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Doubling in median survival in patients diagnosed with multiple myeloma 2005-2019:a real-world study from the UK’s Haematological Malignancy Research Network
Get PDFRecent decades have seen an explosion of therapeutic agents being evaluated in multiple myeloma (MM) clinical trials, and many of these have subsequently been licensed. Sadly, however, despite such advances, MM remains incurable. In addition, the restrictive inclusion and exclusion criteria of many clinical studies often mean that the beneficial effects seen within trials are not uniformly translated across the general patient population once agents are approved for use in routine clinical practice.1-3 Hence, understanding patterns of myeloma diagnosis and treatment in unselected real-world populations, and monitoring how they change over time in light of emerging therapeutic options, are key to informing clinical service strategy and clinical decision-making
A review of integrated reporting practices of JSE-listed companies: evidence of integrated thinking
Get PDFPurpose
This study reviews the integrated reporting practices of companies listed on the Johannesburg Stock Exchange (JSE) to identify features that point to evidence of an integrated thinking logic taking hold at organisations.
Design/methodology/approach
The study is based on the 60 largest entities listed on the JSE by market capitalisation. Using a content analysis, the integrated reports of the companies were systematically coded according to predefined dimension indicators. Descriptive statistics are used to establish correlations among the disclosure themes, allowing for elements of an integrated thinking logic to be identified.
Findings
Reporting practices of organisations remain varied. Some companies are pioneering new ways to deal with the interconnectivity of information, multi-capital management and sustainable development. Others continue to see integrated reporting as an exercise in aggregating financial statements and environmental and social disclosures. The extent to which organisations have internalised integrated thinking provides a possible explanation for these differences.
Research limitations/implications
The study used only publicly available information to assess integrated thinking indirectly.
Originality/value
A matrix exploring features of integrated thinking can inform management, investors and other stakeholders of areas in the business where an integrated approach is necessary in order to assess the organisation’s accounting and governance systems, improving decision-making processes and stakeholder communication
Probing Mn Precatalyst Activation through Time-Resolved Spectroscopy:A Quantitative Evaluation of the Effects of CO and PPh3as Coligands on Ultrafast Dynamics and C–C Bond Formation
Get PDFAn investigation into the effect of a phosphine coligand on the activation of precatalysts for manganese-catalyzed C–H bond functionalization is reported. Although simple precatalysts [MnBr(CO)5] and [Mn2(CO)10] are used extensively in these reactions, there is a dearth of alternate precatalyst structures, which has hindered the development of structure–activity relationships. In this work, the effect of substituting a carbonyl ligand for a phosphine ligand is reported. Investigation of the photochemical activation of the precatalyst fac-[Mn(inpy)(CO)3(PPh3)] (inpy = cyclometalated 1-(pyridin-2-yl)-1H-indole) 3 by time-resolved infrared spectroscopy (TRIR) reveals that light-induced dissociation of a CO ligand occurs preferentially over loss of the phosphine. The ultrafast dynamics of the initially formed solvent complex [Mn(inpy)(CO)2(toluene)(PPh3)] 9 are described, as is the slower substitution of the coordinated solvent by added pyridine to give [Mn(inpy)(CO)2(NC5H5)(PPh3)] 10. Replacing the pyridine with phenylacetylene again results in the substitution of the metal-bound toluene to give the alkyne complex [Mn(inpy)(η2-HC2Ph)(CO)2(PPh3)] 12. The alkyne undergoes a migratory insertion reaction into the Mn–C bond on a microsecond time scale with a very similar first-order rate constant to [Mn(inpy)(CO)4], 2, demonstrating that this key step in Mn-catalyzed reactions is not affected by the presence of the phosphine ligand
'All I Had to Do Was Open My Mouth Wide'-A Qualitative Exploration of the Acceptability of Photobiomodulation for Oral Mucositis Management in Paediatric Supportive Care
Get PDFBACKGROUND: Oral mucositis (OM) presents a common and debilitating side effect of chemotherapy for children and young people (CYP). Photobiomodulation is recommended for OM prevention in international guidance; however, the acceptability of photobiomodulation in paediatric cancer care is uncertain. This study explores this acceptability with CYP, their parents, and healthcare professionals (HCPs). METHODS: Semi-structured interviews with CYP/parent dyads and focus groups with HCPs were audio-recorded and professionally transcribed. Framework analysis was completed utilising the Theoretical Framework of Acceptability (TFA) using an initial deductive approach for theoretical rigour. Over-arching themes within and between constructs and participant groups were developed. Recruitment occurred alongside analysis until there was repetition of data and an absence of novel codes. RESULTS: Twenty-seven participants were interviewed. CYP were aged 8-15 years old; HCPs had diverse professional roles within paediatric oncology and dentistry. Over half of families and three quarters of HCPs had previous photobiomodulation