Inhaled corticosteroids versus long-acting beta -agonists for chronic obstructive pulmonary disease (Review).

Long-acting beta(2)-agonists and inhaled corticosteroids can be used as maintenance therapy by patients with moderate to severe chronic obstructive pulmonary disease. These interventions are often taken together in a combination inhaler. However, the relative added value of the two individual components is unclear

Intranasal fentanyl versus fentanyl pectin nasal spray for the management of breakthrough cancer pain in doses proportional to basal opioid regimen.

Abstract The aim of this randomized, crossover, comparison study was to assess the analgesic and adverse effects of 2 nasal preparations, intranasal fentanyl (INFS) and fentanyl pectin nasal spray (FPNS), for breakthrough pain, given in doses proportional to opioid basal regimen. Each patient randomly received INFS or FPNS in doses proportional to opioid dosages used for background analgesia for 2 pairs of episodes. For each episode of breakthrough pain, pain intensity and adverse effects intensity were recorded just before starting the INFS or FPNS (T0) and 5 minutes (T5), 10 minutes (T10), and 20 minutes (T20) after the administration of the nasal drugs. Sixty-nine patients were studied. The mean age was 63.4 years, and 37 patients were males. For the present analysis, 188 episodes were considered. A statistical decrease in pain intensity was observed with both nasal drugs after 5, 10, and 20 minutes. A decrease in pain intensity of >33% was observed in 16, 102, and 159 treated episodes at T5, T10, and T20, respectively. Adverse effects were of mild nature in most cases or were preexistent because of basal opioid therapy. No differences were found in summed pain intensity difference 20 minutes after dosing. Most of patients did not find substantial preferences. INFS and FPNS were effective and well-tolerated treatments for breakthrough pain management. Both delivery systems, in doses proportional to the basal opioid regimen, provided significant analgesia within 10 minutes, without producing relevant adverse effects. PERSPECTIVE: This article showed that INFS and FPNS in doses proportional to basal opioid regimen are equally safe and effective for the management of breakthrough pain in cancer patients. These data provide new insights on the use of nasal preparations of fentanyl

The Atlas of Knowledge: A look into the capabilities of the IMSA YouTube Channel

After noting a lack of engagement and representation on the IMSA YouTube channel and researching existing science content, we produced an educational video segment for the channel about the brain, based on student surveys. After capturing analytics before and after, we analyzed the change in the channel and denoted this change to the topic, format, and production of our content. Our results will demonstrate how successfully the elements of our video performed as well as the platform of the IMSA YouTube channel

International Veterinary Epilepsy Task Force consensus proposal: Medical treatment of canine epilepsy in Europe

In Europe, the number of antiepileptic drugs (AEDs) licensed for dogs has grown considerably over the last years. Nevertheless, the same questions remain, which include, 1) when to start treatment, 2) which drug is best used initially, 3) which adjunctive AED can be advised if treatment with the initial drug is unsatisfactory, and 4) when treatment changes should be considered. In this consensus proposal, an overview is given on the aim of AED treatment, when to start long-term treatment in canine epilepsy and which veterinary AEDs are currently in use for dogs. The consensus proposal for drug treatment protocols, 1) is based on current published evidence-based literature, 2) considers the current legal framework of the cascade regulation for the prescription of veterinary drugs in Europe, and 3) reflects the authors’ experience. With this paper it is aimed to provide a consensus for the management of canine idiopathic epilepsy. Furthermore, for the management of structural epilepsy AEDs are inevitable in addition to treating the underlying cause, if possible

Towards a rational design of solid drug nanoparticles with optimised pharmacological properties.

