Patterns of weight change after the diagnosis of type 2 diabetes in Scotland and their relationship with glycaemic control, mortality and cardiovascular outcomes: a retrospective cohort study

Acknowledgements The authors would like to thank the Scottish Diabetes Research Network Epidemiology Group for granting permission to use this database. They also thank the data management team in the University of Aberdeen who were the initial conduit for access to these data and also provided validation to the various data cleaning criteria applied. Jeremy J Walker, University of Edinburgh, was invaluable for the original funding application and initial exploration of data. HSRU is funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates. Funding Chief Scientist Office (CSO) reference number: CZG/2/571.

Design and protocol for the Focusing on Clozapine Unresponsive Symptoms (FOCUS) trial : a randomised controlled trial

Acknowledgements Thank you to all the participants who agreed to take part in the trial. This study was supported NHS Research Scotland (NRS), through Chief Scientist Office (CSO) and the Scottish Mental Health Research Network, and the Clinical Research Network-Mental Health. We are grateful to the Psychosis Research Unit (PRU) Service User Reference Group (SURG) for their consultation regarding the design of the study and contribution to the developments of study related materials. We are grateful to our Independent Trial Steering Committee and Independent Data Monitoring Committee for provided oversight of the trial. Funding This project was funded by the National Institute for Health Research Health Technology Assessment (NIHR HTA) programme (project number10/101/02) and will be published in full in Health Technology Assessment. Visit the HTA programme website for further project information. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HTA programme, NIHR, NHS or the Department of Health.

Radio frequency identification and time-driven activity based costing:RFID-TDABC application in warehousing

Purpose: This paper extends the use of Radio Frequency Identification (RFID) data for accounting of warehouse costs and services. Time Driven Activity Based Costing (TDABC) methodology is enhanced with the real-time collected RFID data about duration of warehouse activities. This allows warehouse managers to have accurate and instant calculations of costs. The RFID enhanced TDABC (RFID-TDABC) is proposed as a novel application of the RFID technology. Research Approach: Application of RFID-TDABC in a warehouse is implemented on warehouse processes of a case study company. Implementation covers receiving, put-away, order picking, and despatching. Findings and Originality: RFID technology is commonly used for the identification and tracking items. The use of the RFID generated information with the TDABC can be successfully extended to the area of costing. This RFID-TDABC costing model will benefit warehouse managers with accurate and instant calculations of costs. Research Impact: There are still unexplored benefits to RFID technology in its applications in warehousing and the wider supply chain. A multi-disciplinary research approach led to combining RFID technology and TDABC accounting method in order to propose RFID-TDABC. Combining methods and theories from different fields with RFID, may lead researchers to develop new techniques such as RFID-TDABC presented in this paper. Practical Impact: RFID-TDABC concept will be of value to practitioners by showing how warehouse costs can be accurately measured by using this approach. Providing better understanding of incurred costs may result in a further optimisation of warehousing operations, lowering costs of activities, and thus provide competitive pricing to customers. RFID-TDABC can be applied in a wider supply chain.

Implementation of supply chain management theory in practice:a questionnaire survey in the United Kingdom

Purpose: The purpose of the research described in this paper is to disentangle the rhetoric from the reality in relation to supply chain management (SCM) adoption in practice. There is significant evidence of a divergence between theory and practice in the field of SCM. Research Approach: The authors’ review of the extant SCM literature highlighted a lack of replication studies in SCM, leading to the concept of refined replication being developed. The authors conducted a refined replication of the work of Sweeney et al. (2015) where a new SCM definitional construct – the Four Fundamentals – was proposed. The work presented in this article refines the previous study but adopts the same three-phase approach: focussed interviews, a questionnaire survey, and focus groups. This article covers the second phase of the refined replication study and describes an integrated research design of a questionnaire research to be undertaken in Britain. Findings and Originality: The article presents an integrated research design of a questionnaire research with emphases on the refined replication of previous work of Sweeney et al. (2015) carried out in Ireland and adapting it to the British context. Research Impact: The authors introduce the concept of refined replication in SCM research. This allows previous research to be built upon in order to test understanding of SCM theory and its practical implementation - based on the Four Fundamentals construct - among SCM professionals in Britain. Practical Impact: The article presents the integrated research design of a questionnaire research that may be used in similar studies.

