History and the inequality predicament

Globalisation is affecting daily life almost everywhere, so it seemed logical when the 2005 UN Report on the World Social Situation, The Inequality Predicament, reported that economic inequality is dramatically increasing in Asia, as it has been in the rest of the world. This trend is embedded in spatial and social patterns reproduced over the last two centuries - patterns that comprise a deeper, more pervasive 'inequality predicament' than the UN dares to recognise

Editorial Notes

This book includes the text parts of design proposal presentations as well as academic pa- pers of the International MinD Conference held in Dresden, Germany, in September 2019. Academic papers are marked with the Bachelor’s hat icon ( ) and design proposals are marked with a pen ( ). The content of the special workshops held at the conference is not included in this volume. The proceedings reflect a broad engagement with the field from a diverse range of re- searchers and practitioners from the various design and health disciplines, including prod- uct and interior design, craft, information and communication technologies, architecture and the built environment, psychiatry, psychology, geriatrics and others. Together, the contributions offer an overview of how design – as a process and an outcome – can help to support people to live well with dementia as well as their relatives, carers and care professionals. We hope that these contributions also provide a better insight into how design and designers can be used and developed to do so. By offering these insights and enhanced understanding, we hope to provide a better basis for collaborations between people living with dementia or designing for and concerned with dementia care to contrib- ute to improving life for those living with dementia [... from the Editorial Notes

Orthogonal binding and displacement of different guest types using a coordination cage host with cavity-based and surface-based binding sites

The octanuclear Co(II) cubic coordination cage system H (or HW if it bears external water-solubilising substituents) has two types of binding site for guests. These are (i) the partially-enclosed central cavity where neutral hydrophobic organic species can bind, and (ii) the six 'portals' in the centres of each of the faces of the cubic cage where anions bind via formation of a network of CH⋯X hydrogen bonds between the anion and CH units on the positively-charged cage surface, as demonstrated by a set of crystal structures. The near-orthogonality of these guest binding modes provides the basis for an unusual dual-probe fluorescence displacement assay in which either a cavity-bound fluorophore (4-methyl-7-amino-coumarin, MAC; λem = 440 nm), or a surface-bound anionic fluorophore (fluorescein, FLU; λem = 515 nm), is displaced and has its emission ‘switched on’ according to whether the analyte under investigation is cavity-binding, surface binding, or a combination of both. A completely orthogonal system is demonstrated based using a Hw/MAC/FLU combination: addition of the anionic analyte ascorbate displaced solely FLU from the cage surface, increasing the 515 nm (green) emission component, whereas addition of a neutral hydrophobic guest such as cyclooctanone displaced solely MAC from the cage central cavity, increasing the 440 nm (blue) emission component. Addition of chloride results in some release of both components, and an intermediate colour change, as chloride is a rare example of a guest that shows both surface-binding and cavity-binding behaviour. Thus we have a colourimetric response based on differing contributions from blue and green emission components in which the specific colour change signals the binding mode of the analyte. Addition of a fixed red emission component from the complex [Ru(bipy)3]2+ (Ru) provides a baseline colour shift of the overall colour of the luminescence closer to neutral, meaning that different types of guest binding result in different colour changes which are easily distinguishable by eye

Overview and Strategy Analysis of Technology-Based Nonpharmacological Interventions for In-Hospital Delirium Prevention and Reduction:Systematic Scoping Review

BACKGROUND: Delirium prevention is crucial, especially in critically ill patients. Nonpharmacological multicomponent interventions for preventing delirium are increasingly recommended and technology-based interventions have been developed to support them. Despite the increasing number and diversity in technology-based interventions, there has been no systematic effort to create an overview of these interventions for in-hospital delirium prevention and reduction. OBJECTIVE: This systematic scoping review was carried out to answer the following questions: (1) what are the technologies currently used in nonpharmacological technology-based interventions for preventing and reducing delirium? and (2) what are the strategies underlying these currently used technologies? METHODS: A systematic search was conducted in Scopus and Embase between 2015 and 2020. A selection was made in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Studies were eligible if they contained any type of technology-based interventions and assessed delirium-/risk factor–related outcome measures in a hospital setting. Data extraction and quality assessment were performed using a predesigned data form. RESULTS: A total of 31 studies were included and analyzed focusing on the types of technology and the strategies used in the interventions. Our review revealed 8 different technology types and 14 strategies that were categorized into the following 7 pathways: (1) restore circadian rhythm, (2) activate the body, (3) activate the mind, (4) induce relaxation, (5) provide a sense of security, (6) provide a sense of control, and (7) provide a sense of being connected. For all technology types, significant positive effects were found on either or both direct and indirect delirium outcomes. Several similarities were found across effective interventions: using a multicomponent approach or including components comforting the psychological needs of patients (eg, familiarity, distraction, soothing elements). CONCLUSIONS: Technology-based interventions have a high potential when multidimensional needs of patients (eg, physical, cognitive, emotional) are incorporated. The 7 pathways pinpoint starting points for building more effective technology-based interventions. Opportunities were discussed for transforming the intensive care unit into a healing environment as a powerful tool to prevent delirium. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42020175874; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=17587

