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From Zero Credentials To Full Domain Compromise

Whitepaper called From Zero Credentials to Full Domain Compromise. This paper covers techniques penetration testers can use in order to accomplish an initial foothold on target networks and achieve full domain compromise without executing third party applications or reusing clear text credentials.










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German clean-energy fund sees promise in US distributed solar development

Germany-based clean-energy fund Hep Kapitalverwaltung AG agreed to invest $50 million to $80 million annually in a partnership to develop small solar projects in the U.S.




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Scientists Say Blockchain ‘Delivering on Energy Promises’

One of the first unbiased, major comprehensive reviews of blockchain has concluded that the technology is “actually delivering on its promises in a number of areas directly related to energy”.




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Transmission Tweak Promises Big Cost Benefits for Offshore Wind

Offshore wind development is being pushed further out into deeper waters, emphasizing longer, higher-capacity transmission systems. Most newer offshore wind farms from Europe to the U.S. are looking at hundreds of kilometers of transmission lines: the U.K. Crown Estate's Round 3 allocations, interconnection systems from Germany's North Sea to the U.K.'s National Grid Western Link, and the proposed Atlantic Wind Connector in the U.S. Mid-Atlantic.




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The Promise of Clean Energy Student Entrepreneurs

Cleantech investing has taken quite a hit in recent years. Last year, CBS News highlighted the “cleantech crash” on U.S. primetime television, and Bloomberg New Energy Finance, a Bloomberg-owned energy data firm, has tracked the multi-year decline in cleantech investing. However, there are additional trends that tell another side of the cleantech story and suggest innovation and hope for a low-cost, low-carbon future are far from gone.




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The Hydroelectric Production Incentives Program shows promise to encourage hydro development

With its revival for fiscal year 2014, the Hydroelectric Production Incentives Program shows promise as a new federal revenue stream for hydro facilities.




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God’s Eternal Covenant of Promise (Galatians 3:15–18)

Check here each week to keep up with the latest from John MacArthur's pulpit at Grace Community Church.




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The Promised Arrival of the King (Daniel 9)

Check here each week to keep up with the latest from John MacArthur's pulpit at Grace Community Church.




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The Promise of Peace in a Worried World (Matthew 6:25-34)

Check here each week to keep up with the latest from John MacArthur's pulpit at Grace Community Church.




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Lawbite: Does an oral promise to pay amount to a guarantee?

Deepak Abbhi v Richard John Slade (trading as Richard Slade & Co) [2019] EWCA Civ 2175 The Court of Appeal recently unanimously held that an oral promise by a son-in-law to give money to his father-in-law to pay legal fees was an indemnity and n...




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HR e-briefing 207 - Don't be compromised!

Encouraging settlement of employment disputes outside of the courts and tribunal system remains the cornerstone of employment legislation.  It also remains the case that the vast majority of parties resolve employment disputes without the ne...




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HR e-briefing 207 - Don't be compromised!

Encouraging settlement of employment disputes outside of the courts and tribunal system remains the cornerstone of employment legislation.  It also remains the case that the vast majority of parties resolve employment disputes without the ne...




omise

Despite Bolsonaro's promises, Amazon deforestation hits a new high in first four months of the year

Deforestation in the Brazilian Amazon hit a new high in the first four months of the year, according to data released on Friday, a worrying trend after the devastation caused by record fires last year.




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Creeping Tyranny in the land of Promise

“We view this wicked act as not just man’s inhumanity to fellow man, but a very serious threat to our noble profession and womanhood” – Nigeria Association of Women Journalists (NAWOJ), Akwa Ibom State Council, condemning the arrest and detention of Mary Ekere, a female journalist with The Post by the state government recently. READ […]

The post Creeping Tyranny in the land of Promise appeared first on Nigerian Pilot News.




omise

Crise sanitaire - Croissance �conomique compromise, selon la BFM

A l'instar de tous les pays dans le monde affect�s par la pand�mie Covid-19, Madagascar conna�tra �galement une r�cession �conomique. ......




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The Promise of Redemption, Part 1




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The Promise of Redemption, Part 2




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The Promise of Peace in a Worried World A




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The Promise of Peace in a Worried World B




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PM promises more pandemic aid to come from Ottawa

Prime Minister Justin Trudeau will...




omise

Did God Promise You Prosperity?

