Showing papers by "Keele University published in 1998"

Outcome measures for low back pain research. A proposal for standardized use.

Abstract: Study Design. An international group of back pain researchers considered recommendations for standardized measures in clinical outcomes research in patients with back pain. Objectives. To promote more standardization. Summary of outcome measurement in clinical trials and other types of outcomes research, including meta-analyses, cost-effectiveness analyses, and multicenter studies. Summary of Background Data. Better standardization of outcome measurement would facilitate comparison of results among studies, and more complete reporting of relevant outcomes. Because back pain is rarely fatal or completely cured, outcome assessment is complex and involves multiple dimensions. These include symptoms, function, general well-being, work disability, and satisfaction with care. Methods. The panel considered several factors in recommending a standard battery of outcome measures. These included reliability, validity, responsiveness, and practicality of the measures. In addition, compatibility with widely used and promoted batteries such as the American Academy of Orthopaedic Surgeons Lumbar Cluster were considered to minimize the need for changes when these instruments are used. Results. First, a six-item set was proposed, which is sufficiently brief that it could be used in routine care settings for quality improvement and for research purposes. An expanded outcome set, which would provide more precise measurement for research purposes, includes measures of severity and frequency of symptoms, either the Roland or the Oswestry Disability Scale, either the SF-12 or the EuroQol measure of general health status, a question about satisfaction with symptoms, three types of disability days, and an optional single item on overall satisfaction with medical care. Conclusion. Standardized measurement of outcomes would facilitate scientific advances in clinical care. A short, 6-item questionnaire and a somewhat expanded, more precise battery of questionnaires can be recommended. Although many considerations support such recommendations, more data on responsiveness and the minimally important change in scores are needed for most of the instruments.

Collecting and analysing qualitative data: issues raised by the focus group

Abstract: The focus group has gained considerable popularity as a means of gathering qualitative data in nursing research. This paper examines some of the methodological issues raised by the collection and analysis of focus group data. In respect of data collection, the role of the focus group moderator and the method of recording data are crucial considerations. In particular, the moderator's personal skills and attributes have a considerable influence on the nature and quality of the data gathered. When analysing the data, three principal issues arise. First, it is difficult, and probably misguided, to attempt to infer an attitudinal consensus from focus group data. An apparent conformity of view is an emergent property of the group interaction, not a reflection of individual participants' opinions. Second, measuring strength of opinion from focus group data is problematic. The indicators used to measure attitudes in orthodox survey research are largely inapplicable to the context of focus groups. When comparing data from different focus groups, inferences may be drawn as to the presence of absence of certain views or issues across groups, but not in terms of their relative strength. Third, both methodological and epistemological objections can be raised against attempts to generalize from focus group data. Theoretical generalization is likely to be more feasible than empirical generalization, and if the latter is considered fruitful, it is likely to be of a provisional nature. The effective use of focus groups as a means of gathering qualitative data in nursing research requires due attention to problematic methodological issues such as those explored in this paper.

Outcome of low back pain in general practice: a prospective study

Abstract: Objectives: To investigate the claim that 90% of episodes of low back pain that present to general practice have resolved within one month. Design: Prospective study of all adults consulting in general practice because of low back pain over 12 months with follow up at 1 week, 3 months, and 12 months after consultation. Setting: Two general practices in south Manchester. Subjects: 490 subjects (203 men, 287 women) aged 18›75 years. Main outcome measures: Proportion of patients who have ceased to consult with low back pain after 3 months; proportion of patients who are free of pain and back related disability at 3 and 12 months. Results: Annual cumulative consultation rate among adults in the practices was 6.4%. Of the 463 patients who consulted with a new episode of low back pain, 275 (59%) had only a single consultation, and 150 (32%) had repeat consultations confined to the 3 months after initial consultation. However, of those interviewed at 3 and 12 months follow up, only 39/188 (21%) and 42/170 (25%) respectively had completely recovered in terms of pain and disability. Conclusions: The results are consistent with the interpretation that 90% of patients with low back pain in primary care will have stopped consulting with symptoms within three months. However most will still be experiencing low back pain and related disability one year after consultation.

Innate talents: reality or myth?

Abstract: Talents that selectively facilitate the acquisition of high levels of skill are said to be present in some children but not others. The evidence for this includes biological correlates of specific abilities, certain rare abilities in autistic savants, and the seemingly spontaneous emergence of exceptional abilities in young children, but there is also contrary evidence indicating an absence of early precursors of high skill levels. An analysis of positive and negative evidence and arguments suggests that differences in early experiences, preferences, opportunities, habits, training, and practice are the real determinants of excellence.

Sexual problems: a study of the prevalence and need for health care in the general population.