Chromogenic media for ESBL-positive Enterobacteriaceae

ChromID ESBL agar and Brilliance ESBL agar were compared for the isolation of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae from 298 stools. These had comparable sensitivity and selectivity for the 116 positive samples. Pre-enrichment with cefpodoxime and extending incubation to 48 hours after direct plating both significantly increased sensitivity but reduced selectivity of both agars.This work was supported by a grant awarded to SP from the UK Department of Health, Wellcome Trust and the Health Innovation Challenge Fund (HICF-T5-342 and WT098600). TG is a Wellcome Trust Research Training Fellow. MET is a Clinician Scientist Fellow, supported by the Academy of Medical Sciences and the Health Foundation. The authors declare no conflicts of interest.This is the final version of the article. It first appeared from Elsevier via http://dx.doi.org/10.1016/j.diagmicrobio.2015.11.00

One guest or two? A crystallographic and solution study of guest binding in a cubic coordination cage

A crystallographic investigation of a series of host/guest complexes in which small‐molecule organic guests occupy the central cavity of an approximately cubic M 8 L 12 coordination cage has revealed some unexpected behaviour. Whilst some guests form 1:1 H•G complexes as we have seen before, an extensive family of bicyclic guests – including some substituted coumarins and various saturated analogues – form 1:2 H•G 2 complexes in the solid state, despite the fact that solution titrations are consistent with 1:1 complex formation, and the combined volume of the pair of guests significantly exceeds the Rebek 55±9% packing for optimal guest binding, with packing coefficients of up to 87%. Re‐examination of solution titration data for guest binding in two cases showed that, although conventional fluorescence titrations are consistent with 1:1 binding model, alternative forms of analysis – Job plot and an NMR titration – at higher concentrations do provide evidence for 1:2 H•G 2 complex formation. The observation of guests binding in pairs in some cases opens up new possibilities for altered reactivity of bound guests, and also highlights the recently‐articulated difficulties associated with determining stoichiometry of supramolecular complexes in solution

Pharmacokinetics of Teriparatide (rhPTH[1–34]) and Calcium Pharmacodynamics in Postmenopausal Women with Osteoporosis

Teriparatide (rhPTH[1–34]) affects calcium metabolism in a pattern consistent with the known actions of endogenous parathyroid hormone (PTH). This report describes the pharmacokinetics and resulting serum calcium response to teriparatide in postmenopausal women with osteoporosis. Pharmacokinetic samples for this analysis were obtained from 360 women who participated in the Fracture Prevention Trial. Postmenopausal women with osteoporosis received daily subcutaneous injections of either teriparatide 20 μg (4.86 μmol) or placebo, median 21 months’ treatment. Serum teriparatide and calcium concentrations were measured throughout the study. An indirect-response model was developed to describe the pharmacokinetic–pharmacodynamic relationship between teriparatide concentrations and serum calcium response. The pharmacokinetics of teriparatide were characterized by rapid absorption (maximum concentration achieved within 30 min) and rapid elimination (half-life of 1 h), resulting in a total duration of exposure to the peptide of approximately 4 h. Teriparatide transiently increased serum calcium, with the maximum effect observed at approximately 4.25 h (median increase 0.4 mg/dl [0.1 mmol/l]). Calcium concentrations returned to predose levels by 16–24 h after each dose. Persistent hypercalcemia was not observed; one teriparatide 20 μg-treated patient had a predose serum calcium value above the normal range but <11.0 mg/dl (2.75 mmol/l). Following once-daily subcutaneous administration, teriparatide produces a modest but transient increase in serum calcium, consistent with the known effects of endogenous PTH on mineral metabolism. The excursion in serum calcium is brief, due to the short length of time that teriparatide concentrations are elevated

Design for Behaviour Change as a Driver for Sustainable Innovation: Challenges and Opportunities for Implementation in the Private and Public Sectors

Over the last decade, design for behaviour change has become increasingly recognised as a strategy for enabling social change. Despite this, we are far from understanding its implementation, especially through the private and public sectors. This study has surveyed private and public sector stakeholders with regard to their current knowledge of, and approach to, design for behaviour change. The aim was to identify the challenges for professional stakeholders in understanding, accessing and implementing design for behaviour change. Underpinned by a literature review of design for behaviour change theories and approaches, an online survey and two focus groups with private and public sector stakeholders were conducted with particular focus on small and medium size enterprises (SMEs). The results identified that there is a significant disconnect between available theoretical knowledge of design for behaviour change and its practical implementation. Reasons for this include a lack of awareness and common language, of evidence based examples, and of evaluation methods and inter-sector collaborations. In response, a set of recommendations has been developed to propose ways forward for the wider understanding and application of design for behaviour change