scholarly journals Canadian Thoracic Society 2012 Guideline Update: Diagnosis and Management of Asthma in Preschoolers, Children and Adults: Executive Summary

2012 ◽  
Vol 19 (6) ◽  
pp. e81-e88 ◽  
Author(s):  
M Diane Lougheed ◽  
Catherine Lemiere ◽  
Francine M Ducharme ◽  
Chris Licskai ◽  
Sharon D Dell ◽  
...  
Keyword(s):  
Asthma Control ◽  
Guideline Development ◽  
Action Plan ◽  
Guideline Implementation ◽  
Future Research ◽  
Executive Summary ◽  
Adjunct Therapy ◽  
Diagnosis And Management ◽  
Controller Medication

BACKGROUND: In 2010, the Canadian Thoracic Society (CTS) published a Consensus Summary for the diagnosis and management of asthma in children six years of age and older, and adults, including an updated Asthma Management Continuum. The CTS Asthma Clinical Assembly subsequently began a formal clinical practice guideline update process, focusing, in this first iteration, on topics of controversy and/or gaps in the previous guidelines.METHODS: Four clinical questions were identified as a focus for the updated guideline: the role of noninvasive measurements of airway inflammation for the adjustment of anti-inflammatory therapy; the initiation of adjunct therapy to inhaled corticosteroids (ICS) for uncontrolled asthma; the role of a single inhaler of an ICS/long-acting beta2-agonist combination as a reliever, and as a reliever and a controller; and the escalation of controller medication for acute loss of asthma control as part of a self-management action plan. The expert panel followed an adaptation process to identify and appraise existing guidelines on the specified topics. In addition, literature searches were performed to identify relevant systematic reviews and randomized controlled trials. The panel formally assessed and graded the evidence, and made 34 recommendations.RESULTS: The updated guideline recommendations outline a role for inclusion of assessment of sputum eosinophils, in addition to standard measures of asthma control, to guide adjustment of controller therapy in adults with moderate to severe asthma. Appraisal of the evidence regarding which adjunct controller therapy to add to ICS and at what ICS dose to begin adjunct therapy in children and adults with poor asthma control supported the 2010 CTS Consensus Summary recommendations. New recommendations for the adjustment of controller medication within written action plans are provided. Finally, priority areas for future research were identified.CONCLUSIONS: The present document is an executive summary of the first update of the CTS Asthma Guidelines following the Canadian Respiratory Guidelines Committee’s new guideline development process. Tools and strategies to support guideline implementation will be developed and the CTS will continue to regularly provide updates reflecting new evidence.

scholarly journals Canadian Thoracic Society 2012 Guideline Update: Diagnosis and Management of Asthma in Preschoolers, Children and Adults

2012 ◽  
Vol 19 (2) ◽  
pp. 127-164 ◽  
Author(s):  
M Diane Lougheed ◽  
Catherine Lemiere ◽  
Francine M Ducharme ◽  
Chris Licskai ◽  
Sharon D Dell ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Asthma Control ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Action Plan ◽  
Guideline Implementation ◽  
Adjunct Therapy ◽  
Diagnosis And Management ◽  
Controller Medication

BACKGROUND: In 2010, the Canadian Thoracic Society (CTS) published a Consensus Summary for the diagnosis and management of asthma in children six years of age and older, and adults, including an updated Asthma Management Continuum. The CTS Asthma Clinical Assembly subsequently began a formal clinical practice guideline update process, focusing, in this first iteration, on topics of controversy and/or gaps in the previous guidelines.METHODS: Four clinical questions were identified as a focus for the updated guideline: the role of noninvasive measurements of airway inflammation for the adjustment of anti-inflammatory therapy; the initiation of adjunct therapy to inhaled corticosteroids (ICS) for uncontrolled asthma; the role of a single inhaler of an ICS/long-acting beta2-agonist combination as a reliever, and as a reliever and a controller; and the escalation of controller medication for acute loss of asthma control as part of a self-management action plan. The expert panel followed an adaptation process to identify and appraise existing guidelines on the specified topics. In addition, literature searches were performed to identify relevant systematic reviews and randomized controlled trials. The panel formally assessed and graded the evidence, and made 34 recommendations.RESULTS: The updated guideline recommendations outline a role for inclusion of assessment of sputum eosinophils, in addition to standard measures of asthma control, to guide adjustment of controller therapy in adults with moderate to severe asthma. Appraisal of the evidence regarding which adjunct controller therapy to add to ICS and at what ICS dose to begin adjunct therapy in children and adults with poor asthma control supported the 2010 CTS Consensus Summary recommendations. New recommendations for the adjustment of controller medication within written action plans are provided. Finally, priority areas for future research were identified.CONCLUSIONS: The present clinical practice guideline is the first update of the CTS Asthma Guidelines following the Canadian Respiratory Guidelines Committee’s new guideline development process. Tools and strategies to support guideline implementation will be developed and the CTS will continue to regularly provide updates reflecting new evidence.

