Impacts of Land Abandonment on Vegetation: Successional Pathways in European Habitats

Changes in traditional agricultural systems in Europe in recent decades have led to widespread abandonment and colonization of various habitats by shrubs and trees. We combined several vegetation databases to test whether patterns of changes in plant diversity after land abandonment in different habitats followed similar pathways. The impacts of land abandonment and subsequent woody colonization on vegetation composition and plant traits were studied in five semi-natural open habitats and two arable habitats in six regions of Europe. For each habitat, vegetation surveys were carried out in different stages of succession using either permanent or non-permanent plots. Consecutive stages of succession were defined on a physiognomic basis from initial open stages to late woody stages. Changes in vegetation composition, species richness, numbers of species on Red Lists, plant strategy types, Ellenberg indicator values of the vegetation, Grime CSR strategy types and seven ecological traits were assessed for each stage of the successional pathway. Abandonment of agro-pastoral land-use and subsequent woody colonization were associated with changes in floristic composition. Plant richness varied according to the different habitats and stages of succession, but semi-natural habitats differed from arable fields in several ecological traits and vegetation responses. Nevertheless, succession occurred along broadly predictable pathways. Vegetation in abandoned arable fields was characterized by a decreasing importance of R-strategists, annuals, seed plants with overwintering green leaves, insect-pollinated plants with hemi-rosette morphology and plants thriving in nutrient-rich conditions, but an increase in species considered as endangered according to the Red Lists. Conversely, changes in plant traits with succession within the initially-open semi-natural habitats showed an increase in plants thriving in nutrient-rich conditions, stress-tolerant plants and plants with sexual and vegetative reproduction, but a sharp decrease in protected species. In conclusion, our study showed a set of similarities in responses of the vegetation in plant traits after land abandonment, but we also highlighted differences between arable fields and semi-natural habitats, emphasizing the importance of land-use legacy

EAACI Task force Clinical epidemiology of anaphylaxis: experts’ perspective on the use of adrenaline autoinjectors in Europe

Background Worldwide, guidelines recommend the use of adrenaline autoinjectors (AAIs) for self-medication in patients who experience severe allergic reaction. The European Medical Agency recommends the prescription of two AAIs, which should be carried by patients at all times. The European Academy of Allergy and Clinical Immunology guidelines propose to prescribe a second AAI under some defined conditions. In the present study, we aimed to examine the adherence to these guidelines and prescription behavior of allergy experts regarding the number of AAIs prescribed for a given patient. Methods A standardized questionnaire was applied to the participants of the 5th International Conference of the Network of Online Registration for Anaphylaxis (NORA e. V.). Twenty-six experts (medical doctors with at least 2 years of experience in the field of anaphylaxis) answered the questions regarding the number of autoinjectors prescribed and the reasons influencing their decisions. Results Sixty-eight percent of the experts usually prescribed one AAI, while 32% prescribed two. The pediatricians and physicians with less experience tended to prescribe two autoinjectors more frequently. The experts were more likely to prescribe two adrenaline autoinjectors if the patient was a child, had a previous severe reaction, had mastocytosis, asthma, cardiovascular disease, or high body weight, or lived far from the emergency department. Conclusion Our data confirm the lack of consensus regarding the number of AAIs to prescribe. Despite the European Medical Agency recommendation, the majority of allergy experts prescribed one autoinjector per patient. However, under distinct circumstances (e.g. mastocytosis, asthma, excess body weight, a history of severe anaphylaxis, or restricted access to immediate emergency), experts tended to prescribe more AAIs, which is in accordance with the European Academy of Allergy and Clinical Immunology guidelines

Современные методы оценки персонала ( на примере МБУ ДО СДЮСШОР «Олимп» г. Зеленогорск)