experience. Data were coded for all seven TFA constructs. Four themes, consisting of multiple subthemes, were developed from 42 distinct codes: (i) positive attitudes towards photobiomodulation; (ii) importance of child-centredness and autonomy; (iii) lack of understanding of photobiomodulation treatment; (iv) perceived additional burden to healthcare teams. CONCLUSION: Photobiomodulation for OM prevention is acceptable to CYP, their parents, and HCPs during cancer treatment. Exploration of the theoretical facets of this acceptability supports adaptation of services to overcome highlighted challenges to photobiomodulation acceptance. Photobiomodulation services should be designed to reduce burden on healthcare services, with resources developed to support CYP's autonomy, comprehension and self-efficacy with intra-oral treatment
Scale interactions of deep convection in the Sahel: Exploring ring patterns in lagged cross-correlations of rainfall
Get PDFSpatio-temporal patterns in rainfall are evidence of sub-daily scale interactions in convection in the West African Sahel. Radial normalization of two-dimensional conditional probability maps reveals a ring-like structure in rainfall probabilities surrounding previous rainfall, in both satellite observations and regional climate models. These results support a growing body of evidence that scale interactions in tropical convection can provide predictability on short timescales. Additionally, a km-scale model is shown to represent the spatio-temporal structure of the patterns better compared with the same model at 25 km with parameterized convection. These evaluations indicate the potential for creation or enhancement of statistical prediction tools using model data alongside observations. The mechanism for the patterns is investigated in the km-scale model output, and associations are explored with both convectively generated gravity waves and evaporatively driven cold pools. The area inside the ring-like structure, where the probability of new convection is lower, is associated with a cold and divergent anomaly characteristic of a cold pool. Amplitudes of anomalous mid-level ascent prior to the pattern forming correlate well with amplitudes of the radially normalized probabilities three hours later, suggestive of potential wave-driven enhancement of rainfall probability
“I hope to get some hope”:balancing expectations, hope, and acceptance in naturally occurring consultations without a medical diagnosis
Get PDFBackground: Chronic musculoskeletal pain (CMP) is a prevalent condition often lacking clear biomedical explanations, leading to frustration for both clinicians and patients. The uncertainty surrounding CMP deeply affects the dynamics of clinical consultations. Aim: This study investigates how clinicians and patients navigate expectations and uncertainty in CMP consultations, focusing on the interplay between hope and acceptance. Methods: Nineteen naturally occurring consultations were observed and postconsultation interviews conducted with both patients and clinicians. Data were analysed using reflexive thematic analysis and presented through four individual consultations. Results: The study identified three main themes: expectations, hope, and acceptance. Patients frequently expressed hope for a diagnosis and treatment, while clinicians sought to guide them towards acceptance of their condition and managing symptoms rather than seeking a cure. However, patients often struggled with this approach, viewing it as a loss of hope for improvement. Additionally, patients’ cultural expectations of biomedical solutions affected their response to acceptance-focused communication. The study highlights the tension between encouraging acceptance and maintaining hope. Conclusion: The findings underscore the need for more nuanced communication strategies that strikes the right balance between fostering hope and acceptance, while acknowledging the cultural expectations of biomedical solutions that patients bring into the consultation room
Social enterprise interventions to tackle food insecurity in Sub-Saharan Africa: a scoping literature review
Get PDFBackground: Food insecurity remains a significant global challenge, particularly in low- and middle-income countries (LMICs), where it contributes to the growing prevalence of the double burden of malnutrition. Social enterprises (SEs) are increasingly recognized as effective tools for addressing social challenges through innovative and sustainable approaches. However, their role in mitigating food insecurity in Sub-Saharan Africa has not been extensively explored. This scoping review seeks to assess the scope, depth, and impact of existing research on SE interventions aimed at addressing food insecurity in Sub-Saharan Africa.
Methods: We conducted searches across six academic databases, Medline, EMBASE, CINAHL, Scopus, Web of Science, and Google Scholar, to identify peer-reviewed studies evaluating social enterprise (SE) interventions addressing food insecurity in Sub-Saharan Africa. Additional relevant studies were identified by reviewing citations and references from the initial search results. The selected literature was screened, and data were extracted by two independent reviewers. To ensure accuracy, a third reviewer verified the data extraction process.
Results: Overall, 10 articles were included in this review. The identified SE interventions were categorized into three groups: (1) livestock production and supply, (2) microcredit and loan ventures, and (3) biodiversity and education programs.
