Component-resolved diagnosis of pollen allergy based on skin testing with profilin, polcalcin and lipid transfer protein pan-allergens

BACKGROUND Allergy diagnosis needs to be improved in patients suffering from pollen polysensitization due to the existence of possible confounding factors in this type of patients. OBJECTIVE To evaluate new diagnostic strategies by comparing skin responses to pan-allergens and conventional allergenic extracts with specific IgE (sIgE) to purified allergen molecules. METHODS One thousand three hundred and twenty-nine pollen-allergic patients were diagnosed by a combination of an in vitro method with a panel of 13 purified allergens, including major allergens and pan-allergens, using a high-capacity screening technology (ADVIA-Centaur®) and skin prick test (SPT) to pan-allergens and conventional extracts. RESULTS There was a high concordance (κ index) between in vitro (sIgE to major allergens) and in vivo (SPT to conventional extracts) methods in patients who were not sensitized to pan-allergens, but SPT with conventional extracts failed to diagnose patients with sensitization to pan-allergens. In patients who were simultaneously sensitized to polcalcins and profilins, there was a duplication both in the number of sensitizations to major allergens and in the years of disease evolution. There was a statistical association between sensitization to profilins and/or lipid transfer proteins and food allergy (P<0.0001). CONCLUSION The novel diagnostic strategy has proven to be a valuable tool in daily clinical practice. Introduction of routine SPT to pan-allergens is a simple and feasible way of improving diagnostic efficacy. Patients sensitized to pan-allergens should be tested by an adequate panel of allergenic molecules in order to identify the allergens that are responsible for the allergic disease

From Theory to Practice: Forging a Collaborative Evaluation Strategy for a Culturally-Informed Domestic Violence Initiative

Community programs for domestic violence (DV) in the U.S. have historically focused on White populations. Few programs exist to meet the needs of racial/ethnic minority populations, including Latinx women, who encounter greater barriers to access services than their non-Hispanic White counterparts. Casa de Esperanza is one of the few organizations in the U.S. focused on addressing the unique needs of Latinx survivors of DV. In particular, their Family Advocacy Initiative (FAI) seeks to support Latinx communities impacted by DV by facilitating a variety of services including a 24-hour hotline, shelter, community advocacy, and transitional housing support network.&nbsp;This program utilizes Casa de Esperanza’s Latina Advocacy Framework, which was developed to address the unique risks, considerations, and needs of Latinx communities, but has yet to be empirically evaluated. As part of a graduate community psychology course on assessment, consultation, and evaluation, a university-community partnership was established to explore the process of defining, designing, and planning an evaluation of Casa de Esperanza’s FAI. This paper describes the university team’s process in learning about Casa de Esperanza and the FAI and collaboratively developing an evaluation plan. We briefly summarize the program’s theory of change, review its logic model, and present results from a focus group conducted with program staff. Based on this information we discuss the evaluation and recommendations for implementing it. Throughout the paper, we highlight the need for culturally sensitive programs for survivors of DV and the importance and benefits of collaborative community partnerships and evidence-based evaluative learning

From Theory to Practice: Forging a Collaborative Evaluation Strategy for a Culturally-Informed Domestic Violence Initiative

Community programs for domestic violence (DV) in the U.S. have historically focused on White populations. Few programs exist to meet the needs of racial/ethnic minority populations, including Latinx women, who encounter greater barriers to access services than their non-Hispanic White counterparts. Casa de Esperanza is one of the few organizations in the U.S. focused on addressing the unique needs of Latinx survivors of DV. In particular, their Family Advocacy Initiative (FAI) seeks to support Latinx communities impacted by DV by facilitating a variety of services including a 24-hour hotline, shelter, community advocacy, and transitional housing support network.&nbsp;This program utilizes Casa de Esperanza’s Latina Advocacy Framework, which was developed to address the unique risks, considerations, and needs of Latinx communities, but has yet to be empirically evaluated. As part of a graduate community psychology course on assessment, consultation, and evaluation, a university-community partnership was established to explore the process of defining, designing, and planning an evaluation of Casa de Esperanza’s FAI. This paper describes the university team’s process in learning about Casa de Esperanza and the FAI and collaboratively developing an evaluation plan. We briefly summarize the program’s theory of change, review its logic model, and present results from a focus group conducted with program staff. Based on this information we discuss the evaluation and recommendations for implementing it. Throughout the paper, we highlight the need for culturally sensitive programs for survivors of DV and the importance and benefits of collaborative community partnerships and evidence-based evaluative learning