In the lead-up to the Truth Matters conference in October, we will be focusing our attention on the sufficiency, authority, and clarity of Scripture. Of our previous blog series, none better embodies that emphasis than Frequently Abused Verses. The following entry from that series originally appeared on September 25, 2015. -ed.

What does this verse mean to you?

Most of us have heard that question before—it lurks inside countless Bible studies and Sunday-school classes. It is a postmodern mindset that has become pervasive in the church.

When reading a book, an article, or a blog post, we implicitly understand that its meaning is bound to the author’s intent. The same ought to be true for Scripture—God alone is the arbiter of what He means through what He has revealed in His Word. Yet Scripture is now subject to the whims of the reader, who is prone to read personal experience into the text instead of discovering—and coming under—its objective truth. The worst forms of this are when people think they’re helping God—improving upon His perfection, sanitizing His story, and smoothing out the sharp edges of His truth.

Life is not as subjective as we might like to think. We don’t get to decide what a red light means when we approach a traffic signal. Bank managers can’t arbitrarily determine your account balance. And, thankfully, airlines don’t hire pilots who take the liberty to decide what “runway” means to them. It is absurd to think that we can approach God’s Word with lower standards. God says what He means and means what He says, always speaks without error, and has been kind enough to speak to us with simplicity and clarity.

The tsunami of topical preaching we see today has scarred the evangelical landscape. A topical message is not wrong in and of itself, but problems are inevitable when that becomes the main diet of a congregation. Pastors who preach texts divorced from their context invariably beget congregations who interpret texts divorced from the Author’s intent. The result is that too many believers today have a propensity to treat God’s Word as their own private smorgasbord of theology.

Another place you see this trend—interpreting verses out of context—in action is in choosing of a “life verse.” Many Christians like to pick a verse that speaks to them and try to make it the theme for their lives. It’s no surprise that none of the passages concerning God’s judgment make the cut. Instead, the spectacular promises of blessing and success reign supreme.

And sitting on top of the mountain of verses evangelicals frequently misappropriate and misapply is Jeremiah 29:11, “‘For I know the plans that I have for you,’ declares the Lord, ‘plans for welfare and not for calamity to give you a future and a hope.’”

It’s All About You

Unsurprisingly, Jeremiah 29:11 is a go-to verse for celebrity pastor, Joel Osteen. His takeaway is that “God desires to see you flourish in this life. He wants to see you come out of setbacks stronger, wiser, increased and promoted. He wants to give you hope in your final outcome and see you come to a flourishing finish.” [1] Joel Osteen, Today’s Word with Joel Osteen—May 29, 2012 (Devotional).

Andy Stanley, pastor of America’s largest congregation, says “We may not know for certain everything our future holds, but we know that God thinks good thoughts toward us, to give us a future and a hope.” [2] https://thekingdomcorner.wordpress.com/2009/08/10/andy-stanley-life-may-be-uncertain-but-god-isnt/

Rick Warren also typifies that me-centric approach in his book, The Purpose-Driven Life:

If you have felt hopeless, hold on! Wonderful changes are going to happen in your life as you begin to live it on purpose. God says, “I know what I am planning for you. . . . I have good plans for you, not plans to hurt you. I will give you hope and a good future.” [3] Rick Warren, The Purpose Driven Life (Grand Rapids: Zondervan, 2012) 35.

One has to wonder if Osteen, Stanley, or Warren understand how badly they have misconstrued and misapplied God’s Word—and how they’ve misled their followers. They give zero acknowledgement to the Author’s original intent or His original audience when they rip this verse from its biblical setting. Reading Jeremiah 29:11 in context paints a starkly different picture and delivers a far more profound truth.

It’s Not About You

The nation of Israel had been taken by the Babylonians into captivity. The Temple, as well as the entire city of Jerusalem, was in ruins. Their king was in chains with his eyes gouged out. The glory of Israel as a nation was finished. But in the midst of that terrible situation, God spoke through His prophet Jeremiah:

Thus says the Lord of hosts, the God of Israel, to all the exiles whom I have sent into exile from Jerusalem to Babylon, “Build houses and live in them; and plant gardens and eat their produce. Take wives and become the fathers of sons and daughters, and take wives for your sons and give your daughters to husbands, that they may bear sons and daughters; and multiply there and do not decrease. Seek the welfare of the city where I have sent you into exile, and pray to the Lord on its behalf; for in its welfare you will have welfare.” For thus says the Lord of hosts, the God of Israel, “Do not let your prophets who are in your midst and your diviners deceive you, and do not listen to the dreams which they dream. For they prophesy falsely to you in My name; I have not sent them,” declares the Lord.