Abstract: Background There has been little research carried out on the prevalence and types of sexual dysfunction in the general population, although the indications are that such problems are relatively common. Most common sexual problems are potentially treatable. However GPs have estimated the prevalence of sexual problems to be far lower than survey estimates. Objective To provide an estimate of the prevalence of sexual problems in the general population, and assess the use of and need for professional help for such problems. Methods We used an anonymous postal questionnaire survey. The study was set in four general practices in England*, and the study population was a stratified random sample of the adult general population (n = 4000). The subjects were 789 men and 979 women who responded to the questionnaire. The main outcome measures were the presence and type of current sexual problems in men and women, and the provision and use of treatments for sexual problems. Results A response rate of 44% was obtained. The median age of the responders was 50 years. A third of men (34%) and two-fifths of women (41 %) reported having a current sexual problem. The most common problems were erectile dysfunction (n = 170) and premature ejaculation (n = 88) in men; in women the most widely reported problems were vaginal dryness (n = 186) and infrequent orgasm (n = 166). In men, the proportion of responders reporting sexual problems increased with age, but there was no similar trend in women. Of those responders who reported a sexual problem, 52% said that they would like to receive professional help for this problem, but only one in ten of these people (n = 50) had received such help. Conclusion Among responders there was a high level of reported sexual problems. The most frequently reported problems (vaginal dryness, erectile problems) may be amenable to physical treatment in practice, and yet few had sought or received help. However, many said that they would like to receive help. These figures suggest that there may be an important burden of potentially reversible sexual problems in the general population.

Individual Risk factors for Hip Osteoarthritis: Obesity, Hip Injury and Physical Activity

Abstract: Hip osteoarthritis is a major cause of pain and disability. The authors explored individual risk factors for hip osteoarthritis in a population-based case-control study. The study was performed in two English health districts (Portsmouth and North Staffordshire) from 1993 to 1995. A total of 611 patients (210 men and 401 women) listed for hip replacement because of osteoarthritis over an 18-month period were compared with an equal number of controls selected from the general population and individually matched for age, sex, and family practitioner. Information about suspected risk factors was obtained by a questionnaire administered at interview and a short physical examination. Obesity (odds ratio (OR) = 1.7, 95% confidence interval (CI) 1.3-2.4; highest vs. lowest third of body mass index), previous hip injury (OR = 4.3, 95% CI 2.2-8.4), and the presence of Heberden's nodes (OR = 1.6, 95% CI 1.2-2.2) were independent risk factors for hip osteoarthritis among men and women. Hip injury was more closely related to unilateral as compared with bilateral disease. There were a negative association between cigarette smoking and osteoarthritis among men and a weak positive association with prolonged regular sporting activity. Obesity and hip injury are important independent risk factors for hip osteoarthritis, which might be amenable to primary prevention. Hip osteoarthritis may also arise as part of the polyarticular involvement found in generalized osteoarthritis.

Undergraduate Non‐Completion: Developing an Explanatory Model

Abstract: This paper presents an explanatory model of undergraduate non-completion based, primarily, on the findings of a qualitative case study. Previous research in the field of non-completion is briefly reviewed. Such work is somewhat limited in its explanatory usefulness because it tends to focus on the student as the problem. The causes of non-completion can only be fully understood as the culmination of a complex social process of student-institution interaction which operates within the context of change in higher education. From this sociologically-informed theoretical framework an explanatory model has been devised that shows how the process of withdrawal for conventional students (i.e. students who enter HE through the traditional academic route) is markedly different from that for mature students. For conventional students the factors which appear to be of central importance are student preparedness, compatibility of choice, and time of exit. In contrast, mature students are often forced into non-completion because of external circumstances. Following a detailed description of our explanatory model of undergraduate non-completion, we present a number of strategies for intervention at both national and institutional levels and outline the implications for higher education policy.

Mixed dissociative and molecular adsorption of water on the rutile (110) surface

Abstract: Using first-principles density-functional methods we show that a monolayer of water on the rutile (110) surface contains H2O in both molecular and dissociated forms. Intermolecular hydrogen bonding stabilizes this configuration with respect to the complete dissociative adsorption which would be predicted from studies at lower coverage. The proposed mixed adsorption mode is fully consistent with experimental data, reconciles apparent conflicts within these data, and explains discrepancies between experiment and previous calculations.

'Delivered from the spirit of poverty?' : Pentecostalism, prosperity and modernity in Zimbabwe

Abstract: L'article etudie les rapports du pentecotisme a la modernite et au progres economique en Afrique au Zimbabwe. L'A. montre comment les pentecotistes du Zimbabwe ont faconne leur propre version de la prosperite evangelique pour transformer la societe. Les pentecotistes deviennent autonomes en accomplissant une rupture avec le passe et la tradition impliquant un changement social.

