Establishing and Prioritising Research Questions for the Treatment of Alopecia Areata: The Alopecia Areata Priority Setting Partnership

BACKGROUND: Alopecia areata is a common hair loss disorder that results in patchy to complete hair loss. Many uncertainties exist around the most effective treatments for this condition. OBJECTIVES: To identify uncertainties in alopecia areata management and treatment that are important to both service users (people with hair loss, carers and relatives) and healthcare professionals. METHODS: An alopecia areata priority setting partnership was established between patients, their carers and relatives, and healthcare professionals to identify the most important uncertainties in alopecia areata. The methodology of the James Lind Alliance was followed to ensure a balanced, inclusive and transparent process. RESULTS: In total 2747 treatment uncertainties were submitted by 912 participants, of which 1012 uncertainties relating to alopecia areata (and variants) were analyzed. Questions were combined into "indicative uncertainties" following a structured format. A series of ranking exercises further reduced this list to a top 25 that were taken to a final prioritization workshop where the top 10 priorities were agreed. CONCLUSIONS: We present the top 10 research priorities for alopecia areata to guide researchers and funding bodies to support studies important to both patients and clinicians. This article is protected by copyright. All rights reserved

Patterns of healthy lifestyle and positive health attitudes in older europeans.

Objectives: To determine (i) the extent to which recommended lifestyle healthy behaviors are adopted and the existence of positive attitudes to health; (ii) the relative influence of socio-demographic variables on multiple healthy lifestyle behaviors and positive attitudes to health; (iii) the association between healthy lifestyle behaviors and positive attitudes to health. Design: two distinct healthy behavioral measures were developed: (i) healthy lifestyles based on physical activity, no cigarette smoking, no/moderate alcohol drinking, maintaining a "healthy" weight and having no sleeping problems and (ii) positive health attitudes based on having positive emotional attitudes, such as: self-perceived good health status, being calm, peaceful and happy for most of the time, not expecting health to get worse and regular health check-ups. A composite healthy lifestyle index, ranging from 0 (none of behaviors met) to 5 (all behaviors met) was calculated by summing up the individual's scores for the five healthy lifestyle items. Afterwards, each individual's index was collapsed into three levels: 0-2 equivalent to 'level 1' (subjectively regarded as 'too low'), a score of 3 equivalent to 'level 2' ('fair') and 4-5 as 'level 3' satisfactory 'healthy lifestyle' practices. The same procedure was applied to the positive health attitudes index. Multinomial logistic regression analyses by a forward selection procedure were used to calculate the adjusted odds ratio (OR) with 95% confidence interval (95% CI). Participants: a multi-national sample consisting of 638 older Europeans from 8 countries, aged 65-74 and 75+, living alone or with others. Results and conclusions: maintaining a "healthy" weight was the most frequently cited factor in the healthy lifestyles index and therefore assumed to be the most important to the older Europeans in the study; positive attitudes to health were relatively low; participants achieved a 'satisfactory' level for healthy lifestyles index (level 3) more frequently than a satisfactory level for positive attitudes to health; having a satisfactory 'healthy lifestyle' was directly related to having a satisfactory level of positive attitudes to health based on the positive health attitudes index; income and geographical location in Europe appeared to be key predictors for meeting both the recommended healthy lifestyle factors in the index and having positive health attitudes however, the composition and nature of the study sample should be taken into consideration when considering the impact of the location on healthy lifestyles and attitudes to health across Europe

Luonnonhoitohankkeella kunnostettujen lähteiden ennallistuminen

Opinnäytetyössä tutkittiin, miten Pohjois-Karjalan metsäkeskuksen vuonna 2004 Pienvesiluonnon hoitohankkeella kunnostamat lähteet olivat ennallistuneet. Hankkeet ovat lyhytaikaisia, joten myöhempää jälkitarkastusta ei ehditä tekemään hankkeen aikana. Lähteistä kerättiin tietoja maastoinventointina. Tarkasteltavina asioina olivat lähteen sijainti, kunnostusmenetelmät ja niiden vaikutukset, lähdeallas ja myöhemmät metsänhoidolliset toimenpiteet. Lähteistä saatuja tietoja vertailtiin keskenään. Lähteiden varjostus oli keskimäärin huonontunut avohakkuiden ja myrskytuhojen takia, koska niiden myötä lähteitä varjostavia puita oli vähemmän. Vanhojen rakenteiden, kuten kaivonrenkaiden, poisto oli onnistunut hyvin. Kunnostuksen yhteydessä tehdyistä rakenteista 80 prosenttia oli täysin toimivia. Kunnostettujen lähteiden ennallistumisen seurannan helpottamiseksi lähteiltä tulisi kerätä tarkat tiedot ennen kunnostusta. Ennallistumista voitaisiin seurata omalla hankkeella tai metsäsuunnittelun yhteydessä.The purpose of this study was to investigate the recovery of the springs restored in a nature management project conducted by the Forest Centre of North Karelia in the year 2004. Projects of this nature are short-term and it is therefore necessary to monitor their effects. The data for this study was collected from all the springs restored in the nature management project. The location of the spring, restoration methods and their results, the spring pool as well as the forest management performed after the restoration were observed. The data were then analyzed. On average, the shading of the springs had worsened due to clear-cutting and storm damage, and there were thus fewer trees to cover the springs. Removal of old structures such as well rings had succeeded well. 80 per cent of the structures constructed in the restoration were fully functional. Detailed information on the springs should be collected before restoration to facilitate the monitoring of restored springs. The recovery could also be monitored in a separate project or within forest planning

Establishing and Prioritising Research Questions for the Treatment of Alopecia Areata: The Alopecia Areata Priority Setting Partnership.

BACKGROUND Alopecia areata is a common hair loss disorder that results in patchy to complete hair loss. Many uncertainties exist around the most effective treatments for this condition. OBJECTIVES To identify uncertainties in alopecia areata management and treatment that are important to both service users (people with hair loss, carers and relatives) and healthcare professionals. METHODS An alopecia areata priority setting partnership was established between patients, their carers and relatives, and healthcare professionals to identify the most important uncertainties in alopecia areata. The methodology of the James Lind Alliance was followed to ensure a balanced, inclusive and transparent process. RESULTS In total 2747 treatment uncertainties were submitted by 912 participants, of which 1012 uncertainties relating to alopecia areata (and variants) were analyzed. Questions were combined into "indicative uncertainties" following a structured format. A series of ranking exercises further reduced this list to a top 25 that were taken to a final prioritization workshop where the top 10 priorities were agreed. CONCLUSIONS We present the top 10 research priorities for alopecia areata to guide researchers and funding bodies to support studies important to both patients and clinicians. This article is protected by copyright. All rights reserved