Clinical trials and statistical analyses: what should dermatologists look for in a report?

Clinicians need to evaluate the quality of individual clinical studies and synthesize the information from multiple clinical studies to provide insights in selecting appropriate therapies for patients. Understanding the key statistical principles that underlie a clinical trial and how they may be implemented can help clinicians properly interpret the efficacy and safety findings of clinical trials. Several factors should be considered when evaluating clinical studies reported in the literature, as important differences might exist among reported studies, thereby impacting the reliability of their findings. Studies vary in terms of study design, conduct, analysis, and presentation of findings. The key features to consider when evaluating clinical trials are inferential intent (exploratory versus confirmatory), choice of control group, randomization, extent of blinding, prespecification of analyses, appropriate handling of missing data, and multiple end points. Making comparisons across studies is extremely difficult and rarely statistically justified. However, this article will point out issues to keep in mind when evaluating multiple studies, such as variations in design and study populations.

Integrating Poverty and Gender into Health Programs: A Sourcebook for Health Professionals.

Evidence increasingly shows that poverty and gender inequalities are important determinants of health and influence the opportunity for timely and appropriate health care. These findings suggest that health professionals need to have a sound understanding of health inequalities and their causes, as well as of how they can be addressed. However, through surveys to health ministries and educational institutions in 2001, the World Health Organization Regional Office for the Western Pacific found that awareness of, and capacity to respond to, poverty and gender concerns in health was weak. In response, the Regional Office initiated a project to develop materials to support the integration of poverty and gender concerns into health professional education curricula. The multimodule publication, Integrating Poverty and Gender into Health Programmes: A Sourcebook for Health Professionals, supports evidence-based and participatory learning. The experience to date suggests that the publication might be meeting a long-felt need for such a response.

Working together: health promoting schools and school nurses.

The health of children and adolescents pose multiple challenges for health professionals in these times of rapid socioeconomic, political, cultural, epidemiological and health system changes. The health promoting schools approach and accompanying national models, regional and global initiatives, provide a mechanism for integrating health promotion and core nursing functions into schools and communities, while preventing premature morbidity and mortality from chronic and debilitating conditions. Nurses, in collaboration with educators, other health professionals, students, parents, councils and community members, are core and instrumental means to generate and support change in school settings, aimed at creating environments supportive to health.