Regular treatment with formoterol versus regular treatment with salmeterol for chronic asthma: serious adverse events

An increase in serious adverse events with both regular formoterol and regular salmeterol in chronic asthma has been demonstrated in previous Cochrane reviews.ObjectivesWe set out to compare the risks of mortality and non-fatal serious adverse events in trials which have randomised patients with chronic asthma to regular formoterol versus regular salmeterol.Search methodsWe identified trials using the Cochrane Airways Group Specialised Register of trials. We checked manufacturers' websites of clinical trial registers for unpublished trial data and also checked Food and Drug Administration (FDA) submissions in relation to formoterol and salmeterol. The date of the most recent search was January 2012.Selection criteriaWe included controlled, parallel-design clinical trials on patients of any age and with any severity of asthma if they randomised patients to treatment with regular formoterol versus regular salmeterol (without randomised inhaled corticosteroids), and were of at least 12 weeks' duration.Data collection and analysisTwo authors independently selected trials for inclusion in the review and extracted outcome data. We sought unpublished data on mortality and serious adverse events from the sponsors and authors.Main resultsThe review included four studies (involving 1116 adults and 156 children). All studies were open label and recruited patients who were already taking inhaled corticosteroids for their asthma, and all studies contributed data on serious adverse events. All studies compared formoterol 12 mu g versus salmeterol 50 mu g twice daily. The adult studies were all comparing Foradil Aerolizer with Serevent Diskus, and the children's study compared Oxis Turbohaler to Serevent Accuhaler. There was only one death in an adult (which was unrelated to asthma) and none in children, and there were no significant differences in non-fatal serious adverse events comparing formoterol to salmeterol in adults (Peto odds ratio (OR) 0.77; 95% confidence interval (CI) 0.46 to 1.28), or children (Peto OR 0.95; 95% CI 0.06 to 15.33). Over a six-month period, in studies involving adults that contributed to this analysis, the percentages with serious adverse events were 5.1% for formoterol and 6.4% for salmeterol; and over a three-month period the percentages of children with serious adverse events were 1.3% for formoterol and 1.3% for salmeterol.Authors' conclusionsWe identified four studies comparing regular formoterol to regular salmeterol (without randomised inhaled corticosteroids, but all participants were on regular background inhaled corticosteroids). The events were infrequent and consequently too few patients have been studied to allow any firm conclusions to be drawn about the relative safety of formoterol and salmeterol. Asthma-related serious adverse events were rare and there were no reported asthma-related deaths

Effect on smoking quit rate of telling patients their lung age: the Step2quit randomised controlled trial

Objective To evaluate the impact of telling patients their estimated spirometric lung age as an incentive to quit smoking.Design Randomised controlled trial.Setting Five general practices in Hertfordshire, England.Participants 561 current smokers aged over 35.Intervention All participants were offered spirometric assessment of lung function. Participants in intervention group received their results in terms of "lung age" (the age of the average healthy individual who would perform similar to them on spirometry). Those in the control group received a raw figure for forced expiratory volume at one second (FEV1). Both groups were advised to quit and offered referral to local NHS smoking cessation services.Main outcome measures The primary outcome measure was verified cessation of smoking by salivary cotinine testing 12 months after recruitment. Secondary outcomes were reported changes in daily consumption of cigarettes and identification of new diagnoses of chronic obstructive lung disease.Results Follow-up was 89%. Independently verified quit rates at 12 months in the intervention and control groups, respectively, were 13.6% and 6.4% (difference 7.2%, P=0.005, 95% confidence interval 2.2% to 12.1%; number needed to treat 14). People with worse spirometric lung age were no more likely to have quit than those with normal lung age in either group. Cost per successful quitter was estimated at 280 pound ((euro) 365, $556). A new diagnosis of obstructive lung disease was made in 17% in the intervention group and 14% in the control group; a total of 16% (89/561) of participants.Conclusion Telling smokers their lung age significantly improves the likelihood of them quitting smoking, but the mechanism by which this intervention achieves its effect is unclear.Trial registration National Research Register N0096173751

Corporate social responsibility: issues for future development in the low-fares airlines sector

Research reportFor reasons beyond our control, access to this report will resume on 1 December 2012 - please direct any queries to [email protected] practitioner-focused review of the research that emphasises the issues and opportunities managers might face should they decide to develop their CSR further. Main findings from the research are that sustainable development, corporate social responsibility (CSR), and aviation policies have only limited linkages, especially on the UK regional level. Within the sector, low-fares airlines do have socially-responsible initiatives, mostly centred on environmentally-sensitive technological investment and charitable/community support. However, low-fares airlines do not communicate their activities as widely as other sectors and full-service carriers.Research funded by the Economic and Social Research Council (ESRC) as part of its Business Engagement Scheme under the title Social Responsibility among Low-fares Airlines: Current Practices and FutureTrends (RES 185-3-0046)

Creating a sustainable work environment in British Airways: implications of the 2010 cabin crew dispute.

