Development and validation of a tool to measure collaborative practice between community pharmacists and physicians from the perspective of community pharmacists: the professional collaborative practice tool.

BACKGROUND: Collaborative practice between community pharmacists and physicians is becoming increasingly common. Although tools and models to explore collaborative practice between both health care professionals have been developed, very few have been validated for their use in clinical practice. The objective of this study was to develop and validate a tool for measuring collaborative practice between community pharmacists and physicians from the perspective of community pharmacists. METHODS: The DeVellis method was used to develop and validate the Professional Collaborative Practice Tool. A pool of 40 items with Likert frequency scales was generated based on previous literature and expert opinion. This study was undertaken in Spain. A sample of community pharmacists providing medication reviews with follow-up and a random sample of pharmacists providing usual care were invited to participate. Exploratory and confirmatory factor analysis was used to assess the tool's reliability and content validity. RESULTS: Three hundred thirty-six pharmacists were invited with an overall response rate of 84.8%. The initial 40 items selected were reduced to 14 items. Exploratory Factor Analysis provided a 3-factor solution explaining 62% of the variance. Confirmatory Factor Analysis confirmed the three factors "Activation for collaborative professional practice," the "Integration in collaborative professional practice," and the "Professional acceptance in collaborative professional practice." The tool demonstrated an adequate fit (X2/df = 1.657, GFI = 0.889 and RMSEA = 0.069) and good internal consistency (Cronbach's alpha = 0.924). CONCLUSIONS: The Professional Collaborative Practice Tool has shown good internal reliability and criterion validity. The tool could be used to measure the perceived level of collaborative practice between community pharmacists and physicians and monitor changes over time. Its applicability and transferability to other settings should be evaluated

Spectrally and temporally resolved estimation of neural signal diversity

Quantifying the complexity of neural activity has provided fundamental insights into cognition, consciousness, and clinical conditions. However, the most widely used approach to estimate the complexity of neural dynamics, Lempel-Ziv complexity (LZ), has fundamental limitations that substantially restrict its domain of applicability. In this article we leverage the information-theoretic foundations of LZ to overcome these limitations by introducing a complexity estimator based on state-space models — which we dub Complexity via State-space Entropy Rate (CSER). While having a performance equivalent to LZ in discriminating states of consciousness, CSER boasts two crucial advantages: 1) CSER offers a principled decomposition into spectral components, which allows us to rigorously investigate the relationship between complexity and spectral power; and 2) CSER provides a temporal resolution two orders of magnitude better than LZ, which allows complexity analyses of e.g. event-locked neural signals. As a proof of principle, we use MEG, EEG and ECoG datasets of humans and monkeys to show that CSER identifies the gamma band as the main driver of complexity changes across states of consciousness; and reveals early entropy increases that precede the standard ERP in an auditory mismatch negativity paradigm by approximately 20ms. Overall, by overcoming the main limitations of LZ and substantially extending its range of applicability, CSER opens the door to novel investigations on the fine-grained spectral and temporal structure of the signal complexity associated with cognitive processes and conscious states

Taking Back the Work: A Cooperative Inquiry into Leaders of Color in Movement-Building Organizations

Through the Leadership for a Changing World Research and Documentation program, a group of leaders of color committed to social justice came together to reflect on the specific obstacles leaders of color face as they engage in movement building and to find ways to overcome these barriers. Together they asked: How do we build, strengthen and sustain movement-building organizations led by people of color? In the report, the group has identified four strategies to help community-based leaders of color engage in "taking back the work," with examples of each based on their successful work in communities

Wnt/Lef1 signaling acts via Pitx2 to regulate somite myogenesis

AbstractWnt signaling has been implicated in somite, limb, and branchial arch myogenesis but the mechanisms and roles are not clear. We now show that Wnt signaling via Lef1 acts to regulate the number of premyogenic cells in somites but does not regulate myogenic initiation in the limb bud or maintenance in the first or second branchial arch. We have also analysed the function and regulation of a putative downstream transcriptional target of canonical Wnt signaling, Pitx2. We show that loss-of-function of Pitx2 decreases the number of myogenic cells in the somite, whereas overexpression increases myocyte number particularly in the epaxial region of the myotome. Increased numbers of mitotic cells were observed following overexpression of Pitx2 or an activated form of Lef1, suggesting an effect on cell proliferation. In addition, we show that Pitx2 expression is regulated by canonical Wnt signaling in the epaxial somite and second branchial arch, but not in the limb or the first branchial arch. These results suggest that Wnt/Lef1 signaling regulates epaxial myogenesis via Pitx2 but that this link is uncoupled in other regions of the body, emphasizing the unique molecular networks that control the development of various muscles in vertebrates

