Concurrent and construct evidence supports use of the OMNI Scale by adult women and men to estimate RPE during cycle exercise.

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Placebo comparisons are increasingly being considered for randomised trials assessing the efficacy of surgical interventions. The aim of this paper is to provide a summary of current knowledge on placebo controls in surgical trials. A placebo control is a complex type of comparison group and, although powerful, presents many challenges in a surgical setting. This review outlines what a placebosurgical control entails and our understanding of the placebo phenomenon in the context of surgery. It considers when placebo-surgical controls are acceptable (and when they are desirable) in terms of ethical arguments and regulatory requirements, how a placebo-surgical control should be designed, how to identify and mitigate risk for participants in placebo surgical trials, how such trials should be conducted and interpreted. Use of placebo control is justified in randomised controlled trials of surgical interventions provided there is a strong scientific and ethical rationale. Surgical placebos may be most appropriate where there is poor evidence on the efficacy of the procedure and a justified concern that results of a trial would be associated with high risk of bias, particularly due to the placebo effect. Feasibility work is recommended to optimise RCT design and conduct. This review forms an outline for best practice and provides guidance, in the form of the ASPIRE (Applying Surgical Placebo in Randomised Evaluations) checklist, for those considering the use of a placebo-control in a surgical randomised controlled trial.

The adverse environmental impacts of plastic bags, including production energy costs, limited lifespan, increasing landfill content and inability to biodegrade, provide symbolic and practical evidence of a ‘throwaway’ consumer culture which acts as a significant barrier to sustainable consumption in particular and sustainable development in general. Decoupling consumer behaviour from plastic bag use is therefore an important challenge in the pursuit of sustainable consumption as a precursor to achieving sustainable development. This article provides a critical evaluation of that challenge, set within the theoretical framework of sustainable development. It examines the adverse environmental impacts of plastic bag use and evaluates initiatives by governments and businesses internationally to change consumer behaviour regarding the use of plastic bags in line with sustainable development principles. The politics of this agenda are analysed using a combination of consumer policy and public policy perspectives. Finally, the article draws conclusions regarding the earlier analysis.

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