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  • Open access, Patient-centred medicine, Research methods, Respiratory medicine  (1)
  • Sulfur Deposition  (1)
  • 1
    ISSN: 1573-2932
    Keywords: Asia ; Acid Rain ; Energy ; Emissions ; Sulfur Deposition ; Critical Loads ; Sulfur Dioxide ; Conservation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Energy, Environment Protection, Nuclear Power Engineering
    Notes: Abstract In contrast to Europe and North America, air pollution in Asia is increasing rapidly, resulting in both local air quality problems and higher acidic depositions. In 1989, an east-west group of scientists initiated a multi-institutional research project on Acid Rain and Emissions Reduction in Asia, funded for the past two years by the World Bank and the Asian Development Bank. Phase I, covering 23 countries of Asia, focussed on the development of PC-based software called the Regional Air Pollution INformation and Simulation Model (RAINS-ASIA). A 94-region Regional Energy Scenario Generator was developed to create alternative energy/emission scenarios through the year 2020. A long-range atmospheric transport model was developed to calculate dispersion and deposition of sulfur, based upon emissions from area and large point sources, on a one-degree grid of Asia. The resulting impacts of acidic deposition on a variety of vegetation types were analyzed using the critical loads approach to test different emissions management strategies, including both energy conservation measures and sulfur abatement technologies.
    Type of Medium: Electronic Resource
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  • 2
    Publication Date: 2016-07-07
    Description: Introduction Malignant pleural effusions (MPEs) can complicate most cancers, causing dyspnoea and impairing quality of life (QoL). Indwelling pleural catheters (IPCs) are a novel management approach allowing ambulatory fluid drainage and are increasingly used as an alternative to pleurodesis. IPC drainage approaches vary greatly between centres. Some advocate aggressive (usually daily) removal of fluid to provide best symptom control and chance of spontaneous pleurodesis. Daily drainages however demand considerably more resources and may increase risks of complications. Others believe that MPE care is palliative and drainage should be performed only when patients become symptomatic (often weekly to monthly). Identifying the best drainage approach will optimise patient care and healthcare resource utilisation. Methods and analysis A multicentre, open-label randomised trial. Patients with MPE will be randomised 1:1 to daily or symptom-guided drainage regimes after IPC insertion. Patient allocation to groups will be stratified for the cancer type (mesothelioma vs others), performance status (Eastern Cooperative Oncology Group status 0–1 vs ≥2), presence of trapped lung (vs not) and prior pleurodesis (vs not). The primary outcome is the mean daily dyspnoea score, measured by a 100 mm visual analogue scale (VAS) over the first 60 days. Secondary outcomes include benefits on physical activity levels, rate of spontaneous pleurodesis, complications, hospital admission days, healthcare costs and QoL measures. Enrolment of 86 participants will detect a mean difference of VAS score of 14 mm between the treatment arms (5% significance, 90% power) assuming a common between-group SD of 18.9 mm and a 10% lost to follow-up rate. Ethics and dissemination The Sir Charles Gairdner Group Human Research Ethics Committee has approved the study (number 2015-043). Results will be published in peer-reviewed journals and presented at scientific meetings. Trial registration number ACTRN12615000963527; Pre-results.
    Keywords: Open access, Patient-centred medicine, Research methods, Respiratory medicine
    Electronic ISSN: 2044-6055
    Topics: Medicine
    Published by BMJ Publishing
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