Community-based participatory research (CBPR) answers the call for more patient-centered, community-driven research approaches to address growing health disparities. CBPR is a collaborative research ...approach that equitably involves community members, researchers, and other stakeholders in the research process and recognizes the unique strengths that each bring. The aim of CBPR is to combine knowledge and action to create positive and lasting social change. With its origins in psychology, sociology, and critical pedagogy, CBPR has become a common research approach in the fields of public health, medicine, and nursing. Although it is well aligned with psychology's ethical principles and research aims, it has not been widely implemented in psychology research. The present article introduces CBPR to a general psychology audience while considering the unique aims of and challenges in conducting psychology research. In this article, we define CBPR principles, differentiate it from a more traditional psychology research approach, retrace its historical roots, provide concrete steps for its implementation, discuss its potential benefits, and explore practical and ethical challenges for its integration into psychology research. Finally, we provide a case study of CBPR in psychology to illustrate its key constructs and implementation. In sum, CBPR is a relevant, important, and promising research framework that may guide the implementation of more effective, culturally appropriate, socially just, and sustainable community-based psychology research.
Los rumiantes, debido a las características fermentativas de su sistema digestivo, generan y emiten metano a la atmósfera, un gas de efecto invernadero que contribuye al calentamiento global. Debido ...a la importancia que tiene la ganadería en España, es necesario plantear estrategias que reduzcan dichas emisiones. Una de ellas, es la utilización de almidones vítreos en la formulación de dietas de rumiantes. Su menor degradabilidad ruminal, da lugar a una disminución de la producción de metano. El objetivo de este estudio fue evaluar el comportamiento fermentativo de un sistema de mezclas cebada/maíz, así como, de un concentrado comercial de cebo de terneros con diferentes niveles de maíz. Para ello, se llevó a cabo un análisis in vitro de producción de gas y metano. Las mezclas de cebada/maíz se fermentaron durante 18h y los concentrados durante 18 y 96h. Para las mezclas ceba/maíz, la menor producción de gas se obtuvo con 100% maíz (207,97ml/g), aumentando el metano 0,11mlCH4/g por cada punto porcentual de cebada añadido. Respecto a los concentrados, tras 18h de fermentación la menor producción de gas y metano se asoció al control y al concentrado con mayor nivel de maíz respectivamente. Tras la fermentación 96h el concentrado con mayor nivel de maíz registro los mayores niveles de producción de gas y metano. Ambos cereales muestran diferentes perfiles fermentativos y metanogénicos in vitro, limitando la producción de gas y metano al incluir maíz en concentrado de terneros.
Ruminants are a major source of greenhouse gas emissions because of their fermentative digestive system produces certain end products such as methane. Livestock plays a crucial role in Spain, It therefore seems necessary to develop strategies to reduce these emissions. One of them is the use of vitreous starches in ruminants feed, as their low degradability in the rumen leads to a decrease in methane production. The study aimed to evaluate the effects on ruminal fermentation of different levels of inclusion of corn starch in a barley/corn mixture system, as well as a commercial calf feedstuff based on in vitro analysis of gas and methane production. The barley/corn mixtures were fermented for 18h, while the feedstuffs were fermented for 18 and 96h. For the barley/corn mixtures, the lowest gas production level was observed in the 100% corn (207,97ml/g), increasing methane production by 0,11ml methane/g for each percentage point of barley added. In the feedstuff, after 18h fermentation, the lower gas and methane production was associated to the control and the higher maize concentrate respectively. After 96h of fermentation, the highest gas and methane production level corresponded to the highest starch level. Both cereals show different fermentative and methanogenic profiles in vitro, limiting gas and methane production when corn is included in calf concentrate.
Polygenic risk scores (PRSs) have been demonstrated to identify women of European, Asian, and Latino ancestry at elevated risk of developing breast cancer (BC). We evaluated the performance of ...existing PRSs trained in European ancestry populations among women of African ancestry.
We assembled genotype data for women of African ancestry, including 9241 case subjects and 10 193 control subjects. We evaluated associations of 179- and 313-variant PRSs with overall and subtype-specific BC risk. PRS discriminatory accuracy was assessed using area under the receiver operating characteristic curve. We also evaluated a recalibrated PRS, replacing the index variant with variants in each region that better captured risk in women of African ancestry and estimated lifetime absolute risk of BC in African Americans by PRS category.
