Traditional and Patient-centered Outcomes with Three Classes of Asthma Article

Traditional and Patient-centered Outcomes with Three Classes of Asthma Medication - Article Example By ‘clinical variables’, the authors mean traditional end-points like symptoms, reliever use, forced expiratory volume in one second percent predicted, morning peak expiratory flow and airway hyperresponsiveness; ‘subjective variables’ mean patient-centred benefits like quality of life, patient global assessments and the feeling of improvement as determined by asthma control questionnaire. There are 2 hypotheses in this study which are: 1) Some traditional measurements (clinical variables) of improvement during asthma treatment may not reflect the estimation of benefit by the patient. 2) Patients may benefit (subjective variables) from a specific class of asthma medication in ways which were not captured by the measurement of lung function. Measures of asthma control are a much-debated topic in the recent times. This is because there are various measures to determine the efficacy of treatment. Most researchers use lung function and clinical improvement as criteria for improvement; even the international guidelines are based on these. However, what the researchers perceive as improvement may not be the same in case of patients. Patients may have their own meaning of improvement and only if they feel that a particular class of medicine is effective will they adhere to treatment. This is the basis of the hypotheses in the article under study. This study included 58 subjects from three sites in Sydney and Melbourne, Australia. Only those with mild to moderate asthma, who had previously used a short-acting ß2-agonist with/without an inhaled corticosteroids (ICS) 500  µg beclomethasone equivalent and in the age group 16 to 75 years, were included in the study. In all subjects, ICS treatment was ceased at an entry to the study. Those with mild to moderate asthma were only considered because, in reality, these patients need only monotherapy and they are symptomatic enough to show a treatment response.  Ã‚  

Battle of Shiloh and General A.S. Johnston Research Paper

Battle of Shiloh and General A.S. Johnston - Research Paper Example In order to provide a brief background to the reader, A. S. Johnston was already a decorated war veteran prior to the outbreak of the Civil War. As such, Johnston had already served in the Army of Texas, the Army of the United States prior to becoming a general in the Army of the CSA (Confederate States of America). Johnston had a range of talents and gifts that proved to assist him greatly in taking over his position as general within the Army of the Confederate States of America. ... rtage, lack of capital, and extreme numerical and industrial disadvantages that served to tip the war in favor of the Union was the struggle progressed.2 Regardless of the talent and courage exhibited by a single man, the problems that were extant within the confederacy could not and should not be under-appreciated nor minimized by the actions that a particular individual might have affected. Said one Southern newspaper regarding the loss of Johnston, â€Å"He is said but a few days before the battle in which he fell, to have expressed the determination to discharge his duties and responsibilities to his country according to the best convictions of his mind, and a resolution to redeem his losses at no distant day. According to official report, he fell in the thickets of the battle†.3 Although the South knew that Johnston’s defeats likely changed the course of the war in the West, a strong level of admiration for his daring and tenacity is evoked even in his death. The f irst item that should be considered with relation to Johnston’s effectiveness and overall ability to make a noticeable change on the war was the rather impossible position that he was placed at the outset of the war. With comparison to eastern generals that were tasked with protection vital strongholds and population centers within the South, Johnston was charged with what can only be considered as a nearly impossible task. Although this is a bold statement, one should consider that the resources and manpower that were devoted to Johnston in the western theater of the Civil War were unbelievably small for the amount of territory and key points he was responsible for securing from a numerically superior Northern force. It should be noted that although a talented and brilliant tactician, Johnston made a