The attitudes of owners and veterinary professionals in the United Kingdom to the risk of adverse events associated with using non- steroidal anti-inflammatory drugs (NSAIDs) to treat dogs with osteoarthritis

Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed by veterinary surgeons for the treatment of canine osteoarthritis, and affected dogs may receive these drugs for long periods of time. Whilst short term administration of NSAIDs to dogs is linked to adverse events such as gastrointestinal haemorrhage and renal injury, reports of adverse events associated with their long-term administration are limited in the veterinary literature. This study aimed to investigate the attitudes towards the long term use of NSAIDs for canine osteoarthritis held by three groups who manage osteoarthritic dogs in the United Kingdom: dog owners, veterinary surgeons and veterinary nurses. A qualitative methodology was adopted, using semi-structured interviews and focus groups. Thematic analysis of these data identified three themes: awareness of potential risks; recognition of adverse events; and influence of risk perception on the use of NSAIDs. Awareness of, and concern about, the risk of adverse events associated with NSAID administration to dogs with osteoarthritis was high in all groups, with veterinary surgeons being one of a variety of information sources used by owners to acquire this knowledge. Veterinary surgeons described difficulty in recognising, managing and avoiding adverse events associated with NSAIDs. When adverse events occurred, a wide range of management approaches were adopted ranging from a brief drug respite to permanent cessation of administration of any NSAIDs to that dog. Commonly employed approaches to minimise risk included dose reduction and screening blood tests. This study describes a high level of concern about the risks associated with long term NSAID administration to dogs with osteoarthritis and highlights a diverse range of strategies employed to minimise these risks. The evidence base for these strategies is poor, and this may present a risk to animal welfare if the affected dogs are not receiving adequate analgesia. In order to address this, more accurate and comprehensive data must be supplied to both veterinary professionals and owners on the true frequency of adverse events associated with long term administration of veterinary NSAIDs and how best to avoid them

Effectiveness and safety of lotion, cream, gel, and ointment emollients for childhood eczema: a pragmatic, randomised, phase 4, superiority trial

Background: To our knowledge, there are no trials comparing emollients commonly used for childhood eczema. We aimed to compare the clinical effectiveness and safety of the four main emollient types: lotions, creams, gels, and ointments. Methods: We did a pragmatic, individually randomised, parallel group, phase 4 superiority trial in 77 general practice surgeries in England. Children aged between 6 months and 12 years with eczema (Patient Orientated Eczema Measure [POEM] score >2) were randomly assigned (1:1:1:1; stratified by centre and minimised by baseline POEM score and age, using a web-based system) to lotions, creams, gels, or ointments. Clinicians and parents were unmasked. The initial emollient prescription was for 500 g or 500 mL, to be applied twice daily and as required. Subsequent prescriptions were determined by the family. The primary outcome was parent-reported eczema severity over 16 weeks (weekly POEM), with analysis as randomly assigned regardless of adherence, adjusting for baseline and stratification variables. Safety was assessed in all randomly assigned participants. This trial was registered with the ISRCTN registry, ISRCTN84540529. Findings: Between Jan 19, 2018, and Oct 31, 2019, 12 417 children were assessed for eligibility, 550 of whom were randomly assigned to a treatment group (137 to lotion, 140 to cream, 135 to gel, and 138 to ointment). The numbers of participants who contributed at least two POEM scores and were included in the primary analysis were 131 in the lotion group, 137 in the cream group, 130 in the gel group, and 126 in the ointment group. Baseline median age was 4 years (IQR 2–8); 255 (46%) participants were girls, 295 (54%) were boys; 473 (86%) participants were White; and the mean POEM score was 9·3 (SD 5·5). There was no difference in eczema severity between emollient types over 16 weeks (global p value=0·77), with adjusted POEM pairwise differences of: cream versus lotion 0·42 (95% CI −0·48 to 1·32), gel versus lotion 0·17 (−0·75 to 1·09), ointment versus lotion −0·01 (−0·93 to 0·91), gel versus cream −0·25 (−1·15 to 0·65), ointment versus cream −0·43 (−1·34 to 0·48), and ointment versus gel −0·18 (−1·11 to 0·75). This result remained unchanged following multiple imputation, sensitivity, and subgroup analyses. The total number of adverse events did not significantly differ between the treatment groups (lotions 49 [36%], creams 54 [39%], gels 54 [40%], and ointments 48 [35%]; p=0·79), although stinging was less common with ointments (12 [9%] of 138 participants) than lotions (28 [20%] of 137), creams (24 [17%] of 140), or gels (25 [19%] of 135). Interpretation: We found no difference in effectiveness between the four main types of emollients for childhood eczema. Users need to be able to choose from a range of emollients to find one that they are more likely to use effectively. Funding: National Institute for Health and Care Research

