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PP296 Patient Involvement In An Assessment Of The Management Of Sudden Onset Severe Headache Presenting To The Emergency Department
- Ros Wade, Matthew Walton, Melissa Harden, Robert Hodgson, Alison Eastwood, James Storey, Taj Hassan, Marc Randall, Abu Hassan, John Williams
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- Journal:
- International Journal of Technology Assessment in Health Care / Volume 37 / Issue S1 / December 2021
- Published online by Cambridge University Press:
- 03 December 2021, p. 33
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Introduction
Sudden onset severe headache is usually caused by a primary headache disorder but may be secondary to a more serious problem, such as subarachnoid hemorrhage (SAH). Very few patients who present to hospital with headache have suffered a SAH, but early identification is important to improve patient outcomes. A systematic review was undertaken to assess the clinical effectiveness of different care pathways for the management of headache, suspicious for SAH, in the Emergency Department. Capturing the perspective of patients was an important part of the research.
MethodsThe project team included a patient collaborator with experience of presenting to the Emergency Department with sudden onset severe headache. Three additional patients were recruited to our advisory group. The patient's perspective was collected at various points through the project including at team meetings, during protocol development and when interpreting the results of the systematic review and drawing conclusions.
ResultsPatients were reassured by the very high diagnostic accuracy of computed tomography (CT) for detecting SAH. Patients and clinicians emphasized the importance of shared decision making about whether to undergo additional tests to rule out SAH, after a negative CT result. When lumbar puncture was necessary, patients expressed a preference to have it on an ambulatory basis; further research on the safety and acceptability of ambulatory lumbar puncture was recommended.
ConclusionsPatient input at the protocol development stage helped researchers understand the patient experience and highlighted important outcomes for assessment. Patient involvement added context to the review findings and highlighted the preferences of patients regarding the management of headache.
PP297 Management Of Sudden Onset Severe Headache Presenting To The Emergency Department: A Systematic Review
- Ros Wade, Matthew Walton, Melissa Harden, Robert Hodgson, Alison Eastwood, James Storey, Taj Hassan, Marc Randall, Abu Hassan, John Williams
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- Journal:
- International Journal of Technology Assessment in Health Care / Volume 37 / Issue S1 / December 2021
- Published online by Cambridge University Press:
- 03 December 2021, pp. 33-34
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Introduction
Sudden onset severe headache is usually caused by a primary headache disorder but occasionally is secondary to a more serious problem, such as subarachnoid hemorrhage (SAH). Guidelines recommend non-contrast brain computed tomography (CT) followed by lumbar puncture (LP) to exclude SAH. However, guidelines pre-date the introduction of more sensitive modern CT scanners. A systematic review was undertaken to assess the clinical effectiveness of different care pathways for the management of headache in the Emergency Department.
MethodsEighteen databases (including MEDLINE and Embase) were searched to February 2020. Studies were quality assessed using criteria relevant to the study design; most studies were assessed using the QUADAS-2 tool for diagnostic accuracy studies. Where sufficient information was reported, diagnostic accuracy data were extracted into 2 × 2 tables to calculate sensitivity, specificity, false-positive and false-negative rates. Where possible, hierarchical bivariate meta-analysis was used to synthesize results, otherwise studies were synthesized narratively.
ResultsFifty-one studies were included in the review. Eight studies assessing the accuracy of the Ottawa SAH clinical decision rule were pooled; sensitivity was 99.5 percent, specificity was 23.7 percent. The high false positive rate suggests that 76.3 percent SAH-negative patients would undergo further investigation unnecessarily. Four studies assessing the accuracy of CT within six hours of headache onset were pooled; sensitivity was 98.7 percent, specificity was 100 percent. CT sensitivity beyond six hours was considerably lower (≤90%; 2 studies). Three studies assessing LP following negative CT were pooled; sensitivity was 100 percent, specificity was 95.2 percent. LP-related adverse events were reported in 5.3–9.5 percent of patients.
ConclusionsThe evidence suggests that the Ottawa SAH Rule is not sufficiently accurate for ruling out SAH and does little to aid clinical decision making. Modern CT within six hours of headache onset (with images assessed by a neuroradiologist) is highly accurate, but sensitivity reduces considerably over time. The CT-LP pathway is highly sensitive for detecting SAH, although LP resulted in some false-positives and adverse events.