For thus says the Lord, “When seventy years have been completed for Babylon, I will visit you and fulfill My good word to you, to bring you back to this place. For I know the plans that I have for you,” declares the Lord, “plans for welfare and not for calamity to give you a future and a hope. Then you will call upon Me and come and pray to Me, and I will listen to you. You will seek Me and find Me when you search for Me with all your heart. I will be found by you,” declares the Lord, “and I will restore your fortunes and will gather you from all the nations and from all the places where I have driven you,” declares the Lord, “and I will bring you back to the place from where I sent you into exile.”

Because you have said, “The Lord has raised up prophets for us in Babylon”—for thus says the Lord concerning the king who sits on the throne of David, and concerning all the people who dwell in this city, your brothers who did not go with you into exile—thus says the Lord of hosts, “Behold, I am sending upon them the sword, famine and pestilence, and I will make them like split-open figs that cannot be eaten due to rottenness. I will pursue them with the sword, with famine and with pestilence; and I will make them a terror to all the kingdoms of the earth, to be a curse and a horror and a hissing, and a reproach among all the nations where I have driven them, because they have not listened to My words,” declares the Lord, “which I sent to them again and again by My servants the prophets; but you did not listen,” declares the Lord. You, therefore, hear the word of the Lord, all you exiles, whom I have sent away from Jerusalem to Babylon. (Jeremiah 29:4–20)

In context, verse 11 is clearly not meant as a love letter or a promise of blessing to individual believers in the twenty-first century.

And here are a few other points to consider: How do Joel Osteen, Andy Stanley, and Rick Warren know that God is directly speaking to their congregants in verse 11 but not in Jeremiah 29:17–19, where God promises to send “the sword, famine and pestilence”? Have they considered that God’s soothing promises in verse 11 are delivered to Israel while He has His foot on their neck in judgment (Jeremiah 29:4)? What about the fact that those who received the promise in verse 11 would likely not live to experience its fulfillment seventy years later (Jeremiah 29:10). And in their egotistical exegesis, can they grasp the irony that Israel was in Babylonian slavery because they listened to prophets who tickled their ears (Jeremiah 29:8–9)?

There is something far greater and eternally significant that we learn from this story in its true context. God does not abandon His people! In spite of their sin, God was relentlessly faithful to His covenants regarding Israel’s future and His promised Messiah. Not even Babylonian captivity could prevent His promises from coming to pass.

Likewise His promises to us as New Testament believers concerning our calling and election are also unshakeable (John 10:27–29). And they provide far more lasting comfort than Old Testament verses plucked out of context and misappropriated for modern audiences.




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Did Christ Promise Us Supernatural Power and Protection?

In the lead-up to the Truth Matters conference in October, we will be focusing our attention on the sufficiency, authority, and clarity of Scripture. Of our previous blog series, none better embodies that emphasis than Frequently Abused Verses. The following entry from that series originally appeared on February 10, 2016. -ed.

Next week will mark the second anniversary of Jamie Coots’s death. He was a father, pastor, and one of the stars of the National Geographic Channel’s reality series, Snake Salvation. The show followed Coots’s life and ministry as a prominent leader in a sect of Holiness Pentecostals who incorporate handling poisonous snakes into their worship in fulfilment of the promise of supernatural power and protection in Mark 16:17-18.

Coots died from a snakebite.

Snake handling—once popular throughout the Appalachian states—has dwindled to a tiny subculture of Pentecostals who believe in the practice of the extreme signs and wonders described in Mark 16:17-18. Specifically, they teach that they have the ability to cast out demons, speak in tongues, handle poisonous snakes, drink poison, and heal the sick (they also expose themselves to open flames, although that particular sign is not included in Mark’s gospel). And every couple years, the movement garners headlines because another pastor or congregant has died attempting to fulfill those supposed promises.

Virtually all other charismatics would disavow such extreme behavior, while holding just as tightly to the promises conveyed in the closing verses of Mark’s gospel—albeit more selectively.