Solid drug nanoparticles (SDNs) are a nanotechnology with favourable characteristics to enhance drug delivery and improve the treatment of several diseases, showing benefit for improved oral bioavailability and injectable long-acting medicines. The physicochemical properties and composition of nanoformulations can influence the absorption, distribution, and elimination of nanoparticles; consequently, the development of nanoparticles for drug delivery should consider the potential role of nanoparticle characteristics in the definition of pharmacokinetics. The aim of this study was to investigate the pharmacological behaviour of efavirenz SDNs and the identification of optimal nanoparticle properties and composition. Seventy-seven efavirenz SDNs were included in the analysis. Cellular accumulation was evaluated in HepG2 (hepatic) and Caco-2 (intestinal), CEM (lymphocyte), THP1 (monocyte), and A-THP1 (macrophage) cell lines. Apparent intestinal permeability (Papp) was measured using a monolayer of Caco-2 cells. The Papp values were used to evaluate the potential benefit on pharmacokinetics using a physiologically based pharmacokinetic model. The generated SDNs had an enhanced intestinal permeability and accumulation in different cell lines compared to the traditional formulation of efavirenz. Nanoparticle size and excipient choice influenced efavirenz apparent permeability and cellular accumulation, and this appeared to be cell line dependent. These findings represent a valuable platform for the design of SDNs, giving an empirical background for the selection of optimal nanoparticle characteristics and composition. Understanding how nanoparticle components and physicochemical properties influence pharmacological patterns will enable the rational design of SDNs with desirable pharmacokinetics

Social work in schools.

Mastergradsoppgave i tilpasset opplæring, Avdeling for lærerutdanning og naturvitenskap, Høgskolen i Innlandet, 2017.Norsk: Denne masteroppgaven forsøker å belyse det sosialfaglige arbeidets betydning for å realisere elevenes rettigheter om tilpasset opplæring. Bakgrunnen for undersøkelsen er at psykososialt arbeid og psykisk helse har fått et økt fokus, og det kan se ut til at skolene har et behov for å møte elevenes behov på en bedre måte. Målet er å finne ut av hvilke erfaringer og meninger informantene har av dette arbeidets betydning, og hvilke forutsetninger som må ligge til grunn for å møte elevene best mulig. Oppgaven er fokusert rundt temaet psykososialt arbeid/psykisk helse, tilpasset opplæring, samarbeid og relasjoner. Undersøkelsen viser at skolene har de beste intensjoner i sitt arbeid, og at de har et godt forebyggende perspektiv på arbeidet. Det kommer frem at omfanget er stort, og at mange elever opplever utfordringer i sin hverdag. Dette omfanget gjør at det er behov for å vurdere hvilke sider av arbeidet som fungerer, og hva som kan utvikles for å ivareta elevene enda bedre. Informantene omtaler det som ser ut til å være et skille mellom de sosialfaglig ansatte og de øvrige ansatte, og at det kan se ut til å handle om forståelse. En manglende forståelse av hverandres roller og arbeid, gjør at skolen møter noen utfordringer i arbeidet for å realisere elevenes fullstendige læringspotensial. Det påpekes et ønske og behov om å øke samarbeidet rundt skolens planer, slik at man kan sikre en mer helhetlig og systematisk opplæring for alle. Videre i oppgaven påpekes relasjonenes betydning, og at det relasjonelle arbeidet er essensielt for å kunne avdekke utfordringer, hjelpe og støtte elevene. Skolene har fokus på voksenansvaret i relasjonene, og har avsatt mye tid til relasjonelt arbeid. Skolen har gjort flere grep for å bedre relasjonene, både mellom de ansatte og mellom elevene. Et viktig bidrag er det forebyggende arbeidet, hvor målet er at elevene skal utvikle sin sosiale og emosjonelle kompetanse. Undersøkelsen viser at behovet for å øke skolenes forståelse og kompetanse av sosialfaglige utfordringer er viktig. Dette bidrar til å påvirke elevenes læring, helse og trivsel.English: This master thesis concerns how social work affects the students rights for differentiated teaching. The background for this thesis is the increased focus on psychosocial work and psychic health, and it looks like schools have a need to meet students needs in a better way. The goal is to reveal the experiences and opinions the informants have from the social works effect, and to enlighten the requirements needed to improve the students education. The thesis evolves the following topics: psychosocial work/psychic health, differentiated teaching, cooperation and relations. The study is confirming that the schools have the best intentions for their work, and they have a strong preventive focus in their work. It is a need for social work in schools, and a lot of students experience difficulties as a part of their daily life. This need makes it important for the schools to assess which parts of the work they need to improve, and which they can continue using. The informants is talking about what seems to be a gap between the social workers and the rest of the school staff, and it seems to be caused by a lack of understanding. A lack of understanding of different roles and tasks, makes it difficult for the school to work together in an optimal way to improve the students learning abilities. They point out a need and a wish for an increased collaboration in the schools plans, to secure a more systematic and comprehensive education for everyone. In the thesis they point out the importance of relations, and the fact that relations is crucial to reveal difficulties, help and support the students. The schools have focused on the staffs responsibility to improve and maintain the relations to the students, and they have deposited time to this relational work. The schools have done several measures to improve the relations both between students and staff, but also between the students. An important contribution is the preventive work, where the students develops their social and emotional skills. The thesis shows the importance of increased understanding and competence within social work. This is an important contribution to students learning, health and wellbeing