La Ley de semillas en Argentina: la disputa por el control y el futuro de la agricultura

Desde la llegada de la revolución bioteconológica en la agricultura mundial, las corporaciones semilleras-agroquímicas han avanzado en el control del mercado internacional de alimentos, a partir de diversos mecanismos, entre ellos el de la legislación de derechos de propiedad intelectual. En América Latina, distintos gobiernos han procurado adecuar la legislación nacional a estas tendencias internacionales, con resultado dispar, ya que se ha generado una fuerte resistencia desde organizaciones populares. Argentina, un país de temprana inserción en el mercado internacional de alimentos y de rápida adopción de los derechos de obtentor, está atravesado hoy por una nueva fase de esta disputa, ante la posible sanción de una nueva Ley de Semillas, en la que empresa estadounidense Monsanto está involucrada. Este trabajo hace un repaso del panorama actual desde un punto de vista geográfico, prestando especial atención a las estrategias de las organizaciones que se oponen a la nueva legislación.

Indicators on community art practices: some reflections

From the Divercity project, the article reflects on methodology, good practices and indicators useful for community art practices. At first term, social exclusión is defined as well as community art, and which features it presents. Subsequently, the article reviews the indicators that are being used to measure the success or achievement of community arts practice, raising criticism from equality and including indicators that measure the well-being of women.

Of Marx and Makers: an Historical Perspective on Generative Justice

In Marxist frameworks “distributive justice” depends on extracting value through a centralized state. Many new social movements—peer to peer economy, maker activism, community agriculture, queer ecology, etc.—take the opposite approach, keeping value in its unalienated form and allowing it to freely circulate from the bottom up. Unlike Marxism, there is no general theory for bottom-up, unalienated value circulation. This paper examines the concept of “generative justice” through an historical contrast between Marx’s writings and the indigenous cultures that he drew upon. Marx erroneously concluded that while indigenous cultures had unalienated forms of production, only centralized value extraction could allow the productivity needed for a high quality of life. To the contrary, indigenous cultures now provide a robust model for the “gift economy” that underpins open source technological production, agroecology, and restorative approaches to civil rights. Expanding Marx’s concept of unalienated labor value to include unalienated ecological (nonhuman) value, as well as the domain of freedom in speech, sexual orientation, spirituality and other forms of “expressive” value, we arrive at an historically informed perspective for generative justice. 

BRAF mutation testing algorithm for vemurafenib treatment in melanoma: recommendations from an expert panel.

The incidence of melanoma has increased rapidly over the past 30 years, and the disease is now the sixth most common cancer among men and women in the U.K. Many patients are diagnosed with or develop metastatic disease, and survival is substantially reduced in these patients. Mutations in the BRAF gene have been identified as key drivers of melanoma cells and are found in around 50% of cutaneous melanomas. Vemurafenib (Zelboraf(®) ; Roche Molecular Systems Inc., Pleasanton, CA, U.S.A.) is the first licensed inhibitor of mutated BRAF, and offers a new first-line option for patients with unresectable or metastatic melanoma who harbour BRAF mutations. Vemurafenib was developed in conjunction with a companion diagnostic, the cobas(®) 4800 BRAF V600 Mutation Test. The purpose of this paper is to make evidence-based recommendations to facilitate the implementation of BRAF mutation testing and targeted therapy in patients with metastatic melanoma in the U.K. The recommendations are the result of a meeting of an expert panel and have been reviewed by melanoma specialists and representatives of the National Cancer Research Network Clinical Study Group on behalf of the wider melanoma community. This article is intended to be a starting point for practical advice and recommendations, which will no doubt be updated as we gain further experience in personalizing therapy for patients with melanoma.

