on behalf of the Experimental Cancer Medicine Centres (ECMC) CID trials working group The traditional cancer drug development pathway is increasingly being superseded by trials that address multiple clinical questions. These are collectively termed Complex Innovative Design (CID) trials. CID trials not only assess the safety and toxicity of novel anticancer medicines but also their efficacy in biomarker-selected patients, specific cancer cohorts or in combination with other agents. They can be adapted to include new cohorts and test additional agents within a single protocol. Whilst CID trials can speed up the traditional route to drug licencing, they can be challenging to design, conduct and interpret. The Experimental Cancer Medicine Centres (ECMC) network, funded by the National Institute for Health Research (NIHR), Cancer Research UK (CRUK) and the Health Boards of Wales, Northern Ireland and Scotland, formed a working group with relevant stakeholders from clinical trials units, the pharmaceutical industry, funding bodies, regulators and patients to identify the main challenges of CID trials. The working group generated ten consensus recommendations. These aim to improve the conduct, quality and acceptability of oncology CID trials in clinical research and, importantly, to expedite the process by which effective treatments can reach cancer patients.
Introduction Ethnicity influences dementia etiology, prognosis, and treatment, while culture shapes help‐seeking and care. Despite increasing population diversity in high‐income settlement countries, ethnic minorities remain underrepresented in dementia research. We investigated approaches to enhance the recruitment, and consistent collection and analysis of variables relevant to, ethnic minorities in dementia studies to make recommendations for consistent practice in dementia research. Methods We did a scoping review, searching Embase, PsycINFO, Medline, CENTRAL, and CINAHL between January 1, 2010 and January 7, 2020. Dementia clinical and cohort studies that actively recruited ethnic minorities in high‐income countries were included. A steering group of experts developed criteria through which high‐quality studies were identified. Results Sixty‐six articles were retrieved (51 observational; 15 experimental). Use of interpreters and translators (n = 17) was the most common method to facilitate participant recruitment. Race and ethnicity (n = 59) were the most common variables collected, followed by information on native language (n = 14), country of birth (n = 9), and length of time in country of settlement (n = 8). Thirty‐three studies translated or used a culturally validated instrument. Twenty‐three articles conducted subgroup analyses based on ethnicity. Six high‐quality studies facilitated inclusion through community engagement, collected information on multiple aspects of ethnic diversity, and adjusted/substratified to analyze the impact of ethnicity on dementia. Discussion We make recommendations for consistent recruitment, collection, and reporting of variables relating to ethnic and cultural diversity in dementia research.
Abstract:Purpose:We wanted to provide an enriched understanding of how lawyers keep up-to-date with legal developments. Maintaining awareness of developments in an area (known as 'monitoring') is an important aspect of professional's information work. This is particularly true for lawyers, who are expected to keep up-to-date with legal developments on an on-going basis.Design/methodology/approach:We conducted semi-structured interviews with a group of lawyers who authored and published current awareness content for LexisNexis -a large publishing organisation. The interviews focused on identifying the types of electronic, printed and people-based current awareness resources the lawyers used to keep up-to-date with legal developments and the reasons for their choices. Findings:The lawyers mostly used electronic resources (particularly e-mail alerts and an electronic tool that alerted them to changes in website content), alongside interpersonal sources such as colleagues, customers and professional contacts. Printed media such as journals and newspapers were used more rarely and usually to complement electronic and person-based resources. A number of factors were found to influence choice. These included situational relevance, presentation, utility and trustworthiness, the speed of content acquisition, and interpretation facilitated by the resource. Originality/value:Our findings enrich our understanding of lawyers' monitoring behaviour, which has so far received little direct research attention. Our design suggestions have the potential to feed into the design of new and improvement of existing digital current awareness resources. Our findings have the potential to act as 'success criteria' by which these resources can be evaluated from a user-centred perspective.
The survival of enteric pathogens in sewage sludge can lead to their transferral into the soil environment and subsequent contamination of crops and water courses. This, in turn, can increase the potential spread of gastrointestinal disease. This work aims to determine the persistence of several microorganisms, co‐introduced with sewage sludge, when exposed to varying proportions of sewage sludge to soil. Three microcosm‐based studies are established, inoculated with Salmonella Dublin or an environmentally persistent strain of Escherichia coli (quantified periodically over a period of 42 days), or indigenous sewage sludge E. coli (quantified over a period of 56 days). Treatments consist of a mixture containing: 0, 15, 25, 50, 75, and 100% soil or sludge, depending upon the experiment. Each introduced microorganism decline significantly over time, with greater quantities of soil generally instigating greater die‐off particularly in the cases of environmentally persistent E. coli and S. Dublin. However, this relationship is not proportionally related as sludge/soil mixtures show greater declines than pure soil treatments. In contrast, indigenous sewage sludge E. coli has a more consistent decline across all treatments. This indicates that indigenous strains are more resilient and can be indicative of natural behavior. Moreover, the effects of soil‐borne factors on pathogen attenuation are context dependent and non‐linear, possibly arising from the relative spatial distribution of introduced sludge and attendant microbes in soil.
Interim guidance for health-care professionals and administrators providing hospital care to adult patients with cognitive impairment, in the context of COVID-19 pandemic. More information at https://chsr.centre.uq.edu.au/inter im-guida nce-care-adult-patie nts-cogni tive-impai rment-requi ring-hospi tal-care-during-covid-19-pande mic-austr alia 2 | COGNITIVE IMPAIRMENT MAY INCREASE DURING COVID-19 • COVID-19 can cause delirium
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