Asthma control and management in 8,000 European patients : the REcognise Asthma and LInk to Symptoms and Experience (REALISE) survey

We thank Dr Peter Haidl (Schmallenberg, Germany) and Professor Chantal Raherison-Semjen (Bordeaux, France) for their advice and input on the survey questions. We are also grateful to Weber Shandwick (London, UK) for assistance in developing and running the survey, Incite Marketing Planning Ltd (London, UK) for support in the development of the questionnaire and analysing the results, and Dr Mark Rolfe and Dr Andreas Leidenroth (Oxford PharmaGenesis, Oxford, UK) for medical writing support.Peer reviewedPublisher PD

Patient reported burden of asthma on resource use and productivity across 11 countries in europe

ACKNOWLEDGMENTS Sponsorship for this study and article processing charges were funded by Mundipharma International Limited (Cambridge, UK). All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship of this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published. We thank Emily Taylor, Incite Marketing Planning Limited (London, UK) for assistance in data analysis and Caoimhe McKerr (Adelphi Values, Bollington, UK) for editorial assistance. Support for this assistance was funded by Mundipharma International Limited. Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.Peer reviewedPublisher PD

The single silo university

In 2015, the University of Salford committed to a new five-year institutional strategy. A hallmark of this strategy was the focus on the undeviating single priority of industrial collaboration. The clarity and simplicity of this approach was challenging for many. Over the duration of the strategy’s intended lifespan and in an institution more comfortable with annual revisions to its strategy the unusual persistence of this challenge continued to confront colleagues. The comparative longevity of the strategy also brought positive change by converging perspectives and breaking down traditional demarcations of research, enterprise and, teaching and learning. A nascent realisation that all of these normally discrete activities were some form of knowledge exchange began to find traction across academic units and professional service departments. Our role within this industrial collaboration focused strategy was to understand and evaluate the partnerships being developed as a result of the singular strategic focus. Through our shared systems-thinking perspective and drawing heavily on the literature relating to relationship management we were able to recognise the many individual parameters of a high quality partnership and how they did (or did not) manifest within individual relationships. The chapter concludes with some reflections on the success and the ongoing legacy of the strategy

A Patient-Centered Description of Severe Asthma:Patient Understanding Leading to Assessment for a Severe Asthma Referral (PULSAR)

BACKGROUND: Although severe asthma can be life-threatening, many patients are unaware they have this condition. OBJECTIVES: Patient Understanding Leading to Assessment for a Severe Asthma Referral (PULSAR) is a novel, multidisciplinary working group aiming to develop and disseminate a global, patient-centered description of severe asthma to improve patient understanding of severe asthma and effect a change in patient behavior whereby patients are encouraged to visit their healthcare professional, when appropriate. METHODS: Current definitions from patient organization websites, asthma guidelines, and medication information for key asthma drugs were assessed and informed a multidisciplinary working group, convened to identify common concepts and terminology used to define severe asthma. A patient-centered description of severe asthma and patient checklist were drafted based on working-group discussions and reviewed by an external behavioral scientist for patient understanding and relevance. These were tested using an online US/Canadian survey. RESULTS: The patient-centered description of severe asthma and patient checklist were reviewed and re-drafted by the authors. The text was simplified following the behavioral-scientist review. The survey (n = 153) included 105 patients with severe asthma. Of those with severe asthma, 92.2% of patients reported that the description was consistent with their experiences of severe asthma and 92.6% of patients reported that the PULSAR initiative would encourage them to visit their healthcare provider. CONCLUSION: A patient-centered description of severe asthma has been developed and tested using patients with severe asthma; this description will allow patients to assess whether they might have severe asthma and prompt them to visit their healthcare provider, if appropriate

Terbuthylazine and desethylterbutylazine : recent occurrence, mobility and removal techniques

