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ItemEfficacy and safety of vertebroplasty for treatment of painful osteoporotic vertebral fractures: a randomised controlled trial [ACTRN012605000079640]Buchbinder, R ; Osborne, RH ; Ebeling, PR ; Wark, JD ; Mitchell, P ; Wriedt, CJ ; Wengier, L ; Connell, D ; Graves, SE ; Staples, MP ; Murphy, B (BIOMED CENTRAL LTD, 2008-11-25)BACKGROUND: Vertebroplasty is a promising but as yet unproven treatment for painful osteoporotic vertebral fractures. It involves radiographic-guided injection of various types of bone cement directly into the vertebral fracture site. Uncontrolled studies and two controlled quasi-experimental before-after studies comparing volunteers who were offered treatment to those who refused it, have suggested an early benefit including rapid pain relief and improved function. Conversely, several uncontrolled studies and one of the controlled before-after studies have also suggested that vertebroplasty may increase the risk of subsequent vertebral fractures, particularly in vertebrae adjacent to treated levels or if cement leakage into the adjacent disc has occurred. As yet, there are no completed randomised controlled trials of vertebroplasty for osteoporotic vertebral fractures. The aims of this participant and outcome assessor-blinded randomised placebo-controlled trial are to i) determine the short-term efficacy and safety (3 months) of vertebroplasty for alleviating pain and improving function for painful osteoporotic vertebral fractures; and ii) determine its medium to longer-term efficacy and safety, particularly the risk of further fracture over 2 years. DESIGN: A double-blind randomised controlled trial of 200 participants with one or two recent painful osteoporotic vertebral fractures. Participants will be stratified by duration of symptoms (< and >or= 6 weeks), gender and treating radiologist and randomly allocated to either the treatment or placebo. Outcomes will be assessed at baseline, 1 week, 1, 3, 6, 12 and 24 months. Outcome measures include overall, night and rest pain on 10 cm visual analogue scales, quality of life measured by the Assessment of Quality of Life, Osteoporosis Quality of Life and EQ-5D questionnaires; participant perceived recovery on a 7-point ordinal scale ranging from 'a great deal worse' to 'a great deal better'; disability measured by the Roland-Morris Disability Questionnaire; timed 'Up and Go' test; and adverse effects. The presence of new fractures will be assessed by radiographs of the thoracic and lumbar spine performed at 12 and 24 months. DISCUSSION: The results of this trial will be of major international importance and findings will be immediately translatable into clinical practice.
ItemThe emperor still has no clothes! Genetic determinism as evolutionary psychologyLAZAROW, MELANIE ; Ferrier, Carole (University Presses, 2002)Alas Poor Darwin and It Ain't Necessarily So are excellent tools to help dispel some of the commonly-promoted ideas about genetic determinism that have become so widespread in both academic and popular writing. Evolutionary psychology (EP) has precursors in both sociobiology and eugenics, yet differs from them, pointedly in that sociobiology was never seriously academically accepted while EP is part of the mainstream of academic programs in psychology, biology and anthropology. However it still serves the important ideological purpose of reinforcing sexism, racism and inequality today. EP is needed because, after all, in a society of equal opportunity and social mobility, how is one to explain differences in social power if not by differences in intrinsic ability? Both books show how genetic determinism - although it is poor science - proclaims itself as the legitimate emperor of twenty-first century psychology.
ItemThe effects of obstacles on surface levels and boundary resistance in open channelsFENTON, JD (AUTh Aristotle University of Thessaloniki, 2003)Simple momentum considerations are used to show how the increase in water levels due to obstacles in a natural channel can be calculated. This requires use of a numerical method for solving nonlinear equations, which is not difficult. However it is more insightful to consider an approximate explicit theory, which shows the important quantities governing the problem, and which is accurate enough for practical purposes. It is applicable to obstacles of arbitrary extent and location, in both subcritical and supercritical flow in channels of arbitrary section. A method for the numerical refinement of this is presented, but it will usually not be necessary. The methods are compared with a theory and experimental results for a rectangular channel with vertical cylinders extending the whole depth. Then momentum-loss considerations are applied to explaining the nature of friction laws in open channels. Instead of boundary shear, momentum loss from discrete elements is used as the means of modelling resistance. It is found that the behaviour of Gauckler-Manning's law for wide channels in successfully mimicking the frictional behaviour over a range of depths can be explained, but it does not yet provide a comprehensive theory for general cross-sections.