Impact of Grazing on Alberta’s Northern Temperate Grasslands

Understanding factors affecting elemental carbon stocks on Alberta’s grasslands is of special importance with recent policy shifts focusing on climate change and carbon (C) emissions. A large part of Alberta is native prairie utilized by the beef industry. This study examined soil and vegetation over more than a hundred Alberta grassland sites to better understand the effects that regional climate and grazing have on grassland C. Overall, grazing maintained plant production and increased vegetation diversity. In high precipitation environments, grazing tended to reduce woody species, favor introduced plants, and increase herb production as well as total C stores. Grazing decreased C mass in litter, but led to more C mass in soil, especially in regions with higher precipitation (>475mm). These results suggest that grazing is an important component for maintaining large C masses in soil

En sammenligning av fritidsboligmarkedet på fjellet og ved sjøen i Norge

Det å eie en egen fritidsbolig i Norge er svært populært, og det finnes nok også mange som drømmer om å en dag eie en egen fritidsbolig i Norge. Fritidsboligmarkedet i Norge har gjennom flere år hatt en økende prisvekst, ser man tilbake i 2013 hadde fritidsboliger på landsbasis en nominell gjennomsnittspris på 1 714 844 kroner. I 2022 hadde dermed prisen steget til 2 965 980 kroner (Eiendom Norge et al., 2022). Selv med en økende prisvekst, finnes det i dag store prisforskjeller mellom å kjøpe en fritidsbolig ved sjøen versus på fjellet. Det finnes i dag store prisforskjeller mellom fritidsboligmarkedet ved sjøen og på fjellet, gjennom denne masteroppgaven utformet jeg følgende problemstilling: «Er det utpregete forskjeller i dagens fritidsboligmarked mellom hytter i fjellområder og hytter langs sjøen?» Jeg har forsøk på å analysere sammenhengene mellom størrelse og avstand til fritidsbolig, samt prisen på disse. I tillegg har jeg utført en analyse for å se om turismen har en innvirkning på gjennomsnittlig kjøpspris og antall solgte fritidsboliger i 2020. For å kunne undersøke ulikhetene på fritidsboligmarkedene på fjellet og ved sjøen valgte jeg å legge fokus på Trysil og Kragerø, hvor Trysil referer til hytter i fjellområder og Kragerø til hytter langs sjøen. Jeg har gjennom denne masteroppgaven tatt i bruk kvantitativ forskningsmetode, gjennom bruk av spørreundersøkelse med avhuking og analysering av innhentet tall fra Eiendomsverdi, SSB, NHO-reiseliv og Visit Norway. Resultatene fra spørreundersøkelsen viser til at salgsprisen er det viktigste elementet ved kjøp av fritidsbolig, deretter kommer reiseveien fra bosted til fritidsbolig, og på tredjeplassen har vi aktiviteter i området som kan være alt fra alpinbakke til sykkelløyper og mer. Det kommer også frem gjennom spørreundersøkelsen at de fleste av respondentene foretrekker Trysil fremfor Kragerø, noe som er svært interessant med tanke på de resultatene som kommer frem i de andre analysene som er blitt utført. Resultatene fra de ulike undersøkelsene som er blitt gjennomført viser til at fritidsboligmarkedet i Kragerø har i dag en høyere prissetting på fritidsboligene sammenlignet med Trysilfjellet. Dermed kan det konkluderes basert på analysene og hypotesetestingen som er blitt utført i masteroppgaven at det i dag finnes utpregede forskjeller i dagens fritidsboligmarked mellom hytter i fjellområder og hytter langs sjøen. Resultatene fra undersøkelsen om turismens innvirkning på gjennomsnittlig kjøpspris og antall solgte fritidsboliger for 2020, viser begge til at det i 2020 ikke var en direkte sammenheng mellom disse variablene.Owning your own holiday home in Norway is very popular, and there are probably also many who dream of one day owning their own holiday home in Norway. The holiday home market in Norway has for several years had an increasing price growth, looking back in 2013 holiday homes nationwide had a nominal average price of NOK 1 714 844. Thus, in 2022, the price had risen to NOK 2,965,980 (Eiendom Norway et al., 2022). Even with increasing price growth, there are currently large price differences between buying a holiday home by the sea versus in the mountains. There are currently large price differences between the holiday home market by the sea and in the mountains, through this master's thesis I formulated the following research question: "Are there significant differences in today's holiday home market between cabins in mountainous areas and cabins along the sea?" I have attempted to analyze the relationship between size and distance to holiday homes, as well as the price of these. In addition, I have carried out an analysis to see if tourism has an impact on the average purchase price and number of holiday homes sold in 2020. To investigate the differences in the holiday home markets in the mountains and by the sea, I chose to focus on Trysil and Kragerø, where Trysil refers to cabins in mountain areas and Kragerø to cabins along the sea. Through this master's thesis, I have used quantitative research methods, using a questionnaire with ticking and analysis of collected figures from Eiendomsverdi, Statistics Norway, NHO tourism and Visit Norway. The results from the survey show that the sale price is the most important element when buying a holiday home, then comes the travel distance from place of residence to holiday home, and in third place we have activities in the area that can be anything from alpine slopes to bike trails and more. It also appears from the survey that most of the respondents prefer Trysil to Kragerø, which is very interesting considering the results that emerge from the other analyses that have been performed. The results of the various surveys that have been conducted show that the holiday home market in Kragerø currently has a higher price for holiday homes compared to Trysilfjellet. Thus, it can be concluded based on the analyses and hypothesis testing that have been carried out in the master's thesis that there are today marked differences in today's holiday home market between cabins in mountainous areas and cabins along the sea. The results of the survey on tourism's impact on average purchase price and number of holiday homes sold for 2020 both show that in 2020 there was no direct correlation between these variables