Conventional versus hypofractionated high-dose intensity-modulated radiotherapy for prostate cancer: 5-year outcomes of the randomised, non-inferiority, phase 3 CHHiP trial

BACKGROUND: Prostate cancer might have high radiation-fraction sensitivity that would give a therapeutic advantage to hypofractionated treatment. We present a pre-planned analysis of the efficacy and side-effects of a randomised trial comparing conventional and hypofractionated radiotherapy after 5 years follow-up.

METHODS: CHHiP is a randomised, phase 3, non-inferiority trial that recruited men with localised prostate cancer (pT1b-T3aN0M0). Patients were randomly assigned (1:1:1) to conventional (74 Gy delivered in 37 fractions over 7·4 weeks) or one of two hypofractionated schedules (60 Gy in 20 fractions over 4 weeks or 57 Gy in 19 fractions over 3·8 weeks) all delivered with intensity-modulated techniques. Most patients were given radiotherapy with 3-6 months of neoadjuvant and concurrent androgen suppression. Randomisation was by computer-generated random permuted blocks, stratified by National Comprehensive Cancer Network (NCCN) risk group and radiotherapy treatment centre, and treatment allocation was not masked. The primary endpoint was time to biochemical or clinical failure; the critical hazard ratio (HR) for non-inferiority was 1·208. Analysis was by intention to treat. Long-term follow-up continues. The CHHiP trial is registered as an International Standard Randomised Controlled Trial, number ISRCTN97182923.

FINDINGS: Between Oct 18, 2002, and June 17, 2011, 3216 men were enrolled from 71 centres and randomly assigned (74 Gy group, 1065 patients; 60 Gy group, 1074 patients; 57 Gy group, 1077 patients). Median follow-up was 62·4 months (IQR 53·9-77·0). The proportion of patients who were biochemical or clinical failure free at 5 years was 88·3% (95% CI 86·0-90·2) in the 74 Gy group, 90·6% (88·5-92·3) in the 60 Gy group, and 85·9% (83·4-88·0) in the 57 Gy group. 60 Gy was non-inferior to 74 Gy (HR 0·84 [90% CI 0·68-1·03], pNI=0·0018) but non-inferiority could not be claimed for 57 Gy compared with 74 Gy (HR 1·20 [0·99-1·46], pNI=0·48). Long-term side-effects were similar in the hypofractionated groups compared with the conventional group. There were no significant differences in either the proportion or cumulative incidence of side-effects 5 years after treatment using three clinician-reported as well as patient-reported outcome measures. The estimated cumulative 5 year incidence of Radiation Therapy Oncology Group (RTOG) grade 2 or worse bowel and bladder adverse events was 13·7% (111 events) and 9·1% (66 events) in the 74 Gy group, 11·9% (105 events) and 11·7% (88 events) in the 60 Gy group, 11·3% (95 events) and 6·6% (57 events) in the 57 Gy group, respectively. No treatment-related deaths were reported.

INTERPRETATION: Hypofractionated radiotherapy using 60 Gy in 20 fractions is non-inferior to conventional fractionation using 74 Gy in 37 fractions and is recommended as a new standard of care for external-beam radiotherapy of localised prostate cancer.

FUNDING: Cancer Research UK, Department of Health, and the National Institute for Health Research Cancer Research Network.

A Framework for Spatial Road Safety Assessment: Case Study of Northern Ireland

Road traffic injuries are a major health issue worldwide. There are many factors that can
affect the levels of road traffic collisions which in turn increase the levels of people killed or
seriously injured. When road traffic collisions occur, observed facts are recorded in relation
to the incident. These facts are recorded as variable observations, and for this study,
variables and indicators are defined almost equivalently. There can be hundreds of different
indicators for the various collisions, as different countries face different road situations. This
makes it difficult to perform a road safety assessment, which can be applied globally. The
goal of this study is to select the most appropriate indicators and create a composite
indicator as a function of these indicators, which can be used as summary values, allowing
ease of comparisons between the countries/regions that have undergone a road safety
assessment. The composite indicator will then be used to assess the current situation in
Northern Ireland and provide scores for ranking policing in terms of overall road safety on
their road networks.

