Update on WPA education programs, 2009.

Guidelines by the European Federation of Neurological Societies (EFNS) subcommittee for Continuing Medical Education (CME) – modification 2003

Education: “The process or art of imparting knowledge, skill and judgment; Facts, skills and ideas that have been learnt, either formally or informally.” — Wikipedia 1 The term profession is applied to those persons who have specialized and technical skill or knowledge which they apply, for a fee, to certain tasks that ordinary and unqualified people cannot ordinarily undertake. The term derives from the Latin: “to swear (an oath) …” . — Wikipedia 2 Let’s consider how we as cardiovascular medicine specialists spend our days in the care of people with cardiovascular disease. In the office or making rounds in the hospital, we prescribe drugs and order diagnostic tests; in the noninvasive laboratory, we obtain and interpret images of the heart; in the electrophysiology and cardiac catheterization laboratories, we program and implant devices in patients. When antithrombotic and fibrinolytic drugs are administered, and primary percutaneous coronary intervention is done using balloon catheters and intracoronary stents, lives are saved among patients with acute myocardial infarction. Response by Avorn and Choudhry see p 2221 The mortality risk from heart failure decreases and quality of life increases from the proper and appropriate use of angiotensin-converting enzyme inhibitors and β-blockers. Lipid lowering through the use of statin drugs saves lives and reduces serious cardiovascular complications such as myocardial infarction and stroke when properly prescribed to patients with a variety of manifestations of atherosclerotic vascular diseases. According to a recent publication by Ford and colleagues,3 deaths due to coronary heart disease in the United States declined substantially from 1980 to 2000, resulting in >340 000 fewer deaths in 2000. The authors attributed approximately half of this decline to changes in cardiac risk factors and half to the application of evidence-based therapies. An underlying theme in all of this is that the pharmaceutical, biotechnology, and …

Department of Anesthesiology, University of Rochester Medical Center, Strong Memorial Hospital, Rochester, New York. peter_bailey@urmc.rochester.eduThis issue of Anesthesiology contains the first of what is to be a monthly, article-based continuing medical education (CME) program. Some readers might question whether another CME program or product is needed.Numerous factors are forcing clinicians to evaluate how they obtain CME credits and specialties to assess their CME activities. Travel to CME meetings takes individuals away from family and work. In addition, travel to CME meetings with family can make serious learning a challenge. Of note, the Accreditation Council of Continuing Medical Education has increased its scrutiny of CME programs and the participation of individuals. The American Board of Anesthesiology, and indeed all 24 medical specialties which comprise the American Board of Medical Specialties, is moving toward a certification model based on “maintenance of certification” and “life-long learning and self-assessment.”1Assessment of professional competence is also being developed on several fronts.2Although performance is different from CME, surely they are linked. All these factors and more have contributed to the changing landscape of CME.The American Society of Anesthesiologists and the American Board of Anesthesiology convened a Strategic Planning Committee in the fall of 2003 to assess current American Society of Anesthesiologists CME programs and determine the need, if any, for the development of additional CME products. Starting a CME program in Anesthesiology was enthusiastically endorsed.Each month, one article will be chosen to be the focus of the journal-based CME program which, when successfully completed, will award participants up to 1 h of Category 1 CME credit toward the Accreditation Council of Continuing Medical Education’s Physician Recognition Award. Readers may wonder about the value of 1 h of CME credit. However, if an individual successfully completes the new program every month, the number of CME credits obtained in a year will equal approximately one-half of the annual requirement for Category 1 credits (25) and more than one-third of the credits that are needed annually as defined by the American Board of Anesthesiology for maintenance of certification (35).1We hope the ease with which CME credits can be obtained through this new program, as well as the value of its content, will be appealing to American Society of Anesthesiologists members and other qualified individuals.It is our intent to make the process of obtaining journal-based CME credits straightforward and beneficial. There will undoubtedly be some growing pains. However, with constructive criticism from participants, I am confident that Anesthesiology’s new CME program will be educational and convenient and will allow practitioners to obtain clinically valuable information in one more manner. What’s more, the cost is very modest: American Society of Anesthesiologists members pay only $10.00 per test or $60.00 for the full year; the fee for nonmembers is $15.00 per test or $90.00 for the year.For further information, please see the CME section starting on page 249 of this issue or visit the CME Web site at www.asahq.org/journal-cme. The Web site has a feedback link where participants can comment on the Journal’s new CME activity.So follow the instructions, and let us know what you think and how the program can be improved!