Conclusion: Social enterprises encompass a promising way forward in contributing to tackle food insecurity in SSA. SEs often work in cooperation with other organizations such as community support groups, Non-Governmental Organizations (NGOs), and governmental organizations. The sustainability of such interventions depends on financial viability, local ownership, adaptability, integration with local systems, and effective monitoring and evaluation
Known and unknown biases: a framework for contextualising and identifying bias in animal behaviour research
Get PDFBiases in animal behaviour research are inevitable consequences of our societal and cultural standpoint. To remove our biases, the first stage is to identify them. We call on individual researchers to adopt a more active approach to addressing bias within their research. We propose that biases exist within a matrix defined by the general acceptance of a bias's existence and the understanding of the impact this bias has on research outputs. Borrowing from a conceptual framework previously applied to the study of biodiversity, our matrix consists of four categories: “known knowns” are biases we are aware exist and are empirically tested; “known unknowns” are biases we know of but have limits to being mitigated against; “unknown knowns” are biases which we know exist but are overlooked; and “unknown unknowns” are biases we are unaware exist. Contextualising biases in this way, we believe, will lead to greater investment by individual researchers to locate and mitigate biases in their own research. To facilitate this process, we provide a set of self-reflective questions designed to help researchers critically evaluate the assumptions, limitations, and generalisability of their research. By acknowledging and addressing biases within this framework, we move toward a more robust and trustworthy scientific process
A randomised controlled clinical and cost effectiveness trial of an online integrated bipolar parenting intervention (IBPI) compared to treatment as usual in improving child emotional and behavioural outcomes:a study protocol
Get PDFBackground Bipolar disorder (BD) is a severe mental health problem linked to substantial personal and social costs. Many individuals living with bipolar disorder are parents. Due to the nature of the condition, parents with BD often experience challenges in delivering consistent parenting. In addition, up to 60% of their children experience at least one mental health problem in childhood and are at increased risk of future severe mental health problems including bipolar disorder. This paper describes the rationale and protocol for a definitive randomised controlled trial of a new digital intervention (Integrated Bipolar Parenting Intervention; IBPI) to support effective parenting in the context of BD. Methods and design The randomised controlled clinical and cost-effectiveness trial compares IBPI plus treatment as usual (TAU) with TAU alone. Parents with BD with a child aged 4–11 years old and living in the UK will be recruited through the NHS, mental health charities, and social media. Participants will be screened to confirm a clinical diagnosis of BD. They will then complete baseline assessments and be randomised to receive either IBPI + TAU or TAU with follow up assessments after 24- and 48- weeks. The primary clinical outcome is child emotional and behaviour problems measured by the Strengths and Difficulties Questionnaire at 24 weeks. The primary economic evaluation will be a cost-utility analysis at 24-weeks with quality-adjusted life years (QALYs) measured using the Child Health Utility 9 Dimensions measure of health-related quality of life. Secondary outcomes include parental mood and confidence and family functioning at 24- and 48- weeks, and child emotional and behavioural problems and health economic outcomes at 48 weeks. Discussion Despite the challenges faced by children of parents with BD and the parents themselves, research on how to improve their lives is lacking. This will be the first definitive trial of a tailored intervention that aims to improve child and parent outcomes. Results will be reported in line with CONSORT guidance for clinical and health economic findings. Trial registration ISRCTN Registry (ISRCTN15962574) registered on 03/05/2023
Fast-running thermochemical predictions of quasi-static pressure for confined detonations of plasticised high explosives
Get PDFWhen explosives detonate in a confined space, repeated reflections of the initial shockwave lead to the development of a long-term quasi-static pressure (QSP), which can cause severe structural damage and loss of life. Mixing of the detonation products with an oxygen-rich atmosphere results in additional energy release through ‘afterburn’ reactions, which further increase this pressure. Government agencies tasked with protecting the public from explosive threats require tools that can quickly assess the risk posed by QSP for a range of possible scenarios. Existing empirical relationships for TNT offer rapid calculation, but have not been validated against other explosive types. Conversely, specialised CFD and thermochemical codes can accurately predict QSP development for many explosives, but are computationally expensive. Here we develop a fast-running thermochemical model for the confined detonation of RDX- and PETN-based plastic explosives. Using simplified detonation and combustion reactions for the explosive and binder, we calculate the resulting internal energy change in the chamber atmosphere, and hence the QSP. The resulting predictions are within 3% of experimental values for both oxygenated and inert atmospheres, indicating that the contributions of detonation and afterburn to the energy release are reliably modelled. The thermochemical model is provided as a Python script which can be readily adapted for other explosives and atmospheric conditions
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