Inhaled corticosteroids for asthma: are they all the same?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72783/1/j.1365-2710.2008.00970.x.pd

Palliative chemotherapy beyond three courses conveys no survival or consistent quality-of-life benefits in advanced non-small-cell lung cancer

This randomised multicentre trial was conducted to establish the optimal duration of palliative chemotherapy in advanced non-small-cell lung cancer (NSCLC). We compared a policy of three vs six courses of new-generation platinum-based combination chemotherapy with regard to effects on quality of life (QoL) and survival. Patients with stage IIIB or IV NSCLC and WHO performance status (PS) 0–2 were randomised to receive three (C3) or six (C6) courses of carboplatin (area under the curve (AUC) 4, Chatelut's formula, equivalent to Calvert's AUC 5) on day 1 and vinorelbine 25 mg m−2 on days 1 and 8 of a 3-week cycle. Key end points were QoL at 18 weeks, measured with EORTC Quality of Life Questionnaire (QLQ)-C30 and QLQ-LC13, and overall survival. Secondary end points were progression-free survival and need of palliative radiotherapy. Two hundred and ninety-seven patients were randomised (C3 150, C6 147). Their median age was 65 years, 30% had PS 2 and 76% stage IV disease. Seventy-eight and 54% of C3 and C6 patients, respectively, completed all scheduled chemotherapy courses. Compliance with QoL questionnaires was 88%. There were no significant group differences in global QoL, pain or fatigue up to 26 weeks. The dyspnoea palliation rate was lower in the C3 arm at 18 and 26 weeks (P<0.05), but this finding was inconsistent across different methods of analysis. Median survival in the C3 group was 28 vs 32 weeks in the C6 group (P=0.75, HR 1.04, 95% CI 0.82–1.31). One- and 2-year survival rates were 25 and 9% vs 25 and 5% in the C3 and C6 arm, respectively. Median progression-free survival was 16 and 21 weeks in the C3 and C6 groups, respectively (P=0.21, HR 0.86, 95% CI 0.68–1.08). In conclusion, palliative chemotherapy with carboplatin and vinorelbine beyond three courses conveys no survival or consistent QoL benefits in advanced NSCLC

The state of the evidence base for psychodynamic psychotherapy for children and adolescents

This article reviews outcomes of psychodynamic psychotherapy (PP) for children and adolescents reported in articles identified by a comprehensive review of the literature on treatment evaluations of psychological and medical interventions for mental disorders in pediatric populations. The review identified 48 reports based on 33 studies. While there is evidence of substantial clinical gains associated with PP, in almost all the studies, when contrasted with family-based interventions, PP fares no better and appears to produce outcomes with some delay relative to family-based therapies. Further rigorous evaluations are needed, but evidence to date suggests that the context in which PP is delivered should be extended from the traditional context of individual therapy and parents should be included in the treatment of children

Mikrokreditt - Hvem vil anvende det produktivt og hvorfor?

Da mikrokreditt først oppstod var det et mål å gi fattige tilgang på smålån slik at de på sikt kunne løftes ut av fattigdom ved å investere i produktive prosjekt, men i ettertid har det vist seg at mange ikke bruker mikrokreditt til dette formålet. I denne oppgaven ønsker jeg å undersøke hvem som anvender mikrokreditt produktivt, og hvorfor. Oppgaven er delt inn i en teoretisk del (kapittel 2-4) og en empirisk del (kapittel 5-7). I den teoretiske delen diskuterer jeg hva mikrokreditt er og hva både eldre og nyere forskning sier om hvordan mikrokreditt påvirker de fattige. I den empiriske delen ønsker jeg å studere hva som kjennetegner de som anvender mikrokreditt produktivt/ikke-produktivt. Jeg benytter Heckmans seleksjonsmodell og dataprogrammet Stata når jeg analyserer empirien. I den teoretiske delen finner jeg fra nyere studier at mikrokreditt i gjennomsnitt ikke har den effekten man i starten hadde håpet på, og mye tyder på at de fleste fattige anvender mikrokreditt til konsumutjevning og ikke inntektsgenererende formål. I den empiriske delen finner jeg at sårbarhet1 spiller en vesentlig rolle med hensyn til produktiv anvendelse av mikrokreditt. Selv om mikrokreditt er ment for de mest sårbare er det mange som ikke har mulighet, eller ikke klarer, å anvende mikrokreditt slik som det i utgangspunktet var tenkt