The author was asked by the union Unite to prepare a short report recording the employee relations strategy of BA and to assess the implications of this strategy for the current dispute with cabin crew. In order to undertake this task it was felt by the author that some initial discussion on work sustainability within large successful corporations was necessary to set the context for BA�s strategic choice with regard to industrial relations within the company. This is followed by a short review of extant academic literature on BA�s and other airlines industrial relations approaches, particularly with respect to the full service carrier (FCC), low cost carrier (LCC) debate. The current approach of BA management towards the cabin crew dispute was then recorded, and an analysis proffered of the likely outcomes of this approach in terms of its effects on employee commitment, customer service, safety and profitability

The management of absence: why it matters : an analysis of absence management issues, with a case study based in a UK academic library

This paper seeks to give an overview of some ongoing research into absence management practices in a UK university library. The aim of the research in question is to evaluate the effectiveness of current management practices

Conducting retrospective impact analysis to inform a medical research charity’s funding strategies: The case of Asthma UK

© 2013 Hanney et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.This article has been made available through the Brunel Open Access Publishing Fund.BACKGROUND: Debate is intensifying about how to assess the full range of impacts from medical research. Complexity increases when assessing the diverse funding streams of funders such as Asthma UK, a charitable patient organisation supporting medical research to benefit people with asthma. This paper aims to describe the various impacts identified from a range of Asthma UK research, and explore how Asthma UK utilised the characteristics of successful funding approaches to inform future research strategies. METHODS: We adapted the Payback Framework, using it both in a survey and to help structure interviews, documentary analysis, and case studies. We sent surveys to 153 lead researchers of projects, plus 10 past research fellows, and also conducted 14 detailed case studies. These covered nine projects and two fellowships, in addition to the innovative case studies on the professorial chairs (funded since 1988) and the MRC-Asthma UK Centre in Allergic Mechanisms of Asthma (the ‘Centre’) which together facilitated a comprehensive analysis of the whole funding portfolio. We organised each case study to capture whatever academic and wider societal impacts (or payback) might have arisen given the diverse timescales, size of funding involved, and extent to which Asthma UK funding contributed to the impacts. RESULTS: Projects recorded an average of four peer-reviewed journal articles. Together the chairs reported over 500 papers. All streams of funding attracted follow-on funding. Each of the various categories of societal impacts arose from only a minority of individual projects and fellowships. Some of the research portfolio is influencing asthma-related clinical guidelines, and some contributing to product development. The latter includes potentially major breakthroughs in asthma therapies (in immunotherapy, and new inhaled drugs) trialled by university spin-out companies. Such research-informed guidelines and medicines can, in turn, contribute to health improvements. The role of the chairs and the pioneering collaborative Centre is shown as being particularly important. CONCLUSIONS: We systematically demonstrate that all types of Asthma UK’s research funding assessed are making impacts at different levels, but the main societal impacts from projects and fellowships come from a minority of those funded. Asthma UK used the study’s findings, especially in relation to the Centre, to inform research funding strategies to promote the achievement of impact.This study was funded by Asthma UK

An influenza pandemic : what it could mean for Scottish tourism

There is a growing unease among World Health Organisation (WHO) officials and other global disease surveillance organisations that Avian Flu will mutate into a human influenza pandemic. Such is the concern that the Scottish Executive asked public bodies to prepare business continuity plans based upon the National Health Service Scotland‘s contingency plan and scenarios, and this briefing paper is a consequence of that request

Assessing whether environmental impact is a criterion of consumers when selecting an airline

The aim of this study is to gain insight as to whether environmental impact is a criterion of consumers when actually selecting an airline. Findings indicate that cost and convenience, followed by destinations on offer and departure airports, are the key criteria for consumers in airline ticket purchasing decisions. Airlines may continue environmental activity and disclosure for long-term strategic reasons although individual ticket purchase decisions do not appear to be based primarily on environmental considerations. The research fills a gap in the U.K. empirical literature by exploring whether consumers of airlines operating out of the U.K. consider environmental impacts when making actual ticket purchase decisions

Spotlight on Assistance Dogs-Legislation, Welfare and Research

Assistance dogs are a very diverse group of working dogs that are trained to assist humans with different types of disabilities in their daily lives. Despite these dogs' value for humankind, research on their welfare status, cognitive and behavioural capacities, selection criteria for the best fitting individuals, effective training and management practices, and genetic issues are so far lacking. This review highlights the need to address these topics and to promote progress in legal issues around assistance dogs. The topic of assistance dogs is approached comprehensively by outlining the current status of knowledge in three different dimensions: (1) the legal dimension, outlining important legal issues in the EU and Australia; (2) the welfare dimension; and (3) the dimension of research, covering assistance dog selection and training. For each of these three dimensions, we discuss potential approaches that can be implemented in the future in order to support assistance dog working performance, to protect the dogs' welfare, and to improve our knowledge about them. Additionally, there remain many legal issues, such as the presence of assistance dogs in public areas, the resolution of which would benefit both the assistance dog and the owner with disability