Impact of a multifaceted intervention to improve the clinical management of osteoporosis. The ESOSVAL-F study

<p>Abstract</p> <p>Background</p> <p>A study to evaluate the impact of a combined intervention (in-class and on-line training courses, a practicum and economic incentives) to improve anti-osteoporosis treatment and to improve recordkeeping for specific information about osteoporosis.</p> <p>Methods/design</p> <p>A before/after study with a non-equivalent control group to evaluate the impact of the interventions associated with participation in the ESOSVAL-R cohort study (intervention group) compared to a group receiving no intervention (control group). The units of analysis are medical practices identified by a Healthcare Position Code (HPC) referring to a specific medical position in primary care general medicine in a Healthcare Department of the Region of Valencia, Spain. The subjects of the study are the 400 participating "practices" (population assigned to health care professionals, doctors and/or nurses) selected by the Healthcare Departments of the Valencia Healthcare Agency for participation as associate researchers in the ESOSVAL-R study (intervention group), compared to 400 participating "practices" assigned to primary care professionals NOT selected for participation as associate researchers in the ESOSVAL-R study, who are selected on the basis of their working in the same Healthcare Centers as the practices receiving the interventions (control group). The study's primary endpoint is the appropriateness of treatment according by the Spanish National Health System guide (2010) and the National Osteoporosis Foundation (NOF, 2008) and International Osteoporosis Foundation guidance (IOF, 2008).</p> <p>The study will also evaluate a series of secondary and tertiary endpoints. The former are the suitability of treatment and evaluation of the risk of fracture; and the latter are the volume of information registered in the electronic clinical records, and the evaluation of risks and the suitability of treatment.</p

Adherence to and appropriateness of anti-osteoporotic treatments in patients aged 50 and over in the Valencia Region (Spain). The ESOSVAL-AD Study

<p>Summary</p> <p>Background</p> <p>A study to evaluate the adherence to and appropriateness of anti-osteoporotic treatments in a cohort of men and women aged 50 and over participating in the ESOSVAL-R study.</p> <p>Methods/Design</p> <p><it>Design</it>: An observational, longitudinal, prospective cohort study; Study subjects: Men and women aged 50 and over living in the Valencia Region (Spain) who initiated treatment between June 15, 2009, and June 15, 2011, in primary healthcare centers with electronic medical records; <it>Data sources</it>: The main data source will be electronic medical records. <it>Measurement of results: </it>Degree of compliance with and persistence of anti-osteoporotic treatments, and the proportion of patients with appropriate anti-osteoporotic treatment in accordance with the most relevant and high impact recommendations with clearly defined treatment algorithms in Spain (the Spanish National Health System guide (2010), the General Practitioners' Society (2007) and the General Directorate for Pharmacy and Medical Products of Madrid (2007)), and with the National Osteoporosis Foundation (NOF, 2010), and the International Osteoporosis Foundation guidelines (IOF, 2008); <it>Analysis</it>: 1.) Descriptive analysis of patients undergoing treatment and the treatments prescribed; 2.) Descriptive analysis of compliance with and persistence of anti-osteoporotic treatments; 3.) Analysis of factors associated with compliance with and persistence of treatments by Cox proportional hazard regression models, 4.) Descriptive analysis of appropriateness of treatment; 5.) Analysis of factors associated with the appropriateness of treatment by multilevel models (4 levels: patient, doctor, Basic Healthcare Zone/Primary Healthcare Center, and Health Area variables).</p> <p>Discussion</p> <p>ESOSVAL-AD will provide information regarding adherence to osteoporosis treatments and the factors associated with a higher or lower adherence (including the appropriateness of the treatment) in the Spanish context. A better understanding of this phenomenon and the interventions needed to address it would contribute to the increased effectiveness of therapeutic measures, a reduction in morbidity and mortality, and a corresponding reduction in healthcare costs.</p

