Discordant diagnostic criteria for pneumonia in COPD trials: a review

Inhaled corticosteroids (ICS) have a class effect of increasing pneumonia risk in patients with COPD. However, pneumonia incidence varies widely across clinical trials of ICS use in COPD. This review clarifies methodological differences in defining and recording pneumonia events in these trials and discusses factors that could contribute to the varying pneumonia incidence. Literature searches and screening yielded 40 relevant references for inclusion. Methods used to capture pneumonia events in these studies included investigator-reported pneumonia adverse events, standardised list of signs or symptoms, radiographic confirmation of suspected cases and/or confirmation by an independent clinical end-point committee. In general, more stringent pneumonia diagnosis criteria led to lower reported pneumonia incidence rates. In addition, studies varied in design and population characteristics, including exacerbation history and lung function, factors that probably contribute to the varying pneumonia incidence. As such, cross-trial comparisons are problematic. A minimal set of standardised criteria for diagnosis and reporting of pneumonia should be used in COPD studies, as well as reporting of patients’ pneumonia history at baseline, to allow comparison of pneumonia rates between trials. Currently, within-trial comparison of ICS-containing versus non-ICS-containing treatments is the appropriate method to assess the influence of ICS on pneumonia incidence.

To what extent does a pharmacy curriculum foster diversity and inclusion through paper-based case scenarios?

Background: There is increasing awareness of diversity and inclusion needs within health and education systems to help address access and equity issues for minority groups. Although these calls are well known, there is little guidance for those working within these systems to create meaningful change. The purpose of this study was to critically review case-based teaching material within the authors' programmes through the lens of equity, diversity, and inclusion. Methods: A document analysis of clinical workshop cases extracted from all integrated therapeutics courses administered in 2020 was conducted. Results: Sex, age, and employment status were most commonly presented in cases (84.0%, 97.1%, 49.0% respectively). The majority (90.0%) of cases did not have ethnicity defined. The overwhelming majority of cases did not have living situation (68.3%) or sexual orientation (78.0%) defined. Conclusion: Case-based teaching material within a pharmacy programme was largely undefined according to patient demographics and diversity markers. Findings support the notion that teaching material may have a contributory role towards systemic racism, prejudice, and implicit bias.

Creating Dementia-Friendly Communities for Social Inclusion: A Scoping Review

Aims: This scoping review explores key strategies of creating inclusive dementia-friendly communities that support people with dementia and their informal caregiver. Background: Social exclusion is commonly reported by people with dementia. Dementia-friendly community has emerged as an idea with potential to contribute to cultivating social inclusion. Methods: This scoping review follows the Joanna Briggs Institute scoping review methodology and took place between April and September 2020. The review included a three-step search strategy: (1) identifying keywords from CINAHL and AgeLine; (2) conducting a second search using all identified keywords and index terms across selected databases (CINAHL, AgeLine, MEDLINE, PsycINFO, Web of Science, ProQuest, and Google); and (3) hand-searching the reference lists of all included articles and reports for additional studies. Results: Twenty-nine papers were included in the review. Content analysis identified strategies for creating dementia-friendly communities: (a) active involvement of people with dementia and caregivers (b) inclusive environmental design; (c) public education to reduce stigma and raise awareness; and (d) customized strategies informed by theory. Conclusion: This scoping review provides an overview of current evidence on strategies supporting dementia-friendly communities for social inclusion. Future efforts should apply implementation science theories to inform strategies for education, practice, policy and future research.

Synthesis and Comparative Study of Nanoparticles Derived from Bovine and Human Serum Albumins

This study describes the preparation of nanoparticles derived from bovine serum albumin (BSA) in comparison with the formation of nanoparticles composed of human serum albumin (HSA), when the same preparation procedure was used in both cases. To obtain protein nanoparticles, the method of desolvation with ethanol was employed, followed by the stabilization with urea and cysteine. It was shown that, upon transition from HSA to BSA, the particles with smaller sizes and with a narrower polydispersity were formed. The possibility of the immobilization of the antitumor drug hydroxyurea in such protein nanoparticles by adsorption and inclusion methods has been shown. The drug release profile from the polymer matrix was established.

