Increasing participation of cancer patients in randomised controlled trials: a systematic review

Background: There are many barriers to patient participation in randomised controlled trials of cancer treatments. To increase participation in trials, strategies need to be identified to overcome these barriers. Our aim was to assess the effectiveness of interventions to overcome barriers to patient participation in randomised controlled trials (RCTs) of cancer treatments. Methods: A systematic review was conducted. Published and unpublished studies in any language were searched for in fifteen electronic databases, including MEDLINE, EMBASE, CINAHL and PsycINFO, from inception to the end of 2004. Studies of any interventions to improve cancer patient participation in RCTs, which reported the change in recruitment rates, were eligible for inclusion. RCTs and non-randomised controlled trials as well as before and after studies reporting baseline rates specific to the population being investigated were included. Data were extracted by one reviewer into structured summary tables and checked for accuracy by a second reviewer. Each included study was assessed against a checklist for methodological quality by one reviewer and checked by a second reviewer. A narrative synthesis was conducted. Results: Eight studies were identified that met the inclusion criteria: three RCTs, two non-randomised controlled trials and three observational studies. Six of the studies had an intervention that had some relevance to the UK. There was no robust evidence that any of the interventions investigated led to an increase in cancer patient participation in RCTs, though one good quality RCT found that urologists and nurses were equally effective at recruiting participants to a treatment trial for prostate cancer. Although there was no evidence of an effect in any of the studies, the evidence was not of sufficient quality to be able to conclude that these interventions therefore do not work. Conclusion: There is not a strong evidence-base for interventions that increase cancer patient participation in randomised trials. Further research is required to evaluate the effectiveness of strategies to increase participation in cancer treatment trials

Et l’ère de l’État touche à sa fin : Carl Schmitt et la conceptualisation des changements d’époque historique en relations internationales

Dans Le nomos de la terre, Carl Schmitt se penche sur la fin de l’époque du droit public européen et de l’État que ce droit a soutenu, qui ont reçu peu d’attention. L’exposé qu’il en fait illustre plus largement certaines considérations contenues dans la périodisation des relations internationales. Cet article établit la place négligeable qu’occupe la périodisation dans l’étude des relations internationales avant d’offrir une lecture critique de l’interprétation que donne Schmitt dans Le nomos de la terre. Il conclut en suggérant la façon dont l’interprétation boiteuse de Schmitt nous aide à comprendre la signification plus large du thème de la périodisation des époques historiques en relations internationales.In The Nomos of the Earth, Carl Schmitt presents an account of the end of the epoch of European public law, and the state that it supported, which has received little attention. Yet Schmitt’s account serves to illustrate broader issues involved in the periodization of international relations. This article begins by pointing out the comparative neglect of periodization in international relations before turning to a critical assessment of Schmitt’s account in The Nomos of the Earth. It concludes by suggesting how Schmitt’s flawed account can help us to understand the wider significance of periodization in international relations

Fatal attraction: a critique of Carl Schmitt's international political and legal theory

The ongoing Schmitt revival has extended Carl Schmitt's reach over the fields of international legal and political theory. Neo-Schmittians suggest that his international thought provides a new reading of the history of international law and order, which validates the explanatory power of his theoretical premises – the concept of the political, political decisionism, and concrete-order-thinking. Against this background, this article mounts a systematic reappraisal of Schmitt's international thought in a historical perspective. The argument is that his work requires re-contextualization as the intellectual product of an ultra-intense moment in Schmitt's friend/enemy distinction. It inscribed Hitler's ‘spatial revolution’ into a full-scale reinterpretation of Europe's geopolitical history, grounded in land appropriations, which legitimized Nazi Germany's wars of conquest. Consequently, Schmitt's elevation of the early modern nomos as the model for civilized warfare – the ‘golden age’ of international law – against which American legal universalism can be portrayed as degenerated, is conceptually and empirically flawed. Schmitt devised a politically motivated set of theoretical premises to provide a historical counter-narrative against liberal normativism, which generated defective history. The reconstruction of this history reveals the explanatory limits of his theoretical vocabulary – friend/enemy binary, sovereignty-as-exception, nomos/universalism – for past and present analytical purposes. Schmitt's defective analytics and problematic history compromise the standing of his work for purposes of international theory

Risk factors for race-day fatality in flat racing Thoroughbreds in Great Britain (2000 to 2013)

A key focus of the racing industry is to reduce the number of race-day events where horses die suddenly or are euthanased due to catastrophic injury. The objective of this study was therefore to determine risk factors for race-day fatalities in Thoroughbred racehorses, using a cohort of all horses participating in flat racing in Great Britain between 2000 and 2013. Horse-, race- and course-level data were collected and combined with all race-day fatalities, recorded by racecourse veterinarians in a central database. Associations between exposure variables and fatality were assessed using logistic regression analyses for (1) all starts in the dataset and (2) starts made on turf surfaces only. There were 806,764 starts in total, of which 548,571 were on turf surfaces. A total of 610 fatalities were recorded; 377 (61.8%) on turf. In both regression models, increased firmness of the going, increasing racing distance, increasing average horse performance, first year of racing and wearing eye cover for the first time all increased the odds of fatality. Generally, the odds of fatality also increased with increasing horse age whereas increasing number of previous starts reduced fatality odds. In the ‘all starts’ model, horses racing in an auction race were at 1.46 (95% confidence interval (CI) 1.06–2.01) times the odds of fatality compared with horses not racing in this race type. In the turf starts model, horses racing in Group 1 races were at 3.19 (95% CI 1.71–5.93) times the odds of fatality compared with horses not racing in this race type. Identification of novel risk factors including wearing eye cover and race type will help to inform strategies to further reduce the rate of fatality in flat racing horses, enhancing horse and jockey welfare and safety

Samuel Stirk to William Stephens, June 30, 1788

Samuel Stirk wrote from Savannah, GA to William Stephens, address not included. He wrote regarding a legal issue between Captain Pray and John Kean as surviving partner of Lavien & Kean. He wrote he had directions to withdraw the attached, presumably a lawsuit, if they agreed instead to submit all the accounts to arbitration.https://digitalcommons.kean.edu/lhc_1780s/1350/thumbnail.jp

The relationship between Lp(a) and CVD outcomes: a systematic review

Summary of QUIPS quality assessment domains (60 studies). (DOCX 54 kb