Primary care has a crucial role to play in the prevention, early detection, referral, and risk factor management of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis (NAFLD/NASH). In 2021, a team of European collaborators developed a continuing medical education (CME) program on NAFLD/NASH that consolidates evidence and clinical best practices tailored to the primary care setting. This article reports on the methodology used to design and develop the CME and the results of a feasibility study. An expert advisory group representing both European specialists and general practitioners supported the design of the CME to be implemented in three European settings (Greece, Spain, and Netherlands). The CME features four training modules and problem-based learning using clinical case studies. The CME was tested regarding feasibility and acceptability among a sample of primary care providers (PCPs) in Greece (n = 28) with measurements occurring before, immediately after, and 1 month following the training. Outcome measures included satisfaction with the CME, changes in PCPs' knowledge, attitudes, confidence, and self-reported clinical practices related to NAFLD/NASH. The CME is available as an open-access e-learning course on the European Society for Primary Care Gastroenterology education platform in English, Greek, Spanish, and Dutch. The feasibility study documented high levels of satisfaction, with 96% of PCPs reporting they were extremely or very satisfied with the overall training. Statistically significant increases in PCPs' confidence in NAFLD/NASH-related clinical practices were documented between the pre- and post-assessments. At the follow-up, 62% of GPs reported that the CME had changed their clinical practices related to NAFLD/NASH to a great extent. This CME intervention developed by experts and tailored to PCPs in European settings may serve as an asset for increasing knowledge, confidence, and practice behaviors related to NAFLD/NASH.

Continuing education for medical doctors is not compulsory in Italy. The link with the university is lost shortly after the final medical examination, and there is no other teaching institution for structured continuing medical education (CME). Distance learning gives physicians the opportunity to use updating programs at home at their convenience. Videotel, the Italian videotex system, is the first telematic tool that, at low cost, can reach every home nationwide. Through this system information can be exchanged 24 hours a day, using the Videotel database as central memory, the telephone network as connecting system, and low-cost devices as peripherals. The authors evaluated the technical capacity and didactic efficacy of the Videotel system as a vehicle for CME (in both oncology and general medicine). In an exploratory phase they surveyed physicians of the Italian Province designated for the study, with the objective of promoting the initiative and enrolling physicians interested in this innovative approach to CME. Teachers at Italian universities provided the educational material: interactive lessons, clinical case discussions and problem solving, and multiple-choice questions. Twenty-nine physicians agreed to participate. Despite the interest shown by these physicians, they made very little use of the didactic database. The main reasons for failure to connect with the educational database were the lack of time and unfamiliarity with the instrument. Although the results of the study were discouraging, the authors believe that the resolution of technical problems linked with the system and an increasing familiarity of physicians with telematic and informatic tools in general, together with appropriate incentives, will make the videotex system a feasible, low-cost, efficient vehicle for CME.

An in-person multidisciplinary continuing medical education (CME) program was designed to address previously identified knowledge gaps regarding quality indicators of care in kidney cancer. The objective of this study was to develop a CME program and determine if the program was effective for improving participant knowledge. CME programs for clinicians were delivered by local experts (uro-oncologist and medical oncologist) in four Canadian cities. Participants completed knowledge assessment tests pre-CME, immediately post-CME, and 3-month post-CME. Test questions were related to topics covered in the CME program including prognostic factors for advanced disease, surgery for advanced disease, indications for hereditary screening, systemic therapy, and management of small renal masses. Fifty-two participants attended the CME program and completed the pre- and immediate post-CME tests. Participants attended in Ottawa (14; 27%), Toronto (13; 25%), Québec City (18; 35%), and Montréal (7; 13%) and were staff urologists (21; 40%), staff medical oncologists (9; 17%), fellows (5; 10%), residents (16; 31%), and oncology nurses (1; 2%). The mean pre-CME test score was 61% and the mean post-CME test score was 70% (p=0.003). Twenty-one participants (40%) completed the 3-month post-CME test. Of those that completed the post-test, scores remained 10% higher than the pre-test (p value 0.01). Variability in test scores was observed across sites and between French and English test versions. Urologists had the largest specialty-specific increase in knowledge at 13.8% (SD 24.2, p value 0.02). The kidney cancer CME program was moderately effective in improving provider knowledge regarding quality indicators of kidney cancer care. These findings support continued use of this CME program at other sites.

