Costs, quality of life and cost-effectiveness of open and arthroscopic repair for rotator cuff tears : economic evaluation alongside the UKUFF trial

FUNDING & ACKNOWLEDGEMENTS This project was funded by the NIHR Health Technology Assessment programme (project number 05/47/02) and is published in full in Health Technology Assessment; Vol. 19, No. 80. Further information available at: http://www.nets.nihr.ac.uk/projects/hta/054702 This paper presents independent research commissioned by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, MRC, CCF, NETSCC, the HTA programme or the Department of Health. Due to the confidential nature of the trial data supporting this publication not all of the data can be made accessible to other researchers. Please contact the UKUFF study principal investigator Andrew Carr (andrew.carr@ndorms.ox.ac.uk) for more information. The authors wish to thank the UKUFF trial collaborators for their contribution in managing the conduct of the trial, and for their comments on the interim economic results: Marion Campbell and Hannah Bruhn (Centre for Healthcare Randomised Trials, HSRU, University of Aberdeen), Jonathan Rees MD and David Beard (NDORMS, University of Oxford; NIHR Oxford Biomedical Research Centre), Jane Moser (NDORMS, University of Oxford), Raymond Fitzpatrick and Jill Dawson (NDPH, University of Oxford).

Effects of trawling on sessile megabenthos in the Great Barrier Reef and evaluation of the efficacy of management strategies

A series of related research studies over 15 years assessed the effects of prawn trawling on sessile megabenthos in the Great Barrier Reef, to support management for sustainable use in the World Heritage Area. These large-scale studies estimated impacts on benthos (particularly removal rates per trawl pass), monitored subsequent recovery rates, measured natural dynamics of tagged megabenthos, mapped the regional distribution of seabed habitats and benthic species, and integrated these results in a dynamic modelling framework together with spatio-temporal fishery effort data and simulated management. Typical impact rates were between 5 and 25% per trawl, recovery times ranged from several years to several decades, and most sessile megabenthos were naturally distributed in areas where little or no trawling occurred and so had low exposure to trawling. The model simulated trawl impact and recovery on the mapped species distributions, and estimated the regional scale cumulative changes due to trawling as a time series of status for megabenthos species. The regional status of these taxa at time of greatest depletion ranged from ∼77% relative to pre-trawl abundance for the worst case species, having slow recovery with moderate exposure to trawling, to ∼97% for the least affected taxon. The model also evaluated the expected outcomes for sessile megabenthos in response to major management interventions implemented between 1999 and 2006, including closures, effort reductions, and protected areas. As a result of these interventions, all taxa were predicted to recover (by 2-14% at 2025); the most affected species having relatively greater recovery. Effort reductions made the biggest positive contributions to benthos status for all taxa, with closures making smaller contributions for some taxa. The results demonstrated that management actions have arrested and reversed previous unsustainable trends for all taxa assessed, and have led to a prawn trawl fishery with improved environmental sustainability. © 2015 International Council for the Exploration of the Sea 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Cow, farm, and management factors during the dry period that determine the rate of clinical mastitis after calving

The purpose of the research was to investigate cow characteristics, farm facilities, and herd management strategies during the dry period to examine their joint influence on the rate of clinical mastitis after calving. Data were collected over a 2-yr period from 52 commercial dairy farms throughout England and Wales. Cows were separated for analysis into those housed for the dry period (8,710 cow-dry periods) and those at pasture (9,964 cow-dry periods). Multilevel models were used within a Bayesian framework with 2 response variables, the occurrence of a first case of clinical mastitis within the first 30 d of lactation and time to the first case of clinical mastitis during lactation. A variety of cow and herd management factors were identified as being associated with an increased rate of clinical mastitis and these were found to occur throughout the dry period. Significant cow factors were increased parity and at least one somatic cell count ≥200,000 cells/mL in the 90 d before drying off. A number of management factors related to hygiene were significantly associated with an increased rate of clinical mastitis. These included measures linked to the administration of dry-cow treatments and management of the early and late dry-period accommodation and calving areas. Other farm factors associated with a reduced rate of clinical mastitis were vaccination with a leptospirosis vaccine, selection of dry-cow treatments for individual cows within a herd rather than for the herd as a whole, routine body condition scoring of cows at drying off, and a pasture rotation policy of grazing dry cows for a maximum of 2 wk before allowing the pasture to remain nongrazed for a period of 4 wk. Models demonstrated a good ability to predict the farm incidence rate of clinical mastitis in a given year, with model predictions explaining over 85% of the variability in the observed data. The research indicates that specific dry-period management strategies have an important influence on the rate of clinical mastitis during the next lactation.