Thidiazuron and Colletotrichum coccodes Effects on Ethylene Production by Velvetleaf (Abutilon theophrasti) and Prickly Sida (Sida spinosa)
- Richard H. Hodgson, Robert H. Snyder
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- Journal:
- Weed Science / Volume 37 / Issue 3 / May 1989
- Published online by Cambridge University Press:
- 12 June 2017, pp. 484-489
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The effects of the plant growth regulator thidiazuron and the plant pathogen Colletotrichum coccodes on ethylene synthesis by velvetleaf and prickly sida were investigated. Untreated velvetleaf seedlings produced 1.5 and 2.3 pmol ethylene/mg fresh weight 24 and 48 h after treatment. Treatment with thidiazuron at 200 g ai/ha or C. coccodes at 1 × 109 spores/m2 increased ethylene production by 4.9 and 3.5 pmol/mg, respectively, in 24 h; and by 10.6 and 15.8 pmol/mg, respectively, in 48 h. Combination treatments caused synergistic increases in ethylene production by velvetleaf seedlings of 17.7 and 49.6 pmol/mg in 24 and 48 h, respectively. Thidiazuron at 10 μM, combined with an extract of C. coccodes mycelia, increased ethylene synthesis by more than 4-fold in vacuum-infiltrated excised velvetleaf petioles within 48 h. Thidiazuron at 50 g/ha, combined with an extract of C. coccodes mycelium, increased ethylene synthesis 16-fold in prickly sida seedlings in 24 h. Aminocyclopropane carboxylic acid (ACC), a precursor of ethylene, stimulated ethylene production by velvetleaf petioles more than 8-fold when supplied at 0.75 mM; thidiazuron and the pathogen effects were not discernible in its presence. Aminoethoxyvinyl-glycine (AVG), an inhibitor of ACC synthase, inhibited overall ethylene production by velvetleaf seedlings more than 40% when supplied at 0.58 to 0.67 mM, without obscuring the stimulatory effects of thidiazuron and the pathogen. These results indicate that the growth regulator and the plant pathogen or an extract of the pathogen act in concert to increase ethylene synthesis in velvetleaf. Stimulation probably occurs before the synthesis of ACC in the ethylene biosynthetic pathway.
Growth Retardant Response of Bean (Phaseolus vulgaris) and Woody Plants to Injections of MBR 18337
- John P. Sterrett, Richard H. Hodgson, Robert H. Snyder
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- Journal:
- Weed Science / Volume 31 / Issue 4 / July 1983
- Published online by Cambridge University Press:
- 12 June 2017, pp. 431-435
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The growth retardant activity of MBR 18337 {N-[4-(ethylthio)-2-(trifluoromethyl)phenyl]-methanesulfonamide} was determined by injection into bean plants (Phaseolus vulgaris L. ‘Black Valentine’), California privet seedlings (Ligustrum ovalifolium Hassk.), and saplings of white ash (Fraxinus americana L.) and red maple (Acer rubrum L.). Height and leaf expansion of bean were inhibited by 8 μg of MBR 18337 per plant in growth chamber studies. Sprout growth of California privet grown in the greenhouse was inhibited for 92 days by 80 μg of MBR 18337 per tree, and the growth in the field of ash and maple saplings was retarded by 3.2 mg of MBR 18337 per tree for an entire growing season with little injury. Radioassays for 14C-MBR 18337 indicated rapid translocation of 14C-activity in privet from the lower stem to the region of the apical shoot. More than 80% of the MBR 18337 in the xylem and phloem was oxidized within 14 days.
