Linking NHS data for pediatric pharmacovigilance: Results of a Delphi survey

Background: Adverse drug events are a major cause of patient safety incidents. Current systems of pharmacovigilance under-report adverse drug reactions (ADRs), especially in children, leading to delays in their identification. This is of particular concern, as children especially have an increased vulnerability toADRs. Objectives: The objective was to seek consensus among healthcare professionals (HCPs) about barriers and facilitators to the linkage of routinely collected health data for pediatric pharmacovigilance in Scotland. Methods: A Delphi survey was conducted with a random sample of HCPs including nurses, pharmacists and doctors, working in primary or secondary care, in Scotland. Participants were identified from sampling frames of the target professionals such as an NHS workforce list for general practitioners and recruited by postal invitation. A total of 819 HCPs were invited to take part. Those agreeing to participate were given the option of completing the questionnaires online or as hard copy. Reminders were sent twice at a fortnightly interval. Questions content included description of professional role as well as testing for the willingness to support the proposed project and was informed by the Theoretical Domains Framework of Behavior Change (TDF) and earlier qualitative work. Three Delphi rounds were administered, including a first round for item generation. Results: 121 of those invited agreed to take part (15%). The first round of the Delphi study included 21 open questions and generated over a 1000 individual statements from 61 participants that returned the questionnaires (50.4%). These were rationalized to 149 items for the second round in which participants rated their views on the importance (or not) of each item on a 9-point Likert scale (strongly disagree - strongly agree). After the third round, there was consensus on items that focused on professional standards, and practical requirements, overall there was support for data linkage and a multi-professional approach. Conclusions: It would be acceptable to stakeholders to introduce a data linkage system for pharmacovigilance as long as identified concerns are addressed. Concerns included adherence to current professional, legal and ethical standards, as well resolving practical issues

Seasonal acclimatization to temperature in cardueline finches

1. Seasonal variation in body constituents and utilization of lipid, protein, and carbohydrate during cold stress in American goldfinches were studied to determine relations of these functions to the pronounced seasonal shift in thermogenic capacity documented in a previous study (Dawson and Carey, 1976).Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47119/1/360_2004_Article_BF00686746.pd

At the limits of measurement: The methodological quality of international studies into the size of human trafficking related to prostitution in Northwestern Europe

De aanleiding voor deze literatuurstudie was een motie van Segers/van der Staaij, waarin gevraagd werd om een wetenschappelijke vergelijking te maken van het prostitutiebeleid tussen landen in Noordwest-Europa en het effect van dat beleid op de omvang van mensenhandel in de betreffende landen. De onderzoeksvraag in deze studie luidt: "Wat is er bekend over de relatie tussen prostitutiebeleid in Noordwest-Europa en de omvang van mensenhandel en wat valt er vanuit wetenschappelijk oogpunt te zeggen over de kwaliteit van de bestaande onderzoeken waarop de conclusies over deze relatie zijn gebaseerd?" Om een zo goed mogelijk inzicht in bovengenoemde relatie(s) te krijgen, is dit onderzoek specifiek gericht op landen in Noordwest-Europa: Nederland, België, Noorwegen, Zweden, Finland, Denemarken, Duitsland en Groot Brittannië. Deze landen dekken samen de belangrijkste, voor vergelijkend onderzoek relevante, vormen van prostitutiebeleid, en hebben een infrastructuur die in principe het best mogelijke onderzoek naar de omvang van mensenhandel mogelijk maakt

Aan de grenzen van het meetbare: de methodologische kwaliteit van internationale studies naar de omvang van aan prostitutie gerelateerde mensenhandel met nadruk op Noordwest Europa.

De aanleiding voor deze literatuurstudie was een motie van Segers/van der Staaij, waarin gevraagd werd om een wetenschappelijke vergelijking te maken van het prostitutiebeleid tussen landen in Noordwest-Europa en het effect van dat beleid op de omvang van mensenhandel in de betreffende landen. De onderzoeksvraag in deze studie luidt: "Wat is er bekend over de relatie tussen prostitutiebeleid in Noordwest-Europa en de omvang van mensenhandel en wat valt er vanuit wetenschappelijk oogpunt te zeggen over de kwaliteit van de bestaande onderzoeken waarop de conclusies over deze relatie zijn gebaseerd?" Om een zo goed mogelijk inzicht in bovengenoemde relatie(s) te krijgen, is dit onderzoek specifiek gericht op landen in Noordwest-Europa: Nederland, België, Noorwegen, Zweden, Finland, Denemarken, Duitsland en Groot Brittannië. Deze landen dekken samen de belangrijkste, voor vergelijkend onderzoek relevante, vormen van prostitutiebeleid, en hebben een infrastructuur die in principe het best mogelijke onderzoek naar de omvang van mensenhandel mogelijk maakt

Coincidence of immune-mediated diseases driven by TH1 and TH2 subsets suggests a common aetiology. A population-based study using computerized General Practice data

Background The recent rise in the prevalence of immune‐mediated diseases has been attributed to environmental factors such as a lack of microbial challenge, or dietary change, that deviate the overall balance between mutually antagonistic subsets of T helper (Th) cells. Objective An alternative proposal is that recent environmental changes have resulted in an immune system that is more likely to produce both Th1 and Th 2 responses against benign antigens. The prediction of this hypothesis, that Th1 and Th 2‐mediated diseases are not mutually exclusive, and may be positively associated, is tested here in a whole population. Methods Data from General Practices participating in the Scottish Continuous Morbidity Recording (CMR) project were used to determine the coincidence of the major Th 2‐mediated atopic diseases; asthma, eczema and allergic rhinitis, with the Th1‐mediated autoimmune conditions; type I diabetes, rheumatoid arthritis and psoriasis. We also identified the prescription rates of inhaled therapy for asthma in patients with Th1‐mediated disease. Results There was a significant increase in the risk of presenting with a Th1‐mediated autoimmune condition in patients with a history of allergic disease (standardized prevalence ratio (95% confidence interval) 1.28 (1.18–1.37)). Likewise, the standardized prevalence ratios of presenting with either eczema (1.67 (1.48–1.87)) or allergic rhinitis (1.22 (1.02–1.44)) were significantly increased in subjects with a history of Th1‐mediated disease. There was a particularly strong association between current psoriasis and current eczema (standardized prevalence ratio of psoriasis in subjects with eczema 2.88, 95% confidence interval (CI) 2.38–3.45). There was also a significant increase in prescriptions for inhaled asthma therapy in patients with Th1 disease. Conclusion It is concluded that Th1‐ and Th 2‐mediated diseases are significantly associated in a large General Practice population. This finding supports the proposal that autoimmune and atopic diseases share risk factors that increase the propensity of the immune system to generate both Th1‐ and Th 2‐mediated inappropriate responses to non‐pathological antigens