Vaginal progesterone prophylaxis for preterm birth (the OPPTIMUM study) : a multicentre, randomised, double-blind trial

Acknowledgments We thank the members of the Trial Steering and Data Monitoring Committee and all the people who helped in the conduct of the study (including the OPPTIMUM collaborative group and other clinicians listed in the appendix). We are grateful to Paul Piette (Besins Healthcare Corporate, Brussels, Belgium) and Besins Healthcare for their kind donation of active and placebo drug for use in the study, and to staff of the pharmacy and research and development departments of the participating hospitals. We are also grateful to the many people who helped in this study but who we have been unable to name, and in particular all the women (and their babies) who participated in OPPTIMUM. OPPTIMUM was funded by the Efficacy and Mechanism Evaluation (EME) Programme, a Medical Research Council (MRC) and National Institute of Health Research (NIHR) partnership, award number G0700452, revised to 09/800/27. The EME Programme is funded by the MRC and NIHR, with contributions from the Chief Scientist Office in Scotland and National Institute for Social Care and Research in Wales. The views expressed in this publication are those of the author(s) and not necessarily those of the MRC, National Health Service, NIHR, or the Department of Health. The funder had no involvement in data collection, analysis or interpretation, and no role in the writing of this manuscript or the decision to submit for publication.

An economic analysis of unilateral refusals to license intellectual property

The intellectual property laws in the United States provide the owners of intellectual property with discretion to license the right to use that property or to make or sell products that embody the intellectual property. However, the antitrust laws constrain the use of property, including intellectual property, by a firm with market power and may place limitations on the licensing of intellectual property. This paper focuses on one aspect of antitrust law, the so-called “essential facilities doctrine,” which may impose a duty upon firms controlling an “essential facility” to make that facility available to their rivals. In the intellectual property context, an obligation to make property available is equivalent to a requirement for compulsory licensing. Compulsory licensing may embrace the requirement that the owner of software permit access to the underlying code so that others can develop compatible application programs. Compulsory licensing may undermine incentives for research and development by reducing the value of an innovation to the inventor. This paper shows that compulsory licensing also may reduce economic efficiency in the short run by facilitating the entry of inefficient producers and by promoting licensing arrangements that result in higher prices.

Lisbon Fado: The European Union under Reform

From the Introduction. To address the uncertainties surrounding the Treaty of Lisbon, this book examines several issues from various angles. Regardless of the results of the second referendum in Ireland and the pending ratifications in Poland, the Czech Republic and Germany, the European Union (EU) will not be the same after the Lisbon Treaty. If it comes into effect, Europeans will enter into a new stage in the deepening of the integration process; if it is rejected, the first decade of the 21st Century will represent a period of institutional stagnation in Europe’s integration. Nonetheless, the chapters in this book share the consensus that, despite its limitations, the Lisbon Treaty will make the EU decision making process more efficient, enhance regional democracy and strengthen its international voice.

Helping Moldova stay on the EU course. Proposals for a real 'more for more' approach. EPC Policy Brief, 11 December 2013

At the Vilnius Eastern Partnership (EaP) Summit in November, Moldova initialled its Association Agreement including a Deep and Comprehensive Free Trade Area (DCFTA) with the EU and became the first EaP country to meet all the requirements of their Visa Liberalisation Action Plan. 2014 may prove to be a make or break year for Moldova, with Chisinau facing a number of serious challenges. From the EU’s point of view, it could also prove to be a make or break year for the Eastern Partnership. The period following Vilnius should be a soul-searching time for the EU. Of the three pillars (AA, DCFTA, visa regime) of the Eastern Partnership, two are now being openly challenged by Russia. While the EU should not engage in a populist competition with Russia, it does need to adapt its actions to the realities on the ground. In this Policy Brief, Cristian Ghinea, Amanda Paul and Victor Chirila argue that the EU should work for greater visibility, better public diplomacy and deliver visible, tangible benefits to the Moldovan population as rapidly as possible. Not only will this help counter Russian activities, but it will also help shore up support for pro-EU reformers in the country.