Binding of an arm repeat protein to the kinase domain of the S-locus receptor kinase

Abstract: Screening of a yeast two-hybrid library for proteins that interact with the kinase domain of an S-locus receptor kinase (SRK) resulted in the isolation of a plant protein called ARC1 (Arm Repeat Containing). This interaction was mediated by the C-terminal region of ARC1 in which five arm repeat units were identified. Using the yeast two-hybrid system and in vitro binding assays, ARC1 was found to interact specifically with the kinase domains from SRK-910 and SRK-A14 but failed to interact with kinase domains from two different Arabidopsis receptor-like kinases. In addition, treatment with a protein phosphatase or the use of a kinase-inactive mutant reduced or abolished the binding of ARC1 to the SRK-910 kinase domain, indicating that the interaction was phosphorylation dependent. Lastly, RNA blot analysis revealed that the expression of ARC1 is restricted to the stigma, the site of the self-incompatibility response.

Surgery for obstructive sleep apnoea.

Abstract: BACKGROUND Obstructive sleep apnoea/hypopnoea syndrome(OSAHS) is the periodic reduction or cessation of airflow during sleep. The syndrome is associated with loud snoring, disrupted sleep and observed apnoeas. Surgery for obstructive sleep apnoea/hypopnoea syndrome aims to alleviate symptoms of daytime sleepiness, improve quality of life, and reduce the signs of sleep apnoea recorded by polysomnography. OBJECTIVES The objective of this review was to assess the effects of any type of surgery for the treatment of the symptoms of obstructive sleep apnoea/hypopnoea syndrome in adults. SEARCH STRATEGY We searched the Cochrane Airways Group Specialised Register and reference lists of articles. We contacted experts in the field, research dissemination bodies and other Cochrane Review Groups. Searches were current as of July 2005. SELECTION CRITERIA Randomised trials comparing any surgical intervention for obstructive sleep apnoea/hypopnoea syndrome with other surgical or non-surgical interventions or no intervention. DATA COLLECTION AND ANALYSIS Two reviewers assessed electronic literature search results for possibly relevant studies. Characteristics and data from studies meeting the inclusion criteria were extracted and entered into RevMan 4.2. MAIN RESULTS In the 2005 update for this review eight studies (412 participants) of mixed quality met the inclusion criteria. Data from seven studies were eligible for assessment in the review. No data could be pooled. Uvulopalatopharyngoplasty (UPPP) versus conservative management (one trial): An un validated symptom score showed intermittent significant differences over a 12-month follow-up period. No differences in Polysomnography (PSG) outcomes were reported. Laser-assisted uvulopalatoplasty (LAUP) versus conservative management/placebo (two trials): One study recruited mixed a population, and separate data could not be obtained for this trial. In the other study no significant differences in Epworth scores or quality of life reported. A significant difference in favour of LAUP was reported in terms of apnoea hypopnoea index (AHI) and frequency and intensity of snoring. UPPP versus oral appliance (OA) (one trial): AHI was significantly lower with OA therapy than with UPPP. No significant differences were observed in quality of life. UPPP versus lateral pharyngoplasty (lateral PP) (one trial): No significant difference in Epworth scores, but a greater reduction in AHI with lateral PP was reported. Tongue advancement (mandibular osteotomy) + PPP versus tongue suspension + PPP (one trial): There was a significant reduction in symptoms in both groups, but no significant difference between the two surgery types. Complications reported with all surgical techniques included nasal regurgitation, pain and bleeding. These did not persist in the long term. An additional study assessed the effects of four different techniques. No data were available on between group comparisons. Multilevel temperature-controlled radiofrequency tissue ablation (TCRFTA) versus sham placebo and CPAP (one trial): There was an improvement in primary and secondary outcomes of TCRFTA over sham placebo and but no difference in symptomatic improvement when compared with CPAP. AUTHORS' CONCLUSIONS There are now a small number of trials assessing different surgical techniques with inactive and active control treatments. The studies assembled in the review do not provide evidence to support the use of surgery in sleep apnoea/hypopnoea syndrome, as overall significant benefit has not been demonstrated. The participants recruited to the studies had mixed levels of AHI, but tended to suffer from moderate daytime sleepiness where this was measured. Short-term outcomes are unlikely to consistently identify suitable candidates for surgery. Long-term follow-up of patients who undergo surgical correction of upper airway obstruction is required. This would help to determine whether surgery is a curative intervention, or whether there is a tendency for the signs and symptoms of sleep apnoea to re-assert themselves, prompting patients to seek further treatment for sleep apnoea.