scholarly journals Diagnosis and Management of Pulmonary Hypertension in the Modern Era: Insights from the 6th World Symposium

2019 ◽  
Vol 6 (1) ◽  
pp. 9-22
Author(s):  
Christopher A. Thomas ◽  
Ryan J. Anderson ◽  
David F. Condon ◽  
Vinicio A. de Jesus Perez
Keyword(s):  
Pulmonary Hypertension ◽  
Current Knowledge ◽  
Action Plan ◽  
Future Research ◽  
Treatment Algorithms ◽  
Diagnosis And Management ◽  
Future Research Directions ◽  
Modern Era ◽  
Improve Patient

AbstractThe past 20 years have seen major advances in the diagnosis and management of pulmonary hypertension, a disease associated with significant morbidity and mortality. The 6th World Symposium in Pulmonary Hypertension (WSPH) took place in February 2018 and attempted to consolidate the current knowledge in the field into practical recommendations to help prioritize an action plan to improve patient outcomes and identify future research directions. In this review, we will summarize the highlights of the 6th WSPH proceedings, including revisions to the hemodynamic definitions and classification of the various types of pulmonary hypertension, genetic advances, approaches to risk stratification, and updated treatment algorithms.

scholarly journals The Role of Pharmacists in General Practice in Asthma Management: A Pilot Study

Pharmacy ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 114 ◽  
Author(s):  
Louise Deeks ◽  
Sam Kosari ◽  
Katja Boom ◽  
Gregory Peterson ◽  
Aaron Maina ◽  
...  
Keyword(s):  
General Practice ◽  
Pilot Study ◽  
Asthma Control ◽  
Action Plan ◽  
Asthma Management ◽  
Asthma Control Test ◽  
Appropriate Prescribing ◽  
Device Use ◽  
Practice Methods

Background: Asthma is principally managed in general practice. Appropriate prescribing and medication use are essential, so general practice pharmacists appear suitable to conduct asthma management consultations. This pilot study aimed to evaluate the asthma management role of a pharmacist in general practice. Methods: Analysis of an activity diary and stakeholder interviews were conducted to identify interventions in asthma management; determine whether asthma control changed following pharmacist input; and determine acceptability of asthma management review by a pharmacist in one general practice in Canberra, Australia. Results: Over 13 months, the pharmacist saw 136 individual patients. The most common activities were asthma control assessment; recommendations to adjust medication or device; counselling on correct device use; asthma action plan development and trigger avoidance. For patients with multiple consultations, the mean Asthma Control Test score improved from the initial to last visit (14.4 ± 5.2 vs. 19.3 ± 4.7, n = 23, p < 0.0001). Eight of the 19 (42%) patients moved from having poor to well-controlled asthma. Case studies and qualitative data indicated probable hospital admission avoidance and stakeholder acceptability of asthma management by a practice pharmacist. Conclusions: This pilot study demonstrated it is feasible, acceptable and potentially beneficial to have a general practice pharmacist involved in asthma management. Fuller evaluation is warranted.

scholarly journals Antecedents of Customer Loyalty in Banking Sector: A Mediational Study

2018 ◽  
Vol 43 (2) ◽  
pp. 92-105 ◽  
Author(s):  
Suhail A. Bhat ◽  
Mushtaq A. Darzi ◽  
Shakir H. Parrey
Keyword(s):  
Factor Analysis ◽  
Customer Loyalty ◽  
Structural Equation ◽  
Banking Sector ◽  
Retail Banking ◽  
Future Research ◽  
Service Firms ◽  
Executive Summary ◽  
Customer Trust