Efficacy of Colletotrichum coccodes and Thidiazuron for Velvetleaf (Abutilon theophrasti) Control in Soybean (Glycine max)
- Richard H. Hodgson, Lee A. Wymore, Alan K. Watson, Robert H. Snyder, Anne Collette
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- Journal:
- Weed Technology / Volume 2 / Issue 4 / October 1988
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- 12 June 2017, pp. 473-480
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The plant pathogenic fungus Colletotrichum coccodes (Cc) and the plant growth regulator thidiazuron (TDZ) were evaluated in Maryland and Quebec for velvetleaf control in ‘Williams' and ‘Maple Arrow’ soybean. TDZ was applied at 0, 0.1, 0.2, 0.3, and 0.4 kg ai/ha alone or was combined with Cc at 109 spores/m2 when velvetleaf was at the 1- to 2-leaf (Trial 1) or 4- to 6-leaf (Trial 2) growth stages. Velvetleaf control increased with TDZ rate, and TDZ combined with Cc further increased control. TDZ reduced velvetleaf biomass and height, and Cc increased velvetleaf mortality. In Quebec, Cc also reduced the biomass of velvetleaf treated in Trial 1 and interacted positively with TDZ at this growth stage. Cc nearly halved the rates of TDZ required for 90 and 75% mortality of velvetleaf treated at the 1- to 2-leaf and 4- to 6-leaf stages to 0.09 and 0.12 kg/ha, respectively, in Quebec. Cc similarly lowered the rate of TDZ required for 75% stand reduction of velvetleaf in Trial 1 to 0.17 kg/ha in Maryland. Cool wet weather in Quebec contrasted with warm, dry weather in Maryland. Soybean biomass and yield were increased significantly by treatment with TDZ plus Cc in Trial 1 at both locations.
Thidiazuron Effects on Malvaceae, Corn, Zea mays; and Soybean, Glycine max
- Richard H. Hodgson, Robert H. Snyder
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- Journal:
- Weed Technology / Volume 2 / Issue 3 / July 1988
- Published online by Cambridge University Press:
- 12 June 2017, pp. 342-349
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The growth of two mallow family weeds, velvetleaf and prickly sida, was inhibited 50% when seedlings were treated with less than 200 g ai/ha of thidiazuron. Spurred anoda was unaffected by treatment with up to 1120 g/ha of thidiazuron. Cotton, okra, and hibiscus, all in the mallow family, also were susceptible to thidiazuron treatment. Leaf development in 2-week-old cotton seedlings was inhibited 20% by less than 35 g/ha thidiazuron as were seedling okra and hibiscus. Plants of all these susceptible species were more resistant when grown for 2 months before treatment. Seedlings of soybean displayed localized injury after treatment, but plant height, biomass, and seed production were not significantly affected 10 weeks after treatment with up to 1120 g/ha thidiazuron. Seedlings of corn appeared unaffected by treatment with up to 1120 g/ha thidiazuron.
Contributors
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- By Janice Capel Anderson, S. Wesley Ariarajah, Constantine Belezos, Ian Boxall, Marc Zvi Brettler, Edward Breuer, Daniel Bruno, Mark Chapman, W. T. Dickens, Mark W. Elliott, Eldon Epp, Tassilo Erhardt, Timothy Gorringe, Harriet Harris, Peter C. Hodgson, Leslie Howsam, Werner G. Jeanrond, Scott McLaren, Wayne A. Meeks, Néstor Míguez, Stephen D. Moore, Robert Morgan, Halvor Moxnes, Peter Neuner, Mark Noll, Jorunn Økland, Gaye Ortiz, John Riches, Christopher Rowland, Nicolaas A. Rupke, Edmund J. Rybarczyk, Lamin Sanneh, Constantine Scouteris, R. S. Sugirtharajah, Willard M. Swartley, William R. Telford, David Thompson, Elena Volkova, J. R. Watson, Gerald West, Michael Wheeler, Keith Whitelam
- Edited by John Riches, University of Glasgow
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- Book:
- The New Cambridge History of the Bible
- Published online:
- 09 June 2015
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- 13 April 2015, pp xi-xii
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Absence of a Medieval Climate Anomaly, Little Ice Age and twentieth century warming in Skarvsnes, Lützow Holm Bay, East Antarctica
- Ines Tavernier, Elie Verleyen, Dominic A. Hodgson, Katrien Heirman, Stephen J. Roberts, Satoshi Imura, Sakae Kudoh, Koen Sabbe, Marc De Batist, Wim Vyverman
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- Journal:
- Antarctic Science / Volume 26 / Issue 5 / October 2014
- Published online by Cambridge University Press:
- 12 May 2014, pp. 585-598
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Palaeoclimate changes, such as the Medieval Climate Anomaly and the Little Ice Age, are well-defined in the Northern Hemisphere during the past 2000 years. In contrast, these anomalies appear to be either absent, or less well-defined, in high-latitude regions of the Southern Hemisphere. Here, we inferred environmental changes during the past two millennia from proxies in a sediment core from Mago Ike, an East Antarctic lake in Skarvsnes (Lützow Holm Bay). Variations in lake primary production were inferred from fossil pigments, sedimentological and geochemical proxies and combined with absolute diatom counts to infer past diatom productivity and community changes. Three distinct stratigraphic zones were recognized, resulting from a shift from marine to lacustrine conditions with a clear transition zone in between. The presence of open-water marine diatoms indicates a coastal zone seasonally free of sea ice between c. 2120–1500 cal yr bp. Subsequently, the lake became isolated from the ocean due to isostatic uplift. Freshwater conditions were established from c. 1120 cal yr bp onwards after which the proxies are considered highly sensitive to temperature changes. There is no evidence for a Medieval Climate Anomaly, Little Ice Age or twentieth century warming in our lake sediment record suggesting that studies that have imposed Northern Hemisphere climate anomalies onto Southern Hemisphere palaeoclimate records should be treated with caution.