The herbicide terbuthylazine (TBA) has displaced atrazine in most of EU countries, becoming one of the most regularly used pesticides and, therefore, frequently detected in natural waters. The affinity of TBA for soil organic matter suggests prolonged contamination, once present; degradation leads to the release of the metabolite desethylterbuthylazine (DET), which has a higher water solubility and binds more weakly to organic matter compared to the parent compound, resulting in higher associated risk for contamination of groundwater resources. Additionally, TBA and DET are chemicals of emerging concern because of their persistence and toxicity towards aquatic organisms; moreover, they are known to have significant endocrine disruption capacity to wildlife and humans. Conventional treatments applied during drinking water production do not lead to the complete removal of these chemicals; activated carbon provides the greatest efficiency, whereas ozonation can generate by-products with comparable oestrogenic activity to atrazine. Hydrogen peroxide alone is ineffective to degrade TBA, while UV/H2O2 advanced oxidation and photocatalysis methods are the most effective processes for oxidation of TBA, with efficiencies above 90%. It has been determined that direct photolysis gives the highest degradation efficiency of all UV/H2O2 treatments, while most of the photocatalytic degradation efficiency is attributed to OH radicals, and TiO2 solar-photocatalytic ozonation can lead to almost complete TBA removal in ~30 min. Biomixtures could also be highly effective in preventing groundwater pollution due to TBA and DET, while constructed wetlands provide a valuable buffer capacity, protecting downstream surface waters from contaminated agricultural runoff

Identifying Patient Attitudinal Clusters Associated With Asthma Control : The European REALISE Survey

Acknowledgment Medical writing and editorial support was provided by Oxford PharmaGenesis, Oxford, UK.Peer reviewedPublisher PD

High-risk and multiple human papillomavirus (HPV) infections in cancer-free Jamaican women

<p>Abstract</p> <p>Background</p> <p>Vaccines, that target human papillomavirus (HPV) high risk genotypes 16 and 18, have recently been developed. This study was aimed at determining genotypes commonly found in high-risk and multiple-HPV infections in Jamaican women. Two hundred and fifty three (253) women were enrolled in the study. Of these, 120 pregnant women, aged 15–44 years, were recruited from the Ante Natal Clinic at the University Hospital of the West Indies and 116 non-pregnant, aged 19–83, from a family practice in Western Jamaica. Cervical cell samples were collected from the women and HPV DNA was detected using Polymerase Chain Reaction and Reverse Line Hybridization. HPV genotypes were assessed in 236 women. Data were collected from January 2003 to October 2006.</p> <p>Results</p> <p>HPV DNA was detected in 87.7% (207/236) and of these 80.2% were positive for high-risk types. The most common high-risk HPV types were: HPV 45 (21.7%), HPV 58 (18.8%), HPV 16 (18.4%), HPV 35 (15.0%), HPV 18 (14.5%), HPV 52 (12.0%) and HPV 51(11.1%). Other high-risk types were present in frequencies of 1.4% – 7.2%.</p> <p>Multivariate regression analyses showed that bacterial vaginosis predicted the presence of multiple infections (OR 3.51; CI, 1.26–9.82) and that alcohol use (OR 0.31; CI, 0.15–0.85) and age at first sexual encounter (12–15 years: OR 3.56; CI, 1.41–9.12; 16–19 years, OR 3.53, CI, 1.22–10.23) were significantly associated with high risk infections. Cervical cytology was normal in the majority of women despite the presence of high-risk and multiple infections.</p> <p>Conclusion</p> <p>HPV genotype distribution in this group of Jamaican women differs from the patterns found in Europe, North America and some parts of Asia. It may be necessary therefore to consider development of other vaccines which target genotypes found in our and similar populations. HPV genotyping as well as Pap smears should be considered.</p

Treatment patterns among non-active users of maintenance asthma medication in the United Kingdom : a retrospective cohort study in the Clinical Practice Research Datalink

The authors are also grateful to Dr Michael Gibbs for providing a review of an early draft of this manuscript. Funding Editorial support was provided by Kate Hollingworth of Continuous Improvement Ltd and funded by GlaxoSmithKline (GSK). This study was funded by GSK. DCG, BA, JFB, and MF are employees of GSK and hold GSK shares.Peer reviewedPublisher PD

Consideration of Shared Decision Making in Nursing: A Review of Clinicians’ Perceptions and Interventions

As the number of individuals with chronic illness increases so has the need for strategies to enable nurses to engage them effectively in daily management of their conditions. Shared decision making between patients and nurses is one approach frequently discussed in the literature. This paper reviews recent studies of shared decision making and the meaning of findings for the nurse-patient relationship. Patients likely to prefer to engage in shared decision making are younger and have higher levels of education. However, there is a lack of evidence for the effect of shared decision making on patient outcomes. Further, studies are needed to examine shared decision making when the patient is a child. Nurses are professionally suited to engage their patients fully in treatment plans. More evidence for how shared decision making affects outcomes and how nurses can successfully achieve such engagement is needed