This study evaluates the effectiveness of a continuing medical education (CME) program that sought to increase HIV testing of women attending maternity clinics of the City of Houston Department of Health and Human Services (HDHHS). The CME program consisted of 14 training sessions given in 1995, 1996, 1997, 1999, and 2000. Educational objectives included increasing patient knowledge of HIV perinatal testing, increasing patient appreciation of the importance of HIV testing, and developing staff skills in educating and counseling women to accept HIV testing during pregnancy. The CME program was based on assessment of clinician learning needs and an algorithm of the testing process, both jointly developed by faculty from the University of Texas Health Science Center at Houston School of Public Health and HDHHS personnel. The algorithm was also used to assess the care delivered. The CME was evaluated by examining changes in the percentage of women tested in the maternity clinics. In 1995, the year before the education program, 5.7% of women seen in the maternity clinics were tested for HIV. After the program began, testing rates rose to 64.2% in 1996, 65.5% in 1997, and 43.3% in 1998. Given the decline in testing in 1998, additional CME sessions were conducted in 1999-2000. The rate of testing rose to 62.3% in 1999 and 76.5% in 2000. Cooperative planning between university and health department personnel can create CME programs that alter provider behaviors and service delivery patterns to increase HIV testing. Outcomes need to be regularly monitored, however, to determine the need for maintenance or performance reinforcement.

Valuing the Education Mission: Implementing an Educational Value Units System

A two-year study was undertaken by the American College of Cardiology (ACC) to assess the effects of its continuing medical education (CME) programs on physician practice behavior. The principal method of evaluation was a telephone interview conducted by fellow cardiologists. Participants were interviewed before and after the CME conferences; control groups were drawn from program cancellations and/or attendees at contiguous courses. Data abstracted from patient charts were also collected from a subsample of participants. Specific course-related behavior change reported ranged from 53–74% of the participants, and 7-29% of the controls. Results revealed that the CME courses contained relatively little information that was new to the audience; that numerous other influences on practice interacted with CME content; and that change attributable to CME was generally subtle and often delayed. Theoretical implications for perspectives on physician behavior change and CME programming are presented and discussed.

BackgroundContinuing medical education (CME) is compulsory for physicians in Iran. Recent studies in Iran show that modifications of CME elements are necessary to improve the effectiveness of the educational programmes. Other studies point to an inappropriate, even irrational drug prescribing. Based on a needs assessment study regarding CME for general physicians in the East Azerbaijan province in Iran, rational prescribing practice was recognized as a high priority issue. Considering different educational methods, outcome-based education has been proposed as a suitable approach for CME. The purpose of the study was to obtain experts' consensus about appropriate educational outcomes of rational prescribing for general physicians in CME and developing curricular contents for this education.MethodsThe study consisted of two phases: The first phase was conducted using a two-round Delphi consensus process to identify the outcome-based educational indicators regarding rational prescribing for general physicians in primary care (GPs). In the second phase the agreed indicators were submitted to panels of experts for assessment and determination of content for a CME program in the field.ResultsTwenty one learning outcomes were identified through a modified Delphi process. The indicators were used by the panels of experts and six educational topics were determined for the CME programme and the curricular content of each was defined. The topics were 1) Principles of prescription writing, 2) Adverse drug reactions, 3) Drug interactions, 4) Injections, 5) Antibiotic therapy, and 6) Anti-inflammatory agents therapy. One of the topics was not directly related to any outcome, raising a question about the need for a discussion on constructive alignment.ConclusionsConsensus on learning outcomes was achieved and an educational guideline was designed. Before suggesting widespread use in the country the educational package should be tested in the CME context.