РЕФЕРАТ Бакалаврская работа 94 с., 15 рис., 17 табл., 45 источников, 5 прил. Ключевые слова: оценка персонала, персонал организации, методы оценки, интегральный подход, анализ, анкетирование, эффективность, совер-шенствование методов оценки. Объектом исследования является оценка деятельности тренерско – преподавательского состава в МБУ ДО СДЮСШОР «Олимп» г. Зеленогорска Красноярского края. Цель исследования является выработка рекомендаций по совершенствованию методов оценки персонала. В результате исследования были разработаны мероприятия направленные на совершенствование методов оценки персонала. Степень внедрения: разработанные рекомендации могут быть использованы руководством предприятия с целью эффективности использования персонала предприятия. Область применения: разработанные методы оценки персонала организации могут быть использованы на предприятии, организации, фирме любой отрасли. Экономическая эффективность/значимость работы: эффективность реализации разработанных мероприятий направленных на совершенствование оценки персонала в МБУ ДО СДЮСШОР «Олимп» очевидна, что позволит руководству данного образовательного учреждения повысить эффективность использования персонала предприятия. В будущем планируется разработка наиболее новых методологических аспектов оценки персонала, направленных на совершенствование структуры управления и повышение эффективности использования персонала образовательного учреждения.ESSAY Bachelor work 94 p., 15 fig., 17 tab., 45 sources, 5 adj. Keywords: evaluation of personnel, staff organization, evaluation methods, inte-gral approach, analysis, questioning, efficiency, improvement of assessment methods. The object of the study is to evaluate the activity of coaching - the teacher-sky composition in the MBU to SDYUSSHOR "Olympus" Zelenogorsk Krasnoyarsk Territory. The purpose of this study is to develop recommendations for improving Meto-ing personnel evaluations. As a result of research activities aimed at Sauveur-ment personnel evaluation methods have been developed. Degree of implementation: developed recommendations can be used handle-duction of the enterprise for the purpose of efficient use of personnel of the enterprise. Scope: designed organization personnel evaluation methods can be used in the enterprise, organization, company in any industry. Cost-effectiveness / value of the work: the effectiveness of the implementation of time-work activities aimed at improving the evaluation of staff at MBU to SDYUSSHOR "Olympus" is obvious that enable management of the educational institution more efficient use of personnel of the enterprise. In the future development of the most recent assessment of the methodological aspects of personnel, aimed at improving the management structure and more efficient use of personnel of the educational institution

Which treatment for low back pain? A factorial randomised controlled trial comparing intravenous analgesics with oral analgesics in the emergency department and a centrally acting muscle relaxant with placebo over three days [ISRCTN09719705]

BACKGROUND: About two thirds of adults suffer from backpain at some time during their life. In the emergency room many patients with acute back pain are treated with intravenous non-steroidal analgesics. Whether this treatment is superior to oral administration of non-steroidal analgesics is unknown. Intravenous administration, however, requires considerable amounts of resources and accounts for high workload in busy clinics. In the further course centrally acting muscle relaxants are prescribed but the effectiveness remains unclear. The objective of this study is on the one hand to compare the effectiveness of intravenous with oral non-steroidal analgesics for acute treatment and on the other hand to compare the effectiveness of a centrally active muscle relaxant with placebo given for three days after presentation to the ED (emergency department). METHODS/DESIGN: This study is intended as a randomised controlled factorial trial mainly for two reasons: (1) the sequence of treatments resembles the actual proceedings in every-day clinical practice, which is important for the generalisability of the results and (2) this design allows to take interactions between the two sequential treatment strategies into account. There is a patient preference arm included because patients preference is an important issue providing valuable information: (1) it allows to assess the interaction between desired treatment and outcome, (2) results can be extrapolated to a wider group while (3) conserving the advantages of a fully randomised controlled trial. CONCLUSION: We hope to shed more light on the effectiveness of treatment modalities available for acute low back pain

Tolerance induction through early feeding to prevent food allergy in infants with eczema (TEFFA): rationale, study design, and methods of a randomized controlled trial

BACKGROUND: Up to 8% of all children in industrialized countries suffer from food allergies, whereas children with atopic eczema are affected considerably more frequently. In addition, the type and starting time of weaning foods seem to influence the development of food allergies. However, data from interventional studies on weaning are controversial. The aim of this randomized-controlled clinical trial is to investigate, whether an early introduction of hen's egg (HE), cow's milk (CM), peanut (PN), and hazelnut (HN) in children with atopic eczema can reduce the risk for developing food allergies in the first year of life. METHODS: This is a protocol for a randomized, placebo controlled, double blind, single-center clinical trial. One hundred fifty infants with atopic eczema at 4-8 months of age will be randomized in a 2:1 manner into an active group that will receive rusk-like biscuit powder with HE, CM, PN, and HN (initially approximately 2 mg of each food protein) for 6-8 months or a placebo group, whose participants will receive the same rusk-like biscuit powder without HE, CM, PN, and HN on a daily basis. During the interventional period, the amount of allergens in the study product will be increased three times, each after 6 weeks. All study participants who are sensitized to HE, CM, PN, or HN at the end of the interventional period will undergo an oral food challenge to the respective food in a further visit. Primary endpoint is IgE-mediated food allergy to at least one of the four foods (HE, CM, PN or HN) after 6-8 months of intervention (i.e., at around 1 year of age). Secondary endpoints include multiple food allergies, severity of eczema, wheezing, and sensitization levels against food allergens. DISCUSSION: This clinical trial will assess whether an early introduction of allergenic foods into the diet of children with atopic eczema can prevent the development of food allergies. This trial will contribute to update food allergy prevention guidelines. TRIAL REGISTRATION: German Clinical Trials Register DRKS00016770 . Registered on 09 January 2020

Tolerance induction through non-avoidance to prevent persistent food allergy (TINA) in children and adults with peanut or tree nut allergy: rationale, study design and methods of a randomized controlled trial and observational cohort study