Conceptualization of the Phenomenon of Subjectness of the Network Community Using a Grounded Theory Method

The study of the characteristics of network communities is due to the increasingly complete transition of social life into the Internet space. Subjectness is a key psychological characteristic of a community that manifests itself in its discourse. The method of grounded theory as one of the most advanced methods in the coding paradigm allows conceptualizing the phenomenon of subjectness of network communities by analyzing their discourse. The article shows how this method is consistently used and how the problems associated with the psychological interpretation of constructs generated from the “empirical field” are overcome. So the problem of the diversity manifestations of subjectness was solved by subjective scaling of the contribution of substantive codes during the reconstruction of the structure of implicit ideas about the subjectness of the network community. Further iterations in the process of constructing a ground theory and the development of a short list of discursive markers of subjectness led to the inclusion methods for comparing factor structures. The analysis of the trolling process made it possible to introduce into the developed model of subjectness the ideas about current and potential components.

A FLUORESCENCE CONTRIBUTION TO THE RECOGNITION OF FLUIDS TRAPPED IN MINERALS IN THE CARPATHIAN OUTCROPS

Based on the assumption that fluorescence studies are an important tool in search and characterization of hydrocarbons, samples of rocks, minerals and the organic matter were collected in the Western Carpathian area spreading from the Mszana Górna region in the west to the Bieszczady Mts. in the east, and continuously, towards SE outside the Polish frontier, in Ukraine and Slovakia. Analytical procedures comprised preparation, microscopic observation of the material (organic matter and minerals) from the point of view of inclusions and fluorescence followed by detailed luminescence studies. Those steps have been followed by the microthermometric determinations. The application of the fluid inclusion methods, which are one of the newest analytical tools in the last two decades have led to the characteristics of fluids trapped in the inclusions in the area. The fluorescence studies showed some diversity of hydrocarbons both in compositions and in distribution. The analyses were performed in double-sided polished thin sections prepared based on cold techniques. Fluorescence of inclusions in two minerals, quartz and calcite, was checked in those specific thin sections either in glued wafers, or loose (single) crystals. The fluid inclusion studies were accompanied later on by solid organic matter inclusion studies. Those point to the presence of the following minerals: quartz, dolomite, calcite, clay minerals, gypsum with anhydrite admixture, traces of pyrite and siderite, feldspars. General distribution of fluorescing and not fluorescing inclusions suggests the presence of light hydrocarbons (methane) in the west and south of the area, being enriched in higher hydrocarbons (oil) towards the east.

What Do Schools of Public Health Have to Say About Diversity and Inclusion?

Objective. The purpose of this study was to understand how schools of public health (SPHs) define and operationalize diversity and inclusion. Methods. Data were collected in February 2017 from publicly available websites for each of the 59 Council on Education in Public Health–accredited SPHs, including mission/vision, goals/strategic plans, and diversity statements. Mentions of diversity were quantified to generate the proportion of SPHs that explicitly address diversity or inclusion. As a related secondary point, mentions of equity were also considered. Results. One third of SPHs do not mention diversity, inclusion, or equity as central tenets of the school. Twenty percent do not mention strategic plans or goals related to diversity, inclusion, or equity. Only 12 of the 59 schools define what they mean by diversity. Conclusions. Recently released Council on Education in Public Health accreditation competencies point to a need for increased attention by SPHs to inclusion and equity. Currently, however, most SPHs do not have a clear definition of how they define diversity. Implications. Additional research is needed into how SPHs will evolve their conceptualizations of diversity, inclusion, and equity to meet the training needs of the next generation of public health professionals.

Augmentation mastopexy after bariatric surgery: evaluation of patient satisfaction and surgical results.

ABSTRACT Objective: to evaluate patient satisfaction and surgical results obtained after mastopexy with breast implant inclusion. Methods: we conducted a prospective study of 20 consecutive female patients with a mean age of 39.9 years, submitted to augmentation mastopexy. We applied semi-directed psychological interviews pre and postoperatively. The answers to the evaluations were tabulated, categorized, and allowed patient satisfaction analysis. We evaluated surgical results through photographic analysis of three independent plastic surgeons, in the pre and postoperative periods, when scores were attributed to the following items: breasts shape, breasts volume, breasts symmetry, nipple-areolar complex position, and scar quality and extent. Results: nineteen patients (95%) referred satisfaction with the surgical results attained (p<0,001). The mean sum of the scores attributed by the three surgeons to each patient varied between 4.7 and 10, with an overall mean of 7.28. The results were considered good or great for 65% of the sample and poor for 8.4%. Conclusion: there was a 95% satisfaction rate among patients with the results obtained through augmentation mastopexy. The photographic analysis of the results obtained a mean score of 7.28, considered as a good result, albeit the weak correlation among evaluators.