The bimodality of the 10k zCOSMOS-bright galaxies up to z ~ 1: a new statistical and portable classification based on the optical galaxy properties

Our goal is to develop a new and reliable statistical method to classify galaxies from large surveys. We probe the reliability of the method by comparing it with a three-dimensional classification cube, using the same set of spectral, photometric and morphological parameters.We applied two different methods of classification to a sample of galaxies extracted from the zCOSMOS redshift survey, in the redshift range 0.5 < z < 1.3. The first method is the combination of three independent classification schemes, while the second method exploits an entirely new approach based on statistical analyses like Principal Component Analysis (PCA) and Unsupervised Fuzzy Partition (UFP) clustering method. The PCA+UFP method has been applied also to a lower redshift sample (z < 0.5), exploiting the same set of data but the spectral ones, replaced by the equivalent width of H$\alpha$. The comparison between the two methods shows fairly good agreement on the definition on the two main clusters, the early-type and the late-type galaxies ones. Our PCA-UFP method of classification is robust, flexible and capable of identifying the two main populations of galaxies as well as the intermediate population. The intermediate galaxy population shows many of the properties of the green valley galaxies, and constitutes a more coherent and homogeneous population. The fairly large redshift range of the studied sample allows us to behold the downsizing effect: galaxies with masses of the order of $3\cdot 10^{10}$ Msun mainly are found in transition from the late type to the early type group at $z>0.5$, while galaxies with lower masses - of the order of $10^{10}$ Msun - are in transition at later epochs; galaxies with $M <10^{10}$ Msun did not begin their transition yet, while galaxies with very large masses ($M > 5\cdot 10^{10}$ Msun) mostly completed their transition before $z\sim 1$.Comment: 16 pages, 14 figures, accepted for publication in A&

Lipid profile, cardiovascular disease and mortality in a Mediterranean high-risk population: the ESCARVAL-RISK study

The potential impact of targeting different components of an adverse lipid profile in populations with multiple cardiovascular risk factors is not completely clear. This study aims to assess the association between different components of the standard lipid profile with all cause mortality and hospitalization due to cardiovascular events in a high-risk population. Methods This prospective registry included high risk adults over 30 years old free of cardiovascular disease (2008±2012). Diagnosis of hypertension, dyslipidemia or diabetes mellitus was inclusion criterion. Lipid biomarkers were evaluated. Primary endpoints were all-cause mortality and hospital admission due to coronary heart disease or stroke. We estimated adjusted rate ratios (aRR), absolute risk differences and population attributable risk associated with adverse lipid profiles. Results 51,462 subjects were included with a mean age of 62.6 years (47.6% men). During an average follow-up of 3.2 years, 919 deaths, 1666 hospitalizations for coronary heart disease and 1510 hospitalizations for stroke were recorded. The parameters that showed an increased rate for total mortality, coronary heart disease and stroke hospitalization were, respectively, low HDL-Cholesterol: aRR 1.25, 1.29 and 1.23; high Total/HDL-Cholesterol: aRR 1.22, 1.38 and 1.25; and high Triglycerides/HDL-Cholesterol: aRR 1.21, 1.30, 1.09. The parameters that showed highest population attributable risk (%) were, respectively, low HDL-Cholesterol: 7.70, 11.42, 8.40; high Total/HDL-Cholesterol: 6.55, 12.47, 8.73; and high Triglycerides/ HDL-Cholesterol: 8.94, 15.09, 6.92. Conclusions In a population with cardiovascular risk factors, HDL-cholesterol, Total/HDL-cholesterol and triglycerides/HDL-cholesterol ratios were associated with a higher population attributable risk for cardiovascular disease compared to other common biomarkers