BACKGROUND: Peanuts (PN) and tree nuts (TN) are among the most frequent elicitors of food allergy and can lead to life-threatening reactions. The current advice for allergic patients is to strictly avoid the offending food independently of their individual threshold level, whereas sensitized patients without allergic symptoms should frequently consume the food to avoid (re-)development of food allergy. The aim of this trial is to investigate (I) whether the consumption of low allergen amounts below the individual threshold may support natural tolerance development and (II) to what extent regular allergen consumption in sensitized but tolerant subjects prevents the (re-)development of PN or TN allergy. METHODS: The TINA trial consisting of (part I) a randomized, controlled, open, parallel group, single-center, superiority trial (RCT), and (part II) a prospective observational exploratory cohort study. Children and adults (age 1-67 years) with suspected or known primary PN and/or TN allergy will undergo an oral food challenge (OFC) to determine their clinical reactivity and individual threshold. In the RCT, 120 PN or TN allergic patients who tolerate ≥100 mg of food protein will be randomized (1:1 ratio) to consumption of products with low amounts of PN or TN on a regular basis or strict avoidance for 1 year. The consumption group will start with 1/100 of their individual threshold, increasing the protein amount to 1/50 and 1/10 after 4 and 8 months, respectively. The primary endpoint is the clinical tolerance to PN or TN after 1 year assessed by OFC. In the cohort study, 120 subjects sensitized to PN and/or TN but tolerant are advised to regularly consume the food and observed for 1 year. The primary endpoint is the maintenance of clinical tolerance to PN and/or TN after 1 year assessed by challenging with the former tolerated cumulative dose. DISCUSSION: This clinical trial will help to determine the impact of allergen consumption versus avoidance on natural tolerance development and whether the current dietary advice for PN or TN allergic patients with higher threshold levels is still valid. Trial registration: German Clinical Trials Register; ID: DRKS00016764 (RCT), DRKS00020467 (cohort study). Registered on 15 January 2020, http://www.drks.de

Prävalenz und Charakteristika von Kindern und Jugendlichen mit speziellem Versorgungsbedarf im Kinder- und Jugendgesundheitssurvey (KiGGS) in Deutschland

Um zu bevölkerungsrepräsentativen Einschätzungen der Prävalenz und der Charakteristika von Kindern und Jugendlichen mit gesundheitsbedingtem Versorgungsbedarf zu gelangen, sind Screening-Instrumente entwickelt worden. Diese zielen auf eine Erfassung von Konsequenzen körperlicher, seelischer und verhaltensbedingter Störungen ab, unabhängig von den zugrunde liegenden medizinischen Diagnosen. Eines der bestuntersuchten und unter Machbarkeitsaspekten bewährtesten Instrumente, der CSHCN-(Children with Special Health Care Needs)Screener, wurde in den Elternfragebogen des Kinder- und Jugendgesundheitssurveys (KiGGS) in Deutschland integriert. Die gewichtete Gesamtprävalenz von Kindern und Jugendlichen mit speziellem Versorgungsbedarf betrug 16,0% für Jungen und 11,4% für Mädchen. Bei Kindern im Vorschul- und Schulalter lag nach den Befragungsergebnissen ein spezieller Versorgungsbedarf 2- bis 3-mal häufiger vor als bei Kleinkindern. Bis zu einem Alter von 14 Jahren war ein deutlich höherer Versorgungsbedarf bei Jungen als bei Mädchen für alle Altersgruppen ersichtlich. Am deutlichsten ausgeprägt war der Geschlechtsunterschied bei den 3- bis 10-Jährigen. Kinder und Jugendliche mit Migrationshintergrund wiesen einen signifikant niedrigeren Versorgungsbedarf auf als Kinder ohne Migrationshintergrund. Dies traf insbesondere auf die Jungen (8,0% vs. 17,1%) zu. Signifikante Unterschiede im Versorgungsbedarf nach Sozialstatus, Größe des Wohnortes oder Zugehörigkeit des Wohnortes zu den alten oder neuen Ländern wurden nicht beobachtet. Mit Ausnahme eines fehlenden Zusammenhangs zwischen Versorgungsbedarf und sozioökonomischem Status zeigen die hier berichteten Ergebnisse gute Übereinstimmung mit Beobachtungen im US-amerikanischen National Survey of CSHCN.In order to arrive at population-based estimates on the prevalence and characteristics of children and adolescents with specific health care needs (CSHCN), screening instruments focussing on the consequences of physical, mental and behavioral problems rather than on medical diagnoses have been developed. One of the most feasible and widely tested instruments, the CSHCN screener was added to the self-administered questionnaire for parents of children participating in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). The overall weighted prevalence of CSHCN was 16.0% among boys and 11.4% among girls. Children at kindergarten or school age were more than 2-3 times more likely to screen positive compared to toddlers. Up to 14 years, the sex difference persisted through all age groups and was most pronounced between the ages of 3 and 10 years. Children with a migrant background had significantly lower rates of CSHCN compared to non-migrants. This was particularly true for boys (8.0% vs. 17.1%). CSHCN status was not related to social status, urbanization or residence in former West vs. former East Germany. Except for the lack of association with social status, these results are in good accordance with observations from the US National Survey of CSHCN