Any changes? The future agenda of Sweden's security policy. OSW Commentary No. 126, 28.01.2014

Sweden’s annual security and defence conference, which this year focused on the future of the country’s security policy, was held in Sälen on 12-14 January. It was attended by almost all the leaders of Sweden’s ruling and opposition parties. The discussions have revealed whether and how the mindset of the Swedish elite has changed following the heated debates on defence issues in 2013. The opposition parties (Social Democrats, the Green Party, and the Left Party), which are likely to form a coalition government after the election to the Swedish parliament in September 2014, were given the opportunity to present their own priorities. The discussions have brought to the surface conflicting perceptions within the political elite concerning the threats and challenges to Swedish security, and divergent positions on the future direction of the country’s security and defence policy. It is highly likely that, due to a coalition compromise, the current course of Sweden’s security policy (namely, a policy of non-alignment along with close co-operation with NATO) will be maintained following the parliamentary election, albeit with new “leftist” influences (a greater involvement in the United Nations). Big changes that could lead to a significant strengthening of Sweden’s defence capabilities, or a decision on NATO membership, are not likely. Paradoxically, polls suggest that in the long run a more radical change in Stockholm’s security policy may be shaped by a gradual, bottom-up evolution of public opinion on the issue.

The prospects for the EU-Ukraine free trade agreement. OSW Commentary No. 94, 2012-10-15

The European Union and Ukraine initialled the Deep and Comprehensive Free Trade Area Agreement (DCFTA) on 19 July 2012. The scope of the agreement which the EU and Ukraine reached following their negotiations is much more extensive than that of a typical free trade agreement. It envisages not only the lifting of tariff and extra-tariff barriers but also, more importantly, Kyiv adopting EU legal solutions and standards in this area. Whether the agreement will be signed and implemented is still an open question and depends on the existing political conditions. On the one hand, the repression imposed by the government in Kyiv on its political opponents (including the detention of the former prime minister, Yulia Tymoshenko) has provoked criticism from the EU, which refuses to sign the agreement if the government in Kyiv continues to violate democratic principles. The manner in which Ukraine’s parliamentary elections are conducted this October will be the key test. On the other hand, Russia is increasingly active in its efforts to involve Ukraine in the integration projects it has initiated (the Customs Union and the Eurasian Economic Community). It should be noted that Moscow has effective instruments to exert its will, such as the dependence of the Ukrainian economy on supplies of Russian oil and gas and on exports to the Russian market. Besides, Moscow also has political instruments at its disposal. It is impossible to participate in integration projects both with the EU and with Russia. Therefore, Kyiv will have to make a strategic decision and choose the direction of its economic integration. Unless Ukraine takes concrete action to implement its agreements with the EU, primarily including the free trade agreement, its economic dependence on Russia will grow, and it will be more likely to join the Russian integration projects.

Farmers' purchase agreement for deep well pumps /

Mode of access: Internet.

Financial pamphlets

A collection of miscellaneous pamphlets on finance.

Adapting an apprenticeship model to the needs of English-medium education at the tertiary level in Turkey

Despite the difficulties that we have regarding the use of English in tertiary education in Turkey, we argue that it is necessary for those involved to study in the medium of English. Furthermore, significant advances have been made on this front. These efforts have been for the most part language-oriented, but also include research into needs analysis and the pedagogy of team-teaching. Considering the current situation at this level of education, however, there still seems to be more to do. And the question is, what more can we do? What further contribution can we make? Or, how can we take this process further? The purpose of the study reported here is to respond to this last question. We test the proposition that it is possible to take this process further by investigating the efficient management of transition from Turkish-medium to English-medium at the tertiary level of education in Turkey. Beyond what is achieved by only the language orientation of the EAP approach, and moving conceptually deeper than what has been achieved by the team-teaching approach, the research undertaken for the purpose of this study focuses on the idea of the discourse community that people want to belong to. It then pursues an adaptation of the essentially psycho-social approach of apprenticeship, as people become aspirants and apprentices to that discourse community. In this thesis, the researcher recognises that she cannot follow all the way through to the full implementation of her ideas in a fully-taught course. She is not in a position to change the education system. What she does here is to introduce a concept and sample its effects in terms of motivation, and thereby of integration and of success, for individuals and groups of learners. Evaluation is provided by acquiring both qualitative and quantitative data concerning mature members' perceptions of apprenticed-neophytes functioning as members in the new community, apprenticed-neophytes' perceptions of their own membership and of the preparation process undertaken, and the comparison of these neophytes' performance with that of other neophytes in the community. The data obtained provide strong evidence in support of the potential usefulness of this apprenticeship model towards the declared purpose of improving the English-medium tertiary education of Turkish students in their chosen fields of study.