For example, charismatic prosperity preacher Benny Hinn cites the passage in defense of his faith-healing ministry: “I knew the Lord had told me to pray for the sick as part of preaching the gospel, just as He told the disciples, in Mark 16:18: ‘They will lay hands on the sick, and they will recover.’” [1] Benny Hinn, The Anointing (Nashville: Thomas Nelson, 1997) 49.

And in his book When Heaven Invades Earth, Bill Johnson—pastor of Bethel Redding, one of the most influential charismatic churches in the country—points to the end of Mark’s gospel as a promise of God’s ongoing miraculous work.

As our ministry teams travel around the world, we have come to expect certain things. Healing, deliverance, and conversions are the fruits of our labors. While healing is seldom the subject we teach on, it is one of the most common results. As we proclaim the message of the Kingdom of God, people get well. The Father seems to say, Amen! To His own message by confirming the word with power (see Mark 16:20). [2] Bill Johnson, When Heaven Invades Earth (Shippensburg, PA: Treasure House, 2003) 89.

We could go on with examples of how charismatics of various traditions lean heavily on the closing verses of Mark’s gospel, but you get the point. For many it’s a foundational passage—one that explicitly promises all believers the power to perform signs and wonders.

But is that really the point of the passage? And more importantly, do those verses even belong in your Bible to begin with? Even a simple reading of the text raises some significant questions about its Scriptural authenticity.

Now after He had risen early on the first day of the week, He first appeared to Mary Magdalene, from whom He had cast out seven demons. She went and reported to those who had been with Him, while they were mourning and weeping. When they heard that He was alive and had been seen by her, they refused to believe it. After that, He appeared in a different form to two of them while they were walking along on their way to the country. They went away and reported it to the others, but they did not believe them either. Afterward He appeared to the eleven themselves as they were reclining at the table; and He reproached them for their unbelief and hardness of heart, because they had not believed those who had seen Him after He had risen. And He said to them, “Go into all the world and preach the gospel to all creation. He who has believed and has been baptized shall be saved; but he who has disbelieved shall be condemned. These signs will accompany those who have believed: in My name they will cast out demons, they will speak with new tongues; they will pick up serpents, and if they drink any deadly poison, it will not hurt them; they will lay hands on the sick, and they will recover.” So then, when the Lord Jesus had spoken to them, He was received up into heaven and sat down at the right hand of God. And they went out and preached everywhere, while the Lord worked with them, and confirmed the word by the signs that followed. [And they promptly reported all these instructions to Peter and his companions. And after that, Jesus Himself sent out through them from east to west the sacred and imperishable proclamation of eternal salvation.] (Mark 16:9-20)

As you can see, there are actually two endings to Mark’s gospel contained in the above quote. Verses 9-20 are referred to as the longer ending, while the portion in brackets at the end of verse 20 is called the shorter ending—on its own it would appear immediately after verse 8. Both have appeared individually in a variety of translations—the NASB includes both.

But neither ending appears in the earliest and most reliable New Testament manuscripts. No ancient book has been more carefully preserved than the Bible—we have several thousand manuscripts, with some dating all the way back to mere decades after they were first written. And through the science of textual analysis, scholars have determined that the final verses of Mark were not in the original, inspired text.    

On top of that, as John MacArthur explains in his commentary on the passage, there are also several internal indications that Mark didn’t write either ending.

First, the transition between verse 8 and verse 9 is awkward and disjointed. The conjunction now (from the Greek word de) implies continuity with the preceding narrative, but the focus of verse 9 abruptly shifts to Mary Magdalene rather than continuing a discussion of the women referred to in verse 8. Moreover, it would be strange for Mark to wait until the end of his narrative to introduce Mary Magdalene, as if for the first time . . . when she was already mentioned three times in the prior context (Mark 15:40, 47, 16:1). A similar discontinuity regards Peter, who is singled out in verse 7 yet not mentioned again in verses 9-20. The “shorter ending” . . . attempts to rectify those incongruities by highlighting both Peter and the other women. . . . But this shorter ending has even weaker manuscript evidence to support it than the longer ending.

Second, the vocabulary, style, and structure of the longer ending is not consistent with the rest of Mark’s gospel. There are eighteen words in this section that are not used elsewhere in Mark. For example, the title “Lord Jesus” is used here (v. 19) but is never used anywhere else in Mark’s account.