Effectiveness and safety of opicapone in Parkinson's disease patients with motor fluctuations: The OPTIPARK open-label study

BACKGROUND: The efficacy and safety of opicapone, a once-daily catechol-O-methyltransferase inhibitor, have been established in two large randomized, placebo-controlled, multinational pivotal trials. Still, clinical evidence from routine practice is needed to complement the data from the pivotal trials. METHODS: OPTIPARK (NCT02847442) was a prospective, open-label, single-arm trial conducted in Germany and the UK under clinical practice conditions. Patients with Parkinson’s disease and motor fluctuations were treated with opicapone 50 mg for 3 (Germany) or 6 (UK) months in addition to their current levodopa and other antiparkinsonian treatments. The primary endpoint was the Clinician’s Global Impression of Change (CGI-C) after 3 months. Secondary assessments included Patient Global Impressions of Change (PGI-C), the Unified Parkinson’s Disease Rating Scale (UPDRS), Parkinson’s Disease Questionnaire (PDQ-8), and the Non-Motor Symptoms Scale (NMSS). Safety assessments included evaluation of treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs). RESULTS: Of the 506 patients enrolled, 495 (97.8%) took at least one dose of opicapone. Of these, 393 (79.4%) patients completed 3 months of treatment. Overall, 71.3 and 76.9% of patients experienced any improvement on CGI-C and PGI-C after 3 months, respectively (full analysis set). At 6 months, for UK subgroup only (n = 95), 85.3% of patients were judged by investigators as improved since commencing treatment. UPDRS scores at 3 months showed statistically significant improvements in activities of daily living during OFF (mean ± SD change from baseline: − 3.0 ± 4.6, p < 0.0001) and motor scores during ON (− 4.6 ± 8.1, p < 0.0001). The mean ± SD improvements of − 3.4 ± 12.8 points for PDQ-8 and -6.8 ± 19.7 points for NMSS were statistically significant versus baseline (both p < 0.0001). Most of TEAEs (94.8% of events) were of mild or moderate intensity. TEAEs considered to be at least possibly related to opicapone were reported for 45.1% of patients, with dyskinesia (11.5%) and dry mouth (6.5%) being the most frequently reported. Serious TEAEs considered at least possibly related to opicapone were reported for 1.4% of patients. CONCLUSIONS: Opicapone 50 mg was effective and generally well-tolerated in PD patients with motor fluctuations treated in clinical practice. TRIAL REGISTRATION: Registered in July 2016 at clinicaltrials.gov (NCT02847442)

Peanut‐induced anaphylaxis in children and adolescents: Data from the European Anaphylaxis Registry

Background Peanut allergy has a rising prevalence in high-income countries, affecting 0.5%-1.4% of children. This study aimed to better understand peanut anaphylaxis in comparison to anaphylaxis to other food triggers in European children and adolescents. Methods Data was sourced from the European Anaphylaxis Registry via an online questionnaire, after in-depth review of food-induced anaphylaxis cases in a tertiary paediatric allergy centre. Results 3514 cases of food anaphylaxis were reported between July 2007 - March 2018, 56% in patients younger than 18 years. Peanut anaphylaxis was recorded in 459 children and adolescents (85% of all peanut anaphylaxis cases). Previous reactions (42% vs. 38%; p = .001), asthma comorbidity (47% vs. 35%; p < .001), relevant cofactors (29% vs. 22%; p = .004) and biphasic reactions (10% vs. 4%; p = .001) were more commonly reported in peanut anaphylaxis. Most cases were labelled as severe anaphylaxis (Ring&Messmer grade III 65% vs. 56% and grade IV 1.1% vs. 0.9%; p = .001). Self-administration of intramuscular adrenaline was low (17% vs. 15%), professional adrenaline administration was higher in non-peanut food anaphylaxis (34% vs. 26%; p = .003). Hospitalization was higher for peanut anaphylaxis (67% vs. 54%; p = .004). Conclusions The European Anaphylaxis Registry data confirmed peanut as one of the major causes of severe, potentially life-threatening allergic reactions in European children, with some characteristic features e.g., presence of asthma comorbidity and increased rate of biphasic reactions. Usage of intramuscular adrenaline as first-line treatment is low and needs to be improved. The Registry, designed as the largest database on anaphylaxis, allows continuous assessment of this condition