Taxonomic variations in the gut microbiome of gout patients with and without tophi might have a functional impact on urate metabolism

Objective: To evaluate the taxonomic composition of the gut microbiome in gout patients with and without tophi formation, and predict bacterial functions that might have an impact on urate metabolism. Methods: Hypervariable V3–V4 regions of the bacterial 16S rRNA gene from fecal samples of gout patients with and without tophi (n=33 and n=25, respectively) were sequenced and compared to fecal samples from 53 healthy controls. We explored predictive functional profles using bioinformatics in order to identify diferences in taxonomy and metabolic pathways. Results: We identifed a microbiome characterized by the lowest richness and a higher abundance of Phascolarctobacterium, Bacteroides, Akkermansia, and Ruminococcus_gnavus_group genera in patients with gout without tophi when compared to controls. The Proteobacteria phylum and the Escherichia-Shigella genus were more abundant in patients with tophaceous gout than in controls. Fold change analysis detected nine genera enriched in healthy controls compared to gout groups (Bifdobacterium, Butyricicoccus, Oscillobacter, Ruminococcaceae_UCG_010, Lachnospiraceae_ND2007_group, Haemophilus, Ruminococcus_1, Clostridium_sensu_stricto_1, and Ruminococcaceae_ UGC_013). We found that the core microbiota of both gout groups shared Bacteroides caccae, Bacteroides stercoris ATCC 43183, and Bacteroides coprocola DSM 17136. These bacteria might perform functions linked to one-carbon metabo‑ lism, nucleotide binding, amino acid biosynthesis, and purine biosynthesis. Finally, we observed diferences in key bacterial enzymes involved in urate synthesis, degradation, and elimination. Conclusion: Our fndings revealed that taxonomic variations in the gut microbiome of gout patients with and with‑ out tophi might have a functional impact on urate metabolism. Keywords: Gout, Gut microbiota, Uric acid metabolis

Association of VAV2 and VAV3 polymorphisms with cardiovascular risk factors

Hypertension, diabetes and obesity are cardiovascular risk factors closely associated to the development of renal and cardiovascular target organ damage. VAV2 and VAV3, members of the VAV family proto-oncogenes, are guanosine nucleotide exchange factors for the Rho and Rac GTPase family, which is related with cardiovascular homeostasis. We have analyzed the relationship between the presence of VAV2 rs602990 and VAV3 rs7528153 polymorphisms with cardiovascular risk factors and target organ damage (heart, vessels and kidney) in 411 subjects. Our results show that being carrier of the T allele in VAV2 rs602990 polymorphism is associated with an increased risk of obesity, reduced levels of ankle-brachial index and diastolic blood pressure and reduced retinal artery caliber. In addition, being carrier of T allele is associated with increased risk of target organ damage in males. On the other hand, being carrier of the T allele in VAV3 rs7528153 polymorphism is associated with a decreased susceptibility of developing a pathologic state composed by the presence of hypertension, diabetes, obesity or cardiovascular damage, and with an increased risk of developing altered basal glycaemia. This is the first report showing an association between VAV2 and VAV3 polymorphisms with cardiovascular risk factors and target organ damage

Lifshitz black holes in Brans-Dicke theory

We present an exact asymptotically Lifshitz black hole solution in Brans-Dicke theory of gravity in arbitrary $n(\ge 3)$ dimensions in presence of a power-law potential. In this solution, the dynamical exponent $z$ is determined in terms of the Brans-Dicke parameter $\omega$ and $n$. Asymptotic Lifshitz condition at infinity requires $z>1$, which corresponds to $-(n-1)/(n-2) \le \omega < -n/(n-1)$. On the other hand, the no-ghost condition for the scalar field in the Einstein frame requires $0<z \le 2(n-2)/(n-3)$. We compute the Hawking temperature of the black hole solution and discuss the problems encountered and the proposals in defining its thermodynamic properties. A generalized solution charged under the Maxwell field is also presented.Comment: 32 pages, no figure. v2: revised version. Section 3.1 and Appendix B improved. The argument in Appendix A clarified. v3: References added. v4: analysis on the black hole thermodynamical properties corrected. Final version to appear in JHE