The PlaceMarker Survey: A Place-Based Tool for Supporting the Monitoring and Appraisal of River-Related Projects and Natural Capital Assessments

The PlaceMarker Survey is an operational tool to support the delivery of the core aims of England’s Environment Agency (EA) in helping to increase resilience to climate change, manage flood risk, and create a better place for people and wildlife. It was developed in response to a recognised need by the EA’s National Environmental Assessment and Sustainability (NEAS) team for a broad-based survey undertaken in the field to get to know the site and prior to more specialist surveys. The key aim of the survey is to capture in a systematic and consistent way the character and condition of a place where river-related projects such as flood risk management and river restoration schemes are proposed to inform discussions around the design and planning of a project and provide the baseline for future place-based monitoring. The tool comprises: a Study Area Survey and one or more River Surveys, which provide measurements to generate metrics and information to support assessments of Habitat and Biodiversity, Landscape, Amenity, and Heritage. Data are stored, analysed, retrieved, shared, and displayed through a web-based information system. It is intended that a PlaceMarker Survey will be conducted on at least three occasions in the lifetime of a project or asset: pre-inception of a project to understand the broad environmental baseline and assist in the design of a scheme; immediately post-project to confirm the “as-built condition”; and post-recovery from the works to monitor the environmental response to interventions at the site. Tracking the assessments over time informs evaluations of environmental enhancements and supports decision-making around adaptive management

Multidisciplinary management of acromegaly: A consensus.

The 13th Acromegaly Consensus Conference was held in November 2019 in Fort Lauderdale, Florida, and comprised acromegaly experts including endocrinologists and neurosurgeons who considered optimal approaches for multidisciplinary acromegaly management. Focused discussions reviewed techniques, results, and side effects of surgery, radiotherapy, and medical therapy, and how advances in technology and novel techniques have changed the way these modalities are used alone or in combination. Effects of treatment on patient outcomes were considered, along with strategies for optimizing and personalizing therapeutic approaches. Expert consensus recommendations emphasize how best to implement available treatment options as part of a multidisciplinary approach at Pituitary Tumor Centers of Excellence

A consensus on the diagnosis and treatment of acromegaly comorbidities: an update

Objective: The aim of the Acromegaly Consensus Group was to revise and update the consensus on diagnosis and treatment of acromegaly comorbidities last published in 2013.Participants: The Consensus Group, convened by 11 Steering Committee members, consisted of 45 experts in the medical and surgical management of acromegaly. The authors received no corporate funding or remuneration.Evidence: This evidence-based consensus was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe both the strength of recommendations and the quality of evidence following critical discussion of the current literature on the diagnosis and treatment of acromegaly comorbidities.Consensus Process: Acromegaly Consensus Group participants conducted comprehensive literature searches for English-language papers on selected topics, reviewed brief presentations on each topic, and discussed current practice and recommendations in breakout groups. Consensus recommendations were developed based on all presentations and discussions. Members of the Scientific Committee graded the quality of the supporting evidence and the consensus recommendations using the GRADE system.Conclusions: Evidence-based approach consensus recommendations address important clinical issues regarding multidisciplinary management of acromegaly-related cardiovascular, endocrine, metabolic, and oncologic comorbidities, sleep apnea, and bone and joint disorders and their sequelae, as well as their effects on quality of life and mortality

A Consensus on the Diagnosis and Treatment of Acromegaly Comorbidities: An Update.

OBJECTIVE: The aim of the Acromegaly Consensus Group was to revise and update the consensus on diagnosis and treatment of acromegaly comorbidities last published in 2013. PARTICIPANTS: The Consensus Group, convened by 11 Steering Committee members, consisted of 45 experts in the medical and surgical management of acromegaly. The authors received no corporate funding or remuneration. EVIDENCE: This evidence-based consensus was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe both the strength of recommendations and the quality of evidence following critical discussion of the current literature on the diagnosis and treatment of acromegaly comorbidities. CONSENSUS PROCESS: Acromegaly Consensus Group participants conducted comprehensive literature searches for English-language papers on selected topics, reviewed brief presentations on each topic, and discussed current practice and recommendations in breakout groups. Consensus recommendations were developed based on all presentations and discussions. Members of the Scientific Committee graded the quality of the supporting evidence and the consensus recommendations using the GRADE system. CONCLUSIONS: Evidence-based approach consensus recommendations address important clinical issues regarding multidisciplinary management of acromegaly-related cardiovascular, endocrine, metabolic, and oncologic comorbidities, sleep apnea, and bone and joint disorders and their sequelae, as well as their effects on quality of life and mortality

A Consensus on the Diagnosis and Treatment of Acromegaly Comorbidities: An Update.