Third, the inclusion of apostolic signs does not fit the way the other three gospels conclude their accounts of the resurrection and ascension of Jesus Christ. Though many signs mentioned in this section parallel portions of the book of Acts (cf. Acts 2:4; 9:17; 10:46; 28:8), some are clearly without biblical support, such as being able to “pick up” venomous “serpents” (though perhaps loosely based on Paul’s experience in Acts 28:3-5) or “drink any deadly poison.” [3] John MacArthur, The MacArthur New Testament Commentary: Mark 9-16 (Chicago: Moody Publishers, 2015) 411-412.

Summing up the case against the scriptural credentials of Mark 16:9-20, John MacArthur writes,

The evidence, both external and internal, conclusively demonstrates that verses 9-20 were not originally part of Mark’s inspired record. While they generally summarize truths taught elsewhere in the New Testament, they should always be evaluated in light of the rest of Scripture. No doctrines or practices should be established solely on them. The snake-handling preachers of the Appalachians provide a prime example of the errors that can arise from accepting these verses as authoritative.

Nonetheless, knowing that Mark 16:9-20 is not original should give believers more confidence in the accuracy of the New Testament, not less. As noted above, the science of textual analysis makes it possible for biblical scholars to identify the very few passages that were not part of the original. Such places are clearly marked in modern translations, making it easy for students of Scripture to identify them. Consequently, believers can approach the rest of the text with the settled assurance that the Bible they hold in their hands accurately reflects the original. [4] The MacArthur New Testament Commentary: Mark 9-16, 412.

That conclusion then begs the question: Where did these verses come from?

Most likely, they were added in by a scribe who felt Mark’s original ending was missing something. However, it does not appear that he was so audacious as to concoct an ending from his own imagination. Instead, Mark 16:9-20 is a patchwork quilt of other biblical passages concerning the life of Christ after His resurrection, His commissioning of the apostles, and stories from their ministry in the founding of the church.

Time and space don’t permit me to break down the probable origin of each verse, but let me encourage you to listen to John MacArthur’s sermon on the passage, called “The Fitting End to Mark’s Gospel,” or consult his commentary on Mark 9-16 for more details on how this extrabiblical passage was likely assembled.

And what of Mark’s original ending? Why was it deemed so deficient in the first place? True, it is abrupt and to the point: “They went out and fled from the tomb, for trembling and astonishment had gripped them; and they said nothing to anyone, for they were afraid” (Mark 16:8). But as John MacArthur explains, that abrupt ending perfectly fits both Mark’s style and his purpose for writing at all.

Mark’s ending is abrupt but it is not incomplete. The tomb was empty; the angelic announcement explained that Jesus had risen; and multiple eyewitnesses confirmed those events. The purpose of Mark’s gospel was to demonstrate that Jesus is the Christ, the Son of God (Mark 1:1). Having amply made that point, no further proof was necessary.

Throughout his gospel, Mark consistently punctuated key events in the life of the Lord Jesus by emphasizing the wonder He evoked in the hearts and minds of others. Mark simply moves from one point of amazement about Christ to the next. So the narrative ends where it ought to end. It climaxes with amazement and bewilderment at the resurrection of the crucified Savior (cf. John 20:31). In so doing, it leaves the reader in a place of wonder, awe, and worship, centered on its glorious subject: the Lord Jesus Christ, the Son of God. [5] The MacArthur New Testament Commentary: Mark 9-16, 417-418.

So while Mark 16:9-20 may be a significant proof text for many charismatics, their interpretation is invalidated when we understand that those verses never belonged in Scripture to begin with.




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To serve, not steal time: promises of efficient government offices

Prague Daily Monitor

The Czech political parties are promising more efficient offices, mainly through digitalization. The proposed law for a faster and more effective state originally came from the Starostové a nezávislí party (STAN). Since then ANO and ČSSD have pledged to fulfill the goals of the Digital Česko plan. ODS and the Pirates also have digitalization as part of their platform.

read more




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Hong Kong civil servant in charge of reusable mask giveaway admits transparency shortcomings, promises replacement filter production will go out to tender

A senior civil servant overseeing the distribution of reusable masks to all Hongkongers has promised to put the production of their replacement filters out to tender after admitting to shortcomings in the transparency of the original contract awarded by the government.Annie Choi Suk-han, permanent secretary of the Innovation and Technology Bureau, on Friday rejected suggestions the government had intentionally hidden the identity of the manufacturer chosen for the HK$320 million (US$41 million)…




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Georgia Promises Thorough Probe in Killing of Ahmaud Arbery

More than two months after a black man was shot to death while jogging on a Sunday afternoon, Georgia investigators conceded that the facts show enough evidence to jail a white father and son on charges of felony murder and aggravated assault.  The investigation appeared stalled by local author...