For overall BC, the odds ratio per SD of the 313-variant PRS (PRS313) was 1.27 (95% confidence interval CI = 1.23 to 1.31), with an area under the receiver operating characteristic curve of 0.571 (95% CI = 0.562 to 0.579). Compared with women with average risk (40th-60th PRS percentile), women in the top decile of PRS313 had a 1.54-fold increased risk (95% CI = 1.38-fold to 1.72-fold). By age 85 years, the absolute risk of overall BC was 19.6% for African American women in the top 1% of PRS313 and 6.7% for those in the lowest 1%. The recalibrated PRS did not improve BC risk prediction.
The PRSs stratify BC risk in women of African ancestry, with attenuated performance compared with that reported in European, Asian, and Latina populations. Future work is needed to improve BC risk stratification for women of African ancestry.
COVID-19 patients present a high hospitalization rate with a high mortality risk for those requiring intensive care. When these patients have other comorbid conditions and older age, the risk for ...severe disease and poor outcomes after ICU admission are increased. The present work aims to describe the preliminary results of the ongoing NUTRICOVID study about the nutritional and functional status and the quality of life of adult COVID-19 survivors after ICU discharge, emphasizing the in-hospital and discharge situation of this population.
A multicenter, ambispective, observational cohort study was conducted in 16 public hospitals of the Community of Madrid with COVID-19 survivors who were admitted to the ICU during the first outbreak. Preliminary results of this study include data retrospectively collected. Malnutrition and sarcopenia were screened at discharge using MUST and SARC-F; the use of healthcare resources was measured as the length of hospital stay and requirement of respiratory support and tracheostomy during hospitalization; other study variables were the need for medical nutrition therapy (MNT); and patients’ functional status (Barthel index) and health-related quality of life (EQ-5D-5L).
A total of 176 patients were included in this preliminary analysis. Most patients were male and older than 60 years, who suffered an average (SD) weight loss of 16.6% (8.3%) during the hospital stay, with a median length of stay of 53 (27–89.5) days and a median ICU stay of 24.5 (11–43.5) days. At discharge, 83.5% and 86.9% of the patients were at risk of malnutrition and sarcopenia, respectively, but only 38% were prescribed MNT. In addition, more than 70% of patients had significant impairment of their mobility and to conduct their usual activities at hospital discharge.
This preliminary analysis evidences the high nutritional and functional impairment of COVID-19 survivors at hospital discharge and highlights the need for guidelines and systematic protocols, together with appropriate rehabilitation programs, to optimize the nutritional management of these patients after discharge.
Background
Despite being considered a high‐risk population for invasive fungal disease, specific features of candidemia among solid organ transplant (SOT) recipients remain poorly characterized.
...Methods
We compiled prospective data from two multicenter studies on candidemia performed over two consecutive periods in Spain: the CANDIPOP Study (2010‐2011) and the CANDI‐Bundle Study (2016‐2018). Episodes diagnosed in adult SOT recipients in 10 participating centers were included. Risk factors for clinical failure (all‐cause 7‐day mortality and/or persistent candidemia for ≥72 hours) and 30‐day mortality were investigated by univariate analysis.
Results
We included 55 episodes of post‐transplant candidemia (32 and 23 of which occurred during the first and second periods). Kidney (38.2%) and liver recipients (30.9%) were the most common populations. Candida albicans accounted for 27.3% of episodes. The proportion of C glabrata increased over time (18.8% vs 30.4% for the first and second periods). There were no differences in the rate of fluconazole non‐susceptible isolates (50.0% vs 60.0%, respectively). Clinical failure and 30‐day mortality occurred in 25.5% and 27.3% of episodes and were associated with the severity of candidemia (Pitt score and severe sepsis/septic shock). Kidney transplantation (unadjusted odds ratio uOR: 0.17; 95% confidence interval CI: 0.03‐0.85; P‐value = .020), early catheter removal (uOR: 0.15; 95% CI: 0.03‐0.76; P‐value = .013), and appropriate early antifungal therapy (uOR: 0.14; 95% CI: 0.02‐0.89; P‐value = .041) were protective for 30‐day mortality.
Conclusions
High rates of non‐albicans species and fluconazole non‐susceptibility must be taken into account to optimize therapeutic management and outcomes in SOT recipients with candidemia.
