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2.  Qualitative methods in a randomised controlled trial: the role of an integrated qualitative process evaluation in providing evidence to discontinue the intervention in one arm of a trial of a decision support tool 
Quality & Safety in Health Care  2007;16(3):224-229.
Objective
To understand participants' experiences and understandings of the interventions in the trial of a computerised decision support tool in patients with atrial fibrillation being considered for anti‐coagulation treatment.
Design
Qualitative process evaluation carried out alongside the trial: non‐participant observation and semistructured interviews.
Participants
30 participants aged >60 years taking part in the trial of a computerised decision support tool.
Results
Qualitative evidence provided the rationale to undertake a decision to discontinue one arm of the trial on the basis that the intervention in that arm, a standard gamble values elicitation exercise was causing confusion and was unlikely to produce valid data on participant values.
Conclusions
Qualitative methods used alongside a trial allow an understanding of the process and progress of a trial, and provide evidence to intervene in the trial if necessary, including evidence for the rationale to discontinue an intervention arm of the trial.
doi:10.1136/qshc.2006.018499
PMCID: PMC2464994  PMID: 17545351
3.  The bovine alveolar macrophage. II. In vitro studies with Pasteurella haemolytica. 
Bovine alveolar macrophages were cultured in vitro and challenged with suspensions of live and dead bacteria. These cells showed severe cytotoxic morphological changes and a low rate of phagocytosis after exposure to live Pasteurella haemolytica type I was readily phagocytosed and produced only mild cytotoxic changes.
PMCID: PMC1277652  PMID: 688077
8.  Service provision and use of anticoagulants in atrial fibrillation. 
BMJ : British Medical Journal  1995;311(7004):558-560.
Several large trials have shown that the risk of stroke in patients with non-valvar atrial fibrillation is reduced by treatment with warfarin. Implementing this research evidence requires not only an understanding of the trials' results and of the changes that they imply for clinicians' treatment decisions but also an appreciation of the organisation, quantity, and quality of services required to support these changes. Understanding of these implications is crucial for developing services that allow changes in practice to produce reductions in stroke incidence while minimising the risks of treatment. This article considers the developments in service provision that will probably be required to support the changes in clinical practice suggested by the trials' results. These services will be provided largely by doctors, and their development has implications for doctors in both primary and secondary care.
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PMCID: PMC2550612  PMID: 7663216
9.  An audit of distribution and use of guidelines for management of head injury. 
Quality in Health Care  1993;2(1):27-30.
Ensuring effective distribution of guidelines is an important step towards their implementation. To examine the effectiveness of dissemination of a guidelines card on management of head injury and determine its usefulness to senior house officers (SHOs), a questionnaire survey was performed in May 1990, after distribution of the cards in induction packs for new doctors and at postgraduate lectures and displaying the guidelines in accident and emergency departments and wards. A further survey, in March 1992, assessed the impact of modifying the distribution. All (175) SHOs working in general surgery, accident and emergency medicine, orthopaedics, and neurosciences on 1 February 1990 in 19 hospitals including two neurosurgical units in Northern region were sent self completion questionnaires about awareness, receipt, use, and perceived usefulness of the guidelines. 131 of 163(80%) SHOs in post responded (median response from hospitals 83% (range 50%-100%)). Over three quarters (103, 79%) of SHOs were aware of the guidelines and 82(63%) had ever possessed a guidelines card. Only 36(44%) acquired the card in the induction pack. 92%(98/107) found them useful and 81% (89/110) referred to them to some extent. Owning and carrying the card and referring to guidelines were associated with departmental encouragement to use the guidelines. Increasing the displays of guidelines in wards and departments and the supply of cards to consultants in accident and emergency medicine as a result of this survey did not increase the number of SHOs who received cards (52/83, 63%), but more (71/83, 86%) were aware of the guidelines. The guidelines were welcomed by SHOs and used in treating patients with head injury, but their distribution requires improvement. Increased use of the guidelines may be achieved by introducing other distribution methods and as a result of encouragement by senior staff.
PMCID: PMC1055058  PMID: 10132074
14.  The possible role of stress in the induction of pneumonic pasteurellosis. 
Five groups of range bred calves (four calves per group) were used to investigate the effect of stress on susceptibility to aerosol exposures with bovine herpesvirus-1 or Pasteurella haemolytica. Twelve calves were weaned, transported, processed at a commercial feedlot and transported to isolation facilities three days later. An aerosol challenge of either 10 colony forming units of P. haemolytica or 10 plaque forming units of bovine herpesvirus-1 virus was given to two groups of calves and the third group was not challenged. The fourth group was transported directly to the isolation facilities after weaning and aerosol challenged with P. haemolytica. The fifth group remained at the farm after weaning and was not challenged. All transported animals had elevated plasma cortisol levels which remained above normal for at least three days postchallenge. The blastogenic response of all calves was depressed after leaving the farm and remained depressed throughout the experiment. The suppression correlated well with elevated serum cortisol levels. Calves processed through the feedlot encountered bovine herpesvirus-1 because eight out of 12 animals seroconverted to this antigen. Most calves seroconverted to P. haemolytica whether they were experimentally challenged or not. Where the unchallenged calves encountered P. haemolytica is unknown. Calves challenged with bovine herpesvirus-1 but not with P. haemolytica, had significant clinical signs of pneumonia and two animals died due to bovine herpesvirus-1 infection.(ABSTRACT TRUNCATED AT 250 WORDS)
PMCID: PMC1236058  PMID: 6089981
16.  Library Collection Needed 
PMCID: PMC1790547  PMID: 17422396
19.  A Mouse Model for Estimation of Pasteurella haemolytica Deposition in Calf Lungs Following Aerosol Exposure 
A method used to calculate the number of Pasteurella haemolytica reaching the lungs of calves during an aerosol exposure is described. This method is based on a linear relationship of bacterial deposition in lungs of mice and calves when exposed to the same bacterial aerosol.
PMCID: PMC1320330  PMID: 7127195
23.  Factors associated with mortality in feedlot cattle: the Bruce County Beef Cattle Project. 
The design of and the analysis of data from the Bruch County Beef Cattle Project, particularity the field study, are presented and discussed. A major value of the study may lie in its ability to relate laboratory findings to events in the field. The factor most strongly related to mortality was ration, with cattle on hay based rations having a much lower mortality on average than cattle on corn based rations. In general, management activities associated with growing cattle (as opposed to fattening) over the first winter were sparing for mortality. Groups of cattle given prophylactic vaccines or drugs within two days of arrival tended to experience higher mortality (not statistically higher) than those cattle not receiving those measures, or cattle groups recieving the same prophylactics more than 48 hours after arrival. However, these results require validation in the remaining years of the study. Fibrinous pneumonia was the most frequent diagnosis in the calves on postmortem examination.
PMCID: PMC1320028  PMID: 7397593
25.  Book Review of “Cell Pathology” 
PMCID: PMC1697485  PMID: 17422017

Results 1-25 (73)