Measurement Properties of Questionnaires Assessing Complementary and Alternative Medicine Use in Pediatrics: A Systematic Review

Complementary and alternative medicine (CAM) is commonly used by children, but estimates of that use vary widely partly due to the range of questionnaires used to assess CAM use. However, no studies have attempted to appraise measurement properties of these questionnaires. The aim of this systematic review was to critically appraise and summarize measurement properties of questionnaires of CAM use in pediatrics.A search strategy was implemented in major electronic databases in March 2011 and conference websites, scientific journals and experts were consulted. Studies were included if they mentioned a questionnaire assessing the prevalence of CAM use in pediatrics. Members of the team independently rated the methodological quality of the studies (using the COSMIN checklist) and measurement properties of the questionnaires (using the Terwee and Cohen criteria).A total of 96 CAM questionnaires were found in 104 publications. The COSMIN checklist showed that no studies reported adequate methodological quality. The Terwee criteria showed that all included CAM questionnaires had indeterminate measurement properties. According to the Cohen score, none were considered to be a well-established assessment, two approached the level of a well-established assessment, seven were promising assessments and the remainder (n = 87) did not reach the score's minimum standards.None of the identified CAM questionnaires have been thoroughly validated. This systematic review highlights the need for proper validation of CAM questionnaires in pediatrics, which may in turn lead to improved research and knowledge translation about CAM in clinical practice

Fludarabine, cytarabine, granulocyte colony-stimulating factor, and idarubicin with gemtuzumab ozogamicin improves event-free survival in younger patients with newly diagnosed aml and overall survival in patients with npm1 and flt3 mutations

Purpose To determine the optimal induction chemotherapy regimen for younger adults with newly diagnosed AML without known adverse risk cytogenetics. Patients and Methods One thousand thirty-three patients were randomly assigned to intensified (fludarabine, cytarabine, granulocyte colony-stimulating factor, and idarubicin [FLAG-Ida]) or standard (daunorubicin and Ara-C [DA]) induction chemotherapy, with one or two doses of gemtuzumab ozogamicin (GO). The primary end point was overall survival (OS). Results There was no difference in remission rate after two courses between FLAG-Ida + GO and DA + GO (complete remission [CR] + CR with incomplete hematologic recovery 93% v 91%) or in day 60 mortality (4.3% v 4.6%). There was no difference in OS (66% v 63%; P = .41); however, the risk of relapse was lower with FLAG-Ida + GO (24% v 41%; P < .001) and 3-year event-free survival was higher (57% v 45%; P < .001). In patients with an NPM1 mutation (30%), 3-year OS was significantly higher with FLAG-Ida + GO (82% v 64%; P = .005). NPM1 measurable residual disease (MRD) clearance was also greater, with 88% versus 77% becoming MRD-negative in peripheral blood after cycle 2 (P = .02). Three-year OS was also higher in patients with a FLT3 mutation (64% v 54%; P = .047). Fewer transplants were performed in patients receiving FLAG-Ida + GO (238 v 278; P = .02). There was no difference in outcome according to the number of GO doses, although NPM1 MRD clearance was higher with two doses in the DA arm. Patients with core binding factor AML treated with DA and one dose of GO had a 3-year OS of 96% with no survival benefit from FLAG-Ida + GO. Conclusion Overall, FLAG-Ida + GO significantly reduced relapse without improving OS. However, exploratory analyses show that patients with NPM1 and FLT3 mutations had substantial improvements in OS. By contrast, in patients with core binding factor AML, outcomes were excellent with DA + GO with no FLAG-Ida benefit

Natural Health Products (NHPs) and Canadian Pharmacy Students: Core Competencies

Objective: To reach consensus on entry-to-practice natural health product (NHP)-related competency statements for Canadian pharmacy students. Methods: Four rounds of a modified Delphi method were conducted. Participants; pharmacy educators,and representatives from Canadian pharmacy organizations (n=17), ranked their level of agreement using a 5-point Likert scale. Results: Consensus occurred when all participants ranked a statement 4 or 5. Three core NHP-related competencies were identified: 1) the ability to incorporate NHP knowledge when providing pharmaceutical care; 2) the ability to access and critically appraise NHP-related information sources, and 3) the ability to provide appropriate education to patients and other health care providers on the effectiveness and potential adverse effects and drug interactions of NHPs. Two additional NHP-related competency statements emerged as important, but consensus was not achieved. Conclusions: If the developed core NHP-related competency statements are widely implemented, Canadian pharmacists will be able to fulfill their NHP-related professional responsibilities upon entry-to-practice.MAS

Biological control of turfgrass diseases with organic composts enriched with Trichoderma atroviride

The increasing demand of natural products for the control of plant diseases has led to the search for biological control agents, namely fungi, often isolated from composts of organic residues. By composting two different mixes of agro-industrial residues, P1 and P2 composts were obtained, from where a known antagonist, Trichoderma atroviride, was isolated. Later, a second composting process was performed and when the composting mix reached room temperature, the previously isolated T. atroviride was inoculated in both composts to enrich its population (E) and named as P1E and P2E. The suppressive capacity of these two composts against Sclerotium rolfsii, Clarireedia spp. and Rhizoctonia solani was tested two weeks after T. atroviride inoculation, in 100 mL pots with turfgrass seeded with Agrostis stolonifera. The tested treatments were: composts P1 and P2 without any treatment; thermally treated P1 and P2 (P1t, P2t); P1 and P2 enriched without and with previous thermic treatment (P1E, P2E, P1tE, P2tE), and a commercial peat-based substrate, natural (P) and thermally treated (Pt), enriched (PE) and enriched after thermal treatment (PtE). Enriched composts achieved the highest disease control. P1E was more effective in controlling Clarireedia spp.; pots with infected plants grown on P1E, showed 53.5% less affected area compared to P1t. P2E was more effective against R. solani; results showed 69.3% less affected area compared to P2t and both were effective in S. rolfsii control, with a reduction of 38.5% in P1E and 43.5% in P2E. The larger population of Trichoderma spp. observed in the enriched substrates associated to the greater enzyme activity, namely and N-acetyl-β-glucosaminidase, standing out in P2E, will have contributed strongly to the biocontrol of the studied diseases. An increase in some macro and micronutrients was observed in the enriched heat-treated substrates.FCT: SFRH/BD/109218/2015info:eu-repo/semantics/publishedVersio