Establishing the relationship of inhaler satisfaction, treatment adherence, and patient outcomes : A prospective, real-world, cross-sectional survey of US adult asthma patients and physicians

Date of Acceptance: 26/06/2015 Acknowledgements The disease-specific program, on which the analyses were based, was designed and run by Adelphi Real World. The program was supported by a number of pharmaceutical companies, including Meda Pharmaceuticals. This specific analysis, together with this publication, was supported by Meda Pharmaceuticals. The decision to publish was made jointly by all authors cited. Medical writing support and literature searching was provided by Carole Alison Chrvala, PhD of Health Matters, Inc.Peer reviewedPublisher PD

CALIPER database of paediatric reference intervals: key milestones and future directions

Accurately established reference intervals are essential to interpret laboratory test results and assess patient health. Poorly established reference intervals can lead to misdiagnosis, subjecting patients to anxiety, unnecessary testing, and/or infection risk. The clinical importance of reference intervals is well recognised. However, establishing robust reference intervals is a complex process, especially for the paediatric population. Therefore, available reference intervals are often incomplete, cover a limited paediatric age interval, and/or do not consider gender differences. CALIPER, a collaborative study among Canadian paediatric centres, is addressing these critical gaps by determining age- and sex-specific paediatric reference intervals for over 80 biomarkers using samples collected from over 8,500 children and adolescents. These reference intervals established on the Abbott ARCHITECT have been transferred to other major analytical platforms, broadening the utility of the CALIPER database. The effect of diurnal variation, post-prandial effects, biological variation, and storage temperature on analyte concentration has also been assessed. Knowledge translation initiatives, including peer-reviewed publications, an online database, and a smartphone application, allow physicians and laboratory technicians worldwide to easily access the CALIPER database. This project has made great progress in addressing critical knowledge gaps in paediatric reference intervals, ultimately benefiting paediatric healthcare across Canada and globally

Impact of night-time symptoms in COPD : a real-world study in five European countries

Peer reviewedPublisher PD

San Luis Obispo Children\u27s Museum: The Circuit Lab

Executive Summary Over a nine month period, the senior project team worked closely with the San Luis Obispo Children’s Museum to develop a new interactive exhibit for the museum’s Science, Technology, Engineering, and Mathematics (STEM) floor. The initial budget given for this project was $3,000. The museum’s requirements for a new exhibit were that it must be safe for young children to use, require minimal supervision, is interactive, has learning objectives, and is economically feasible and sustainable. The team chose to build an exhibit that would teach young children about simple circuitry and electronics. First, extensive research of circuits, children’s museums, children\u27s safety laws and practices, attention span of the relevant age group of children, and existing solutions was completed in order to build a strong background on the topic. An observational time study was also done at the SLO Children’s Museum to gather more information about the end user. Next, a conceptual model of the exhibit was formed. Through an iterative design process, the team developed multiple functional prototypes and conducted electronic testing to reach a final design. The exhibit is made up of three interactive stations that each teaches a unique concept. The stations include an interface that requires user input to cause a response. The first station teaches how different resistance affects a circuit, namely, Ohm’s Law. At this station, the user compares the effect a big resistor and a small resistor would have on a circuit involving an LED fan. The second station teaches the concept of completing a circuit in order to function correctly. Here, the user builds a circuit using childproofed custom pieces that will, if done correctly, illuminate an electroluminescent (EL) wire that is outlined in the shape of a volcano. The third station teaches the idea of electronics and circuits being a part of everyday life. This station is a plexi-glass display that includes everyday devices opened up to show their internal circuitry and wiring. In addition, the team also worked with the museum to construct effective and simplified signage that would instruct the user on how to interact with the exhibit. The exhibit is scheduled to be open by July of 2015. Furthermore, in order for the exhibit to be maintained, the team has built numerous, interchangeable spare parts and have given design specifications and a build manual to the museum to refer to. Ultimately, the team was successful in staying within the budget by only spending$388.62 overall

Evaluating the Role of Nuclear Energy in Virginia’s Zero-Carbon Electricity Future