The viscosity of liquid iron at the physical conditions of the Earth's core

Abstract: It is thought that the Earth's outer core consists mainly of liquid iron and that the convection of this metallic liquid gives rise to the Earth's magnetic field. A full understanding of this convection is hampered, however, by uncertainty regarding the viscosity of theouter core. Viscosity estimates from various sources span no less than 12 orders of magnitude1,2, and it seems unlikely that thisuncertainty will be substantially reduced by experimental measurements in the near future. Here we present dynamical first-principles simulations of liquid iron which indicate that the viscosity of iron at core temperatures and pressures is at the low end of the range of previous estimates — roughly 10 times that of typical liquid metals at ambient pressure. This estimate supports the approximation commonly made in magnetohydrodynamic models that the outer core is an inviscid fluid3,4,5 undergoing small-scale circulation and turbulent convection6, rather than large-scale global circulation.

European governance and new constitutionalism: Economic and Monetary Union and alternatives to disciplinary Neoliberalism in Europe

Abstract: (1998). European governance and new constitutionalism: Economic and Monetary Union and alternatives to disciplinary Neoliberalism in Europe. New Political Economy: Vol. 3, No. 1, pp. 5-26.

What are Physical Properties

Abstract: This paper concerns an issue in the metaphysics of properties. The issue is: what are physical properties? What distinguishes physical properties from all other properties? My conclusions will be ‘downbeat’. I will argue that some major recent approaches to this issue prove unsatisfactory, and that the issue is much more intractable than has widely been supposed. The moral I draw is that there is no principled and well-defined distinction between physical properties and all other properties, and accordingly certain programmes in metaphysics should be abandoned because they mistakenly assume that there is such a distinction.

Imprecision in Finite Resolution Spatial Data

Abstract: An important component of spatial data quality is the imprecision resulting from the resolution at which data are represented. Current research on topics such as spatial data integration and generalization needs to be well-founded on a theory of multi-resolution. This paper provides a formal framework for treating the notion of resolution and multi-resolution in geographic spaces. It goes further to develop an approach to reasoning with imprecision about spatial entities and relationships resulting from finite resolution representations. The approach is similar to aspects of rough and fuzzy set theories. The paper concludes by providing the beginnings of a geometry of vague spatial entities and relationships.

Relativistic Quantum Mechanics: With Applications in Condensed Matter and Atomic Physics

Abstract: This graduate text introduces relativistic quantum theory, emphasising its important applications in condensed matter physics. Basic theory, including special relativity, angular momentum and particles of spin zero are first reprised. The text then goes on to discuss the Dirac equation, symmetries and operators, and free particles. Physical consequences of solutions including hole theory and Klein's paradox are considered. Several model problems are solved. Important applications of quantum theory to condensed matter physics then follow. Relevant theory for the one electron atom is explored. The theory is then developed to describe the quantum mechanics of many electron systems, including Hartree-Fock and density functional methods. Scattering theory, band structures, magneto-optical effects and superconductivity are among other significant topics discussed. Many exercises and an extensive reference list are included. This clear account of relativistic quantum theory will be valuable to graduate students and researchers working in condensed matter physics and quantum physics.

Combining empirical results in software engineering

Abstract: In this paper we investigate the techniques used in medical research to combine results from independent empirical studies of a particular phenomenon: meta-analysis and vote-counting. We use an example to illustrate the benefits and limitations of each technique and to indicate the criteria that should be used to guide your choice of technique. Meta-analysis is appropriate for homogeneous studies when raw data or quantitative summary information, e.g. correlation coefficient, are available. It can also be used for heterogeneous studies where the cause of the heterogeneity is due to well-understood partitions in the subject population. In other circumstances, meta-analysis is usually invalid. Although intuitively appealing, vote-counting has a number of serious limitations and should usually be avoided. We suggest that combining study results is unlikely to solve all the problems encountered in empirical software engineering studies, but some of the infrastructure and controls used by medical researchers to improve the quality of their empirical studies would be useful in the field of software engineering.

First-principles calculation of transport coefficients

Abstract: We demonstrate the practical feasibility of calculating transport coefficients such as the viscosity of liquids completely from first principles using the Creen-Kubo relations. Results presented for liquid aluminum are shown to have a statistical error of only ca. 5%. The importance of such calculations is illustrated by results for a liquid iron-sulfur alloy under Earth's core conditions, which indicate that the viscosity of the liquid outer core is no more than an order of magnitude higher than that of typical liquid metals under ambient conditions. [S0031-9007(98)07869-7].

An optimal extraction algorithm for imaging photometry

Abstract: This paper is primarily an investigation of whether the ‘optimal extraction’ techniques used in CCD spectroscopy can be applied to imaging photometry. It is found that using such techniques provides a gain of around 10 per cent in signal-to-noise ratio over normal aperture photometry. Formally, it is shown to be equivalent to profile fitting, but offers advantages of robust error estimation, freedom from bias introduced by mis-estimating the point spread function, and convenience. In addition some other techniques are presented, which can be applied to profile fitting, aperture photometry and the ‘optimal’ photometry. Code implementing these algorithms is available at http://www.astro.keele.ac.uk/~timn/.