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Drugs Show Promise for Some Advanced Lung Cancers

Title: Drugs Show Promise for Some Advanced Lung Cancers
Category: Health News
Created: 4/29/2015 12:00:00 AM
Last Editorial Review: 4/30/2015 12:00:00 AM




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Arthritis Drug Shows Promise for Ulcerative Colitis

Title: Arthritis Drug Shows Promise for Ulcerative Colitis
Category: Health News
Created: 5/3/2017 12:00:00 AM
Last Editorial Review: 5/4/2017 12:00:00 AM




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Newer Diabetes Drug Shows Promise in Kids, Teens

Title: Newer Diabetes Drug Shows Promise in Kids, Teens
Category: Health News
Created: 4/30/2019 12:00:00 AM
Last Editorial Review: 4/30/2019 12:00:00 AM




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Treatments Targeting Social Behavior Hormone Show Promise With Autism

Title: Treatments Targeting Social Behavior Hormone Show Promise With Autism
Category: Health News
Created: 5/1/2019 12:00:00 AM
Last Editorial Review: 5/2/2019 12:00:00 AM




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Coronavirus Vaccine Shows Promise

Title: Coronavirus Vaccine Shows Promise
Category: Health News
Created: 4/29/2020 12:00:00 AM
Last Editorial Review: 4/29/2020 12:00:00 AM




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Experimental Drug Shows Promise for Schizophrenia

Title: Experimental Drug Shows Promise for Schizophrenia
Category: Health News
Created: 4/16/2020 12:00:00 AM
Last Editorial Review: 4/17/2020 12:00:00 AM




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Magnetic Brain 'Zap' Shows Promise Against Severe Depression

Title: Magnetic Brain 'Zap' Shows Promise Against Severe Depression
Category: Health News
Created: 4/7/2020 12:00:00 AM
Last Editorial Review: 4/8/2020 12:00:00 AM




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Long-acting, Injectable Buprenorphine: Great Promise, but Significant Barriers to Use

To the Editor—A 30-day injectable form of buprenorphine branded as SublocadeTM (Buprenorphine XR SQ) was approved by the FDA in 2017. This medication is administered by a health care professional subcutaneously in the abdomen to treat opioid use disorder. This long-acting delivery system holds great promise for many patients who have barriers to taking daily transmucosal buprenorphine-containing medications such as those with poor adherence to a daily medication. It is beneficial for those who have difficulty safely storing their medications, including patients who have children in the home, unstable housing, or live with others who have a use disorder. This product is also an option for patients who prefer mono-product buprenorphine. As Buprenorphine XR SQ is administered directly by a health care professional, it does not contain the abuse-deterrent naloxone that some patients feel causes side effects.

There are two ways to acquire Buprenorphine XR SQ: 1) order product from the distributor (buy and bill); or 2) dispensed from a specialty pharmacy for a specific patient (specialty pharmacy) [1]. For the buy and bill option, the health care setting must be certified through the Risk Evaluation and Mitigation Strategy (REMS) program and adhere to dispensing regulations [2]. We found this challenging to implement in the outpatient setting, thus we pursued the specialty pharmacy option. It ultimately took us nearly one year to complete the process.

The following are the barriers we faced with our first attempt. As a controlled substance, the medication must be stored in a refrigerated lockbox. Before...




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Brief interventions for obesity when patients are asked to pay for weight loss treatment: an observational study in primary care with an embedded randomised trial