Adverse Childhood Life Events and Postpartum Psychosis in Bipolar Disorder

Background Women with bipolar disorder are at increased risk of postpartum psychosis. Adverse childhood life events have been associated with depression in the postpartum period, but have been little studied in relation to postpartum psychosis. In this study we investigated whether adverse childhood life events are associated with postpartum psychosis in a large sample of women with bipolar I disorder. Methods Participants were 432 parous women with DSM-IV bipolar I disorder recruited into the Bipolar Disorder Research Network (www.BDRN.org). Diagnoses and lifetime psychopathology, including perinatal episodes, were obtained via a semi-structured interview (Schedules for Clinical Assessment in Neuropsychiatry; Wing et al., 1990) and case-notes. Adverse childhood life events were assessed via self-report and case-notes, and compared between women with postpartum psychosis (n=208) and those without a lifetime history of perinatal mood episodes (n=224). Results There was no significant difference in the rate of any adverse childhood life event, including childhood sexual abuse, or in the total number of adverse childhood life events between women who experienced postpartum psychosis and those without a lifetime history of perinatal mood episodes, even after controlling for demographic and clinical differences between the groups. Limitations Adverse childhood life events were assessed in adulthood and therefore may be subject to recall errors. Conclusions We found no evidence for an association between adverse childhood life events and the occurrence of postpartum psychosis. Our data suggest that, unlike postpartum depression, childhood adversity does not play a significant role in the triggering of postpartum psychosis in women with bipolar disorder.

Two Roads to Public Sociology

Nira Yuval-Davis , an Israeli dissident, has been a long-standing defender of human rights: a founder member of Women Against Fundamentalism, and the international research network of Women in Militarized Conflict Zones, a consultant to different divisions of the United Nations as well as to various NGOs, including Amnesty International. Known internationally for her research on gender, racism, and religious fundamentalism, her books include Racialized Boundaries , Gender and Nation , The Politics of Belonging , Women against Fundamentalism . She is Director of the Research Centre on Migration, Refugees and Belonging at the University of East London. In this essay she conducts an internal conversation with the renowned Israeli sociologist, now deceased, Baruch Kimmerling, on the different roads to public sociology.

Comorbid Migraine in Major Depressive Disorder Suggests a Subgroup Related to Bipolar Disorder

Aims: Previous small-scale studies suggest presence of migraine in major depressive disorder (MDD) is associated with specific clinical characteristics that may overlap with those of bipolar disorder. We aimed to compare a broad range of characteristics in participants who have MDD with and without migraine, and to explore possible similarities between those characteristics associated with the presence of migraine in MDD and those in bipolar disorder in a large UK sample. Methods: Lifetime and episodic clinical characteristics and affective temperaments in DSM-IV MDD with (n=134) and without (n=218) migraine were compared. Characteristics associated with the presence of migraine were then compared with a sample of participants with DSM-IV bipolar disorder (n=407). All participants were recruited into the Bipolar Disorder Research Network (www.bdrn.org). Results: The presence of migraine in MDD was associated with female gender (76.9% vs 56.9%, p<0.001), younger age of onset (23 vs 27 years, p=0.002), history of attempted suicide (38.3% vs 22.7%, p=0.002), and more panic/agoraphobia symptomatology (6 vs 4, p<0.001). Female gender (OR=2.44, p=0.006) and younger age of onset (OR=0.97, p=0.013) remained significant in a multivariate model. These clinical characteristics were not significantly different to those of our participants with bipolar disorder. Conclusions: The presence of migraine in MDD delineates a subgroup of individuals with a more severe illness course. The clinical presentation of this subgroup more closely resembles that of bipolar disorder than that of MDD without migraine. The presence of migraine in major depression may be a marker of a specific subgroup that could be useful in future research.