Describing and communicating uncertainty within the semantic web

The Semantic Web relies on carefully structured, well defined, data to allow machines to communicate and understand one another. In many domains (e.g. geospatial) the data being described contains some uncertainty, often due to incomplete knowledge; meaningful processing of this data requires these uncertainties to be carefully analysed and integrated into the process chain. Currently, within the SemanticWeb there is no standard mechanism for interoperable description and exchange of uncertain information, which renders the automated processing of such information implausible, particularly where error must be considered and captured as it propagates through a processing sequence. In particular we adopt a Bayesian perspective and focus on the case where the inputs / outputs are naturally treated as random variables. This paper discusses a solution to the problem in the form of the Uncertainty Markup Language (UncertML). UncertML is a conceptual model, realised as an XML schema, that allows uncertainty to be quantified in a variety of ways i.e. realisations, statistics and probability distributions. UncertML is based upon a soft-typed XML schema design that provides a generic framework from which any statistic or distribution may be created. Making extensive use of Geography Markup Language (GML) dictionaries, UncertML provides a collection of definitions for common uncertainty types. Containing both written descriptions and mathematical functions, encoded as MathML, the definitions within these dictionaries provide a robust mechanism for defining any statistic or distribution and can be easily extended. Universal Resource Identifiers (URIs) are used to introduce semantics to the soft-typed elements by linking to these dictionary definitions. The INTAMAP (INTeroperability and Automated MAPping) project provides a use case for UncertML. This paper demonstrates how observation errors can be quantified using UncertML and wrapped within an Observations & Measurements (O&M) Observation. The interpolation service uses the information within these observations to influence the prediction outcome. The output uncertainties may be encoded in a variety of UncertML types, e.g. a series of marginal Gaussian distributions, a set of statistics, such as the first three marginal moments, or a set of realisations from a Monte Carlo treatment. Quantifying and propagating uncertainty in this way allows such interpolation results to be consumed by other services. This could form part of a risk management chain or a decision support system, and ultimately paves the way for complex data processing chains in the Semantic Web.

The Specialist: Coming Soon To Your Local Hotel

In an article entitled - The Specialist: Coming Soon To Your Local Hotel - by Stan Bromley, Regional Vice President and General Manager, Four Seasons Clift Hotel, San Francisco, the author’s introduction states: “An experienced hotelier discusses the importance of the delivery of a high “quality-to-value” ratio consistently to guests, particularly as the hotel market becomes specialized and a distinction is drawn between a “property” and a “hotel.” The author’s primary intention is to make you, the reader, aware of changes in the hospitality/hotel marketplace. From the embryo to the contemporary, the hotel market has consistently evolved; this includes but is not limited to mission statement, marketing, management, facilities, and all the tangibles and intangibles of the total hotel experience. “Although we are knocking ourselves out trying to be everything to everyone, I don't think hotel consumers are as interested in “mixing and matching” as they were in the past,” Bromley says. “Today's hotel guest is looking for “specialized care,” and is increasingly skeptical of our industry-wide hotel ads and promises of greatness.” As an example Bromley makes an analogy using retail outlets such as Macy’s, Saks, and Sears, which cater to their own unique market segment. Hotels now follow the same outline, he allows. “In my view, two key factors will make a hotel a success,” advises Bromley. “First, know your specialty and market to that segment. Second, make sure you consistently offer a high quality-to-value ratio. That means every day.” To emphasize that second point, Bromley offers this bolstering thought, “The second factor that will make or break your business is your ability to deliver a high "quality/value" ratio-and to do so consistently.” The author evidently considers quality-to-value ratio to be an important element. Bromley emphasizes the importance of convention and trade show business to the hotel industry. That business element cannot be over-estimated in his opinion. This doesn’t mean an operator who can accommodate that type of business should exclude other client opportunities outside the target market. It does mean, however, these secondary opportunities should only be addressed after pursuing the primary target strategy. After all, the largest profit margin lies in the center of the target. To amplify the above statement, and in reference to his own experience, Bromley says, “Being in the luxury end of the business I, on the other hand, need to uncover and book individuals and small corporate meetings more than convention or association business.

