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BackgroundCorticosteroids are used to treat conditions including acute asthma and croup where they are often given in short-courses. This study evaluated the tolerability and palatability of oral prednisolone and dexamethasone in children in Saudi Arabia (SA) and the UK.MethodsA prospective observational/interview study was performed. Palatability was evaluated by asking patient/parent’s opinions of the taste and acceptability of the medication. Children pointed at the appropriate face on a scale depicting: 1 ‘dislike very much’, 2 ‘dislike a little’, 3 ‘not sure’, 4 ‘like a little’ and 5 ‘like very much’.1 Tolerability, in particular nausea, vomiting and abdominal pain was evaluated by direct questioning of the patient/parents after each administration. Data was collected over three months in each centre. Patients aged 2–18 years treated with oral prednisolone or dexamethasone in hospital were approached to participate.ResultsIn SA, 122 patients (89 asthma, 33 croup), aged 2–10 years (mean=4.3) were recruited: 52 received prednisolone base tablets; 37 prednisolone sodium phosphate syrup; 33 dexamethasone elixir. In the UK, of 133 patients (80 asthma, 53 croup) aged 2–16 years (mean=4.9): 38 received prednisolone base tablets; 42 prednisolone sodium phosphate soluble tablets; 53 dexamethasone sodium phosphate oral solution.SA: Day 1 prednisolone base tablet palatability scores: 1 (88.5%); 2 (11.5%). Day 2 scores: 1 (64.4%); 2 (28.9%); 3 (6.7%). Day 1 prednisolone sodium phosphate solution palatability scores: 1 (48.6%); 2 (40.5%); 3 (10.8%). Day 2 scores: 1 (10.8%); 2 (67.6%); 3 (21.6%). Day 1 dexamethasone elixir palatability scores: 1 (27.3%); 2 (48.5%); 3 (24.2%).UK: Day 1 prednisolone base tablet palatability scores: 1 (76.3%); 2 (13.1%); 3 (5.3%); 4 (5.3%). Day 2 scores: 1 (61.3%); 2 (19.4%); 3 (16.1%); 4 (3.2%). Day 1 prednisolone sodium phosphate soluble tablet palatability scores: 1 (35.7%); 2 (26.2%); 3 (23.8%); 4 (11.9%) 5 (2.4%). Day 2 scores: 1 (16.7%); 2 (58.2%); 3 (16.7%); 4 (4.2%); 5 (4.2%). Day 1 dexamethasone sodium phosphate solution palatability scores: 1 (5.7%); 2 (28.3%); 3 (37.7%); 4 (17%); 5 (11.3%).Dexamethasone sodium phosphate solution had the highest palatability scores (P<706;0.0001). The score was lowest for prednisolone base tablets in both centres (P<0.0001).In SA prednisolone base tablets were associated with more cases of nausea (24 vs 7) and vomiting (5 vs 0) than prednisolone sodium phosphate syrup (p=0.008 and p=0.073 respectively). In the UK vomiting occurred significantly more frequently with prednisolone base tablets (8) than prednisolone sodium phosphate soluble tablets (2) (p=0.041).In both centres dexamethasone was associated with less side effects but with no significant difference between the formulations. Vomiting (1 vs 0), nausea (7 vs 3) and abdominal pain (10 vs 8) occurred more with dexamethasone sodium phosphate solution than dexamethasone elixir (p=1, p=0.53 and p=0.55 respectively).ConclusionsDexamethasone sodium phosphate solution was the most palatable preparation. Prednisolone base tablets were rated the least palatable and were also the least well tolerated. Palatability scores seemed to improve with second doses.ReferenceH. Hames H, Seabrook JA, Matsui D, Rieder MJ, Joubert GI. A palatability study of a flavoured dexamethasone preparation versus prednisolone liquid in children. Can. J. Clin. PharmacolJanuary 2008;15(1):e95–8.

This paper contributes to the expanding landscape of methodological approaches and tools for investigating organizational sustainability communication. Our method allows for exploring two-way interactions between company risk and sustainability reporting. We present a basic but extendable method, while using only publicly available data. Our method adds additional features to established methods: It covers only risk (not returns), as theory mainly supports risk-reporting relationships and not return-reporting relationships. It tests for reverse causality of the risk-reporting relationship and links complementary explanations to different theoretical schools. Our method tests the model by employing data from a market with mandatory sustainability reporting to avoid self-selection bias.

The purpose of this article is to highlight the misnaming of the phrase \"systemically important\" used in the context of non-deposit taking non-banking financial companies in India which is in wide divergence of spirit with which it is used globally. Moreover, the method for designation of a systemically important financial institution which is solely based on asset size in India is also untuned with the practice adopted globally where a number of parameters along with multiple staged processes are defined for its identification. Recently published discussion paper on non-banking financial company has further raised the perplexity by introducing phrase \"systemically significant\" indicating a joint set with systemically important non-banking financial companies whereas in literary sense both the phrases are synonymous to each other. There is a need to remove dichotomy in the use of these two phrases and also to converge the use of systemically important in consonance with the spirit as it is used globally in context of non-banking financial companies.