Residual neuromuscular blockade after general anesthesia using nondepolarizing neuromuscular blocking agents has pathophysiological, clinical, and economic consequences. A significant number of ...patients under muscle relaxation sustain residual curarization.
Observational, prospective, multicenter study of a cohort of patients (Residual Curarization in Spain Study, ReCuSS). Residual blockade was defined as TOFr<0.9. Patients >18 years-old under general anesthesia, including at least one dose of non-depolarizing neuromuscular blocking agents, and transferred extubated and spontaneously ventilating to the postanesthesia care unit were included. Pre- and intraoperative data were recorded, including, patient characteristics, ASA physical status, experience of the anesthesiologist, type of surgery, temperature monitoring, surgery duration, neuromuscular blockade-related parameters, type of anesthesia (halogenated-balanced, intravenous propofol-based, other), and use of neuromuscular monitoring.
A total of 763 patients from 26 hospitals were included, 190 patients (26.7%) showing residual paralysis. Female patients were more prone to residual neuromuscular blockade. Length of surgery, type of relaxant used (benzylisoquinolines), halogenated anesthesia, absence of intraoperative specific monitoring, avoidance of drug reversal, and neostigmine reversal (vs. sugammadex), were significantly related to residual blockade. In the postanesthesia care unit, patients with residual neuromuscular blockade had an increased incidence of respiratory events and tracheal reintubation.
The incidence of residual blockade in Spain is similar to that published in other settings and countries. Female gender, longer duration of surgery, and halogenated drugs for anesthesia maintenance were related to residual paralysis, as were NMBA specific items, such as the use of benzylisoquinoline drugs, and the absence of reversal or reversal with neostigmine.
This work studies the effects of different sodium (in the range of 4–10%), potassium (0–4%) and calcium (0–6%) chloride salt mixtures on the fermentation profile of Gordal olives processed according ...to the Spanish style. For this purpose, response surface methodology based on a simplex centroid mixture design with constrain (sum of salt percentages = 10%) was used. All treatments reached appropriate titratable acidity levels, but this parameter could not be related to the initial chloride salt concentration. The presence of CaCl2 led to lower initial and after-fermentation pHs, delayed sugar diffusion into the brine, its maximum concentration and titratable acidity formation. CaCl2 also delayed Enterobacteriaceae and yeast sprang, decreasing their overall growth. This chloride salt also showed a tendency to reduce overall lactic acid bacteria growth. KCl had a similar behaviour to NaCl but, in general, increased overall microbial growth. Thus, a partial substitution of NaCl in Spanish-style green olives with KCl and CaCl2 does not substantially modify the fermentation profile but does produce some changes, which, when properly managed, could help to improve product processing.
► The use of statistical modelling techniques allowed the optimisation of the fermentative process as a function of diverse chloride salts combinations. ► Results show that an appropriate lactic acid process can also be obtained with lower sodium content. ► CaCl2 affected the microbiological and physic-chemical profile of fermentation, reducing overall microbial growth. ► The partial substitution of NaCl by KCl or CaCl2 did not represent a microbial safety risk for the fermented olives.
The determination in a sample of the activity concentration of a specific radionuclide by gamma spectrometry needs to know the full energy peak efficiency (FEPE) for the energy of interest. The ...difficulties related to the experimental calibration make it advisable to have alternative methods for FEPE determination, such as the simulation of the transport of photons in the crystal by the Monte Carlo method, which requires an accurate knowledge of the characteristics and geometry of the detector. The characterization process is mainly carried out by Canberra Industries Inc. using proprietary techniques and methodologies developed by that company. It is a costly procedure (due to shipping and to the cost of the process itself) and for some research laboratories an alternative in situ procedure can be very useful. The main goal of this paper is to find an alternative to this costly characterization process, by establishing a method for optimizing the parameters of characterizing the detector, through a computational procedure which could be reproduced at a standard research lab. This method consists in the determination of the detector geometric parameters by using Monte Carlo simulation in parallel with an optimization process, based on evolutionary algorithms, starting from a set of reference FEPEs determined experimentally or computationally. The proposed method has proven to be effective and simple to implement. It provides a set of characterization parameters which it has been successfully validated for different source-detector geometries, and also for a wide range of environmental samples and certified materials.
