Long-term safety and efficacy of trifarotene 50 μg/g cream, a first-in-class RAR-γ selective topical retinoid, in patients with moderate facial and truncal acne.

BackgroundTreatment for both facial and truncal acne has not sufficiently been studied.ObjectivesTo evaluate the long-term safety and efficacy of trifarotene in both facial and truncal acne.MethodsIn a multicentre, open-label, 52-week study, patients with moderate facial and truncal acne received trifarotene 50 μg/g cream (trifarotene). Assessments included local tolerability, safety, investigator and physician's global assessments (IGA, PGA) and quality of life (QOL). A validated QOL questionnaire was completed by the patient at Baseline, Week 12, 26 and 52/ET.ResultsOf 453 patients enrolled, 342 (75.5%) completed the study. Trifarotene-related treatment-emergent adverse events (TEAEs) were reported in 12.6% of patients, and none was serious. Most related TEAEs were cutaneous and occurred during the first 3 months. Signs and symptoms of local tolerability were mostly mild or moderate and severe signs, and symptoms were reported for 2.2% to 7.1% of patients for the face and 2.5% to 5.4% for the trunk. Local irritation increased during the first week of treatment on the face and up to Weeks 2 to 4 on the trunk with both decreasing thereafter. At Week 12, IGA and PGA success rates were 26.6% and 38.6%, respectively. Success rates increased to 65.1% and 66.9%, respectively at Week 52. Overall success (both IGA and PGA success in the same patient) was 57.9% at Week 52. At Week 52 visit, 92/171 (53.8%) patients who had completed their assessments had scores from 0 to 1 (i.e. no effect of acne on their QOL) vs. 47/208 (22.6%) patients at Baseline visit.ConclusionIn this 52-week study, trifarotene was safe, well tolerated and effective in moderate facial and truncal acne

Recruitment, Retention, and Future Direction for a Heart Health Education and Risk Reduction Intervention Led by Community Health Workers in an African American Majority City

Heart disease is a leading cause of death for African Americans. A community-academic partnership cross-trained community health workers to engage African American adults in a 6-month heart health education and risk reduction intervention. We conducted a one-group feasibility study using a one group (pre-posttest) design. A total of 100 adults were recruited from 27 zip codes in an African American majority city through community-based organizations (46%), churches (36%), and home visits (12%). Ninety-six percent were African American; 55% were female, 39% were male, and 6% were transgender. Their mean age was 44.6 years (SD=15.9). Ninety-two percent had health insurance. Seventy-six percent of participants averaged blood pressure (BP) readings\u3e130/80 mmHg. Eleven percent of participants had a 30% or higher probability of developing cardiovascular disease in the next 10 years. Six-month follow-up was completed with 96% of participants. There were statistically significant increases in knowledge and in perception of personal risk for heart disease. However, slightly more participants (n=77, 80.2%) had BP\u3e130/80 mmHg. The Community Advisory Group recommended expanding the intervention to 12 months and incorporating telehealth with home BP monitoring. Limited intervention duration did not meet longer term objectives such as better control of high BP and sharing risk reduction planning with primary care providers

Exploring leadership in multi-sectoral partnerships

This article explores some critical aspects of leadership in the context of multi-sectoral partnerships. It focuses on leadership in practice and asks the question, `How do managers experience and perceive leadership in such partnerships?' The study contributes to the debate on whether leadership in a multi-sectoral partnership context differs from that within a single organization. It is based on the accounts of practising managers working in complex partnerships. The article highlights a number of leadership challenges faced by those working in multi-sectoral partnerships. Partnership practitioners were clear that leadership in partnerships was more complex than in single organizations. However, it was more difficult for them to agree a consensus on the essential nature of leadership in partnership. We suggest that a first-, second- and third-person approach might be a way of better interpreting leadership in the context of partnerships

The illusion of competency versus the desirability of expertise: Seeking a common standard for support professions in sport

In this paper we examine and challenge the competency-based models which currently dominate accreditation and development systems in sport support disciplines, largely the sciences and coaching. Through consideration of exemplar shortcomings, the limitations of competency-based systems are presented as failing to cater for the complexity of decision making and the need for proactive experimentation essential to effective practice. To provide a better fit with the challenges of the various disciplines in their work with performers, an alternative approach is presented which focuses on the promotion, evaluation and elaboration of expertise. Such an approach resonates with important characteristics of professions, whilst also providing for the essential ‘shades of grey’ inherent in work with human participants. Key differences between the approaches are considered through exemplars of evaluation processes. The expertise-focused method, although inherently more complex, is seen as offering a less ambiguous and more positive route, both through more accurate representation of essential professional competence and through facilitation of future growth in proficiency and evolution of expertise in practice. Examples from the literature are also presented, offering further support for the practicalities of this approach

Leading school networks, hybrid leadership in action?

A range of different constructs are used to describe and define the way that leadership operates in education settings. This range can be presented as binary categories of leadership, in which either one, or the other form of leadership is preferred, but not both. An example of this is the contrast made between solo and distributed leadership. A more sophisticated alternative has been proposed, which is to consider leadership as a hybrid activity, one which entails a range of approaches inspired by varying ideals. Taking this ‘hybrid’ notion of leadership this article explores the nature of leadership in networks of schools. Illustrated with data from three case studies of school networks this article highlights some of the issues and tensions in the enactment of the hybrid forms of leadership encountered in these networks. This article concludes with some reflections on the adoption of hybrid notions of leadership in researching and enacting educational leadership and specifically on the place of school networks in that consideration

Histone deacetylases as new therapy targets for platinum-resistant epithelial ovarian cancer

Introduction: In developed countries, ovarian cancer is the fourth most common cancer in women. Due to the nonspecific symptomatology associated with the disease many patients with ovarian cancer are diagnosed late, which leads to significantly poorer prognosis. Apart from surgery and radiotherapy, a substantial number of ovarian cancer patients will undergo chemotherapy and platinum based agents are the mainstream first-line therapy for this disease. Despite the initial efficacy of these therapies, many women relapse; therefore, strategies for second-line therapies are required. Regulation of DNA transcription is crucial for tumour progression, metastasis and chemoresistance which offers potential for novel drug targets. Methods: We have reviewed the existing literature on the role of histone deacetylases, nuclear enzymes regulating gene transcription. Results and conclusion: Analysis of available data suggests that a signifant proportion of drug resistance stems from abberant gene expression, therefore HDAC inhibitors are amongst the most promising therapeutic targets for cancer treatment. Together with genetic testing, they may have a potential to serve as base for patient-adapted therapies

Transfer of training in an academic leadership development program for program coordinators

The higher education sector has increasingly begun to pay more attention to academic leadership. This qualitative study explores how such an investment in a 20-week leadership development program influenced the behaviour of 10 academic staff in the role of program coordinator 6 to 12 months following participation in the program. Otherwise known as program directors or department chairs, academic staff in this role are responsible for coordinating and leading degree courses or programs. Leadership learning and changes in the behaviour of program coordinators was evident, particularly in regard to building influence, communicating more effectively and managing upwards. Improved confidence in their ability to perform the role was a lasting outcome and the use of peer learning and coaching was an important part of the success of the intervention. However, workload factors, succession planning and orientation were seen to be factors that impact on leadership development in this role. The findings suggest that participation in well designed academic leadership programs can result in a lasting transfer of training for program coordinators