Summary Background Long‐term oral triazole antifungal therapy is the cornerstone of management for patients with chronic pulmonary aspergillosis (CPA). Itraconazole is the first‐line choice of treatment. Voriconazole, posaconazole or isavuconazole can be used as alternative treatments in case of resistance or intolerance. All of these can cause significant adverse drug reactions. Objectives To evaluate how CPA patients tolerate voriconazole and isavuconazole after prior triazole therapy. Methods We performed a retrospective observational study at the UK National Aspergillosis Centre. Medical records for all consecutive CPA patients started on isavuconazole and voriconazole during an observation period of 12 and 6 months respectively were analysed. Results During this study period, 20 patients were started on isavuconazole and 21 patients on voriconazole. Adverse events were seen in 18 of 21 (86%) the patients in the voriconazole group and 12 of 20 (60%) in the isavuconazole group (P = 0.02). For those who developed adverse events to these agents, the rates of discontinuation of therapy were comparable (ie 10/18 [56%], voriconazole vs 8/12 [67%], isavuconazole; P = 0.54). Five (25%) patients in the isavuconazole group who were intolerant to other triazoles tolerated the standard dose of isavuconazole. Conclusions Compared with isavuconazole, adverse events were significantly higher in CPA patients commenced on voriconazole. Isavuconazole may be an option for those patients who are intolerant to other triazoles.

Wheelchair Fencing (WF) is a Paralympic sport which is practiced by athletes with physical disabilities and is classified into three categories according to the degree of activity limitation the impairment causes in the sport.All Paralympic sports are requested to develop their own evidence-based classification system to enhance the confidence in the classification process however, this is yet to be achieved in WF. Research within WF is scarce therefore, the aim of this study was to reach expert consensus on the physical characteristics that underpin performance of athletes competing in the sport as this is known as one of the initial steps required to achieve an evidence-based classification system. Sixteen Paralympic WF coaches were invited to take part in a 3-round Delphi study, with experts drawing consensus on qualities of speed, strength, power, flexibility and motor control of the trunk and fencing arm being associated with increased athletic success. The required qualities of the nonfencing arm led to diverging opinions across the expert panel. This study provides clear guidance of the physical qualities to be developed to maximise athletic performance while also providing the initial framework to guide future WF classification research.

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Comparative research related to any aspect of the process of breach in either the pre-trial, sentencing or release phases is relatively rare. Comparative studies of decision making in the specific context of breach process are particularly lacking. One reason for the dearth of research in this area is the many challenges presented by comparative research across different jurisdictions. This article focuses on the development of a vignette methodology to explore the decision-making aspect of the breach process from a comparative perspective across a number of different European jurisdictions. The vignettes are designed to explore the decision-making aspects of two different types of breach process – the process of breach that follows on from a breach of conditions of early release from prison and the process that follows a breach of conditions attached to the completion of an unpaid work order. The article begins by contextualizing the research in debates about the relationship between compliance, legitimacy and rising prison populations. It critically examines the nature of vignette methodology and then discusses the specific challenges of using vignettes in comparative research as well as the development, piloting and evaluation of the decision-making vignettes in focus. We conclude by discussing some of the challenges we faced and particularly our challenge in terms of the development of the methodology – enhancing the comparability of the findings.