Criteria for Accrediting Expert Wine Judges*
- Robert Hodgson, Jing Cao
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- Journal of Wine Economics / Volume 9 / Issue 1 / May 2014
- Published online by Cambridge University Press:
- 30 September 2013, pp. 62-74
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A test for evaluating wine judge performance is developed. The test is based on the premise that an expert wine judge will award similar scores to an identical wine. The definition of “similar” is parameterized to include varying numbers of adjacent awards on an ordinal scale, from No Award to Gold. For each index of similarity, a probability distribution is developed to determine the likelihood that a judge might pass the test by chance alone. When the test is applied to the results from a major wine competition, few judges pass the test. Of greater interest is that many judges who fail the test have vast professional experience in the wine industry. This leads to us to question the basic premise that experts are able to provide consistent evaluations in wine competitions and, hence, that wine competitions do not provide reliable recommendations of wine quality. (JEL Classifications: C02, C12, D81)
On Rating Wines with Unequal Judges
- Robert T. Hodgson
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- Journal of Wine Economics / Volume 3 / Issue 2 / Winter 2008
- Published online by Cambridge University Press:
- 08 June 2012, pp. 226-227
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How Expert are “Expert” Wine Judges?*
- Robert T. Hodgson
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- Journal of Wine Economics / Volume 4 / Issue 2 / Winter 2009
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- 08 June 2012, pp. 233-241
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Recent papers by Hodgson (2008) and Gawel and Godden (2008) have questioned the consistency of expert wine judges in a wine competition setting. In the latter paper, a methodology introduced in psychometric research to measure judge reliability corrected for chance was used to quantify judge consistency (Cohen, 1968). This paper extends that notion, suggesting a value of 0.7 for Cohen's weighted kappa might be used to define an expert wine judge. With that criterion, less than 30% of judges who participated in either of the two studies would be considered “expert.” (JEL Classification: C1, L15)
An Examination of Judge Reliability at a major U.S. Wine Competition*
- Robert T. Hodgson
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- Journal of Wine Economics / Volume 3 / Issue 2 / Winter 2008
- Published online by Cambridge University Press:
- 08 June 2012, pp. 105-113
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Wine judge performance at a major wine competition has been analyzed from 2005 to 2008 using replicate samples. Each panel of four expert judges received a flight of 30 wines imbedded with triplicate samples poured from the same bottle. Between 65 and 70 judges were tested each year. About 10 percent of the judges were able to replicate their score within a single medal group. Another 10 percent, on occasion, scored the same wine Bronze to Gold. Judges tend to be more consistent in what they don't like than what they do. An analysis of variance covering every panel over the study period indicates only about half of the panels presented awards based solely on wine quality. (JEL Classification: Q13, Q19)
An Analysis of the Concordance Among 13 U.S. Wine Competitions*
- Robert T. Hodgson
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- Journal of Wine Economics / Volume 4 / Issue 1 / Spring 2009
- Published online by Cambridge University Press:
- 08 June 2012, pp. 1-9
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An analysis of over 4000 wines entered in 13 U.S. wine competitions shows little concordance among the venues in awarding Gold medals. Of the 2,440 wines entered in more than three competitions, 47 percent received Gold medals, but 84 percent of these same wines also received no award in another competition. Thus, many wines that are viewed as extraordinarily good at some competitions are viewed as below average at others. An analysis of the number of Gold medals received in multiple competitions indicates that the probability of winning a Gold medal at one competition is stochastically independent of the probability of receiving a Gold at another competition, indicating that winning a Gold medal is greatly influenced by chance alone. (JEL Classification: D02, Q19)
Chapter 6 - National Systems for Managing the Risks from Climate Extremes and Disasters
- from Section III