Cow, farm, and herd management factors in the dry period associated with raised somatic cell counts in early lactation

This study investigated cow characteristics, farm facilities, and herd management strategies during the dry period to examine their joint influence on somatic cell counts (SCC) in early lactation. Data from 52 commercial dairy farms throughout England and Wales were collected over a 2-yr period. For the purpose of analysis, cows were separated into those housed for the dry period (6,419 cow-dry periods) and those at pasture (7,425 cow-dry periods). Bayesian multilevel models were specified with 2 response variables: ln SCC (continuous) and SCC >199,000 cells/mL (binary), both within 30 d of calving. Cow factors associated with an increased SCC after calving were parity, an SCC >199,000 cells/mL in the 60 d before drying off, increasing milk yield 0 to 30 d before drying off, and reduced DIM after calving at the time of SCC estimation. Herd management factors associated with an increased SCC after calving included procedures at drying off, aspects of bedding management, stocking density, and method of pasture grazing. Posterior predictions were used for model assessment, and these indicated that model fit was generally good. The research demonstrated that specific dry-period management strategies have an important influence on SCC in early lactation.

Pinniped diet composition: a comparison of estimation models

Along the west coast of the United States, the potential impact of increasing pinniped populations on declining salmonid (Oncorhynchus spp.) stocks has become an issue of concern. Fisheries managers need species-specific estimates of consumption by pinnipeds to evaluate their impact on salmonid stocks. To estimate consumption, we developed a model that estimates diet composition by reconstructing prey biomass from fecal samples. We applied the model to data collected from harbor seals (Phoca vitulina) that are present year-round in the lower Columbia River where endangered stocks of salmonids pass as returning adults and as seaward-migrating smolts. Using the same data, we applied the split-sample frequency of occurrence model, which avoids reconstructing biomass by assuming that each fecal sample represents an equal volume of consumption and that within each sample each prey item represents an equal proportion of the volume. The two models for estimating diet composition yielded size-specific differences in consumption estimates that were as large as tenfold for the smallest and largest prey. Conclusions about the impact of harbor seal predation on adult salmonids, some of their largest prey species, remain uncertain without some appropriate rationale or further information (e.g. empirical captive studies) to discriminate between these models.

Interpersonal Aspects of Thinking Skills in an Intercultural Language Learning Context

Asking and answering certain types of questions are thought to develop thinking skills in all types of classrooms. Previous research has demonstrated that asking higher order questions and answering with elaborated responses are associated with high achievement in first, second, and foreign language contexts. Typically more attention is paid to question frequency or achievements inferred from individual performances than to the dialogues in which asking and answering occurs. This paper argues for a focus on the construction of responses in interaction as an alternative to the investigation of questions, effects of training or individual measurements of performance. Drawing on interactional data from an adult English as a Second Language classroom, it is argued that constructing an answer to a critical question appears to be a highly collaborative and evaluative affair. The thinking skills literature suggests that responding to higher order questions is an individual higher cognitive function, however it is argued in this paper that in attempting to construct evaluative answers language learners are involved not only in a cognitive task, which may or may not be helpful to language learning, but also in a complex social task in which perspectives need to be negotiated, stances taken and identities navigated. It is suggested that higher order thinking cannot be separated from the social and cultural knowledge through which it is brought into being. It is argued that any implementation of thinking skills in an English language teaching context ought to consider interpersonal and social aspects, particularly in intercultural settings.

Urban logistics: how can it meet policy makers' sustainability objectives?

This paper discusses how urban freight activity can function such that it meets the urban sustainability objectives policy makers are now beginning to implement. It considers: the importance of urban freight transport in maintaining the economic vitality of the city; the negative impacts that it imposes; the concept of urban sustainability and the development of sustainability strategies; and the means and measures by which freight transport could be made more sustainable. It presents results from a project that investigated the current freight transport operations of seven different companies in three urban areas in the UK. The potential operational, financial and environmental effects of four policy measures on these operations are considered.

Review of survey techniques used in urban freight studies

Report produced as part of the Green Logistics project (EPSRC and Department for Transport funded). This report is based on a review of studies in which data has been collected to obtain an understanding of road-based urban freight transport activities and patterns of operation. Studies from the UK and other countries have been included in this review. While it may be thought that relatively few such studies have been conducted, approximately 60 such studies have been identified as taking place in the UK and approximately 100 elsewhere since the 1960s. In addition, other studies have been carried out in order to assess industry and policy maker opinions about urban freight transport , however this type of study and survey work is not the focus of this report. Gaining an understanding of road-based urban freight transport activities is an important element in determining the current sustainability of such activity (in economic, social and environmental terms) and how best to go about enhancing its sustainability. By reviewing the existing survey work in this subject it has been possible to draw together the methodologies developed and implemented. This should therefore be of help in understanding which techniques are most commonly used, the strengths and limitations of the various techniques, and in assessing the most suitable urban freight survey techniques for a given study.

Survey forms used in urban freight studies

Report produced as part of the Green Logistics project (EPSRC and Department for Transport funded). This report contains examples of survey forms used in urban freight studies both in the UK and overseas. The studies from which these examples have been drawn range in data from 1970-2008. The purpose of the report is to provide insight into the types of questions used in different survey techniques and also into the design of survey forms. It is hoped that bringing together in a single document these examples of urban freight survey forms will be of use to researchers involved in such studies in future in planning and designing their survey work. Examples of several different types of survey techniques are provided including: Establishment surveys -- Commodity flow surveys -- Freight operator surveys -- Roadside interview surveys -- Driver surveys -- Vehicle observation surveys -- Parking surveys -- Vehicle trip diaries -- Service provider surveys