Virginia faces unprecedented load growth due to data center development in Dominion territory, a phenomenon which significantly complicates the state’s commitment to a zero-carbon electricity mix and creates enormous risk for Dominion ratepayers. This paper seeks to present stakeholders with a clear sense of the benefits and challenges of meeting surging demand with and without new nuclear facilities. First, I analyze Dominion’s 2023 Integrated Resource Plan to demonstrate the scale of the demand surge and the exorbitant cost of non-compliance with state climate laws. While alternative plans are presented, I find that they ignore real-world factors like local solar opposition and the eventual retirement of the state’s extensive natural gas generation fleet and nuclear plants. Two theoretical portfolios are examined – one which meets Virginia’s 2045 demand with only existing nuclear, variable renewable energy (VRE), and battery storage; and one which incorporates new nuclear. The VRE-reliant portfolio provides material economic benefits, but presents a greater reliability risk and is significantly more land-intensive. I conclude that to meet state climate goals while meeting demand affordably, a) utility planning processes must be more transparent and inclusive; b) local solar bans should be eliminated, while preserving localities ability to consider proposals on a project-by-project basis; c) the state should not permit utilities to gamble on major new nuclear projects in the short-term, and d) community engagement and planning should begin for new nuclear facilities in the medium-term as the demand picture and the economics of new nuclear become clearer

The relationship between zinc intake and serum/plasma zinc concentration in adults: a systematic review and dose–response meta-analysis by the EURRECA Network

Dietary zinc recommendations vary widely across Europe due to the heterogeneity of pproaches used by expert panels. Under the EURRECA consortium a protocol was designed to systematically review and undertake meta-analyses of research data to create a database that includes “best practice” guidelines which can be used as a resource by future panels when setting micronutrient recommendations. As part of this process, the objective of the present study was to undertake a systematic review and meta-analysis of previously published data describing the relationship between zinc intake and status in adults. Searches were performed of literature published up to February 2010 using MEDLINE, Embase, and Cochrane Library. Data extracted included population characteristics, dose of zinc, duration of study, dietary intake of zinc, and mean concentration of zinc in plasma or serum at the end of the intervention period. An intake-status regression coefficient was estimated for each individual study, and pooled meta-analysis undertaken. The overall pooled for zinc supplementation on serum/plasma zinc concentrations from RCTs and observational studies was 0.08 (95% CI 0.05, 0.11; p<0.0001; I2 84.5%). An overall of 0.08 means that for every doubling in zinc intake, the difference in zinc serum or plasma concentration is (20.08 = 1.06), which is 6%. Whether the dose-response relationship, as provided in this paper, could be used as either qualitative or quantitative evidence to substantiate the daily zinc intake dose necessary to achieve normal or optimal levels of biomarkers for zinc status, remains a matter of discussion

‘Repeat abortion’, a phrase to be avoided? Qualitative insights into labelling and stigma

Background In recent years there has been growing international interest in identifying risk factors associated with ‘repeat abortion’, and developing public health initiatives that might reduce the rate. This article draws on a research study looking at young women's abortion experience in England and Wales. The study was commissioned with a specific focus on women who had undergone more than one abortion. We examine what may influence women's post-abortion reproductive behaviour, in addition to exploring abortion-related stigma, in the light of participants' own narratives. Study design Mixed-methods research study: a quantitative survey of 430 women aged 16–24 years, and in-depth qualitative interviews with 36 women who had undergone one or more abortions. This article focuses on the qualitative data from two subsets of young women: those we interviewed twice (n=17) and those who had experienced more than one unintended/unwanted pregnancy (n=15). Results The qualitative research findings demonstrate the complexity of women's contraceptive histories and reproductive lives, and thus the inherent difficulty of establishing causal patterns for more than one abortion, beyond the obvious observation that contraception was not used, or not used effectively. Women who had experienced more than one abortion did, however, express intensified abortion shame. Conclusions This article argues that categorising women who have an abortion in different ways depending on previous episodes is not helpful. It may also be damaging, and generate increased stigma, for women who have more than one abortion

A systematic review of non-pharmacological interventions for primary Sjögren’s syndrome

The objective of this systematic review was to assess the efficacy of non-pharmacological interventions for the management of primary Sjögren’s syndrome. We searched the following databases from inception to September 2014; Cochrane Database of Systematic Reviews; Medline; Embase; PsychINFO; Cinahl and clinical trials registers. We included randomised controlled trials of any non-pharmacological interventions. Two review authors independently reviewed titles and abstracts against the inclusion/exclusion criteria and independently assessed trial quality and extracted data. 1463 studies were identified of which 17 full text articles were screened and 5 studies were included in the review with a total of 130 participants randomised. The included studies investigated effectiveness of an oral lubricating device for dry mouth, acupuncture for dry mouth, lacrimal punctum plugs for dry eyes and psychodynamic group therapy for coping with symptoms. Overall the studies were of low quality and at high risk of bias. Although one study showed punctum plugs to improve dry eyes it was too small for the findings to be conclusive. Overall we identified no evidence to support any non-pharmacological interventions to improve PSS. The area needs quality large randomised controlled trials that are reported according to CONSORT guidelines and address important issues to patients