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- By Padma Narsey Lal, Tom Mitchell, Paulina Aldunce, Heather Auld, Reinhard Mechler, Alimullah Miyan, Luis Ernesto Romano, Salmah Zakaria, Andrew Dlugolecki, Takuo Masumoto, Neville Ash, Stefan Hochrainer, Robert Hodgson, Tarik Ul Islam, Sabrina McCormick, Carolina Neri, Roger Pulwarty, Ataur Rahman, Ben Ramalingam, Karen Sudmeier-Reiux, Emma Tompkins, John Twigg, Robert Wilby
- Edited by Christopher B. Field, Vicente Barros, Thomas F. Stocker, Qin Dahe
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- Book:
- Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation
- Published online:
- 05 August 2012
- Print publication:
- 28 May 2012, pp 339-392
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Summary
Executive Summary
This chapter assesses how countries are managing current and projected disaster risks, given knowledge of how risks are changing with observations and projections of weather and climate extremes [Table 3–2, 3.3], vulnerability and exposure [4.3], and impacts [4.4]. It focuses on the design of national systems for managing such risks, the roles played by actors involved in the system, and the functions they perform, acknowledging that complementary actions to manage risks are also taken at local and international level as described in Chapters 5 and 7.
National systems are at the core of countries' capacity to meet the challenges of observed and projected trends in exposure, vulnerability, and weather and climate extremes (high agreement, robust evidence). Effective national systems comprise multiple actors from national and sub-national governments, private sector, research bodies, and civil society, including community-based organizations, playing differential but complementary roles to manage risk according to their accepted functions and capacities. These actors work in partnership across temporal, spatial, administrative, and social scales, supported by relevant scientific and traditional knowledge. Specific characteristics of national systems vary between countries and across scales depending on their socio-cultural, political, and administrative environments and development status. [6.2]
The national level plays a key role in governing and managing disaster risks because national government is central to providing risk management-related public goods as it commonly maintains financial and organizational authority in planning and implementing these goods (high agreement, robust evidence). National governments are charged with the provision of public goods such as ensuring the economic and social well-being, safety, and security of their citizens from disasters, including the protection of the poorest and most vulnerable citizens. They also control budgetary allocations as well as creating legislative frameworks to guide actions by other actors.
Chemical limnology in coastal East Antarctic lakes: monitoring future climate change in centres of endemism and biodiversity
- Elie Verleyen, Dominic A. Hodgson, John Gibson, Satoshi Imura, Enn Kaup, Sakae Kudoh, Aaike De Wever, Tamotsu Hoshino, Andrew McMinn, Dagmar Obbels, Donna Roberts, Steve Roberts, Koen Sabbe, Caroline Souffreau, Ines Tavernier, Wim van Nieuwenhuyze, Eric van Ranst, Nicole Vindevogel, Wim Vyverman
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- Journal:
- Antarctic Science / Volume 24 / Issue 1 / 06 February 2012
- Published online by Cambridge University Press:
- 23 September 2011, pp. 23-33
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Polar lakes respond quickly to climate-induced environmental changes. We studied the chemical limnological variability in 127 lakes and ponds from eight ice-free regions along the East Antarctic coastline, and compared repeat specific conductance measurements from lakes in the Larsemann Hills and Skarvsnes covering the periods 1987–2009 and 1997–2008, respectively. Specific conductance, the concentration of the major ions, pH and the concentration of the major nutrients underlie the variation in limnology between and within the regions. This limnological variability is probably related to differences in the time of deglaciation, lake origin and evolution, geology and geomorphology of the lake basins and their catchment areas, sub-regional climate patterns, the distance of the lakes and the lake districts to the ice sheet and the Southern Ocean, and the presence of particular biota in the lakes and their catchment areas. In regions where repeat surveys were available, inter-annual and inter-decadal variability in specific conductance was relatively large and most pronounced in the non-dilute lakes with a low lake depth to surface area ratio. We conclude that long-term specific conductance measurements in these lakes are complementary to snow accumulation data from ice cores, inexpensive, easy to obtain, and should thus be part of long-term limnological and biological monitoring programmes.