A randomized trial of specialized versus standard neck physiotherapy in cervical dystonia

We thank: the patients who took part; Monsieur John-Pierre Bleton for training the physiotherapists; Gladys McPherson (Senior IT Manager), Adesoji Adeyemi (programmer) and Diana Collins (data entry) from the Centre for Healthcare Randomised Trials, University of Aberdeen who provided the randomisation and database service; and the funders including The Dystonia Society, the RS Macdonald Charitable Trust, The Sir Halley Stewart Trust, The Foyle Foundation and The Garfield Weston Foundation. The Dystonia Society and other funders had no role in the design, conduct, analysis or writing of the report or the decision to submit the manuscript.

Risk of fracture amongst patients with Parkinson's disease and other forms of parkinsonism

Acknowledgements We thank all the participants who took part, the research fellows (Kate Taylor, Robert Caslake, David McGhee, Angus Macleod) and nurses (Clare Harris, Joanna Gordon, Anne Hayman, Hazel Forbes) who helped assess the participants, and the study secretaries (Susan Kilpatrick, Pam Rebecca) and data management team (Katie Wilde, David Ritchie). The PINE study was funded by the BMA Doris Hillier award, Parkinson's UK, the RS McDonald Trust, NHS Grampian Endowments, SPRING and the BUPA Foundation. None of the funders had any influence in the study design, the collection, analysis and interpretation of the data, the writing of the report or the decision to submit the article for publication.

When group members go against the grain : an ironic interactive effect of group identification and normative content on healthy eating

Acknowledgements The research leading to these results has been funded by a Tandem Grant from the European Health Psychology Society/CREATE, awarded to the first and second author. The funder had no involvement in the study design, collection or analysis of data, writing the report, or the decision to submit this manuscript for publication.

Nurses’ perceptions of nursing presence and the relationship between nursing presence and moral sensitivity in nurses working with people with dementia in residential care

Aim: The aim of this study was to measure nursing presence among nurses caring for people with dementia in residential care settings, and to investigate the relationship between nursing presence and moral sensitivity. Background: Nursing presence is a core relational skill in nursing and holds many benefits for nurses and their patients. Moral sensitivity is defined as how one recognises the moral elements of a situation, and how one’s moral or ethical decision making may impact on an individual. Methods: A descriptive, cross sectional quantitative methodology was used with a sample of 150 registered nurses. The Presence of Nursing Scale for Registered Nurses was used to investigate nursing presence, and the Moral Sensitivity Questionnaire for moral sensitivity. Results: Findings from the study demonstrated that participants agreed with the majority of elements of nursing presence, (mean 76.97, SD= 7.51). A mean score of 36.22 was evidence of a well developed level of moral sensitivity in participants. Nurses who perceived themselves to be highly present to their patients also scored highest on certain elements of moral sensitivity such as moral strength. Nursing presence was also found to be more developed in those participants that rated themselves as having higher levels of expertise based on Benner’s (1984) definitions. Older nurses also scored higher on nursing presence. There was a high level of agreement that factors such as lack of time (n=133), and heavy workload influenced nursing presence. Nurses, who were older and had longer clinical experience, were shown to have greater moral strength. There were differences in elements of moral sensitivity between groups of nurses who ranked themselves according to Benner’s (1984) competence framework with higher scores evident in the more expert groups. Conclusion: Overall, this study showed that participants had a well developed level of nursing presence, and certain elements of moral sensitivity are positively related to nursing presence. Nursing presence appears to be linked to the level of expertise of the nurse but factors such as time and workload do influence nursing presence.