User evaluation of the first prototype of the interactive web tool EcoRunner

EcoRunner is an interactive web tool that has been designed to be the “best possible” modelling tool for portraying direct and indirect environmental effects of household metabolism when it comes to energy, carbon and nitrogen. This report analyses the first two steps of a pilot study evaluating households‟ reactions to, and use of, the tool. Participants were asked first to use EcoRunner to record their consumption of 115 different products and services into five main categories; housing, household purchases, leisure, transports and compensatory measures. Afterwards they were asked to answer six open-ended questions about their experiences in using the tool and to give suggestions for improvements. The results show that household purchases represent the largest part of money spent, and as a consequence also the largest flows of energy, carbon dioxide equivalents, and nitrogen. Households with children spent considerably more money per year on all consumption sectors, with the exception of compensatory measures. In general participants rated the testing exercise as interesting and the tool as user-friendly. However, the results also show a major contradiction; some respondents felt that the tool was too detailed and complex, whereas others wanted a more detailed level. The time period for consumption (yearly basis) was problematic for some users, and some stated that they would have preferred to use metric units to describe their consumption instead of a monetary unit. Some households asked for more items related to both compensatory measures and the non-formal economical sector. The results of these first two steps of the pilot study in evaluating EcoRunner have provided valuable and insightful information that will be used as guidelines in further refinements of the tool

EcoRunner : User Experiences of a Web Based Environmental Feedback Tool Addressing Household Consumption

Feedback is generally used to monitor progress toward different goals and standards in life, and to adjust behaviour accordingly. EcoRunner was developed as a web-based feedback tool providing environmental and financial information about households’ daily consumption. This paper presents a user experience study of this feedback tool, and addresses the influences of goal-setting on the experience. The results show that people who more often set financial and pro-environmental goals in life find the tool more attractive, more useful, believing it to have influenced their current behaviour and believing it will be helpful when changing (regulating) future consumption behaviour. Conclusions are drawn that feedback tools like EcoRunner may have different effects for different subgroups in society. It is further suggested that EcoRunner could be used as a tool in education, at different levels in schools and higher education, for enlightening consumers about the relationship between household spending and environmental consequences

Safety and tolerability of an immediate-release formulation of theoral direct thrombin inhibitor AZD0837 in the prevention of stroke and systemic embolism in patients with atrial fibrillation.

AZD0837 is an investigational oral anticoagulant which is converted to the active form, ARH067637, a selective direct thrombin inhibitor. The present study, a multicentre, randomised, parallel-group, dose-guiding study, assessed the safety and tolerability of an immediate-release formulation of AZD0837 compared with dose-adjusted warfarin in the prevention of stroke and systemic embolic events in atrial fibrillation (AF) patients. Two hundred fifty AF patients with at least one additional risk factor for stroke were randomised to receive either immediate-release AZD0837 (150mg twice daily [bid] or 350mg bid, blinded treatment) or dose-adjusted warfarin (international normalised ratio 2.0-3.0, open treatment) for three months. The safety and tolerability of 150mg bid AZD0837 appeared to be as good as that of warfarin. Total bleeding events were six with 150mg bid AZD0837, 15 with 350mg bid AZD0837, and eight with warfarin. Alanine aminotransferase elevations (>3xupper limit of normal) were infrequent, without apparent differences between treatment groups. A numerically higher incidence of serious adverse events was observed with 350mg bid AZD0837 compared with 150mg bid, with six of 13 being cardiac related, all with different diagnoses. An increase in mean serum creatinine of approximately 10% was observed in both AZD0837 groups, which returned to baseline after completion of therapy. There were no strokes, transient ischaemic attacks or cerebral haemorrhages with any of the treatments. In conclusion, the safety and tolerability of 150mg bid immediate-release AZD0837 appeared to be as good as that of dose-adjusted warfarin. However, larger studies will be needed to define the safety profile of AZD0837

2019 updated consensus statement on the diagnosis and treatment of pediatric pulmonary hypertension : The European Pediatric Pulmonary Vascular Disease Network (EPPVDN), endorsed by AEPC, ESPR and ISHLT

The European Pediatric Pulmonary Vascular Disease Network is a registered, non-profit organization that strives to define and develop effective, innovative diagnostic methods and treatment options in all forms of pediatric pulmonary hypertensive vascular disease, including pulmonary hypertension (PH) associated with bronchopulmonary dysplasia, PH associated with congenital heart disease (CHD), persistent PH of the newborn, and related cardiac dysfunction. The executive writing group members conducted searches of the PubMed/MEDLINE bibliographic database (1990–2018) and held face-to-face and web-based meetings. Ten section task forces voted on the updated recommendations, based on the 2016 executive summary. Clinical trials, meta-analyses, guidelines, and other articles that include pediatric data were searched using the term “pulmonary hypertension” and other keywords. Class of recommendation (COR) and level of evidence (LOE) were assigned based on European Society of Cardiology/American Heart Association definitions and on pediatric data only, or on adult studies that included >10% children or studies that enrolled adults with CHD. New definitions by the World Symposium on Pulmonary Hypertension 2018 were included. We generated 10 tables with graded recommendations (COR/LOE). The topics include diagnosis/monitoring, genetics/biomarkers, cardiac catheterization, echocardiography, cardiac magnetic resonance/chest computed tomography, associated forms of PH, intensive care unit/lung transplantation, and treatment of pediatric PH. For the first time, a set of specific recommendations on the management of PH in middle- and low-income regions was developed. Taken together, these executive, up-to-date guidelines provide a specific, comprehensive, detailed but practical framework for the optimal clinical care of children and young adults with PH