OBJECTIVE: The aim of the Acromegaly Consensus Group was to revise and update the consensus on diagnosis and treatment of acromegaly comorbidities last published in 2013. PARTICIPANTS: The Consensus Group, convened by 11 Steering Committee members, consisted of 45 experts in the medical and surgical management of acromegaly. The authors received no corporate funding or remuneration. EVIDENCE: This evidence-based Consensus was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe both the strength of recommendations and the quality of evidence following critical discussion of the current literature on the diagnosis and treatment of acromegaly comorbidities. CONSENSUS PROCESS: Acromegaly Consensus Group participants conducted comprehensive literature searches for English-language papers on selected topics, reviewed brief presentations on each topic, and discussed current practice and recommendations in breakout groups. Consensus recommendations were developed based on all presentations and discussions. Members of the Scientific Committee graded the quality of the supporting evidence and the consensus recommendations using the GRADE system. CONCLUSIONS: Evidence-based approach consensus recommendations address important clinical issues regarding multidisciplinary management of acromegaly-related cardiovascular, endocrine, metabolic, and oncologic comorbidities, sleep apnea, and bone and joint disorders and their sequelae, as well as their effects on quality of life and mortality

Consensus on diagnosis and management of Cushing's disease: a guideline update

reserved53siCushing's disease requires accurate diagnosis, careful treatment selection, and long-term management to optimise patient outcomes. The Pituitary Society convened a consensus workshop comprising more than 50 academic researchers and clinical experts to discuss the application of recent evidence to clinical practice. In advance of the virtual meeting, data from 2015 to present about screening and diagnosis; surgery, medical, and radiation therapy; and disease-related and treatment-related complications of Cushing's disease summarised in recorded lectures were reviewed by all participants. During the meeting, concise summaries of the recorded lectures were presented, followed by small group breakout discussions. Consensus opinions from each group were collated into a draft document, which was reviewed and approved by all participants. Recommendations regarding use of laboratory tests, imaging, and treatment options are presented, along with algorithms for diagnosis of Cushing's syndrome and management of Cushing's disease. Topics considered most important to address in future research are also identified.mixedFleseriu M.; Auchus R.; Bancos I.; Ben-Shlomo A.; Bertherat J.; Biermasz N.R.; Boguszewski C.L.; Bronstein M.D.; Buchfelder M.; Carmichael J.D.; Casanueva F.F.; Castinetti F.; Chanson P.; Findling J.; Gadelha M.; Geer E.B.; Giustina A.; Grossman A.; Gurnell M.; Ho K.; Ioachimescu A.G.; Kaiser U.B.; Karavitaki N.; Katznelson L.; Kelly D.F.; Lacroix A.; McCormack A.; Melmed S.; Molitch M.; Mortini P.; Newell-Price J.; Nieman L.; Pereira A.M.; Petersenn S.; Pivonello R.; Raff H.; Reincke M.; Salvatori R.; Scaroni C.; Shimon I.; Stratakis C.A.; Swearingen B.; Tabarin A.; Takahashi Y.; Theodoropoulou M.; Tsagarakis S.; Valassi E.; Varlamov E.V.; Vila G.; Wass J.; Webb S.M.; Zatelli M.C.; Biller B.M.K.Fleseriu, M.; Auchus, R.; Bancos, I.; Ben-Shlomo, A.; Bertherat, J.; Biermasz, N. R.; Boguszewski, C. L.; Bronstein, M. D.; Buchfelder, M.; Carmichael, J. D.; Casanueva, F. F.; Castinetti, F.; Chanson, P.; Findling, J.; Gadelha, M.; Geer, E. B.; Giustina, A.; Grossman, A.; Gurnell, M.; Ho, K.; Ioachimescu, A. G.; Kaiser, U. B.; Karavitaki, N.; Katznelson, L.; Kelly, D. F.; Lacroix, A.; Mccormack, A.; Melmed, S.; Molitch, M.; Mortini, P.; Newell-Price, J.; Nieman, L.; Pereira, A. M.; Petersenn, S.; Pivonello, R.; Raff, H.; Reincke, M.; Salvatori, R.; Scaroni, C.; Shimon, I.; Stratakis, C. A.; Swearingen, B.; Tabarin, A.; Takahashi, Y.; Theodoropoulou, M.; Tsagarakis, S.; Valassi, E.; Varlamov, E. V.; Vila, G.; Wass, J.; Webb, S. M.; Zatelli, M. C.; Biller, B. M. K

Multidisciplinary management of acromegaly: A consensus.

The 13th Acromegaly Consensus Conference was held in November 2019 in Fort Lauderdale, Florida, and comprised acromegaly experts including endocrinologists and neurosurgeons who considered optimal approaches for multidisciplinary acromegaly management. Focused discussions reviewed techniques, results, and side effects of surgery, radiotherapy, and medical therapy, and how advances in technology and novel techniques have changed the way these modalities are used alone or in combination. Effects of treatment on patient outcomes were considered, along with strategies for optimizing and personalizing therapeutic approaches. Expert consensus recommendations emphasize how best to implement available treatment options as part of a multidisciplinary approach at Pituitary Tumor Centers of Excellence