Clinical Practice Guidelines for Dementia in Australia: A step towards improving uptake of research findings in health and aged-care settings

This author accepted manuscript (post print) is made available following a 12 month embargo form date of publication (21 April 2016) in accordance with the publisher copyright policy

Asthma in the elderly and aging societies in Asia Pacific

Asthma is a chronic inflammatory disease of the airway with airway hyperresponsiveness and constriction. Asthma occurs globally and affects people of all ages. The world’s population is increasingly becoming older. They are also facing increase in non-communicable diseases including asthma and chronic obstructive pulmonary disease. Global facts for asthma (from asthma facts [1] and key messages [2]) ••�Some 235-300 million people currently suffer from asthma. The prevalence of asthma has increased following transition to a modern, urban lifestyle [3, 4]. ••Globally, 250,000 people die of asthma every year. ••�Asthma deaths are related to lack of proper treatment. ••�In Japan, 90 % of deaths from asthma occur in people 60 years and over [5]

Demographics of infertility and management of unexplained infertility

Peer reviewedPostprin

Atrial fibrillation: diagnosis and management—summary of NICE guidance

This article summarises the updated National Institute for Health and Care Excellence (NICE) guideline, Atrial fibrillation: diagnosis and management,1 focusing on three areas where new evidence has led to a change in recommendations: bleeding risk prediction, anticoagulation, and ablation. We explain the Guideline Committee’s rationale for these recommendations and highlight challenges to implementation

Evolution of Asthma Concept and Effect of Current Asthma Management Guidelines

Concept of asthma has changed from symptom-complex or airway hypersensitivity to airway inflammation and airway remodeling. Based on this concept asthma management guidelines (JGL) has been developed in Japan. Death from asthma has decreased drastically since the publication of the guidelines, although it is still high in elderly population. Further works are expected for "zero-death" from asthma and for tighter control of airway inflammation and resultant airway remodeling

Patients' preferences for subcutaneous trastuzumab versus conventional intravenous infusion for the adjuvant treatment of HER2-positive early breast cancer: final analysis of 488 patients in the international, randomized, two-cohort PrefHer study

BACKGROUND: Patients with HER2-positive early breast cancer (EBC) preferred subcutaneous (SC) trastuzumab, delivered via single-use injection device (SID), over the intravenous (IV) formulation (Cohort 1 of the PrefHer study: NCT01401166). Here we report patient preference, healthcare professional satisfaction, and safety data pooled from Cohort 1 and also Cohort 2, where SC trastuzumab was delivered via hand-held syringe. PATIENTS AND METHODS: Patients were randomized to receive 4 adjuvant cycles of 600 mg fixed-dose SC trastuzumab followed by 4 cycles of standard IV trastuzumab, or vice versa. The primary endpoint was overall preference proportions for SC or IV, assessed by patient interviews in the evaluable ITT population. RESULTS: A total of 245 patients were randomized to receive SC followed by IV and 243 received IV followed by SC (evaluable ITT populations: 235 and 232 patients, respectively). SC was preferred by 415/467 (88.9%; 95% CI, 85.7-91.6; P<.0001; two-sided test against null hypothesis of 65% SC preference); 45/467 preferred IV (9.6%; 7-13); 7/467 indicated no preference (1.5%; 1-3). Clinician-reported adverse events occurred in 292/479 (61.0%) and 245/478 (51.3%) patients during the pooled SC and IV periods, respectively (P<.05; 2x2 chi2); 16 patients (3.3%) in each period experienced grade 3 events; none were grade 4/5. CONCLUSION: PrefHer revealed compelling and consistent patient preferences for SC over IV trastuzumab, regardless of SID or hand-held syringe delivery. SC was well tolerated and safety was consistent with previous reports, including the HannaH study (NCT00950300). No new safety signals were identified compared to the known IV profile in EBC. PrefHer and HannaH confirm that SC trastuzumab is a validated and preferred option over IV for improving patients' care in HER2-positive breast cancer

Assessment of Dissolution Profile of Marketed Aceclofenac Formulations

Statistical comparison of dissolution profiles under a variety of conditions relating to formulation characteristics, lot-to-lot, and brand-to-brand variation attracts interest of pharmaceutical scientist. The objective of this work is to apply several profile comparison approaches to the dissolution data of five-marketed aceclofenac tablet formulations. Model-independent approaches including ANOVA-based procedures, ratio test procedure, and pair wise procedure. The ratio test includes percentage, area under the curve, mean dissolution time, while the pair wise procedure includes difference factor (f1), similarity factor (f2), and Rescigno index. In the model-dependent approach, zero order, first order, Hixson-Crowell, Higuchi, and Weibull models were applied to the utilization of fit factors. All the approaches were applicable and useful. ANOVA with multiple comparison tests was found to be sensitive and discriminating for comparing the profiles. Weibull parameters were more sensitive to the difference between two release kinetic data in terms of curve shape and level

Diagnosis of dementia in residential aged care settings in Australia: an opportunity for improvements in quality of care?

To examine the cognitive status of Australians living in residential aged care facilities (RACFs) and whether or not a dementia diagnosis was recorded.Cross-sectional study of 541 residents of 17 RACFs spanning four states. Examination of cognitive status by Psychogeriatric Assessment Scale Cognitive Impairment Scale (PAS-Cog) and dementia diagnosis from medical records.The study population included 65% of residents with a diagnosis of dementia recorded, and 83% had a PAS-Cog score of four or more indicating likely cognitive impairment. More than 20% of participants had likely cognitive impairment (PAS-Cog ≥4), but no diagnosis of dementia; 11% had moderate-to-severe cognitive impairment (PAS-Cog ≥10) but no recorded dementia diagnosis.There may be a lack of formal diagnosis of dementia in Australian RACFs. Greater efforts from all health professionals to improve diagnosis in this setting are required. This is an opportunity for improved person-centred care and quality of care in this vulnerable population.Suzanne M Dyer, Emmanuel S Gnanamanickam, Enwu Liu, Craig Whitehead Maria Crott