UK’s transportation network is supported by critical geotechnical assets (cuttings/embankments/dams) that require sustainable, cost-effective management, while maintaining an appropriate service level to meet social, economic, and environmental needs. Recent effects of extreme weather on these geotechnical assets have highlighted their vulnerability to climate variations. We have assessed the potential of surface wave data to portray the climate-related variations in mechanical properties of a clay-filled railway embankment. Seismic data were acquired bimonthly from July 2013 to November 2014 along the crest of a heritage railway embankment in southwest England. For each acquisition, the collected data were first processed to obtain a set of Rayleigh-wave dispersion and attenuation curves, referenced to the same spatial locations. These data were then analyzed to identify a coherent trend in their spatial and temporal variability. The relevance of the observed temporal variations was also verified with respect to the experimental data uncertainties. Finally, the surface wave dispersion data sets were inverted to reconstruct a time-lapse model of S-wave velocity for the embankment structure, using a least-squares laterally constrained inversion scheme. A key point of the inversion process was constituted by the estimation of a suitable initial model and the selection of adequate levels of spatial regularization. The initial model and the strength of spatial smoothing were then kept constant throughout the processing of all available data sets to ensure homogeneity of the procedure and comparability among the obtained VS sections. A continuous and coherent temporal pattern of surface wave data, and consequently of the reconstructed VS models, was identified. This pattern is related to the seasonal distribution of precipitation and soil water content measured on site.

Time-lapse monitoring of fluid induced geophysical property variations within an unstable earthwork using P-wave refraction

A significant portion of the UK’s transportation system relies on a network of geotechnical earthworks (cuttings and embankments) that were constructed more than 100 years ago, whose stability is affected by the change in precipitation patterns experienced over the past few decades. The vulnerability of these structures requires a reliable, cost- and time-effective monitoring of their geomechanical condition. We have assessed the potential application of P-wave refraction for tracking the seasonal variations of seismic properties within an aged clay-filled railway embankment, located in southwest England. Seismic data were acquired repeatedly along the crest of the earthwork at regular time intervals, for a total period of 16 months. P-wave first-break times were picked from all available recorded traces, to obtain a set of hodocrones referenced to the same spatial locations, for various dates along the surveyed period of time. Traveltimes extracted from each acquisition were then compared to track the pattern of their temporal variability. The relevance of such variations over time was compared with the data experimental uncertainty. The multiple set of hodocrones was subsequently inverted using a tomographic approach, to retrieve a time-lapse model of VPVP for the embankment structure. To directly compare the reconstructed VPVP sections, identical initial models and spatial regularization were used for the inversion of all available data sets. A consistent temporal trend for P-wave traveltimes, and consequently for the reconstructed VPVP models, was identified. This pattern could be related to the seasonal distribution of precipitation and soil-water content measured on site.

Tarif des droits d'entrées établis à Versailles ordonnés être levés par édit du Roi donné à Gand au mois d'août 1745, à commencer du 1er octobre suivant

[Acte. 1745-08-00]

Recueil de pièces, manuscrites et imprimées, concernant l'affaire de la prétendue possession de religieuses Ursulines, à Auxonne, et la réforme de l'Ordre de Cîteaux. (1651-1667).

Originaux et copies. Dossier concernant l'affaire de la prétendue possession de religieuses Ursulines, à Auxonne (1660-1663), dans lequel on remarque : Lettre orig. du docteur « Bachot » au chancelier Séguier, 1663 (fol. 1) ; — Mémoires orig. de « B. LE GOUZ » sur cette affaire, notamment : « Mémoire secret, contenant partie des raisons contre la possession, tirées de l'une et l'autre procédure, la première faicte par l'official d'Auxonne, le huictième novembre 1660, l'autre par le commissaire du Parlement, réduicte en abrégé... » [même mémoire dans le manuscrit français 18695, fol. 23], deux exemplaires (fol. 3 et 21), — « La vérité recogneue au faict de la possession des religieuses de Sainte-Ursule d'Auxonne » [même mémoire dans le manuscrit français 18695, fol. 1], deux exemplaires (fol. 39 et 87), — et « Preuves qui résultent de la procédure faite par commissaire député par arrest du Parlement de Dijon, du cinquième janvier 1661, pour l'instruction du procès de la soeur Barbe Buvée, dicte de Sainte-Colombe, religieuse professe au couvent des Ursulles d'Auxonne, accusée de magie, de sortilège et d'infanticide » [même mémoire dans le manuscrit français 18695, fol. 93] (fol. 127) ; — « Arrest du Parlement de Dijon, qui renvoie la soeur Buvée... des accusations contre elles formées », 1662 (fol. 79) ; — « Les maulx horribles que souffrent les religieuses d'Auxonne... », mémoire justificatif (fol. 83). Dossier concernant la réforme de Cîteaux (1651-1667), dans lequel on remarque : Notes de la main du chancelier Séguier, min. (fol. 183 et 296) ; — « Lettre du révérendissime abbé de Cisteaux, chef et supérieur général de son Ordre, à tous les abbez, abbesses... de son Ordre, sur ce qu'il a fait auprés de sa Sainteté, en son voyage de Rome, suivant les intentions du Roy très-chrestien, pour la réformation du mesme Ordre », deux exemplaires portant la signature autographe de « D. Claude [Vaussin], abbé général de Cisteaux », 1662, etc., in-4°, impr. de 48 pages (fol. 184 et 394) ; — « Mémoire sur le bref de sa Sainteté, présenté au Roy par son nonce et envoyé à monseigneur le chancelier » (fol. 208) ; — « Indictio capituli generalis sacri Cisterciensis Ordinis, anno Domini 1667, ex decreto... Alexandri papae VII, in Cistercio celebrandi », 1666, in-4°, impr. (fol. 212) ; — « Breve sanctissimi domini nostri Alexandri papae VII pro generali Ordinis Cisterciensis reformatione », 1666, in-4°, impr., trois exemplaires (fol. 214, 276 et 284) ; — Arrêts du Conseil d'État, concernant la réforme de l'Ordre de Citeaux, 1661-1666, in-4°, impr. et manuscrits (fol. 222. etc.) ; — « Brevia apostolica Urbani papae VIII et Innocentii papae X suscepta et registrata a capitulo generali Ordinis Cisterciensis anno 1651 », in-4°, impr. (fol. 252) ; — « Réflexions importantes pour les agents du chapitre général de l'Ordre de Cisteaux contre les abstinents du mesme Ordre », in-4°, impr. (fol. 266) ; — « Les surprises faites à la religion de N. S. P. le pape Alexandre VII, contenuës en son bref du XIX avril 1666, sur le sujet de la réforme de l'Ordre de Cisteaux », in-4°, impr. (fol. 270) ; — « Ordre de la procédure de l'affaire de Cisteaux » (fol. 292) ; — « Défense du bref de Nostre S. Père le Pape, par lequel il a terminé les diférens de l'Ordre de Cisteaux... », 1662, in-4°, impr. (fol. 331) ; — « Réflexions sur la requeste présentée au Roy sous le nom des abbez et religieux de l'étroite observance de l'Ordre de Cisteaux, contre le bref de sa Sainteté, rendu pour la réformation générale de l'Ordre de Cisteaux », in-4°, impr. (fol. 384).