Poor Adherence With Medication Refill and Medical Supplies Maintenance as Risk Factors for Inpatient Asthma Admission in Children

Background. Asthma results in significant pediatric hospitalizations in the inner city. Many asthmatic children were admitted to our hospital as a result of lack of medications or medical supplies that had been previously prescribed ( ran out, broken, or lost ). Objective. To identify the incidence of children admitted for asthma because of lack of prescribed medications/supplies and to assess risk factors for poor adherence between groups. Methods. This was a prospective chart review of 200 asthmatic children admitted to Children\u27s Hospital of Michigan, Detroit. The data included asthma severity, lack of prescribed medications/medical supplies, and outpatient management. Results. In all, 35.5% or 71/200 of asthmatic children admitted had lack of prescribed medication/supplies (9% lacked both). The most common deficiency was β2-agonist (20.5%; 41/200). Teenagers had the highest lack of medications/medical supplies (55.6%; 5/9) compared with toddlers (17.2%; 16/93) and preschoolers (17.9%; 5/28). Patients with severe persistent asthma had a higher incidence of lacking medicine (31.8%; 7/22) compared with 25% (14/56) with moderate persistent asthma and 23.4% (15/64) of mild asthmatics. We found the lack of asthma medical supplies, including nonfunctioning or lost nebulizers/spacers, in 44.4% (4/9) of teenagers, 17.2% (16/93) of toddlers, and 21.4% (6/28) of preschool-aged children. We found no significant difference in these deficiencies whether patients were managed by asthma specialists or primary care providers. Conclusions. Significant numbers of asthmatic children admitted reported lack of prescribed medications/medical supplies. The most severe asthmatics were most likely to run out of medications. Interventions targeted at these deficiencies may avoid hospitalizations

Space Laboratory Mission Simulation and Test in a Closed Ecological System

The design, development, and management of advance manned space systems wiU be facilitated through the use of mission simulation techniques. These techniques are being used in the Space Cabin Simulator prograia which has been initiated at the Douglas Aircraft Company. The first phase of this program has recently been completed. In this phase, a four man crew accomplished a 30 day mission vhile confined in a double vailed space chamber which duplicates projected space cabin conditions. This mission simulation was quite successful in many respects. Some results of this phase are presented and future phases of the program are discussed

Introduction: looking beyond the walls

In its consideration of the remarkable extent and variety of non-university researchers, this book takes a broader view of ‘knowledge’ and ‘research’ than in the many hot debates about today’s knowledge society, ‘learning age’, or organisation of research. It goes beyond the commonly held image of ‘knowledge’ as something produced and owned by the full-time experts to take a look at those engaged in active knowledge building outside the university walls

Utilizing an interim futility analysis of the OVAL study (VB-111-701/GOG 3018) for potential reduction of risk: A phase III, double blind, randomized controlled trial of ofranergene obadenovec (VB-111) and weekly paclitaxel in patients with platinum resistant ovarian cancer

OBJECTIVE: Report the results from a preplanned interim analysis of a phase III, double blind, randomized controlled study of ofranergene obadenovec (VB-111), a targeted anti-cancer gene therapy, in combination with paclitaxel in patients with platinum resistant ovarian cancer (PROC). METHODS: The OVAL (NCT03398655) study is an on-going study where patients are randomly assigned in a 1:1 ratio to weekly paclitaxel 80 mg/m2 with VB-111 or placebo. The protocol specifies a pre-planned unblinded futility interim analysis of CA-125 response per GCIG criteria in the first 60 evaluable patients. The futility rule determined for this analysis was that the response rate of VB-111 must be greater than the response rate of placebo by at least 10% in order to continue the study. Coincident with the interim analysis, the blinded CA-125 response rate was estimated as a proportion of the first 60 evaluable patients with CA-125 response per GCIG criteria. Post-treatment fever is provided as a possible surrogate marker of VB-111 therapy activity. RESULTS: The median age of the evaluable patients was 62 years (range 41-82); 97% had high-grade serous cancer; 58% had been treated with 3 or more previous lines of therapy, 70% received prior anti-angiogenic treatment, 43% received prior PARP inhibitors. CA-125 response in the VB-111 and weekly paclitaxel treated arm met the pre-specified interim criterion of an absolute advantage of 10% or higher compared to the control. Blinded results show a 53% CA-125 response rate (32/60) with 15% complete response (n=9). Assuming balanced randomization and an absolute advantage of 10% or higher to the VB-111 arm, it may be deducted that the response in the VB-111 treatment arm is 58% or higher. Among patients with post-treatment fever, the CA-125 response rate was 69%. CONCLUSIONS: At the time of the interim analysis, response rate findings are comparable to the responses seen in a similar patient population in the phase I/II study. The independent data and safety monitoring committee (iDSMC) recommended continuing the OVAL trial as planned. No new safety signals were identified

A novel business strategies framework of do-it-yourself practices in logistics to minimise environmental waste and improve performance

The transportation sector is consuming a high quantity of oil and producing air pollution, CO2 and allergies, as well as promoting the storage of goods in traditional warehouses. It is not only creating waste and environmental pollution but also increasing temperature, air pollution and low rainfall. The present study intends to uncover and understand the challenges of logistic infrastructure as well as how the adoption of do-it-yourself (DIY) business strategies is useful to encourage those practices and technology which are useful in transforming the logistic infrastructure into an eco-friendly environment. The DIY focuses on purposely utilising digital technologies to increase the engagement and involvement of customers in businesses. Moreover, DIY enables organisations to produce products and services that are highly demanded and have high acceptability. After doing an extensive literature review, the enablers of DIY are identified, and empirical investigation has been conducted. The analysis of the study provides a business strategies framework of DIY which would help the logistics managers in the proper implementation of the DIY practices to minimise negative environmental impact and improve business performance

Scientific publishing and the reading of science in nineteenth-century Britain: a historiographical survey and guide to sources

[FIRST PARAGRAPH] It is now generally accepted that both the conception and practices of natural enquiry in the Western tradition underwent a series of profound developments in the late eighteenth and early nineteenth century—developments which have been variously characterized as a ‘second scientific revolution’ and, much more tellingly, as the ‘invention of science’. As several authors have argued, moreover, a crucial aspect of this change consisted in the distinctive audience relations of the new sciences. While eighteenth-century natural philosophy was distinguished by an audience relation in which, as William Whewell put it, ‘a large and popular circle of spectators and amateurs [felt] themselves nearly upon a level, in the value of their trials and speculations, with more profound thinkers’, the science which was invented in the late eighteenth and early nineteenth century was, as Simon Schaffer has argued, marked by the ‘emergence of disciplined, trained cadres of research scientists’ clearly distinguished from a wider, exoteric public. Similarly, Jan Golinski argues that the ‘emergence of new instrumentation and a more consolidated social structure for the specialist community’ for early nineteenth-century chemistry was intimately connected with the transformation in the role of its public audience to a condition of relative passivity. These moves were underpinned by crucial epistemological and rhetorical shifts—from a logic of discovery, theoretically open to all, to a more restrictive notion of discovery as the preserve of scientific ‘genius’, and from an open-ended philosophy of ‘experience’ to a far more restrictive notion of disciplined ‘expertise’. Both of these moves were intended to do boundary work, restricting the community active in creating and validating scientific knowledge, and producing a passive public