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IntroductionThe utility of fractional exhaled nitric oxide (FeNO) in randomised controlled trials (RCTs) of asthma, particularly the minimal clinical important difference (MCID), is uncertain. The American Thoracic Society recommends that the MCID for FeNO is a relative change of ≥20%. However, this effect size has not been validated against other clinical outcomes. Here we report the relationship between FeNO and a patient reported outcome measure of asthma control, for which the MCID is known, in a secondary analysis of two RCTs in mild-moderate asthma.MethodsThe PRACTICAL and Novel-START studies were 52-week open-label RCTs comparing as-required SABA with or without maintenance ICS versus as-required ICS-formoterol. This analysis includes participants with measurements of both FeNO and the Asthma Control Questionnaire-5 item (ACQ-5). FeNO was analysed on the logarithm (log) scale, and associations between change in log FeNO and ACQ-5 were estimated. The MCID for the ACQ-5 is 0.5. Associations were assessed with Spearman’s rank correlation coefficient, t-tests, and logistic regression. A sub-group analysis was performed for those participants with ‘active uncontrolled’ asthma, baseline FeNO ≥25ppb and ACQ ≥1.5.ResultsA total of 1398 participants had FeNO and ACQ-5 data and, of these, 242 had ‘active uncontrolled’ asthma. There was a weak association between change in log FeNO and ACQ-5; correlation coefficient 0.08 (P=0.002) and 0.14 (P=0.026) for the total and sub-group respectively (figure 1). In the total group the mean (SD) change in log FeNO for those with an ACQ-5 improvement of < 0.5 was -0.14 (0.60), N=820; and -0.25 (0.64), N=530 for those with ACQ-5 improvement ≥0.5; representing geometric mean ratios of 0.87 and 0.78 respectively. In the sub-group these values were -0.33 (0.57), N=69; and -0.52 (0.61), N=173; representing geometric mean ratios of 0.72 and 0.59 respectively. AUC-ROC in the two groups for FeNO versus an improvement in ACQ-5 ≥0.5 was 0.54 overall and 0.59 in the sub-group.DiscussionFeNO changes are a poor surrogate for the ACQ-5. However, the magnitude of the changes in FeNO in those with an improvement in ACQ-5 ≥ 0.5 supports that the MCID for FeNO may be about a 20% relative change.Please refer to page A291 for declarations of interest related to this abstract.Abstract P166 Figure 1Change in ACQ-5 versus log FeNO in ‘active uncontrolled’ sub-group.

The Charlotte-Mecklenburg Utility Department (CMUD), a municipal agency, provides water and wastewater services to approximately 500,000 residents of Charlotte and Mecklenburg counties in the southern Piedmont region of North Carolina. Spurred by inquiries from the private sector, unsolicited proposals to purchase system components, and political interest, CMUD decided to allow private firms to compete with city staff for the operation and maintenance of two of the department's eight treatment plants. Eight proposals were received from private firms and from the department's own bid team, referred to as Charlotte Mecklenburg-Contract Operations (CM-ConOP). CM-ConOp submitted the lowest-cost proposal, which will result in savings of $ 4.2 million over the contract's five-year term. In addition, the Charlotte model for competition showed that the public sector can compete successfully with private firms and that the result can be a complete change in the way the agency does business.

In the embolic triad, pulmonary embolism or any other potential embolic presentation (of various organ systems) is possible and could cause delayed diagnosis. Because of the diverse nature of the potential presentation, a low threshold for consideration of myxoma in the differential is recommended. Heart failure symptoms which include paroxysmal nocturnal dyspnea, orthopnea, or dyspnea on exertion are often seen if they are due to mitral valve involvement or peripheral edema and abdominal distention if due to tricuspid valve involvement [2,7].

Little is known about the relationship among body weight, body image, and HIV/AIDS sexual risk behaviors. We examined this issue in a midwestern U.S. metropolitan area community sample of 316 men who have sex with men, a group at relatively high risk for HIV/AIDS. All data were self-reported by questionnaire using standard items to assess current body image, height and weight, and HIV/AIDS sexual risk behaviors. Logistic regression models were used to estimate cross-sectional associations. Forty-nine (15%) of the 316 men were classified as obese, and 56 (18%) had unsafe sex in the past three months. Normal weight or overweight men were 3.6 times more likely than obese men to have had unsafe sex, after adjusting for differences in body image and age. Men with better body image were 1.4 times more likely than men with lower body image to have had anal sex, after adjusting for differences in body weight and age. Non-obese men were no more or less likely than were obese men to have engaged in anal sex or in any sex in the past three months. This is the first study showing a positive relationship between below-obese body weight and unsafe sex and between better body image and anal sex in men who have sex with men. Future research should investigate these novel findings, perhaps using other study designs and data collection tools with less measurement error. Advances in knowledge about HIV/AIDS risk factors, including body weight and body image, could potentially contribute to more effective approaches to reducing this risk.