Open questions and misconceptions in the diagnosis and management of anemia in patients with gastrointestinal bleeding

Despite high prevalence of iron deficiency anemia (IDA) in patients with acute or chronic gastrointestinal bleeding (GIB), IDA and iron deficiency (ID) are frequently untreated. Reasons may be misconceptions about the impact and diagnosis of IDA and the efficacy of new treatments. Addressing these misconceptions, this article summarizes current evidence for better understanding and management of GIB-associated IDA. Despite only few controlled studies evaluated the efficacy of iron treatment in patients with GIB, there is consistent evidence suggesting that: (a) IDA should be diligently investigated, (b) effective treatment of ID/IDA improves outcomes such as health-related quality of life and can avoid severe cardiovascular consequences, and (c) intravenous iron should be considered as well-tolerated treatment in this setting. Overall, the misconceptions and practices outlined in this article should be replaced with strategies that are more in line with current guidelines and best practice in GIB and other underlying conditions of ID/IDA.A pesar de la alta prevalencia de anemia por déficit de hierro (ADH) en pacientes con hemorragia digestiva (HD) aguda o crónica, la ADH y el déficit de hierro (DH) son frecuentemente infratratados. Diversos conceptos erróneos sobre el impacto, el diagnóstico y la eficacia de los nuevos tratamientos de la ADH probablemente lo justifican. Para abordar estos errores conceptuales, este artículo resume la evidencia actual para una mejor comprensión y manejo de la ADH. A pesar de que existen pocos estudios controlados que hayan evaluado la eficacia del tratamiento con hierro en pacientes con HD, hay evidencia que sugiere que: (a) la ADH debe ser investigada diligentemente; (b) el tratamiento eficaz del DH/ADH mejora la calidad de vida relacionada con la salud y puede evitar relevantes complicaciones cardiovasculares, y (c) el hierro intravenoso debe ser considerado como un tratamiento bien tolerado en este contexto. En general, los conceptos erróneos y las prácticas inadecuadas descritas en este artículo deben ser reemplazados por estrategias que estén más en línea con las directrices actuales y buenas prácticas clínicas en HD y otras condiciones causantes del DH/ADHinfo:eu-repo/semantics/publishedVersio