BackgroundA brief intervention whereby GPs opportunistically facilitate an NHS-funded referral to a weight loss programme is clinically and cost-effective.AimTo test the acceptability of a brief intervention and attendance at a weight loss programme when GPs facilitate a referral that requires patients to pay for the service.Design and settingAn observational study of the effect of a GP encouraging attendance at a weight loss programme requiring self-payment in the West Midlands from 16 October 2018 to 30 November 2018, to compare with a previous trial in England in which the service was NHS-funded.MethodSixty patients with obesity who consecutively attended primary care appointments received an opportunistic brief intervention by a GP to endorse and offer a referral to a weight loss programme at the patient’s own expense. Participants were randomised to GPs who either stated the weekly monetary cost of the programme (basic cost) or who compared the weekly cost to an everyday discretionary item (cost comparison). Participants were subsequently asked to report whether they had attended a weight loss programme.ResultsOverall, 47% of participants (n = 28) accepted the referral; 50% (n = 15) in the basic cost group and 43% (n = 13) in the cost comparison group. This was significantly less than in a previous study when the programme was NHS-funded (77%, n = 722/940; P<0.0001). Most participants reported the intervention to be helpful/very helpful and appropriate/very appropriate (78%, n = 46/59 and 85%, n = 50/59, respectively) but scores were significantly lower than when the programme was NHS-funded (92% n = 851/922 and 88% n = 813/922, respectively; P = 0.004). One person (2%) attended the weight loss programme, which is significantly lower than the 40% of participants who attended when the programme was NHS-funded (P<0.0001).ConclusionGP referral to a weight loss programme that requires patients to pay rather than offering an NHS-funded programme is acceptable; however, it results in almost no attendance.




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The Elusive Promise of Bioimpedance in Fluid Management of Patients Undergoing Dialysis




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Overdiagnosis of lung cancer with low-dose computed tomography screening: meta-analysis of the randomised clinical trials

In low-dose computed tomography (LDCT) screening for lung cancer, all three main conditions for overdiagnosis in cancer screening are present: 1) a reservoir of slowly or nongrowing lung cancer exists; 2) LDCT is a high-resolution imaging technology with the potential to identify this reservoir; and 3) eligible screening participants have a high risk of dying from causes other than lung cancer. The degree of overdiagnosis in cancer screening is most validly estimated in high-quality randomised controlled trials (RCTs), with enough follow-up time after the end of screening to avoid lead-time bias and without contamination of the control group.

Nine RCTs investigating LDCT screening were identified. Two RCTs were excluded because lung cancer incidence after the end of screening was not published. Two other RCTs using active comparators were also excluded. Therefore, five RCTs were included: two trials were at low risk of bias, two of some concern and one at high risk of bias. In a meta-analysis of the two low risk of bias RCTs including 8156 healthy current or former smokers, 49% of the screen-detected cancers were overdiagnosed. There is uncertainty about this substantial degree of overdiagnosis due to unexplained heterogeneity and low precision of the summed estimate across the two trials.

Key points

  • Nine randomised controlled trials (RCTs) on low-dose computed tomography screening were identified; five were included for meta-analysis but only two of those were at low risk of bias.

  • In a meta-analysis of recent low risk of bias RCTs including 8156 healthy current or former smokers from developed countries, we found that 49% of the screen-detected cancers may be overdiagnosed.

  • There is uncertainty about the degree of overdiagnosis in lung cancer screening due to unexplained heterogeneity and low precision of the point estimate.

  • If only high-quality RCTs are included in the meta-analysis, the degree of overdiagnosis is substantial.

  • Educational aims

  • To appreciate that low-dose computed tomography screening for lung cancer meets all three main conditions for overdiagnosis in cancer screening: a reservoir of indolent cancers exists in the population; the screening test is able to "tap" this reservoir by detecting biologically indolent cancers as well as biologically important cancers; and the population being screened is characterised by a relatively high competing risk of death from other causes

  • To learn about biases that might affect the estimates of overdiagnosis in randomised controlled trials in cancer screening




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    Zens Comes Closest to Delivering the Wireless Charger Apple AirPower Promised to Be

    It delivers almost all the functionality Apple promised, with a steep Apple-like price tag to match.




    omise

    PromisePay changes gear

    Fast-growing Melbourne payments company PromisePay is ramping its growth plans in the global platform economy.




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    Tiny devices promise new horizon for security screening and medical imaging

    Miniature devices that could be developed into safe, high-resolution imaging technology, with uses such as helping doctors identify potentially deadly cancers and treat them early, have been created.




    omise

    After 160,000 accounts are compromised, Nintendo shuts down NNID logins

    Nintendo today confirmed earlier reports of account breaches dating back over the past few weeks. The gaming giant issued an update (via Nintendo Japan) noting that around 160,000 Nintendo Accounts were impacted, which found multiple being used to purchase digital items without the owner’s consent. Along with the purchasing powers, the offending parties may have […]




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    Blood test shows promise for detecting the deadliest cancers early

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