This cross-sectional study was designed to explore the completion of continuing medical education (CME) programs and identify the factors influencing their completion. The data for this study were generated from the National CME Program Application and Information Feedback Online System and the Sichuan CME Administrative Platform. The data were processed using descriptive analysis, Chi-square test, and binary logistic regression methods. The completion of each CME program was determined by the research team members according to the criteria created by the Office of the Sichuan CME Commission. A total of 180 hospitals and 3,622 CME programs were included. Among the 3,622 CME programs, 2,936 (81.1%) were determined to be completed. Comparative analysis showed that in terms of hospital characteristics, specialist hospitals, county hospitals, hospitals with 500-1,000 beds, and hospitals in the regions with government medical expenditure input equal to or more than 3,000 million RMB displayed the highest completion rates. For program attributes, national programs, programs in the field of pharmacy, and programs with 1-3 duration days demonstrated the highest completion rates. The binary logistic regression analysis showed that hospital region with different government medical expenditure input had the strongest positive association with the completion of CME programs [OR = 2.922, 95%CI (1.642-5.198)], while the duration time showed the strongest negative association [OR = 0.235, 95%CI (0.141-0.393)]. This is the first study in China to analyze the completion of CME programs and identify its influencing factors at the provincial level. It is recommended that the government in the region should pay great attention to the construction of measures regarding the factors affecting the completion of CME programs. This includes providing more financial support to CME providers to ensure the formal operation of their CME activities, formulating guidelines on the application of CME programs to reasonably allocate and control the distribution of accredited CME programs across different hospital scales and disciplines, especially offering more training support to county hospitals, promulgating administrative documents to raise attention to the completion of CME programs, and special scrutiny on CME programs with longer durations to provide and protect training opportunities for those in need.

Health care reform should be driven by the goals of better patient experience, improved population health, lower per capita costs, and improved provider satisfaction. Electronic consultation (eConsult) services have been adopted by several jurisdictions in the United States, Canada, and Europe to improve access to specialists by primary care providers (PCPs) and are being heralded as a key component for delivery of coordinated care. The primary intent of an eConsult service is to provide PCPs with efficient, timely, direct access to specialist expertise to help guide the management of their patients, reduce the need for unnecessary face-to-face specialty consultations, and improve the quality of the initial face-to-face consultation when needed, through the preconsultative communication.In addition to improving access to care, eConsult services have been praised by PCPs and specialists for their educational value, in particular their ability to enrich practice-based learning. Less recognized, but equally important from the educational perspective, include the abilities of eConsult programs to promote reflection by PCPs and specialists, improve collegiality and professionalism between primary and specialist care, inform continuing professional development activities and maintenance of certification, and enhance training programs' teaching of effective communication and care coordination.As eConsult services become increasingly available, the medical community must leverage the educational opportunities inherent in eConsult programs to further improve the delivery of coordinated specialty care. The educational role of eConsults should be considered as a priority outcome in their evaluation and must be highlighted and optimized in next iterations of eConsult systems design.

