Oral steroids for the resolution of otitis media with effusion (OME) in children (OSTRICH): study protocol for a randomised controlled trial

Background Otitis media with effusion (OME) is an accumulation of fluid in the middle ear affecting about 80% of children by the age of 4 years. While OME usually resolves spontaneously, it can affect speech, behaviour and development. Children with persistent hearing loss associated with OME are usually offered hearing aids or insertion of ventilation tubes through the tympanic membrane. Oral steroids may be a safe and effective treatment for OME, which could be delivered in primary care. It has the potential to benefit large numbers of children and reduce the burden of care on them and on health services. However, previous trials have either been too small with too short a follow up period, or of too poor quality to give a definite answer. The aim of the OSTRICH trial is to determine if a short course of oral steroids improves the hearing of children with OME in the short and longer term. Methods/Design 380 participants (children aged 2-8 years) are recruited from Hospital Ear, Nose and Throat departments in Wales and England. A trained clinician seeks informed consent from parents of children with symptoms attributable to OME for at least 3 months and with confirmed bilateral hearing loss at study entry. Participants are randomised to a course of oral steroid or a matched placebo for one week. Outcomes include audiometry, tympanometry and otoscopy assessments, symptoms, adverse effects, functional health status, quality of life, resource use and cost effectiveness. Participants are followed up at 5 weeks, and at 6 and 12 months after the day of randomisation. The primary outcome is audiometry-confirmed satisfactory hearing at 5 weeks. Discussion There is an important evidence gap regarding clinical and cost effectiveness of short courses of oral steroid treatment for OME. Identifying an effective, safe, non-surgical intervention for OME in children for use in primary care would be of great benefit to children, their families and the NHS

Salve Regina Arboretum Ten Year Plan to Reach Level III Accreditation

The Salve Regina University Arboretum, located in Newport, Rhode Island is currently registered as a Level II arboretum and is intertwined with the city of Newport Arboretum. The university now has intentions to reach Level III status, as part of a ten-year plan. This plan was developed by the students of the Spring 2018 BIO 255: Conservation Biology course, instructed by Dr. Jameson Chace, Associate Professor of biology at Salve Regina University. As part of a curriculum geared towards civic engagement, the class focused on creating and optimizing strategies that can be applied to the ten-year plan. These strategies were applied to the plan categorically: a team to inventory the current tree collection; a team to develop formal educational programming; a team for informal educational programming; a team to establish goals for conservation initiative related to the arboretum; a team dedicated to research related to arboreta; and a team to develop a list of species of special interest to add to the arboretum in the coming years. In the following document, each team’s strategies for the ten-year plan are outlined. Each of the components of this plan incorporate means to fulfill the conditions to meet Level III arboretum status so that the arboretum can apply for official registration. The aforementioned teams were tasked with designing a foundation on which to work up from. This includes formal educational programming to be applied to classroom settings and informal educational programming which can be applied to community outreach-based settings. The teams that worked to strengthen the arboretum’s mission of conservation focused on researching trees that can fit into the current landscape while providing some sort of benefit to the surrounding flora/fauna. Further, many of the species of interest, such as the chestnut, hold historical value to the greater Rhode Island region. In all, the Salve Regina Arboretum must achieve a total of 500 unique species of trees and woody plants as part of its efforts to apply for Level III status. In addition to the programming and research performed so far by the student teams, the arboretum must also hire a curator to manage the programming and to oversee the arboretum as a whole. Additionally, the arboretum must continue to actively collaborate with other arboreta and should encourage scientific research. It is important to recognize that the Salve Regina University Arboretum has already been utilized in the field of microbiology and has gained some attention at the university as a resource for further research and investigation. This ten year plan, along with resources within in it, is designed to provide a list of potential guidelines and ideas that can be applied for the arboretum’s benefit and growth. The Salve Regina University arboretum is a continually growing and developing part of the greater Newport, Rhode Island community, and will continue to strengthen its mission and that of the university which oversees its success.https://digitalcommons.salve.edu/bio255_arboretum/1000/thumbnail.jp