Patient reported outcome measures for allergy and asthma in children:PROMS for allergy and asthma in children

There is increasing recognition of the importance of patient's perceptions of disease and their assessments of heathcare processes. Patient‐reported outcome measures (PROMs) are therefore now regarded as at least as important as the traditional objective measures of disease. For minors, parental and, except in the very young and severally cognitively impaired, the child's perspectives are important because they provide unique and complementary information. In this review, we summarize the evidence on PROMs for allergy and asthma for use in children. Overall, there are fewer PROMs available for use in children than in adults. We were able to identify some validated pediatric PROMs that have been developed for use in atopic eczema/dermatitis, food allergy, allergic rhinitis/rhinoconjunctivitis, and asthma. There is very limited evidence on deploying these instruments out with research settings. There is therefore a pressing need to report on the experiences of using PROMs for allergy and asthma in routine clinical care. In particular, there is a need to understand how acceptable these are to children/carers, whether they can be incorporated into routine clinical assessments and if they are responsive to changes in treatment made in routine clinical practice

Water-loss dehydration and aging

This review defines water-loss and salt-loss dehydration. For older people serum osmolality appears the most appropriate gold standard for diagnosis of water-loss dehydration, but clear signs of early dehydration have not been developed. In older adults, lower muscle mass, reduced kidney function, physical and cognitive disabilities, blunted thirst, and polypharmacy all increase dehydration risk. Cross-sectional studies suggest a water-loss dehydration prevalence of 20-30% in this population. Water-loss dehydration is associated with higher mortality, morbidity and disability in older people, but evidence is still needed that this relationship is causal. There are a variety of ways we may be able to help older people reduce their risk of dehydration by recognising that they are not drinking enough, and being helped to drink more. Strategies to increase fluid intake in residential care homes include identifying and overcoming individual and institutional barriers to drinking, such as being worried about not reaching the toilet in time, physical inability to make or to reach drinks, and reduced social drinking and drinking pleasure. Research needs are discussed, some of which will be addressed by the FP7-funded NU-AGE (New dietary strategies addressing the specific needs of elderly population for a healthy ageing in Europe) trial

Comment Letters to proposed statement on standards for attestation engagements : Management\u27s discussion and analysis

https://egrove.olemiss.edu/aicpa_sas/1108/thumbnail.jp

Equivalence and noninferiority trials – are they viable alternatives for registration of new drugs? (III)

The scientific community's reliance on active-controlled trials is steadily increasing, as widespread agreement emerges concerning the role of these trials as viable alternatives to placebo trials. These trials present substantial challenges with regard to design and interpretation as their complexity increases, and the potential need for larger sample sizes impacts the cost and time variables of the drug development process. The potential efficacy and safety benefits derived from these trials may never be demonstrated by other methods. Active-controlled trials can develop valuable data to inform both prescribers and patients about the dose- and time-dependent actions of any new drug and can contribute to the management and communication of risks associated with the relevant therapeutic products

The use of interim data and Data Monitoring Committee recommendations in randomized controlled trial reports: frequency, implications and potential sources of bias

Background: Interim analysis of accumulating trial data is important to protect participant safety during randomized controlled trials (RCTs). Data Monitoring Committees (DMCs) often undertake such analyses, but their widening role may lead to extended use of interim analysis or recommendations that could potentially bias trial results.Methods: Systematic search of eight major publications: Annals of Internal Medicine, BMJ, Circulation, CID, JAMA, JCO, Lancet and NEJM, including all randomised controlled trials ( RCTs) between June 2000 and May 2005 to identify RCTs that reported use of interim analysis, with or without DMC involvement. Recommendations made by the DMC or based on interim analysis were identified and potential sources of bias assessed. Independent double data extraction was performed on all included trials.Results: We identified 1772 RCTs, of which 470 (27%; 470/1772) reported the use of a DMC and a further 116 (7%; 116/1772) trials reported some form of interim analysis without explicit mention of a DMC. There were 28 trials ( 24 with a formal DMC), randomizing a total of 79396 participants, identified as recommending changes to the trial that may have lead to biased results. In most of these, some form of sample size re-estimation was recommended with four trials also reporting changes to trial endpoints. The review relied on information reported in the primary publications and methods papers relating to the trials, higher rates of use may have occurred but not been reported.Conclusion: The reported use of interim analysis and DMCs in clinical trials has been increasing in recent years. It is reassuring that in most cases recommendations were made in the interest of participant safety. However, in practice, recommendations that may lead to potentially biased trial results are being made

The emergence of circular economy: a new framing around prolonging resource productivity

In this article we use Hirsch and Levin’s (1999) notion of ‘umbrella concepts’ as an analytical lens, in order to articulate the valuable catalytic function the circular economy concept could perform in the waste and resource management debate. We realize this goal by anchoring the circular economy concept in this broader debate through a narrative approach. This leads to the insight that while the various resource strategies grouped under circular economy’s banner are not new individually, the concept offers a new framing of these strategies by drawing attention to their capacity of prolonging resource use as well as to the relationship between these strategies. As such, circular economy offers a new perspective on waste and resource management and provides a new cognitive unit and discursive space for debate. We conclude by discussing research opportunities for the IE community relating to the concept’s theoretical development and its implementation. Specifically, we pose that reinvigorating and growing the social science aspects of IE is required for both. After all, it is the wide adoption and collective implementation of an idea that shapes our material future

Modelling a Historic Oil-Tank Fire Allows an Estimation of the Sensitivity of the Infrared Receptors in Pyrophilous Melanophila Beetles

Pyrophilous jewel beetles of the genus Melanophila approach forest fires and there is considerable evidence that these beetles can detect fires from great distances of more than 60 km. Because Melanophila beetles are equipped with infrared receptors and are also attracted by hot surfaces it can be concluded that these infrared receptors are used for fire detection