Executive Summary The competition among the organizations is increasing continuously and there has been a rapid shift in the business process deliverance. Financial service firms are striving to improve their business processes by liaising with customers to survive and compete successfully. The literature has obstinately emphasized on the utmost importance of trust and loyalty to survive in the financial sector. This study aims to explore the role of customer knowledge management (CKM) and satisfaction as antecedents of customer trust in the retail banking sector. The causal relationships existing between CKM, satisfaction, trust, and loyalty are explored. The mediating role of customer trust in the knowledge–loyalty and satisfaction–loyalty relationships is also explored. The data has been collected randomly from 412 customers of a private bank through survey by questionnaire. The research instrument has been developed and purified through factor analysis (confirmatory factor analysis). Structural equation modelling (SEM) has been employed to examine the causal relationship and fitness of the proposed model. The findings of the study reveal that CKM and satisfaction positively impact customer trust, and customer trust has a significant impact on loyalty. Besides, trust partially mediates the effect of knowledge and satisfaction on loyalty. The findings of the study are valuable to managers and strategists in understanding customer need in order to formulate the relevant customer loyalty programmes. However, the study focused on retail banking sector and uses data from a single bank only. Future research may evaluate the generalizability of findings across other banks as well as other nationalities. The main contribution of this study is to the loyalty literature by empirically validating the identified antecedents and demonstrating their role in managing loyalty. Furthermore, the study provides some valuable insights into the relational exchanges between variables wherein some inferences are derived from results regarding trust and loyalty.

scholarly journals Perceived CSR and Corporate Reputation: The Mediating Role of Employee Trust

2018 ◽  
Vol 43 (3) ◽  
pp. 139-151 ◽  
Author(s):  
Rama Shankar Yadav ◽  
Sanket Sunand Dash ◽  
Shreyashi Chakraborty ◽  
Manoj Kumar
Keyword(s):  
Corporate Reputation ◽  
Underlying Mechanism ◽  
Future Research ◽  
Clear Understanding ◽  
Executive Summary ◽  
Trust Development ◽  
Employee Trust ◽  
Mediating Role ◽  
Corporate Social

Executive Summary This research article focuses on the importance of corporate social responsibility (CSR) in building corporate reputation of an organization. Scholars have studied CSR as an antecedent of corporate reputation, but the underlying mechanism of this process has been rarely explored. In order to fill this research gap, authors conducted an empirical study on 210 employees working in an automobile organization in India. The conceptual framework based on comprehensive literature review hypothesized that the perceived CSR of an organization may lead to trust development among the employees which in turn may lead to building of corporate reputation of the organization. The model was tested and all the hypotheses were accepted. Hence, it may be inferred that perceived CSR of an organization may develop a sense of trust among employees of an organization and in turn leading to the building of corporate reputation. The study has several implications for managers and scholars. The findings give a clear understanding that CSR activities of any organization can lead to trust development among employees at the same time they may aid in enhancing the corporate reputation of an organization. Hence, we suggest that in order to gain maximum benefits from CSR, managers should ensure that all the employees are aware of their firm’s CSR activities. Further, managers should adopt CSR activities that have high salience among current or potential employees so that its benefits are positively impacting its stakeholders and the firm. Such CSR activities can include investments in institutions where training is imparted to the organization’s workforce; organizing social welfare activities in areas close to the company’s location. The study also has future research implications for researchers working in the area of CSR. Scholars can explore other mediating variables which may explain the underlying mechanism between CSR and corporate reputation. The study can also be replicated in other sectors in order to enhance the generalizability of the findings.

Role of the allergist in diagnosis and management of patients with uveitis

JAMA ◽  
1966 ◽  
Vol 195 (3) ◽  
pp. 167-172 ◽  
Author(s):  
T. E. Van Metre
Keyword(s):  
Diagnosis And Management

Coping Humor as a Mediator Between Emotional Intelligence and Job Satisfaction

2017 ◽  
Vol 16 (3) ◽  
pp. 155-159 ◽  
Author(s):  
Peizhen Sun ◽  
Jennifer J. Chen ◽  
Hongyan Jiang
Keyword(s):  
Job Satisfaction ◽  
Emotional Intelligence ◽  
Future Research ◽  
Satisfaction Scale ◽  
Primary School Teachers ◽  
Mediating Role ◽  
Regulation Of Emotion ◽  
The Relationship ◽  
Overall Job Satisfaction

Abstract. This study investigated the mediating role of coping humor in the relationship between emotional intelligence (EI) and job satisfaction. Participants were 398 primary school teachers in China, who completed the Wong Law Emotional Intelligence Scale, Coping Humor Scale, and Overall Job Satisfaction Scale. Results showed that coping humor was a significant mediator between EI and job satisfaction. A further examination revealed, however, that coping humor only mediated two sub-dimensions of EI (use of emotion and regulation of emotion) and job satisfaction. Implications for future research and limitations of the study are discussed.

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