Contributors
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. Hackett, Getatchew Haile, Douglas John Hall, Nicholas Hammond, Daphne Hampson, Jehu J. Hanciles, Barry Hankins, Jennifer Haraguchi, Stanley S. Harakas, Anthony John Harding, Conrad L. Harkins, J. William Harmless, Marjory Harper, Amir Harrak, Joel F. Harrington, Mark W. Harris, Susan Ashbrook Harvey, Van A. Harvey, R. Chris Hassel, Jione Havea, Daniel Hawk, Diana L. Hayes, Leslie Hayes, Priscilla Hayner, S. Mark Heim, Simo Heininen, Richard P. Heitzenrater, Eila Helander, David Hempton, Scott H. Hendrix, Jan-Olav Henriksen, Gina Hens-Piazza, Carter Heyward, Nicholas J. Higham, David Hilliard, Norman A. Hjelm, Peter C. Hodgson, Arthur Holder, M. Jan Holton, Dwight N. Hopkins, Ronnie Po-chia Hsia, Po-Ho Huang, James Hudnut-Beumler, Jennifer S. Hughes, Leonard M. Hummel, Mary E. Hunt, Laennec Hurbon, Mark Hutchinson, Susan E. Hylen, Mary Beth Ingham, H. Larry Ingle, Dale T. Irvin, Jon Isaak, Paul John Isaak, Ada María Isasi-Díaz, Hans Raun Iversen, Margaret C. Jacob, Arthur James, Maria Jansdotter-Samuelsson, David Jasper, Werner G. Jeanrond, Renée Jeffery, David Lyle Jeffrey, Theodore W. Jennings, David H. Jensen, Robin Margaret Jensen, David Jobling, Dale A. Johnson, Elizabeth A. Johnson, Maxwell E. Johnson, Sarah Johnson, Mark D. Johnston, F. Stanley Jones, James William Jones, John R. Jones, Alissa Jones Nelson, Inge Jonsson, Jan Joosten, Elizabeth Judd, Mulambya Peggy Kabonde, Robert Kaggwa, Sylvester Kahakwa, Isaac Kalimi, Ogbu U. Kalu, Eunice Kamaara, Wayne C. Kannaday, Musimbi Kanyoro, Veli-Matti Kärkkäinen, Frank Kaufmann, Léon Nguapitshi Kayongo, Richard Kearney, Alice A. Keefe, Ralph Keen, Catherine Keller, Anthony J. Kelly, Karen Kennelly, Kathi Lynn Kern, Fergus Kerr, Edward Kessler, George Kilcourse, Heup Young Kim, Kim Sung-Hae, Kim Yong-Bock, Kim Yung Suk, Richard King, Thomas M. King, Robert M. Kingdon, Ross Kinsler, Hans G. Kippenberg, Cheryl A. Kirk-Duggan, Clifton Kirkpatrick, Leonid Kishkovsky, Nadieszda Kizenko, Jeffrey Klaiber, Hans-Josef Klauck, Sidney Knight, Samuel Kobia, Robert Kolb, Karla Ann Koll, Heikki Kotila, Donald Kraybill, Philip D. W. Krey, Yves Krumenacker, Jeffrey Kah-Jin Kuan, Simanga R. Kumalo, Peter Kuzmic, Simon Shui-Man Kwan, Kwok Pui-lan, André LaCocque, Stephen E. Lahey, John Tsz Pang Lai, Emiel Lamberts, Armando Lampe, Craig Lampe, Beverly J. Lanzetta, Eve LaPlante, Lizette Larson-Miller, Ariel Bybee Laughton, Leonard Lawlor, Bentley Layton, Robin A. Leaver, Karen Lebacqz, Archie Chi Chung Lee, Marilyn J. Legge, Hervé LeGrand, D. L. LeMahieu, Raymond Lemieux, Bill J. Leonard, Ellen M. Leonard, Outi Leppä, Jean Lesaulnier, Nantawan Boonprasat Lewis, Henrietta Leyser, Alexei Lidov, Bernard Lightman, Paul Chang-Ha Lim, Carter Lindberg, Mark R. Lindsay, James R. Linville, James C. Livingston, Ann Loades, David Loades, Jean-Claude Loba-Mkole, Lo Lung Kwong, Wati Longchar, Eleazar López, David W. 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Phan, Isabel Apawo Phiri, William S. F. Pickering, Derrick G. Pitard, William Elvis Plata, Zlatko Plese, John Plummer, James Newton Poling, Ronald Popivchak, Andrew Porter, Ute Possekel, James M. Powell, Enos Das Pradhan, Devadasan Premnath, Jaime Adrían Prieto Valladares, Anne Primavesi, Randall Prior, María Alicia Puente Lutteroth, Eduardo Guzmão Quadros, Albert Rabil, Laurent William Ramambason, Apolonio M. Ranche, Vololona Randriamanantena Andriamitandrina, Lawrence R. Rast, Paul L. Redditt, Adele Reinhartz, Rolf Rendtorff, Pål Repstad, James N. Rhodes, John K. Riches, Joerg Rieger, Sharon H. Ringe, Sandra Rios, Tyler Roberts, David M. Robinson, James M. Robinson, Joanne Maguire Robinson, Richard A. H. Robinson, Roy R. Robson, Jack B. Rogers, Maria Roginska, Sidney Rooy, Rev. Garnett Roper, Maria José Fontelas Rosado-Nunes, Andrew C. Ross, Stefan Rossbach, François Rossier, John D. Roth, John K. Roth, Phillip Rothwell, Richard E. 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Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- Book:
