Bertha Palmer and Anna Wintour: How Does Private Patronage Impact Identity-Building within Cultural Institutions?

Founded to provide a young nation with cultural foundations and dedicated to educating its public, the large historic cultural institutions of the United States find their origin in private initiatives and of private-public-partnerships for the benefit of the communities they serve. This thesis outlines that, at its core, museums and their funding structures in the United States exist in the format we find today because of the active and informed contributions of their patrons. It is these contributions that have shaped the American museum landscape over the course of its history. Two case studies – Bertha Palmer and her bequest to the Art Institute of Chicago, and Anna Wintour and the Met Gala – will demonstrate that while donorship mechanisms have changed since the inception of many cultural institutions in the United States in the 1870s, the relationships between patrons and institutions still function within the same operational framework and reveal the same theoretical structures. Utilizing First Name Bourdieu’s theoretical framework on different forms of capital provides a baseline through which the two case studies can be compared and analyzed

Diagnostic accuracy of calculated serum osmolarity to predict dehydration in older people: adding value to pathology lab reports

Objectives: To assess which osmolarity equation best predicts directly measured serum/plasma osmolality and whether its use could add value to routine blood test results through screening for dehydration in older people. Design: Diagnostic accuracy study Participants: Older people (≥65 years) in 5 cohorts: Dietary Strategies for Healthy Ageing in Europe (NU-AGE, living in the community), Dehydration Recognition In our Elders (DRIE, living in residential care), Fortes (admitted to acute medical care), Sjöstrand (emergency room) or Pfortmueller cohorts (hospitalised with liver cirrhosis). Reference standard for hydration status: Directly measured serum/plasma osmolality: current dehydration (serum osmolality >300mOsm/kg), impending/current dehydration (≥295mOsm/kg). Index tests: 39 osmolarity equations calculated using serum indices from the same blood draw as directly measured osmolality. Results: Across five cohorts 595 older people were included, of whom 19% were dehydrated (directly measured osmolality >300mOsm/kg). Of 39 osmolarity equations, five showed reasonable agreement with directly measured osmolality and three had good predictive accuracy in subgroups with diabetes and poor renal function. Two equations were characterized by narrower limits of agreement, low levels of differential bias and good diagnostic accuracy in ROC plots (areas under the curve >0.8). The best equation was osmolarity =1.86 × (Na+ + K+) + 1.15 × glucose + urea + 14 (all measured in mmol/L). It appeared useful in people aged ≥65 years with and without diabetes, poor renal function, dehydration, in men and women, with a range of ages, health, cognitive and functional status. Conclusions: Some commonly used osmolarity equations work poorly, and should not be used. Given costs and prevalence of dehydration in older people we suggest use of the best formula by pathology laboratories using a cutpoint of 295mOsm/L (sensitivity 85%, specificity 59%), to report dehydration risk opportunistically when serum glucose, urea and electrolytes are measured for other reasons in older adults