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Despite large amounts of available roof space, long pay-back periods for investments in photovoltaic (PV) power plants often hinder PV installations in industrial parks. Photovoltaic citizen participation initiatives (PV-CPI) are an alternative way of financing PV power plants that add non-financial benefits to these investments. This paper analyzed the feasibility of the installation of PV power plants focused on high rates of self-consumption financed by citizen participation initiatives on the roofs of five companies located in the Austrian Ennshafen industrial business park based on the net present value and the discounted pay-back period and compared it to a standard financing scheme, assuming a predetermined interest rate for participants as well as economies of scale with respect to the specific installation costs due to a joint purchase of the PV power plants. To calculate the feasibility, site-specific data and literature input have been used. The results show that despite an interest rate above the current interest rates of conservative forms of investments provided to (small-scale) investors, a payback-period of 17–23 years can be reached while the joint purchase can lead to a competitive feasibility of the PV-CPI compared to an individual purchase of PV power plants.

PurposeAcute leukemia (AL) is associated with substantial morbidity and mortality. We assessed the prevalence and correlates of pain in patients with newly diagnosed or relapsed AL.MethodsPatients with newly diagnosed or relapsed AL admitted to a comprehensive cancer center completed the Memorial Symptom Assessment Scale (MSAS), which assesses prevalence, severity, and distress associated with pain and other symptoms. Factors associated with severe pain were assessed using logistic regression. Two raters completed chart reviews in duplicate for patients with severe pain (MSAS severity ≥ 3/4) to determine the site of pain.ResultsThree hundred eighteen patients were recruited from January 2008 to October 2013: 245 (77.0%) had acute myeloid or acute promyelocytic leukemia (AML/APL) and 73 (23.0%) had acute lymphoblastic leukemia (ALL); 289 (90.9%) were newly diagnosed and 29 (9.1%) had relapsed disease. Pain was reported in 156/318 (49.2%), of whom 55/156 (35.3%) reported severe pain (≥ 3/4). Pain was associated with all psychological symptoms (all p < 0.005) and some physical symptoms. Severe pain was associated with younger age (p = 0.02), worse performance status (p = 0.04), ALL diagnosis (p = 0.04), and time from onset of chemotherapy (p = 0.03), with pain peaking at 4 weeks after chemotherapy initiation. The most common sites of severe pain were oropharynx (22; 40%), head (12; 21.8%), and abdomen (11; 20%). Only 3 patients (0.9%) were referred to the symptom control/palliative care team during the month prior to or following assessment.ConclusionsPain is frequent, distressing, and predictable in patients undergoing induction chemotherapy for AL. Further research is needed to assess the efficacy of early supportive care in this population.

The aim of this study is to propose an approach for developing trustworthy recommendations as part of urgent responses (1–2 week) in the clinical, public health, and health systems fields. We conducted a review of the literature, outlined a draft approach, refined the concept through iterative discussions, a workshop by the Grading of Recommendations Assessment, Development and Evaluation Rapid Guidelines project group, and obtained feedback from the larger Grading of Recommendations Assessment, Development and Evaluation working group. A request for developing recommendations within 2 week is the usual trigger for an urgent response. Although the approach builds on the general principles of trustworthy guideline development, we highlight the following steps: (1) assess the level of urgency; (2) assess feasibility; (3) set up the organizational logistics; (4) specify the question(s); (5) collect the information needed; (6) assess the adequacy of identified information; (7) develop the recommendations using one of the 4 potential approaches: adopt existing recommendations, adapt existing recommendations, develop new recommendations using existing adequate systematic review, or develop new recommendations using expert panel input; and (8) consider an updating plan. An urgent response for developing recommendations requires building a cohesive, skilled, and highly motivated multidisciplinary team with the necessary clinical, scientific, and methodological expertise; adapting to shifting needs; complying with the principles of transparency; and properly managing conflicts of interest. •The proposed approach for developing trustworthy recommendations as part of urgent responses (1–2 week) builds on the general principles of trustworthy guideline development.•The approach proposes the following steps: (1) assess the level of urgency; (2) clarify and focus the scope of question(s); (3) prioritize and collect the information needed; (4) assess the adequacy of identified information; and then (5) develop recommendations;•Developing recommendations can consist of (1) adopting existing recommendations; (2) adapting existing recommendations; (3) developing new recommendations using existing systematic reviews; or (4) developing new recommendations using identified information and panel input.