•A computational method for characterizing an HPGe spectrometer has been developed.•Detector characterized using as reference photopeak efficiencies obtained experimentally or by Monte Carlo calibration.•The characterization obtained has been validated for samples with different geometries and composition.•Good agreement with the certified values of references material is obtained.•The method has been successfully tested for environmental samples.
Background and ImportanceCytomegalovirus (CMV) is one of the most common pathogens in immunocompromised patients. Patients who develop severe CMV infection should be treated with antiviral agents ...until symptoms are resolved and plasma CMV load is controlled. Management of these patients is sometimes difficult due to resistance or ineffectiveness.Aim and ObjectivesTo describe the response to combined treatment with letermovir, ganciclovir and anti-CMV immunoglobulins (Ig) for CMV infection in an immunocompromised patient refractory to monotherapy treatments.Material and MethodsWe describe the case of a 72-year-old male diagnosed with Good’s syndrome (thymoma-associated immunodeficiency), who developed enterocolitis and systemic infection by CMV. Initially, treatment with IV ganciclovir produced clinical and virological response, but later relapse occurred and resistance to ganciclovir was detected. IV Foscarnet was initiated, obtaining response. After switching to oral letermovir (secondary prophylaxis) having low plasma CMV levels, the patient showed virological failure and foscarnet therapy was reinitiated. After a transient response, foscarnet proved to be insufficient (alone or in combination with ganciclovir) to stop a progressive rise in CMV plasma levels. To control CMV and facilitate intravenous to oral switch, combined treatment with oral letermovir and IV ganciclovir was proposed, added to anti-CMV Ig that the patient was already receiving monthly since the onset of CMV infection.Effectiveness of this triple therapy was assessed by reduction of CMV plasma load.ResultsWhen absence of letermovir resistance was confirmed, combined off-label use of letermovir, ganciclovir and anti-CMV Ig was approved. The authorisation was based on the absence of therapeutic alternatives and the support of several cases reflecting the good results of this triple therapy.Despite an initial peak in CMV viral load, triple therapy exhibited a good virological response (CMV <1000 copies/ml) and tolerance. No renal or bone marrow toxicity was detected. IV Ganciclovir was later replaced by valganciclovir for home treatment, maintaining low levels of CMV <300 copies/ml.Abstract 5PSQ-131 Figure 1Conclusion and RelevanceThis is the first case of letermovir-ganciclovir-antiCMV Ig combined therapy in a patient with acquired immune deficiency. Previously, it was used in a small cohort of transplant patients. Therefore, this triple therapy should be considered as a possible therapeutic alternative for refractory CMV infection, even if resistant to ganciclovir.References and/or AcknowledgementsConflict of InterestNo conflict of interest
Large epidemiological studies that use accelerometers for physical behavior and sleep assessment differ in the location of the accelerometer attachment and the signal aggregation metric chosen. This ...study aimed to assess the comparability of acceleration metrics between commonly-used body-attachment locations for 24 hours, waking and sleeping hours, and to test comparability of PA cut points between dominant and non-dominant wrist. Forty-five young adults (23 women, 18-41 years) were included and GT3X + accelerometers (ActiGraph, Pensacola, FL, USA) were placed on their right hip, dominant, and non-dominant wrist for 7 days. We derived Euclidean Norm Minus One g (ENMO), Low-pass filtered ENMO (LFENMO), Mean Amplitude Deviation (MAD) and ActiGraph activity counts over 5-second epochs from the raw accelerations. Metric values were compared using a correlation analysis, and by plotting the differences by time of the day. Cut points for the dominant wrist were derived using Lin's concordance correlation coefficient optimization in a grid of possible thresholds, using the non-dominant wrist estimates as reference. They were cross-validated in a separate sample (N = 36, 10 women, 22-30 years). Shared variances between pairs of acceleration metrics varied across sites and metric pairs (range in r
: 0.19-0.97, all p < 0.01), suggesting that some sites and metrics are associated, and others are not. We observed higher metric values in dominant vs. non-dominant wrist, thus, we developed cut points for dominant wrist based on ENMO to classify sedentary time (<50 mg), light PA (50-110 mg), moderate PA (110-440 mg) and vigorous PA (≥440 mg). Our findings suggest differences between dominant and non-dominant wrist, and we proposed new cut points to attenuate these differences. ENMO and LFENMO were the most similar metrics, and they showed good comparability with MAD. However, counts were not comparable with ENMO, LFENMO and MAD.
PDF