Current Opinion in Allergy and Clinical Immunology was launched in 2001. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of allergy and clinical immunology are divided into 14 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Editors and Section Editors for this issue. EDITORS Mark BallowMark BallowDr Mark Ballow received his MD from the University of Chicago Pritzker School of Medicine, USA. After a pediatric residency at Yale-New Haven Hospital, USA, he completed an immunology fellowship at the University of Minnesota Hospitals, USA. He was the Chief of Clinical and Experimental Immunology at Walter Reed Army Medical Center, USA. He was then appointed as Chief of the Division of Clinical Immunology in the Department of Pediatrics at the University of Connecticut, USA from 1975 to 1988, and became Chief of the Division of Allergy/Clinical Immunology and Pediatric Rheumatology, and Program Director of the Allergy/Immunology fellowship program at The Women and Children's Hospital of Buffalo, State University of New York at Buffalo, USA from 1988 to 2012. He is presently Training Program Director of the Allergy/Immunology Fellowship program at University of South Florida, Allergy & Immunology Division at All Children's Hospital in St Petersburg, FL. Dr Ballow is certified by the American Board of Pediatrics, American Board of Allergy & Immunology (ABAI), and in Clinical Laboratory Immunology. He was on the Board of Directors of the ABAI from 1992–1998. He has served on four editorial boards including the Journal of Allergy and Clinical Immunology (1984–1989; 1995–2000), and is an Ad Hoc reviewer for a number of pediatric, allergy and immunology journals. He has recently been appointed to the editorial board of Journal of Allergy and Clinical Immunology: In Practice. Dr Ballow has served as an ad hoc member of several NIH study sections, and was a member of the committee that published the first Allergy and Immunology Medical Knowledge Self Assessment Program (MK-SAP), and was a member of the new 3rd edition AI-MK-SAP. Dr Ballow is a Fellow of the American Academy of Asthma, Allergy and Immunology, and has served on the Board of Directors of the Academy (1996–1999), and has chaired the A/I Training Program Directors, Basic Clinical immunology Interest Section, and the Post-graduate Education Program. He was President of the American Academy of Allergy, Asthma and Immunology in 2010–2011. Dr Ballow is a member of the Clinical Immunology Society, the Florida Allergy Society, and the American College of Allergy, Asthma and Immunology. He also has served on the Blood Product Advisory Committee of the FDA. Dr Ballow's major clinical interests include chronic sinusitis, primary immune deficiency disorders, and the uses and mechanisms of action of Intravenous Immune Globulin (IGIV). His research interests include the immunology of the newborn infant and the immunoregulatory effects of IVIG, Vitamin A and retinoic acid. G. Walter CanonicaG. Walter CanonicaProfessor Giorgio Walter Canonica is Director of the Allergy & Respiratory Diseases Clinic, Genoa University, Italy, a GALEN Centre of Excellence. Professor Canonica first specialised in pulmonary diseases after having received his medical degree from the University of Genoa, Italy. He then specialised in Allergy and Clinical Immunology at Florence University, Italy. He subsequently conducted clinical immunology and allergology research in several European universities and institutes, in addition to two years at the Medical University of South Carolina, USA. Since returning to the University of Genoa in 1995, Professor Canonica has held a number of academic positions including Director of the Speciality School of Allergy and Clinical Immunology, Director of the Specialty School of Pulmonary Diseases and Chairman of Chairman of the Dept of Medical Specialties (University Hospital S. Martino Genoa, Italy). He is Board Member of ARIA (Allergic Rhinitis and its impact Asthma) guidelines) and GALEN (Global Allergy and Asthma European Network). Professor Canonica's research interests include examination of the molecular events and interactions between immunocompetent cells, inflammatory cells and epithelial cells in allergic inflammation and airway remodelling. He is particularly involved in new strategies in the treatment of allergic disease, including biological response modifiers, such as specific immunotherapy (with a special focus on SLIT – sublingual immunotherapy - and Severe Asthma treatment with biologics). Professor Canonica has published extensively in international journals and acts as a referee of many immunology journals. In addition, Professor Canonica is a member of a number of societies, he was President of World Allergy Organization 2008/09. He is also currently President of Global Asthma Association - Interasma. He was President of SIMeR (Italian Society of Respiratory Medicine) 2000–2003 and he is Honorary President of this same Society since 2007. He is currently President of SIAAIC Italian Society of Allergy, Asthma and Clinical Immunology (2014–2017). SECTION EDITORS Ruby PawankarRuby PawankarProf. Ruby Pawankar MD, PhD, FRCP (UK), FAAAAI is currently the Immediate Past President of the World Allergy Organization (WAO) and was WAO President from January 2012 to December 2013, after serving as a member of the Board of Directors since 2001, as Treasurer 2008–2009 and as President-Elect 2010–2011. She is currently also the President of the Indian Academy of Allergy. She is Professor of Allergy in the Department of Pediatrics at Nippon Medical School, Tokyo, Japan, and Guest Professor at the Kyung Hee University School of Medicine in Seoul, Korea and the Showa University School of Medicine in Tokyo, Japan. After graduating in medicine from the Armed Forces Medical College, Pune, India, Prof. Pawankar did her