Decline of Leach’s Storm Petrels Hydrobates leucorhous at the largest colonies in the northeast Atlantic

Leach’s Storm Petrel Hydrobates leucorhous has undergone substantial population declines at North Atlantic colonies over recent decades, but censusing the species is challenging because it nests in burrows and is only active at colonies at night. Acoustic playback surveys allow birds present in nest sites to be detected when they respond to recordings of vocalisations. However, not all birds respond to playback on every occasion, response rate is likely to decline with increasing distance between the bird and the playback location, and the observer may not detect all responses. As a result, various analysis methods have been developed to measure and correct for these imperfect response and detection probabilities. We applied two classes of methods (calibration plot and hierarchical distance sampling) to acoustic survey data from the two largest colonies of breeding Leach’s Storm Petrels in the northeast Atlantic: the St Kilda archipelago off the coast of northwest Scotland, and the island of Elliðaey in the Vestmannaeyjar archipelago off the southwest of Iceland. Our results indicate an overall decline of 68% for the St Kilda archipelago between 2000 and 2019, with a current best estimate of ~8,900 (95% CI: 7,800–10,100) pairs. The population on Elliðaey appears to have declined by 40 –49% between 1991 and 2018, with a current best estimate of ~5,400 (95% CI: 4,300–6,700) pairs. We also discuss the relative efficiency and precision of the two survey methods

Decline of Leach’s Storm Petrels Hydrobates leucorhous at the largest colonies in the northeast Atlantic

Leach’s Storm Petrel Hydrobates leucorhous has undergone substantial population declines at North Atlantic colonies over recent decades, but censusing the species is challenging because it nests in burrows and is only active at colonies at night. Acoustic playback surveys allow birds present in nest sites to be detected when they respond to recordings of vocalisations. However, not all birds respond to playback on every occasion, response rate is likely to decline with increasing distance between the bird and the playback location, and the observer may not detect all responses. As a result, various analysis methods have been developed to measure and correct for these imperfect response and detection probabilities. We applied two classes of methods (calibration plot and hierarchical distance sampling) to acoustic survey data from the two largest colonies of breeding Leach’s Storm Petrels in the northeast Atlantic: the St Kilda archipelago off the coast of northwest Scotland, and the island of Elliðaey in the Vestmannaeyjar archipelago off the southwest of Iceland. Our results indicate an overall decline of 68% for the St Kilda archipelago between 2000 and 2019, with a current best estimate of ~8,900 (95% CI: 7,800–10,100) pairs. The population on Elliðaey appears to have declined by 40 –49% between 1991 and 2018, with a current best estimate of ~5,400 (95% CI: 4,300–6,700) pairs. We also discuss the relative efficiency and precision of the two survey methods

Effect of a Perioperative, Cardiac Output-Guided Hemodynamic Therapy Algorithm on Outcomes Following Major Gastrointestinal Surgery A Randomized Clinical Trial and Systematic Review