- The Cambridge Dictionary of Christianity
- Published online:
- 05 August 2012
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- 20 September 2010, pp xi-xliv
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Measurement of long-term outcomes in observational and randomised controlled trials
- Richard Hodgson, Chris Bushe, Robert Hunter
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- Journal:
- The British Journal of Psychiatry / Volume 191 / Issue S50 / August 2007
- Published online by Cambridge University Press:
- 02 January 2018, pp. s78-s84
- Print publication:
- August 2007
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Background
Randomised controlled trials (RCTs) are the gold standard for evaluating treatment efficacy. However, the outcomes of RCTs often lackclinical utility and usually do not address real-world effectiveness
AimsTo review how traditional RCTs may be triangulatedwith other methodologies such as observational studies and pragmatic trials by highlighting recently reported studies, outcomes used and their respective merits
MethodLiterature review focusing on drug treatment
ResultsRecently reported observational and some pragmatic studies show a degree of consistency in reported results and use outcomes that have face validity for clinicians
ConclusionsNo single experimental paradigm or outcome provides the necessary data to optimise treatment of mental illness in the clinical setting
Production characteristics of high-yielding dairy cows
- D. R. Neilson, C. T. Whittemore, M. Lewis, J. C. Alliston, D. J. Roberts, L. S. Hodgson-Jones, J. Mills, H. Parkinson, J. H. D. Prescott
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- Journal:
- Animal Production / Volume 36 / Issue 3 / June 1983
- Published online by Cambridge University Press:
- 02 September 2010, pp. 321-334
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- June 1983
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Understanding the relationships between food intake, milk output and body condition in high-yielding dairy cows is crucial in determining suitable management strategies. During two winter feeding periods 38 and 37 cows were individually fed, to appetite, complete diets which on average contained 11·7 MJ metabolizable energy per kg dry matter and comprised grass silage, concentrate meal and brewers' grains (draff). The groups' mean 305-day yield was 7 240 kg (s.d. 1 281) with 42 g (s.d. 4·3) fat per kg. Regression analysis was carried out to describe dry-matter intake both for 26 weeks post calving and for four successive 6-week periods from calving. The final equations, which had a residual s.d. of 0·07 to 0·10 of the observed intake, included milk yield, cow size and a measure of body-condition change. The cows were divided into three groups (high, medium and low) on two criteria: (1) mean milk yield (MJ/day) during the first 26 weeks of lactation and (2) post-calving backfat index determined ultrasonically. Differences were found between milk-yield groups from gross efficiency (milk yield (MJ)/energy intake (MJ metabolizable energy)) (P < 0·001), mean metabolizable energy intake (MJ/day) (P < 0·01), dry-matter intake as a proportion of live weight (P < 0·05), and post calving live weight (kg) (P < 0·05). Differences were found between backfat-index groups for maximum backfat loss and loss to day 42 (P < 0·001); also for mean live weight during the 26 weeks and post calving live weight (P < 0·001), dry-matter intake as a proportion of live weight (P < 0·05) and lactation number (P < 0·05). Interactions were found between the milk yield groups and backfat groups for milk yield (P < 0·01) and gross efficiency (P < 0·05) with the fattest group containing the highest and lowest yields and efficiencies.