residency and post-graduation from BJ Medical College, Pune, India. Thereafter, she trained in Allergy & Clinical Immunology at the Nippon Medical School and Juntendo University School of Medicine in Tokyo, Japan from where she obtained her doctorate. Prof. Pawankar serves on numerous committees and boards of many academic organizations and grant reviews, is a Member/Fellow of organizations including the Collegium International Allergolicum, the American Academy of Allergy, Asthma and Immunology, the American College of Allergy and Immunology, the European Academy of Allergy and Clinical Immunology and the Japanese Society of Allergology. She has delivered several orations/named lectures nationally and internationally including the SK Malik Oration and DN Shivpuri Oration. She is a recipient of many academic awards including the World Achievement Award in Allergy from Thailand; the International Distinguished Fellow Award from the American College of Allergy, Asthma & Immunology; and especially the Pravasi Bharatiya Samman Award from the President of India for excellence in medicine. Prof. Pawankar's research has focused on the cellular and molecular mechanisms of allergy, immune cells like mast cells and T cells, epithelial cell-immune cell interactions, novel roles of IgE, mast cell-IgE cascade, environmental pollution, immunotherapy and novel therapies for respiratory allergies. In 1995, she was the first to report on the increased presence and role of gamma delta T cells in allergic rhinitis. In 1997, she was among the first to show that mast cells in perennial allergic rhinitis exhibit increased expression of the IgE receptor as well as being a major source of the obligatory pro- allergic Th2 cytokines interleukin IL-4, and IL-13 capable of driving local allergen-specific IgE synthesis by B lymphocytes and has formed the basis of the successful therapeutic targeting of these cytokines with biological therapeutics. Her research and educational activities have been strongly translational as it applies to clinical science. This has resulted in 411 publications including peer-reviewed original articles in: Journal of Allergy and Clinical Immunology, Journal of Clinical Investigation, Journal of Immunology, Blood, American Journal of Respiratory and Critical Care Medicine, Allergy, Clinical & Experimental Allergy, International Archives of Allergy and Immunology, Current Opinion in Allergy and Clinical Immunology etc, and invited reviews and book chapters. She is an Editor/ Associate Editor of peer-reviewed journals such as: International Archives of Allergy, Clinical Experimental Immunology, Current Opinion in Allergy and Clinical Immunology etc., and books including the 6 volume book ‘Allergy Frontiers’, the WAO White Book on Allergy, Update on Respiratory Disorders, and is a co-author of several consensus documents. She has mentored over 30 fellows from Japan and abroad. Prof. Pawankar has chaired as President and organized several international congresses including: the 10th Trans Pacific Allergy Congress in Mumbai, India; the first and the Middle East Allergy Congress, in 2009 and 2011 respectively; the WAO International Scientific Conference (WISC) 2012, India; the World Allergy Asthma Congress 2013, Milan, Italy, as well as several educational programs and has been a visiting faculty to lecture at several institutions such as Harvard Medical School, USA; the University of Wisconsin, USA; Imperial College, London, UK; Catholic University, Argentina; the University of Sao Paolo, Brazil and Mahidol University, Thailand. At an organizational level, her vision is to create a channel of dialogue with all stakeholders to address the unmet global public health issue of asthma and allergies in the context of non-communicable diseases (NCDs) via an integrated approach that could lead to increased resources for research, improved patient care, better health care delivery, and preventative strategies. David P. SkonerDavid P. SkonerDr David P. Skoner is Director of the Division of Allergy, Asthma, and Immunology in the Department of Medicine of Allegheny General Hospital in Pittsburgh, Pennsylvania, USA. He is also Professor of Medicine at the Temple University School of Medicine in Philadelphia, Pennsylvania, USA and Clinical Professor of Pediatrics, West Virginia University School of Medicine, USA. Previously, he was Associate Professor of Pediatrics and Otolaryngology at the University of Pittsburgh, School of Medicine, USA and has served as the Chief of the Section of Allergy/Immunology and Director of the Allergy and Immunology Training Program at the Children's Hospital of Pittsburgh, USA. Dr Skoner received his BS degree from Juniata College in Huntingdon, Pennsylvania, USA and his MD degree from Temple University in Philadelphia, Pennsylvania, USA. He served his residency in general pediatrics at Children's Hospital in Cincinnati, Ohio, USA, and he completed his fellowship in allergy/immunology at Children's Hospital in Pittsburgh. His current research interests include the relationships between respiratory viruses, asthma, immunity, and stress; the relationship between viral and allergen-induced nasal inflammation and middle ear disease; and the efficacy and safety (HPA axis function and growth in children) of inhaled and intranasal steroids. Dr Skoner has received NIH funding and written more than 100 articles and given more than 200 presentations on respiratory disease. His articles and abstracts have been published in many leading journals, including Pediatrics, Journal of Allergy and Clinical Immunology, Pediatric Research, American Journal of Respiratory and Critical Care Medicine, The Journal of the American Medical Association, and American Review of Respiratory Disease. Dr Skoner serves on the editorial advisory boards of the journals Current Allergy and Asthma