Importance: small trials suggest that postoperative outcomes may be improved by the use of cardiac output monitoring to guide administration of intravenous fluid and inotropic drugs as part of a hemodynamic therapy algorithm.Objective: to evaluate the clinical effectiveness of a perioperative, cardiac output–guided hemodynamic therapy algorithm.Design, setting, and participants: OPTIMISE was a pragmatic, multicenter, randomized, observer-blinded trial of 734 high-risk patients aged 50 years or older undergoing major gastrointestinal surgery at 17 acute care hospitals in the United Kingdom. An updated systematic review and meta-analysis were also conducted including randomized trials published from 1966 to February 2014.Interventions: patients were randomly assigned to a cardiac output–guided hemodynamic therapy algorithm for intravenous fluid and inotrope (dopexamine) infusion during and 6 hours following surgery (n=368) or to usual care (n=366).Main outcomes and measures: the primary outcome was a composite of predefined 30-day moderate or major complications and mortality. Secondary outcomes were morbidity on day 7; infection, critical care–free days, and all-cause mortality at 30 days; all-cause mortality at 180 days; and length of hospital stay.Results: baseline patient characteristics, clinical care, and volumes of intravenous fluid were similar between groups. Care was nonadherent to the allocated treatment for less than 10% of patients in each group. The primary outcome occurred in 36.6% of intervention and 43.4% of usual care participants (relative risk [RR], 0.84 [95% CI, 0.71-1.01]; absolute risk reduction, 6.8% [95% CI, ?0.3% to 13.9%]; P?=?.07). There was no significant difference between groups for any secondary outcomes. Five intervention patients (1.4%) experienced cardiovascular serious adverse events within 24 hours compared with none in the usual care group. Findings of the meta-analysis of 38 trials, including data from this study, suggest that the intervention is associated with fewer complications (intervention, 488/1548 [31.5%] vs control, 614/1476 [41.6%]; RR, 0.77 [95% CI, 0.71-0.83]) and a nonsignificant reduction in hospital, 28-day, or 30-day mortality (intervention, 159/3215 deaths [4.9%] vs control, 206/3160 deaths [6.5%]; RR, 0.82 [95% CI, 0.67-1.01]) and mortality at longest follow-up (intervention, 267/3215 deaths [8.3%] vs control, 327/3160 deaths [10.3%]; RR, 0.86 [95% CI, 0.74-1.00]).Conclusions and relevance: in a randomized trial of high-risk patients undergoing major gastrointestinal surgery, use of a cardiac output–guided hemodynamic therapy algorithm compared with usual care did not reduce a composite outcome of complications and 30-day mortality. However, inclusion of these data in an updated meta-analysis indicates that the intervention was associated with a reduction in complication rate

Training future generations to deliver evidence-based conservation and ecosystem management

1. To be effective, the next generation of conservation practitioners and managers need to be critical thinkers with a deep understanding of how to make evidence-based decisions and of the value of evidence synthesis. 2. If, as educators, we do not make these priorities a core part of what we teach, we are failing to prepare our students to make an effective contribution to conservation practice. 3. To help overcome this problem we have created open access online teaching materials in multiple languages that are stored in Applied Ecology Resources. So far, 117 educators from 23 countries have acknowledged the importance of this and are already teaching or about to teach skills in appraising or using evidence in conservation decision-making. This includes 145 undergraduate, postgraduate or professional development courses. 4. We call for wider teaching of the tools and skills that facilitate evidence-based conservation and also suggest that providing online teaching materials in multiple languages could be beneficial for improving global understanding of other subject areas.Peer reviewe

Manifesto for the future of work and organizational psychology

This manifesto presents 10 recommendations for a sustainable future for the field of Work and Organizational Psychology. The manifesto is the result of an emerging movement around the Future of WOP (seewww.futureofwop.com), which aims to bring together WOP-scholars committed to actively contribute to building a better future for our field. Our recommendations are intended to support both individuals and collectives to become actively engaged in co-creating the future of WOP together with us. Therefore, this manifesto is openand never“finished.”It should continuously evolve, based on an ongoing debate around our professional values and behavior. This manifesto is meant, first of all, for ourselves as an academic community. Furthermore, it is also important for managers, decision makers, and other stakeholders and interested parties,such as students, governments and organizations, as we envision what the future of WOP could look like, and it is only through our collective efforts that we will be able to realize a sustainable future for all of us