This study examined how cultural mistrust, religious beliefs, gender role conflicts, and history of mental health experience would impact attitudes of African American toward psychotherapy. The sample consisted of 194 African Americans students attending Tennessee State University and 94 who lived in an identified community in Nashville, TN. Participants completed the Cultural Mistrust Inventory (CMI), Religious Orientation Scale (ROS), Gender Role Conflict Scale (GCRS) and Attitudes toward Seeking Professional Psychological Help Scale (ATSPPH). Pearson r correlations did not indicate a relationship between cultural mistrust and gender role conflicts was not supported but was approaching the level of significance, r(196) = -.131, p = .067. However, correlations were conducted to assess the positive relationship between gender role conflicts and attitudes towards seeking psychological help. The data supported a significant positive relationship between the two variables contrary to the stated hypothesis r (192) = .226, p = .001. Thus concluding that a more masculine belief did not yield a person to seek out psychological. Limitations of this study, as well as implications and recommendations for future research and practice, are discussed.

The Ninety-seventh Annual session of the Danville Baptist Association was held with the St. Johnsbury Church, June 19-21, 1906. The gathering was made up of the six pastors of the association twenty-one delegates and twenty visitors. The addresses were full of fervor and interesting.

The prospect of being able to acquire a troubled, but otherwise attractive business at a bargain price is prompting many strategic buyers and private equity firms to pursue distressed sale situations. In the ACG-Thomson Reuters Mid-Year Dealmakers Survey released in April, a majority of the private equity firm respondents indicated they would be pursuing distressed sales as part of their business strategy, some 20% for the first time. A buyer can always follow the well-trodden stock purchase route. It avoids a visit to the courthouse and any bankruptcy-related stigma. In doing so, however, liabilities and liens remain in place and consents are likely to be required from lenders and others. Of course, the buyer can acquire assets at a secured lender foreclosure sale. Such a route is dependent on the lenders conducting such a sale. Effectuating a sale through the bankruptcy process carries distinct advantages.

Field studies were conducted at Goiânia, GO, Brazil, on an Oxisol (clayey, kaolinitic, isothermic, Typic Haplustox) and at Jussara, GO, Brazil, on an Oxisol (loamy sand, kaolinitic, isothermic, Typic Haplustox) during 1995 and 1996 to determine the carryover effect of fomesafen, imazamox, and acifluorfen, applied to edible bean, on rotational crops (maize, sorghum, rice, and millet) and to estimate the level of soil residues under Brazilian Savanna conditions. Averaged across locale, year, and rate, fomesafen dissipation time (DT50) (37.5 d) was longer than acifluorfen (27.5 d) and imazamox (25.9 d). For both locations, soil herbicide persistence (average of herbicides) was longer in 1995 than in 1996. This was due to higher soil moisture content in 1996. The sensitivity of rotational crops to fomesafen and imazamox residues was, in decreasing order: sorghum, corn, millet, and rice, and for acifluorfen: sorghum, corn, rice, and millet. The period between herbicide application and rotational crop planting (PAP) varied in agreement with the sensitivity of rotational crops to herbicide residues in soil and the persistence of the herbicide. Considering both location and year, the PAP for fomesafen (250 g ai ha−1) ranged from 69 to 132 d for corn, 114 to 179 d for sorghum, 29 to 95 d for rice, and 52 to 111 d for millet; the PAP for imazamox (40 g ai ha−1) ranged from 68 to 111 d for corn, 78 to 139 d for sorghum, 25 to 75 d for rice, and 40 to 102 d for millet; and the PAP for acifluorfen (170 g ai ha−1) ranged from 56 to 89 d for corn, 96 to 139 d for sorghum, 61 to 95 d for rice, and 43 to 82 d for millet.

The Democeracy of the Third Congressional Distric of Ohio, composed of the counties of Preble, Warrer, Butler, and Moztgomery, met this day, in this city, at 11 o'clock, parshant to adjournment to appoint two delegaies, and two alternate delegates, to the National Democratic Convention to be held in Chicago, July 4th, 1854.