Reports, and Current Opinion in Allergy and Clinical Immunology, and previously served on the editorial board of the American Journal of Rhinology. He is a Fellow of the American Academy of Pediatrics and a member of the Society of Pediatric Research, the American Academy of Allergy, Asthma and Immunology, the American College of Allergy, Asthma & Immunology, the Association for Research in Otolaryngology, and the American Pediatric Society. He has been recognized as one of America's ‘Top Doctors’ (Pediatric Allergy & Immunology, Castle Connolly Medical Ltd.) from 2001 to 2014, as one of the Most Influential Doctors by USA TODAY (http://www.usatoday.com/yourlife/health/most-influential-doctors.htm), and as a U.S. News Top Doctor (www.usnews.com/top-doctors). He was invited to join the Best Pharmaceuticals for Children Act (BPCA) Pediatric Asthma Therapeutics Group convened by the National Institute of Child Health and Human Development. Dr Skoner co-founded the Nemacolin Asthma Conference (www.ahn.org/nemacolin-asthma), a continuing medical education (CME) program that attracts a national and an international audience and faculty, now in its ninth year. He also founded and is the President of ‘For Your Good Health’ (www.fygh.org), a Pennsylvania non-profit corporation that brings together asthma stakeholders in the development and implementation of state-of the-art programs to educate children with asthma and their caregivers about the disease and its management. The aim of these programs is to reduce asthma's impact on patients, caregivers, the community, and the healthcare system by helping the patients to lead near-normal lives. He also serves on the board of the non-profit Greater Pittsburgh Allergy Asthma and Immunology Society (GPAAIS), which serves to educate and inform physicians and other health care providers. Dr Skoner was selected as a finalist in the category of ‘Health Care Provider: Physician’ for the 2013 Pittsburgh Business Times Health Care Heroes Awards. J. Andrew GrantJ. Andrew GrantDr Grant is a native of Florida and received his undergraduate degree from Harvard University, USA, in biochemical sciences. After attending Duke Medical School, USA, he did a residency in internal medicine at New York Hospital – Cornell Medical Center in New York City, USA. He did a fellowship in immunology with Leroy Hood at the National Institutes of Health and an allergy-immunology clinical fellowship at Johns Hopkins University, USA, with Phillip Norman and Lawrence Lichtenstein. In 1973, he established the first basic and clinical research program in allergy in Texas at the University of Texas Medical Branch in Galveston, USA. Presently he is Clinical Professor in the Departments of Medicine and Microbiology-Immunology and training program Director in Allergy-Immunology at that institution. He has served as Division Director and Vice Chair for Research within the Department of Internal Medicine. He vacations during the summer months in Colorado and has been appointed Clinical Professor at University of Colorado Medical School, USA. Dr Grant has been an active member of the American Academy of Allergy, Asthma and Immunology for over four decades. His contributions to this organization include chairing the Program Directors Assembly, Mechanisms of Allergy Interest Section, Postgraduate Education Committee, Scientific Workshops and Exhibits Committee, and Immunotherapy Committee. He served on the Editorial Board of the Journal of Allergy and Clinical Immunology. He founded In-training Examination for Allergy-Immunology postdoctoral fellows, the first subspecialty exam of its type. Dr Grant served as President of the Texas Allergy Asthma and Immunology Society and a Director of the American Board of Allergy and Immunology, and a member of the Residency Review Committee for Allergy and Immunology. He chaired the Pulmonary Allergy Drugs Advisory Committee of the Food and Drugs Administration and currently is a member of the Allergenic Products Advisory Committee. He was a visiting professor at the National Heart and Lung Institute with Professor Barry Kay in 1994. Dr Grant's research interests have included mechanisms of cellular activation especially the role of chemokines and novel therapies for allergic disorders. Currently he is emphasizing management of difficult patients with urticaria and angioedema. He has authored over 190 publications and chapters and 175 presentations at national and international meetings. Peter Howarth Professor Peter Howarth is Professor of Allergy and Respiratory Medicine and Honorary Consultant Physician within Medicine at the University of Southampton with a clinical and research focus on asthma, particularly severe asthma, and allergy. Professor Howarth has supervised over 20 PhD and DM students (scientists and clinicians) and his research involves Local, National and International collaboration. He has participated in EU funded collaborative programmes, such as BIOAIR and GA2LEN, focusing respectively on severe asthma and allergic diseases, and is joint work package 4 lead for UBIOPRED, the EU/EFPIA funded IMI programme on severe asthma. Professor Howarth has published over 200 peer reviewed papers and lectured extensively at National and International specialist society meetings as an invited speaker. Professor Howarth has contributed to National, European and International (World Health Organisation) guidelines on the management of rhinitis and asthma. He has been on the council of The British Society of Allergy and Clinical Immunology, advisor on allergy to Asthma UK and has been chairman of the board of trustees of Allergy UK. He is currently President of Allergy UK and a trustee of AAIR.

State University of New York Upstate Medical University College of Medicine

The Fertility and Sterility® continuing medical education program